Schwartz: Every minute, on average, four Indians have heart attacks.

Shetty: Where’s the patient?

Schwartz: Most can’t afford to see a doctor, let alone receive life-saving treatment. But one man is using his every heart-beat to change that…

Shetty: Can you organise the cap and a mask?

Schwartz: Devi Prasad Shetty knows what it takes to preserve a life. This cardiac surgeon and his team have saved 17,000 of them. The mechanics, he says, are easy - it’s the cost which kills.

Shetty: You see, in our country every year, 2.5 million people need to undergo heart operations and currently only about 50,000 people are undergoing the operation. Only 50,000.

Schwartz: What happens to the rest of them?

Shetty: Oh they all perish gradually over a period of time.

Schwartz: Indians have one of the highest rates of genetic heart disease in the world. Like Vadival, many are born with heart defects – but no money to fix them. Even the relatively easy task of drying corn is exhausting for this ten year old Without an operation, he may not see his eleventh birthday.

Father: Life here is hard. A daily wage is just a few rupees. With that we must feed the family and pay for health expenses.

Schwartz: Can you afford a heart operation for Vadival?

Father: I’m told it costs 95,000 rupees. People say some organisations will help cover the cost, so I’ve appealed to them but with no luck.

Schwartz: Vadival and his family are labourers in the poor tribal district of Chamarajnagar in southern India. Their landlord owns everything here – effectively, even them. They’re hoping he’ll lend them the money for Vadival’s operation. But at 60 percent interest, that will indenture the family for generations to come.

Father: We’ll borrow the money and pay the interest. We want this operation at any cost. That’s what we’re trying for.

Shetty: 80 percent of the patients we treat in our country belong to that category. They are the people who are aware of what’s going on in their child’s life or in their own life, yet they cannot access health care. Our dream is to create hospitals where the masses, the common people of the world can get inside these hospitals and get the operations done with dignity.

Schwartz: There’s little room for dignity at the crowded government hospital in Chamarajnagar. It’s survival of the richest. But Vadival is about to be thrown a life-line

Shetty: If you can connect me to Chamarajnagar.

Schwartz: Three hundred kilometres away, in Bangalore, Dr Devi Prasad Shetty is preparing for his daily round of consultations.

Shetty: Where do you live?

Father: Ajjipura

Shetty: What’s the problem with your son?Father: He has palpitations when he walks, a high temperature and he doesn’t eat well.

Schwartz: Dr Shetty has established basic coronary care units in nineteen remote government hospitals around India. These are linked via satellite to his hospital in Bangalore – allowing him to consult patients who’d otherwise never access specialist medical advice.

Shetty: He needs open heart surgery. He has a hole in the heart so we will close it during open heart surgery. You come down to Bangalore and we’ll operate on him on Monday or Tuesday. Do you have any questions?

Father: Yes sir… We are running short of money. You must help us, sir.

Shetty: Don’t worry about the money. We will help you. In our lifetime, if you want high technology health care to reach out to the masses, the only solution is telemedicine.
One doctor in one hospital can treat people are thousands of miles away through the telemedicine connectivity. That totally changes the horizon of health care. So it goes beyond boundaries. I treat patients who are sitting in Bangalore, patients who are in Mauritius, Malaysia and part of India where I would never travel because of various reasons. So, the beauty of telemedicine is that it makes ordinary doctors do extraordinary things.

Schwartz: Extraordinary is a word often associated with Dr Shetty and his team. Their reputation – like their telemedicine network – now extends well beyond their Bangalore headquarters.

Bangladeshi patient: I respect him like a saint. Yes, really. People in my country respect him as a saint.

Schwartz: Saed Rahman is from Bangladesh. He’s one of 300 patients at Narayana Hrudayalaya - Dr Shetty’s Bangalore coronary care hospital. A quarter of the patients now come from Asian countries where heart operations are either not available or far more expensive. Doing the rounds can take hours… everyone wants to express their gratitude

Calcutta patient: You are my saviour, you are my God in flesh and blood. I am here as you have asked me to come here from Calcutta -- so I surrender my heart and soul to you. It is up to you.

Shetty: I am doing exactly what I am supposed to do. But people consider that it’s a generosity and a charity I’m just doing my duty as any other individual. But unfortunately overall society’s degraded to such a level that just being a normal human being is considered as Godly.

Schwartz: Day and night, Dr Shetty’s waiting room is full.
He trained in London and could have stayed there and made a fortune. But 14 years ago he returned to India and was inspired to greater works by one of his patients… Mother Teresa.

Shetty: She is singularly responsible for the way we think today. As one of her very famous sayings that the hand which helps is much more precious than the hand which prays.

Schwartz: Dr Shetty’s chance meeting with Mother Teresa changed not only his life, but also those of the thousands of people he’s gone on to help -- people like Vadival, who’s just arrived with his family from Chamarajnagar.

Shetty: What’s your name?

Vadival: Vadival.

Schwartz: For Vadival and his parents, this is an overwhelming experience.

Shetty: Out of 100 children operated on, 90 get better. So there is some risk in this operation. Any operation will have a risk. He needs an operation. There is no alternative.

Schwartz: This is the first time they’ve left their village. And the first time anyone of means has offered them help with no strings attached.

Father: The fees are 95,000 rupees. I have just 20,000.

Shetty: It’s OK. Please sit down. We’ll do everything Don’t worry about the money. We will help you.Schwartz: The generosity shown to Vadival is not exceptional.
This is one of the largest paediatric wards in a coronary care hospital anywhere in the world.

Shetty: This is a little fella with a whole in the heart…

Schwartz: Half of these children have had free operations or they’ve received financial assistance organised by the hospital’s charitable trust. Dr Colin John is the head of paediatrics.

John: So far, by the grace of God, I can confidently say that we haven’t turned away a single child or adult for lack of financial support.

Schwartz: That’s due to donations, he says, as well as smart management.

Shetty: A government hospital run by the government of India, about 85 to 90 percent of their budgetary allocation goes for salaries. In the Western countries, about 60 to 70 percent of the yearly expense goes for the salaries. In our hospital it’s 20 percent to 22 percent.

Schwartz: Dr Shetty insists heart care does not have to be as expensive as the World Health Organisation and International medical companies make it.

Shetty: If you make an echo-machine which gives the image of the liver. Then that machine say costs 10,000 dollars. But the same machine, you say it images the heart - it will be sold for 50,000 dollars. Because anything to do with the heart every one wants a premium.

Schwartz: That premium, he says, often costs poor people like Vadival their lives

Shetty: Because of the myopic approach of all these agencies a hundred years after the first heart operation only 8 percent of the world’s population today has access to heart surgery. For 92 percent of the world’s population, heart surgery is still a distant dream.

Schwartz: For Vadival, that dream is about to become reality

Nurse: Please wait in reception. The operation will take three or four hours. After the operation he’ll be shifted to the intensive care unit and you can see him there.

Schwartz: It will be an anxious wait for Vadival’s parents. At stake is their son’s life, and theirs. With no social security in India, the entire family’s future hinges on Vadival’s capacity to earn a living. Dr Colin John will lead the operating team.

John: Most of our children can’t afford this operation, so we rely on support from other organisations and individuals to finance their operation.

Schwartz: He worked in Australian public hospitals for seven years before returning home to join Dr Shetty’s staff. In Australia, he says, the hole in Vadival’s heart would probably have been diagnosed at birth, and this operation done years earlier

John: One of the reasons I came back from Australia was to make sure that we have the same opportunities.

Schwartz: Dr Shetty doesn’t want the opportunities limited to just India’s poor. He’s hoping to build a chain of heart hospitals right across the developing world.

Shetty: Indian surgeons and the hospitals are trying to develop a system of heart surgery which is affordable to the masses. Where there’ll be a large number of hospitals doing a huge number of operations, like 20, 30 operations every day. And this is the formula which is going to transform the way that heart surgery is developed.

Schwartz: But it’s the individual transformation which keeps staff here going

John: The operation is finished. The boy is fine. We will be putting him in intensive care and you can go see him when we do.(mother tries to touch doctor’s feet)Please don’t.

Schwartz: For Vadival’s parents, the relief is almost too much to bear.Shetty: Very few people in the world get the opportunity to save 17,000 lives. This opportunity very few people get and we are very privileged to have this opportunity - so this is what keeps us going.

Schwartz: A day after the operation, Vadival is well on the road to a normal life.

Schwartz: Dr. Colin, how is Vadival?

John: He’s done very well, he’s gone to plan – extremely well, as well as you can get.

Schwartz: How are you feeling today?

Father: I’m very happy.

John: He says he’s very happy.

Schwartz: What do you think of Dr Shetty and Dr ColinJohn and the hospital here?

Father: This is like a temple – they’re all like Gods.

Shetty: Feeling okay? Any pain?

Schwartz: As far as Dr Shetty’s concerned, it’s all in a day’s work.

Shetty: The language of pain is universal, it is the same language. The language of happiness and language of pain is same whether you are American or Australian or Indian. And today there is a solution.