November 18, 2019

Dear PHL Friends,

The year 2019 has been a busy and productive year for PHL.  We have been able to resume our work in Nicaragua.  In April a Nicaraguan patient with a critical cardiac condition underwent successful surgery at ECU and Vidant Health in Greenville, NC.  We are grateful for the care donated by the cardiac surgery team, the hospital, and the University.  In May a small general cardiology brigade evaluated a number of patients at HEODRA, the hospital in Leon where we serve.  There was strong support by hospital leadership.

In July our electrophysiology team participated in a busy brigade dealing with patients who have cardiac rhythm problems.  Team members included 14 Americans and 4 Nicaraguans working together for a very productive week.  A total of 96 patients were evaluated in the clinic, including 36 new patients.  Procedures were performed on 9 patients to implant or revise pacemakers or implantable defibrillators (both are surgically placed devices used to treat serious rhythm problems).  In addition, 5 electrophysiology studies were performed (these are catheter-based tests to diagnose and treat rhythm problems).  The team also provided clinical education for physicians and staff at HEODRA.  Again, hospital leadership was very helpful.

In September a general cardiology brigade worked at HEODRA.  The team of 18 Americans and several Nicaraguans worked together in the clinic.  Hospital leadership was very attentive and helpful.  We evaluated 149 patients, including performing an echocardiogram (cardiac ultrasound, a test used to diagnose cardiac problems) on each patient.  A number of these patients also underwent transesophageal echocardiography (cardiac ultrasound tests performed through the throat) for more detailed evaluation.  Almost every patient had serious cardiac disease, mostly valvular disease from rheumatic fever and adult congenital heart disease.  Many would benefit from cardiac surgery or percutaneous interventional procedures (correction of cardiac conditions done through the leg blood vessels). Some of these patients will be scheduled for these procedures during the next brigade.

We are planning a one-week brigade during late January 2020.  This will include cardiology clinic and performing percutaneous interventional procedures (15-18 cases).  We are not able to offer cardiac surgery during this brigade, but we are working to be able to offer surgery during our Fall 2020 brigade.  We are planning to resume taking a small group of American students.  A clinical lecture series is also planned.  In preparation for our continued work in Leon, we have shipped a large container of medical equipment and supplies to HEODRA.

Further plans for 2020 include another electrophysiology brigade in the summer and a general cardiology and cardiac surgical brigade in the fall.  We are hoping to resume our pediatric cardiology program.  Plans are being made to continue our primary care activities in Nicaragua, as well.

We have made several changes in PHL leadership.  Jack Rose and John Paar will each continue to be actively involved; each has earned the title President Emeritus.  Eric Van Tassel was elected as President, and Mike Yeung as Vice President.  We are fortunate to have a dedicated, active Board of Directors.  Please feel free to communicate with us.

Regarding PHL communication, please note the following:  Our mailing address has changed, as shown on the heading of this letter.  We will continue mailing a paper copy of our annual newsletter; our periodic updates will be sent by email.  If your email address has changed, or you have not previously sent us your email, please confirm your preferred email address to  We will also post the newsletter and updates on our website:

The overall goals of PHL remain the same: to provide specialty and general health care to the citizens of Nicaragua, to educate Nicaraguan and American medical professionals, and to provide needed medical supplies and medications to health care facilities in Nicaragua.  PHL receives no government funding.  Therefore, our work depends upon private donations.  Medical equipment, supplies, and shipping are very expensive.  For example, the shipping container we just sent to Nicaragua cost $14,500.  We recently purchased essential hemodynamic monitoring equipment costing $4000.   Most components of the cardiopulmonary bypass system (necessary for cardiac surgery) are near end of life and will need replacement soon.  It is estimated this will cost approximately $50,000.  Your financial contributions are needed in order that PHL can continue its mission of helping the people of Nicaragua.  Please consider making a contribution.  Checks should be made payable to PHL and mailed to the address found in the letterhead.  Contributions are tax-deductible.  If you are interested in volunteering for a brigade, please contact Eric at  Thank you for your continued support.


Eric Van Tassel, President
Jack Rose, President Emeritus
John Paar, President Emeritus