Let’s walk together 2

Title of the project

Let’s walk together 2

Place of the action

Asmara, Eritrea

Description of the context

As many African countries, Eritrea is a low-income country with a critical health situation, in particular in paediatric orthopaedics. In Asmara there is one orthopaedics dept at Halibet hospital: this is the only Orthopaedics ward in all Eritrea. The ward has 34 patient-beds, 2 operating rooms and 5 orthopaedics surgeons (1 for every 1,300,000 inhabitants) whose activities are oriented almost exclusively on trauma, neglecting paediatric orthopaedic pathology, which would require dedicated facilities, with trained MD and health personnel capable of early detecting and  treating children affected by orthopaedics deformities such as congenital clubfoot, developmental hip dysplasia, axial deviations of the limbs, scoliosis. If these pathologies are not early diagnosed and treated, they will worsen during growth, compromising any social relationship and quality of life. Furthermore, secondary deformities and late diagnoses are often very severe and require delicate and complex surgical interventions. Following an official request of the  Eritrean Ministry of Health, in 2008 AnlaDi started to support orthopaedic surgery through the project  “Let’s Walk Together” aiming at establishing the first Paediatric Orthopaedics dept in the country. In collaboration with the Rizzoli Orthopaedic Institute of Bologna and Halibet hospital in Asmara, from 2008 to 2019, over 1000 children have been visited and about 500 children have been operated for orthopaedics deformities such as congenital clubfoot.

In 2019, after 10 years of fruitful collaboration with the Eritrean authorities, the Eritrean Ministry of Health requested us to intervene in the treatment of Evolutionary Dysplasia of the Hip-DDH (hip development anomaly which occurs during intra-uterine life and leads to an alteration of the conformation and ligaments between the femoral head and the acetabulum. Because of its tendency to evolve and worsen over time, this pathology requires to be diagnosed and treated as early as possible. The treatment induces the best possible centering (“reduction”) to allow the coxo-femoral joint to develop properly. The Eritrean Ministry’s request is motivated by the frequency of this disabling pathology, especially among young girls and women, by the Halibet staff’s lack of adequate skills, and, above all, by the lack of a health registry and therefore epidemiological data.

The project

The general objective of the project is to improve the quality of public health services in Eritrea, especially in the Paediatric Orthopaedics sectors, through trainings and supply of medical equipment for enabling Eritrean orthopaedic surgeons to effectively manage DDH in all stages: prevention, early diagnosis, bloodless and bloody treatment and follow up. The project aims at guaranteeing basic health conditions to children, indispensable conditions to start building a culture of peace and non-violence, fundamental for the future of this country. The specific objectives are:

1. To provide the health services of a modern hospital where Eritrean population can receive the necessary care the impact of DDH-Developmental Hip Dysplasia in Eritrean infants and children.
2. To improve paediatric orthopaedic quality, medical competences and surgical interventions
3. To improve national guidelines for paediatric orthopaedic assistance, and to organise professional training programs for Eritrean orthopaedic doctors, nurses and health staff working in the operating rooms of Halibet Hospital.

The objectives of the project will be achieved through a collaboration with the Eritrean Minister of Health, the Admin of Halibet  Hospital, Meyer Hospital in Florence and Annulliamo la Distanza. The Italian medical team will be supported by a local team. During the mission, the Italian specialists will provide a training on the job. The Italian MDs will provide complete sets of the necessary surgical equipment and instruments which ultimately will be donated to the Eritrean MDs in order to ensure their  full autonomy.

The expected results are:

R1. Halibet Hospital has been equipped with surgical instruments and equipment dedicated to Paediatric Orthopaedics, in particular for the early diagnosis and treatment of DDH
R2: Two missions of the medical volunteers from Annulliamo la Distanza/ Meyer hospital has taken place in order to train local staff (orthopaedics, anaesthesiologists, and nurses) on ​​DDH and on the diagnosis, bloody and bloodless treatment of DDH
R3: Over 200 children with malformations have been visited  and at least 40 operations have been performed
R4: 6 Eritrean MDs and 5 nurses have been trained

Achieved result

The achieved results will be included in this section as soon as possible.