This story is republished from the New York & Michigan Solutions Journalism Collaborative.
- Michigan-based program, “Project My Heart Your Heart,” recycles pacemakers from deceased individuals to support patients in need in less affluent countries.
- The initiative involves a diverse coalition, including medical professionals, funeral directors, and students, aiming to bridge the global access gap for these critical devices.
- The program faces challenges such as regulatory barriers and the necessity for meticulous device reconditioning to ensure safety and effectiveness.
The world still reels from the ravages of COVID, but it’s not the No.1 medical killer. That dubious distinction belongs to heart disease, which claims millions of lives every year, especially in poor countries where adequate health care can be scarce.
But a one-of-a-kind worldwide coalition of volunteers – heart doctors, funeral homes, crematoriums, foreign governments, private businessmen, wealthy donors, a 70-year-old international charity and a handful of Michigan college students – is working to change that grim fact.
The group is recycling heart pacemakers, taken from the dead, to give new life to the sick in some of the world’s poorest places, through a Michigan-based program called Project My Heart Your Heart.
Reconditioning and reusing donated pacemakers can give “hundreds of thousands who might otherwise die a chance for life,” says Dr. Kim Eagle, director of the University of Michigan Health System’s Frankel Cardiovascular Center in Ann Arbor and co-founder in 2009 of My Heart Your Heart.
“Experts estimate that as many as a million people in the world die each year for lack of pacemakers,” adds Dr. Thomas Crawford, professor of internal medicine at U-M and principal investigator and director of the program.
Globally, heart disease killed about 17.9 million people in 2019, three-quarters of them in lower-income countries, according to the World Health Organization. (Heart disease is a catch-all phrase for a number of cardiovascular conditions.)
Ironically, experts say heart diseases like coronary artery blockages are becoming more common as modernization abroad yields more food, including fast food — leading to more obesity.
My Heart Your Heart got an unlikely start, with one heart.
A Michigan cardiologist, Timir Baman, was approached in 2009 by the husband of a heart patient who had died and was to be cremated. Pacemakers are powered by batteries that must be removed before cremation because they can explode.
The man wondered if his wife’s pacemaker could be recycled and given to someone who couldn’t afford a new one – which can cost $2,000 to $3,000 abroad (up to $7,000 in the U.S.).
Baman carefully sterilized the device at home, including deep cleaning with a toothbrush, and sent it to the Philippines, where it was successfully implanted in a heart patient.
Years of study, published articles, experimentation, red tape and religious and ethical questions followed. The Food and Drug Administration prohibits recycling pacemakers in the United States over concerns about blood contamination. However, in 2015 the agency approved use of recycled pacemakers in several foreign countries, which also must give consent.
Along the way My Heart Your Heart developed many education and business partners in its pacemaker effort. By 2017, the program had outgrown its space at U-M and partnered on a pacemaker recycling laboratory with World Medical Relief, a charity based in Southfield, Michigan.
“Saving lives, making an impact, means the world to me,” says Eric Puroll, My Heart Your Heart project manager and head of World Medical’s pacemaker laboratory, which is named for donors Sheldon and Marion Davis.
“This lab is the only such facility in the world,” adds Dr. George Samson, head of World Medical Relief, showing a string of pacemakers shiny as jewels as they dry on a line after initial cleaning.
On Saturdays as many as a dozen medical student volunteers from U-M, Wayne State University and Oakland University may be working in the lab. They are surrounded by bins and barrels filled with thousands of used pacemakers – not much larger than a silver dollar – taken from deceased cardiac patients.
Pacemakers control irregular heart rhythm. Flexible wires called leads run from the pacemaker to one or more chambers of the heart and deliver electric signals.
Puroll wears a hair net to avoid contamination as he removes tiny screws from a pacemaker’s leads, part of a five-step preliminary process done at the lab.
Nearby, Husain Hakim, a U-M volunteer, sits at a computer and enters model, serial number and battery information from pacemakers that may eventually make the cut.
Since the lab opened about 50,000 pacemakers have come into World Medical and some 1,500 have been reconditioned, according to Puroll. About 500 have actually been implanted in heart patients in a dozen countries, both by My Heart Your Heart volunteer doctors who travel abroad and by local doctors. Only about 20 percent are successfully recycled.
“Obstacles are many, but we believe it’s the right thing to do,” says U-M’s Crawford, who has implanted recycled pacemakers or trained doctors in Sierra Leone, Kenya, Mexico and Bolivia.
Now My Heart Your Heart is thinking bigger. It is conducting a large clinical trial involving 260 patients. The aim is to show that recycled pacemakers can work as well as new ones.
When the study is done “I hope we’ve proven we can do this safely and effectively,” says Dr. Eagle.
He looks forward to the possibility of creating pacemaker training programs for doctors in poor countries and establishing recycling centers like World Medical’s all over the U.S.
Founded in 1953, World Medical Relief collects and reconditions all types of donated medical equipment and supplies and ships them to more than 100 countries around the world that request aid.
World Medical would occasionally get a few pacemakers from funeral homes and crematoriums that did not know what else to do with them. Before My Heart Your Heart, most were melted down or thrown away.
But now some 500 funeral homes and crematoriums around the country send pacemakers to the lab, says Puroll.
The O’Brien-Sullivan Funeral Home in Novi, Michigan, has been contributing pacemakers for more than 10 years, says its president, John P. O’Brien.
While extracting devices from loved ones may be a touchy subject, “most families are glad to participate when I tell them about the pacemaker program,” O’Brien says.
Two other key volunteer partners in My Heart Your Heart are Implant Recycling in Sterling Heights, Mich., and Northeast Scientific in Waterbury, Conn.
Implant Recycling is in the business of melting down medical devices for the metal. But it has donated thousands of pacemakers to My Heart Your Heart in recent years, says CEO Brad Wasserman, although many come back to him as unsuitable to be reused.
“It’s a humanitarian thing, it can save lives,” he says. “Crematoriums just used to throw the pacemakers away.”
Northeast Scientific does both initial and final deep cleaning of pacemakers for My Heart Your Heart, says CEO Craig Allmendinger.
“We’re making a big difference,” he says. “I’m getting calls from cardiovascular programs around the world” interested in pacemaker recycling. “African countries especially are waking up to the resource.”
Sheldon Davis, a semi-retired Michigan businessman, and his wife, Marion, have supported the pacemaker lab with financial donations for years.
“The people at My Heart Your Heart have done a fantastic job,” says Davis, who got involved while volunteering through his church. “We’re thankful we have the opportunity to help those poor souls, in countries that need help badly.”
Alan Fisk has been an editor and reporter at Detroit Free Press, Newsday, The New York Times, The Detroit News and other publications over a 50-year journalism career. He grew up in Detroit and graduated from Wayne State University. He has also taught journalism at Wayne State, the University of Michigan, Oakland University and New York University. He lives in St. Clair Shores, Mich.