“IOCCA Carrying Out Sensational Surgeries for Children with Cardiac Disease in Eritrea” Dr. Andreas Urban Part II & Final

International teams of cardiac surgeons have continued to visit Eritrea and conduct extensive operations for Eritrean children with cardiac diseases. ARCHEMED, a German group of surgeons, is among those teams which have been very keen to come to the country with an aim of alleviating the dire consequences of cardiac disease. An excerpt of a brief interview with Dr. Andreas Urban, Pediatric Cardiac Surgeon, highlights the endeavors that have been exerted by the international medical teams, especially the ARCHEMED group. On our last issue we published the first part of the interview. And below is the gist of the last part of the briefings about the successful cardiac surgeries they have so far carried out.

To which age group do you carry out cardiac operation?

We consider people from zero to 18 years old as children. Based on this we operated children from zero to 18 years old. But at the moment most of them are very young, which is logic because we want to operate them before they die. After this, there is no use. So far the smallest child we have operated weighs 1500 grams and the youngest was five days old. About less than 2% of those children who are operated die during or after the operation, which means more than 98% of all the patients we operated survive and enjoy normal quality of life. During or after operation, an average rate of 2% death is worldwide in the best level of achievement registered. The best hospitals worldwide, for instance, have about 2% mortality rates in cardiac diseases for children. So the quality of cardiac surgery in Eritrea is at the top. For me, I think, this is a sensational outcome especially in developing countries. In Eritrea many children with cardiac disease also suffer from other diseases like pneumonia infections and so on. So to achieve survival rate of more than 98% is fantastic. Once more, I could boldly say that IOCCA is the best center of cardiac surgery both in terms of achievement and number of survivors in Africa.

What is the cause or the reason for cardiac disease?

I think the reason for cardiac disease is difficult to understand because it’s worldwide the same. For example, worldwide about 1% of all children born alive have cardiac disease. So there is no differ-ence between Eritrea, Germany or any part of the world for the origin and reason of the disease. But it is clearly known that about 70% of children with cardiac diseases die at the age of two or three years and the rest 30% eventually die later. This means, the disease can only be tackled with cardiac surgery. So if you carry out cardiac surgery for children with such a problem, the quality of life will be normal and they will not die prematurely.

How do you evaluate the Competence of Eritrean cardiac Surgeons?

We have a lot of help from the Eritrean cardiac surgery personnel. For example we wouldn’t be able to do our work without Professor Tsigereda Gebrehiwet, the chief of the pediatric clinic, and without Dr. Yosief Tewolde, the chief and professor of surgery. So, in every area of the cardiac surgery, there is good help from all Eritrean personnel. But, one point I would like to mention is that all the machines at our center are very expensive, so they need proper maintenance. However, we don’t have trained technicians who work with us to maintain these machines. If I can have a wish to the Eritrean government to have technicians who would work in our team, we would train them to maintain what we have created here in the center. For instance, we have an oxygen plant, medical gases plant, and machines for heart lung, ventilation machine, infusion pumps among others that need proper maintenance.

Do you have any information you would like to add?

Finally, we together can be proud that we have this International Operation Center for Children in Asmara (IOCCA). If I say together, I do that on purpose, because without the help of Eritrean leadership and the Ministry of Health, it wouldn’t have been possible to build such center. On the other side, without the tremendous help of all members of the four groups who work in their free time, for no money, such outcome would not be achieved. So, it is a team approach. It is also a big fun to be able to work together peacefully with Eritrean and other international staffs towards helping Eritrean sick children to get normal quality of life. So, we are here and we are looking ahead to come back.

Dr. Andreas Urban

As cardiac surgery could not be carried out individually, the success story that continued to be achieved is the result of a team work. Hence, DR. Martin Schmidt-Niemann, a German Anesthesiologist, among the Specialists in this filed, puts his remark as follows:

I am Dr. Martin Schmidt-Niemann and I am a German. By profession, I am an Anesthesiologist and I came from n a Children’s Center in Germany. I am also consultant of anesthesiology back in Germany.

I joined the cardiac surgery team as a nurse but now I am a doctor in Anesthesiology. To date I have worked for about 15 years in this profession. As a member of the ARCHEMED group, I am here in Eritrea for the 9th time which is probably for nine years.

My aim to come to Eritrea is to help this project of cardiac surgery for children, which is organized by Dr. Andreas Urban. At first Dr. Urban asked me whether I could help for this cardiac surgery project here in Eritrea. Because I am internationally well experienced on anesthesiology, I accepted his request and I started to come here to help the children with cardiac problem and I love what I am doing. It is indeed an interesting place to be in.

The reason why such surgeon groups are interested to do such remarkable and successful cardiac surgery for Eritrean children is that, I think we are pretty much sure that we can do something good for children with heart disease. We have the feeling that we can bring all the experience to Eritrea because there is no much experience for these especial cases in the country. I think, together, we can do a good job and help a lot of Eritrean children survive in a good and stable condition for a long period of time.

On my view, the skill of the Eritrean surgery personnel is pretty much good, helpful and inquisitive to know and learn more about the cardiac surgery. Among the Eritrean medical experts, Dr. Yosief Tewolde surgeon at Orotta National Referral Hospital is a good surgeon and Professor Tsegereda, Chief of the Pediatric Clinic in the hospital, have been gaining too much experience from the skill transfer we have continued to share. So all the surgery personnel are wonderful and I like them very much.

If Eritrea wants to start to do the cardiac surgery on her own, especially in my profession i.e. anesthesiology, I think you need to do a lot of things and learn more about it, chiefly in terms of personnel and equipments. Now, we are starting something at the IOCCA and in the future, if you are to mange it on your own, you should plane to acquire a higher skill in Anesthesiology, since a higher Anesthesiology is the heart of a successful cardiac surgery. Therefore, to be able to carry out a high quality of cardiac surgery like this by your own, you need more education and trainings in all areas of the professions, including surgery.

Finally, this kind of highly qualified surgery is an expensive kind of medical care. But setting up such a center is highly important no matter how expensive such operations would be. But thanks to the establishment of IOCCA, many lives of Eritrean children with cardiac disease have been saved. I am happy to be part of live saving mission that have been carried out in Eritrea and I like to come back too.

DR. Martin Schmidt-Niemann