A Move Forward in Kidney Stones Treatment
Partnership is the motto of the Eritrean Government. This reality is manifested by Eritrea’s developmental path, characterized by social equity in the health and education sectors.
In today’s issue, we look at the importance of partnering for socially equitable healthcare development. We’ll take a glance at the visit of Italian surgeons in Eritrea this past week.
For years now, the Ministry of Health works in close collaboration with other health institutions and medical doctors from Italy, Germany, Switzerland, Austria, and the Sudan, among others.
Their visit comes at an important juncture. As highlighted by local news, a new machine has been introduced at the Orotta National Referral Hospital for the treatment of kidney stones.
Despite its complicated and perhaps intimidating name, the recently introduced Extra Corporal Shock Wave Lithotripsy (ECSWL) is actually a potentially greatly impactful technological innovation that facilitates and lightens the burden associated with treating kidney stones.
Kidney stones, common found in both adults and children, can be painful and may require medical surgery to remove it. Unfortunately, treatments often differ between those living in less developed countries versus those living in the so-called ‘First World’.
Well, this will no longer be the case in Eritrea.
This new lithotripsy machine, a first in the country, came by way of Eritrea’s partners in Germany. Additional partners, including Italian surgeons and medical technicians, visited the country this week to inaugurate the machine.
So far, the therapeutic approach is already showing positive outcomes.
Italian technician Massimiliano visited focusing intently on training and sharing experience with local medical doctors about the instrument’s application. His maiden visit in Eritrea, Massimiliano expressed his pleasure in seeing the motivation and eagerness to learn by the cast of astute, young Eritrean medical doctors.
One of them, the young and energetic Dr. Abdureza Mohammed, seemed poised and in total control of the machine while I observed him in the operation room, working under the tutelage of watchful Italian technicians, who made themselves available for any looming intraoperative questions on the sidelines.
Dr. Abdureza later told me how it was important “to keep close collaboration with doctors from abroad, which enable us to grow and continue learning from their expertise”. Such expertise was exhibited in visiting senior surgeons, Dr. Salvatore Galanti and Dr. Gianfranco Cicciu, the President and Vice-President of the association Onlus Consulcesi, respectfully.
Their visit provided long hours of applied clinical expertise and observation in addition to a number of medical surgeries related to kidney and other diseases and assistance to local staff in applying lithotripsy therapy. With years of savoir-faire on top of familiarity with Eritrea, that included more than twenty visits, their longstanding collaboration is greatly appreciated, said Dr. Habteab Mehari.
So what is new about the new machine to treat kidney stones? According to the New Oxford American Dictionary, kidney stones, known as renal calculus, “are a hard mass formed in the kidneys, typically consisting of insoluble calcium compounds”.
It is known for being painful, which can be prevented by drinking sufficient liquid while having a healthy diet and weight.
Dr. Galanti explained that the high calcium content water in Eritrea may help explain the reason for the prevalence of kidney stones in Eritrea. Widespread reduced water consumption may also contribute, making therapy for kidney stones a very relevant national concern.
Thus, the recent introduction of the lithotripsy device will help ease the burden on both patients and medical doctors in the treatment of kidney stones.
In the past, treating kidney stones required open surgery. Consequently, anesthesia was required, introducing with it the added risk of complications in the patient. Open surgery is also time consuming to both medical corps and patients. Operations could exhaust more than four hours to treat one patient.
In addition, a whole team of medical personnel was required, from preoperative preparation to postoperative recovery. Patients had to stay overnight after the operation.
Other methods have been introduced such as the of laserbased kidney treatments. However, these and all other treatments still remained taxing on patients, doctors and the healthcare system.
Without a doubt, the ECSWL machine is already showing its effectiveness at Orotta Hospital. Dr Abdureza explained that, thanks to the device, the hospital is able to effectively treat 10 to 11 patients per day since each operation takes about roughly an hour.
Last Thursday, eager patients witnessed with encouragement the cast of Italian and Eritrean surgeons and doctors carefully and methodically working their way through the long, snaking line of patients slated for lithotripsy.
Fortunately, there is no longer the need for patients to undergo the pain of the knife. By only paying 1,500 Nakfa, while requiring only four medical personnel during the entire process, lithotripsy has become time- and cost-efficient, not to mention human resource efficient.
One may wonder about the details and process of this new operation. In brief, a patient suffering from kidney stones between 4 millimeters to 2 centimeters in diameter is eligible for treatment via ECSWL, assuming they do not suffer from any other serious health conditions.
As I walked in the operation room wearing a medical mask and gown. I saw the patient placed on a cushion and the surgeon conducted prerequisite X-ray or ultrasound tests to precisely locate the stone.
Then the ECSWL device was applied. The machine works its wonder by beaming high-energy, focused sound waves through the body, without injuring it, and breaks apart the targeted stone into small pieces.
The residual debris from the kidney stones can more easily travel through the urinary tract and finally pass from the body. The procedure is in the outpatient setting. No thought of avoiding hospital visits may lead to rejoice in patients oft reluctant to make the visit.
After three to four hours of recovery, Dr. Galanti explained, the patient can leave the hospital and go back to his or her normal endeavors.
The investment made by the Ministry of Health is certainly a boon to citizens around the country. Keeping strong ties with international institutions and organizations is unquestionably noteworthy in improving the services provided to people in
Eritrea.
Dr. Abdureza explained, “before, many patients had to go abroad for treatment and pay a huge amount of money or be drawn into debt. However, the visit of experts from other countries will help ease the burden of many.”
Clearly, challenges remain within the Eritrean health care system in terms of providing timely services and materials while providing access to essential medicines.
Nonetheless, continuing and enhancing partnership, and exchanging experiences with professionals from abroad will undeniably help Eritrea overcome current shortcomings and raise the expertise, therapeutic capacity, experience and managerial skills of Eritrean healthcare professionals.