Pediatric Surgery Project
Supervisor: Dr. Guglielmo Mazzoni
Dr. Giorgio Pasquini, who had 10 years field experience at HEWO Hospital, envisioned the necessity to start up a paediatric surgery project. This project began in 2012 when in October we made a survey of the medical, surgical and paediatric health situation in Tigray. We visited all Quihà and Makallè hospitals.
Birth rate in Ethiopia is triple that in Italy, whereas mortality in the first 5 years of life is 20 times higher.
The few paediatricians are mostly located in the larger cities. Paediatrics in the peripheral health units are run by nurses specialised in paediatrics. The paediatrician usually visits the unit only once a week at both Quihà and Hewo hospital. At Quihà hospital about 900 children aged from 0 to 5 are visited each month. The recently built Ayder University hospital in Makallè is not yet able to cover all the medical and specialized needs. The first students specialized in general surgery will soon graduate.
Paediatric surgery is still considered a super specialization as orthopaedics and gynaecology are not available. In all the Tigray region (42,000 km2 and 10 million inhabitants) there is no paediatric surgeon. The few general surgeons do what they are able to even if they don't have the necessary know-how. Complex cases which they cannot solve are sent to Addis Abeba which is 800 km away. In a country twice the size of France, all transport is by road, as now there is only one active railway (Addis Abeba - Gibuti). The majority of the population does not have the time, the means or the money to undertake a 800 km journey by road (which are in terribly poor condition).
A paediatric surgery project at Hewo Hospital is not only useful, but absolutely essential. During the first mission we operated 20 children. In 2013 during 2 missions we operated 32 children. We then began to encounter the first difficulties.
The distance between the operating theatre and the paediatric ward is enormous, as you can see in Figure 4. Transporting patients is not always simple. A perfect solution, as requested by Makallè Health Bureau, would be the construction of a Maternal Infant Ward with attached operating theatre and near the paediatric ward. This is not easily accomplished due to the prohibitive costs