Cardiology in Paradise

Cedars-Sinai physicians seek funds to start fellowship in Saipan

Saipan is a place of paradox. Though it's an island paradise, its population is generally poor and suffering from illnesses brought on by the Americanization of their diets with a preponderance of fast foods high in fat and low in nutrients.

This medical challenge drew four Cedars-Sinai cardiologists to the largest island of the Commonwealth of the Northern Mariana Islands. The team brought portable echocardiogram machines and spent two weeks in Saipan this past spring, teaching healthcare workers and conducting cardiology clinics.

Cardiology fellows David Singh, M.D., and Rita Ng, M.D., instituted the plan after participating in a similar Saipan trip as residents at the University of California, San Francisco. The pair enlisted Robert Siegel, M.D., director of the Cardiac Noninvasive Laboratory, and Huai Luo, M.D., cardiologist and sonographer, to join them.

"David and I wanted to continue taking our training to developing areas, and we wanted to put a cardiology slant to it," Dr. Ng said.

The Mariana Islands are about 120 miles north of Guam in the Pacific Ocean, with Saipan measuring just 12 miles long and 5.6 miles across. Many of the health problems among the Commonwealth's population are related to obesity and hypertension, known as the "new world syndrome" brought on by changes in diet. Roughly half of the population lives below the poverty line.

The team is seeking funding to create a regular rotation for Cedars-Sinai cardiology fellows and physicians at the Commonwealth Health Center, which is the only hospital among the Northern Mariana Islands.

"We want to make this sustainable," said Dr. Siegel of Cedars-Sinai physicians going to Saipan. "We want to broaden the scope and gather grants to ensure funding. There is a very strong sense of civic and moral responsibility to provide for underserved populations like this."

Traveling to Saipan presents learning opportunities for those who participate as many of the illnesses there aren't common in the United States. For example, the hospital regularly follows more than 400 patients with rheumatic heart disease.

"I've never seen that many cases of rheumatic heart disease," said Dr. Siegel. "You might see five cases a year here. It's a great learning experience to be in a place where such diseases are more prevalent."

One of their patients will be coming to the United States for treatment. Michelle, a 13-year-old girl who was an active soccer player, has been hospitalized twice during the past year for heart failure.

The team was able to diagnose the problem, and Mending Kids International and Alfredo Trento, M.D., director of the Division of Cardiothoracic Surgery, are helping bring her to Cedars-Sinai for a mitral valve replacement.

(l-r) Dr. Rita Ng, Dr. David Singh, Michelle's father, Michelle, a 13-year-old patient, Dr. Siegel and Dr. Luo.

Dr. Siegel shows medical workers echocardiogram techniques at Commonwealth Health Center, the only hospital in the Northern Mariana Islands.