Malformations and deformities of the spine, arms and legs, if left untreated, lead to permanent disabilities for many children in Eritrea, with loss of mobility and ability to work. Basic pediatric orthopedic care does not exist in Eritrea: there is neither medical training in pediatric orthopedics nor structured physiotherapy or orthopedic technical care. Yet the majority of pediatric orthopedic conditions—if diagnosed in time—can be treated conservatively, effectively and with relatively little effort.
Since spring 2025, the POCA (Pediatric Orthopedic Centre of Asmara) project has been housed in the newly renovated premises at Orotta Hospital and serves as a point of contact for children with disabilities of any kind. In particular, children with physical and intellectual impairments are admitted here in cooperation with the Social Pediatrics project, registered and referred for the necessary interdisciplinary treatment.
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The treatment concept of the “Pediatric Orthopedics Project” is multidimensional:
1. Orthopedic surgery
Necessary operations to correct axial deformities, tendon shortening or stabilizations are performed by specialized pediatric orthopedic teams at Halibet Hospital. The often important follow-up treatment with physiotherapy and orthopedic technology is in turn covered by POCA and is intended to ensure the success of the operation even after the surgical team has left.
2. Clubfoot treatment
One subfield of pediatric orthopedics is the treatment of clubfoot. This foot deformity can be successfully treated in infancy through a targeted treatment concept (Ponseti) consisting of a small tendon release and a special casting technique, thereby ensuring the child’s ability to walk. Since 2005, a clubfoot clinic initiated by project lead Dr. Katja von dem Busche has been in place, through which numerous children have already learned to walk successfully. The project benefits from its direct proximity to physiotherapy and orthopedic technology.
3. Physiotherapy
It is important to assemble a physiotherapy team at POCA that is enabled to carry out independent treatment measures through targeted instruction by ARCHEMED physiotherapists, while also training and supporting the affected parents. Especially for children with intellectual disabilities, cooperation with the Social Pediatrics team and the Eritrean association NAIDDE is of inestimable value for providing good care to this patient group.
4. Orthopedic technology
Providing children with stabilizing or corrective aids is an important building block in the pediatric orthopedic care concept. For this purpose, aids are produced and fitted in a small workshop at POCA, and Eritrean orthopedic technicians are trained. Often, with little effort in the right place, a maldevelopment can be corrected and a later lifelong disability avoided.
Project Management
Orthopedic Surgery: Elisa Kühn, OTA, Neckargemünd
Clubfoot Treatment: Dr. Katja von dem Busche, pediatric surgeon, Berlin
Physiotherapy: Angela Schulze-Wiehenbrauck, pediatric physiotherapist, Soest
Orthopedic Technology: Friedrich Jahns, master orthopedic technician, Bad Essen