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Con­ge­ni­tal mal­for­ma­ti­ons of the uri­na­ry and geni­tal tracts, kid­ney stones, blad­der dise­a­ses, unde­s­cen­ded testic­les or peni­le mal­for­ma­ti­ons are the main tasks of the paed­ia­tric uro­lo­gy team. Twice a year, the ARCHEMED team tra­vels to Asma­ra, whe­re an avera­ge of almost 200 child­ren are exami­ned and more than 40 are ope­ra­ted on during each mis­si­on.

At the begin­ning of their mis­si­ons, the paed­ia­tric uro­lo­gists deter­mi­ne whe­ther a child is to be trea­ted con­ser­va­tively or sur­gi­cal­ly. In par­ti­cu­lar, the pro­ce­du­res that were pre­vious­ly not pos­si­ble due to a lack of spe­cia­li­sed doc­tors are car­ri­ed out. Many child­ren have For exam­p­le, many child­ren have pro­blems with uri­na­ti­on, which can lead to an unob­s­truc­ted uri­ne loss through an expo­sed blad­der in child­ren. The­se wet and extre­me­ly unp­lea­sant­ly smel­ling child­ren have no future in Eri­trea, becau­se tho­se who ‘stink’ are excluded from atten­ding school. This means, con­se­quent­ly, having no chan­ce of fur­ther edu­ca­ti­on and being unable to lead a nor­mal social and rela­ti­onship life – a vege­ta­ti­ve exis­tence on the mar­gins of socie­ty is pre-pro­grammed.   

Archemed Kinderurolgie Patient
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The aim is to distin­gu­ish bet­ween imme­dia­te fea­si­bi­li­ty and long-term pro­ject plan­ning. The on-site trai­ning of local sur­ge­ons, sur­gi­cal nur­sing staff (anaes­the­sia tech­ni­ques, sur­gi­cal assis­tance) and the trai­ning of staff and par­ents in the paed­ia­tric ward to impro­ve post­ope­ra­ti­ve care (hygie­ne, wound care, dres­sings) is essen­ti­al. Pre­cise IT docu­men­ta­ti­on (a dedi­ca­ted pro­gram­me for ope­ra­ti­ons, pro­gress, after­ca­re and logi­stics has been deve­lo­ped for this pur­po­se) pro­vi­des the data for resour­ce plan­ning and moni­to­ring results. At the end of 2015, ARCHEMED brought a dona­ted litho­tripter (‘stone machi­ne’) to Asma­ra. With the help of shock waves, it can be used to break up and thus remo­ve all stones in the uro­ge­ni­tal tract, which occur rela­tively fre­quent­ly in Eri­trea. So far, around 230 child­ren have been suc­cessful­ly trea­ted with it, and their uri­na­ry, kid­ney and blad­der stones have been remo­ved. The litho­tripter is also to be used by local spe­cia­lists at a later date.

Pro­ject manage­ment

Dr. Regi­na Str­e­de­le, paed­ia­tric uro­lo­gist, Munich