Background

Eritrea has been a war zone for more than 30 years from 1962 to independence in 1993 and is, until today, one of the poorest countries in the world (BIP/capita 1,250 US$).

Out of 5 million inhabitants, 53% live below poverty level, 73% are malnourished and only 58% of the populations have access to water. The figures are speaking for themselves: Life expectancy at birth (53 years), Infant death until the age of 5 (78/1,000 live birth), maternal death (1,000/100,000 births). These key figures reflect not only the high fertility rate (5.4 children per woman and a birth rate of 38.7/1,000) but also a very low level of medical support. The expenses for healthcare amount to only 36 US$ per person/year, only 1 medical doctor per 100,000 persons and 3 midwives per 100,000 females. Only 28% of births take place under the supervision of medical personnel. There are only >0.05 hospital beds per 1,000 persons.

The first medical university in Eritrea was inaugurated in 2006. Before that, medical students had to study in Addis Abeba in Ethiopia and most of them did not return to their home country. Last year the first medical doctors graduated in Eritrea. Additional new educational programs in paediatrics, surgery and gynaecology should help to retain these doctors in Eritrea.

In Eritrea many children are born with congenital heart diseases and most of them die without medical treatment.

Since 1996, the German Foundation Hammerforum e.V. has been present in Eritrea with the founding member Prof. em. Andreas Urban, former head of department of the children’s heart surgery of St. Augustin.

Since then a pediatric infrastructure has been established on the premises of the Orotta hospital including the International Operation Center for Children in Asmara (IOCCA). Throughout the year, international teams from Germany, Italy and Switzerland perform surgery, including heart surgery, for children in the Orotta hospital.

The medical faculty of the University of Asmara is also supported. All this takes place in close collaboration with the Eritrean Government, the Hammerforum e.V. from Germany, the Supporting Committee from Switzerland for Eritrea (SUKE) and EurAsia Heart. In the near future a teaching hospital will be established.

In contrast to other missions of EurAsia Heart, we need to send an entire, independently working team of heart surgeons to Eritrea. This team comprises intensive care specialists, anaesthetists, cardiologists, intensive care and theatre nurses, all in all about 20 persons. One mission, including costs for flight and hotel for the team, amounts to approximately CHF 38,000.  All of these costs are covered by donations of companies and private persons. All team members work free of charge and during their holidays. In addition, accessories and supply materials have to be shipped to Eritrea.

The pediatric medical treatment takes place in a separate one-storey building, built by the Italians in the 1930s, located on the premises of the Orotta hospital in Asmara.  During the last 15 years this building has been equipped with two operation theatres, sterilization, intensive and monitoring units. Two years ago a cardiac catheter lab followed.

Water supply for this building is provided by reservoir and fire hoses. The reservoirs receive the water periodically from tanks provided by the municipal water supplies. However, from time to time water shortages occur.

Oxygen is distributed via oxygen bottles which are manually connected to the internal distribution network. Since there are often electricity outages, the main medical installations are secured via emergency generator. Although there is no air condition, the temperature in the building is quite moderate due to the high ceilings. During the month of May Asmara has a quite agreeable climate with temperatures between 22 – 28°C.

Because of the limited resources the children are carefully selected. Of the vast number of children in need of treatment, those are selected that have a good chance to be helped with one operation. Children who suffer from multiple diseases cannot be helped.

Dr. Tsegereda looks after the children before and after surgery. That this is done by local doctors is very important as this ensures the long-term medical self-sustainability.