On February 20th, 2023, the 107th Peking University Medical Humanities Forum was held at Room 716, Yifu Teaching Building, Peking University Health Science Center. Geng Zhi, Associate Chief Physician of the Cardiovascular Center, the Second Affiliated Hospital of Nanjing Medical University, Lecturer in Surgery and the initiator of the “Heart Protection Project” was invited to deliver a lecture entitled “Let Me Protect Your Heart—Ten-year Development of the Heart Protection Project”. According to Geng Zhi, his team has carried out a public welfare assistance project for children with congenital heart disease in difficult families. Dr. Jiang Haiting (Postdoc, Research Associate, School of Health Humanities, Peking University) chaired the lecture.

Congenital heart defect (CHD) ranks first among all birth defects in China. The incidence of the disease is about 0.7%-1.4%. Every year, about 150 thousand children with CHD are born. In poor, rural and remote areas, many children with CHD could not get timely diagnosis and treatment and die prematurely. This disease is regarded as the “number one killer” of newborns and has become an important reason for many families to become poor or return to poverty due to illness.

Geng Zhi pointed out that the “Heart Protection Project” is a poverty alleviation project by improving health care, which was organized and launched by the Cardiovascular Center of the Second Affiliated Hospital of Nanjing Medical University. The project aims to provide free assistance to children with CHD in difficult families. It is led by Professor Li Qingguo, Vice President of the Second Affiliated Hospital of Nanjing Medical University, Director of the Cardiovascular Center, and an expert in cardiac surgery. Currently, there are over 100 team members. In June 2014, while Li Qingguo was chatting with his colleague Tan Xiao, who was providing medical support in Kezhou, Xinjiang Uygur Autonomous Region, he learned that the incidence of CHD in Xinjiang was particularly high. In addition, because of insufficient medical conditions, the children in Xinjiang could not be diagnosed and treated in time. What is more, in some families, all family members suffer from CHD. In August 2014, Li Qingguo sent his co-workers especially to Xinjiang, and more than 100 children were screened for CHD at Kezhou People’s Hospital. After that, patients who were suitable for surgery were sent to Nanjing for free treatment. From this time on, the “Heart Protection Project”, a special free treatment project mainly targeting children with congenital heart disease from families in need, has been implemented in many areas.

According to Geng Zhi: “I am a member of the post-80s generation and an ordinary doctor in our department. What I do is very ordinary. I just practice the duties of a doctor and a member of CPC. As a cardiologist, we do our best not to let any child lose the opportunity of surgery”. Over the past decade, almost all of the screening in rural areas have been carried out on weekends. Whenever the team arrives at a place, the first step is to build a solid defense line against CHD—delivering lectures and professional training for local grassroots doctors. The local grassroots doctors should be gathered, and the prevention and treatment of CHD would be introduced to them. Therefore, with some common sense about CHD, more children with CHD would be detected at the early stage. In addition, science education about this disease would be provided to their parents. It would further promote the achievement of “strengthening the health care at the primary level” goal.

For the children with CHD, in order to address the cost of diagnosis and treatment, the main approach is to optimize services about medical expenses incurred outside of a patient’s home province, and the assistance is mainly provided through three channels: reimbursement for medical expenses, hospital cost reduction, and foundation aid. Sometimes, the team needs to contact several public foundations for a child’s expense. Therefore, there are four full-time secretaries from the Cardiovascular Center of the Second Affiliated Hospital, who fill out forms and application forms for children and their parents. Geng Zhi said: “After all, for patients who are almost illiterate, following these procedures is not easy. Therefore, we will do what we can for them. And this will help more children with CHD return to society in a healthy state”. However, since more than 99% children, who benefit from “Heart Protection Project”, come from other places. Direct settlement of nonlocal hospitalization bills has become a key part of protecting the medical insurance rights of patients. In response to the differences in the overall planning level and information technology level of some patients’ insured areas, in order to ensure the quality of service, the branch of nonlocal hospitalization in Nanjing Healthcare Security Administration has  specially started WeChat working groups, which aims at providing 24-hour services, improving service for children with CHD, and ensuring direct settlement of nonlocal hospitalization bills.

Geng Zhi emphasized that “Today, we have sown the seeds, and the harvest will be the hope for the health of children with CHD”. In order to ensure the safety of surgery and the effect of treatment, all core members of the team have studied in Fuwai Hospital to joined the training canter of cardiovascular technology in Fuwai Hospital. Moreover, the expert studio of Professor Li Shoujun has been set up. At the same time, the team has integrated the resources of internal medicine and surgery, focusing team building, optimizing hardware construction. Arranging the operating room, cardiac care unit, and general ward on the same floor, has provided great convenience for patients and has ensured medical safety. In addition, the team carried out humanized care and minimally invasive treatment, providing patients with meticulous care, emotional appeal, and regular follow-up visits.

Over the past ten years, the team for “Heart Protection Project” has kept the instructions of General Secretary Xi Jinping—“Prosperity for all is impossible without health for all” and “People first, lives first” in mind. According to the work arrangement of the provincial Party committee and provincial government in Jiangsu Province, the team has combined the project with other work of medical support from governments at all levels, various enterprises and institutions. They have successively visited impoverished, rural, and remote areas such as Xinjiang Uygur Autonomous Region, Qinghai Province, Tibet Autonomous Region, Guizhou Province, Sichuan Province, Shaanxi Province, Anhui Province, Gansu Province, Chongqing Municipality, and the northern of Jiangsu Province, and carried out free screening and assistance for CHD. In this work, more than 100,000 people have been screened. More than 400 free clinics and popular science lectures have been held. More than 10,000 county and township grassroots medical staff have been trained for free. More than 10 million RMB of charity funds have been raised, and nearly 1,000 patients with CHD from needy families have been provided with assistance. This project has enabled medical workers to contribute to helping patients’ families overcome difficulties, consolidating the achievements of poverty alleviation, and assisting in rural revitalization.

After the lecture, a heated discussion on the issues of “poverty alleviation by providing medical insurance and aid” “health system” “medical professionalism” “ideological and political education and teaching” “medical humanities practice” and so on was carried out among Geng Zhi and the audience. Moreover, the follow-up cooperation matters were discussed. Wang Yue, Vice President of the School of Health Humanities,Professor of Health Law, pointed out that the “Heart Protection Project” is a heart to heart project. As a targeted poverty alleviation by providing medical service, this project reflects the responsibility of medical specialists, and promotes the initiative of “Healthy China”.

Jiang Haiting