Together with Kyrgyz colleagues Prof Dr Madjid Samii and Board Member Sonja Quandt-Wolf inaugurated a brand-new operation room for Pediatric Neurosurgery in Bishkek. The German Ambassador Dr Peter Rudolf Scholz (on the right hand) is also proud of this facility, from which the affected children of the whole country will benefit.
It is the first of its kind throughout Kyrgyzstan: On June 6, 2016, the world's leading neurosurgeon Prof Dr Madjid Samii (President of the International Neuroscience Institute INI Hannover) inaugurated an operating room for neurosurgical treatment of children which was built and equipped at a European level by the Foundation Zuversicht für Kinder (Confidence for Children). Professor Samii is the Head of the Board of Trustees of the Foundation and brought an international team of leading pediatric neurosurgeons to the Kyrgyz capital of Bishkek. In the following days they successfully performed first surgeries of children with hydrocephalus in this new operating room.
Congenital or acquired hydrocephalus is one of the most common diseases of infants and children worldwide. Approx. 80 per cent will be born in countries with limited or no access to adequate neurosurgical care. If left untreated, hydrocephalus in children does not just cause pain and suffering but it also results in serious brain damage, severe developmental delay, blindness and, ultimately, death. Indeed, 90 per cent of the hydrocephalic children who are left untreated end up with irreversible neurological deficits or early death. In the rare instances in which the affected child survives, the neurological deficits and the disfigured appearance due to the abnormally enlarged head lead to its social isolation.
We want to help these children now. Learn more details about our new project and how you can support us with even small donations.
There are no reliable statistics on the global incidence of hydrocephalus. It is estimated, however, that every year 400,000 new-born babies worldwide are going to be affected by hydrocephalus.
Nowadays the surgical management is possible in most of the cases and the great majority of the affected subjects enjoy normal psychomotor development postoperatively when the condition is timely recognized and early treated. Based on our standards, treating hydrocephalus is comparatively easy for experienced neurosurgeons.
In transition and emerging economies the situation is rather different: In many of these countries there are no adequate facilities for neurosurgical care at all or neurosurgical facilities inadequate to deal with the paediatric population. In these countries, it is impossible to diagnose the condition early on, and well equipped maternity clinics and medical infrastructures are practically inexistent. Furthermore, even when a specialized hospital does exist, usually in the capital city, most families could not afford to get there, let alone pay for an operation or for a cerebrospinal fluid shunt device, which is necessary to implant in about half of the cases. Hence, in countries such as these, hydrocephalus is a condition that is associated with poverty.
Up to now there have been no major global actors who have directed their efforts towards offering medical (neurosurgical) care to this target group. In cooperation with the World Federation of Neurosurgical Societies (WFNS) and the International Neuroscience Institute (INI) the German Foundation Zuversicht für Kinder is therefore going to initiate a global campaign programme to assist with the surgical treatment of hydrocephalus children.
After the official inauguration of the new neurosurgical operating room in the National Children's Hospital Bishkek an international expert team performed the first endoscopic surgery of a hydrocephalus child.
Prof Dr Madjid Samii wants to make available all his international contacts to highly qualified neurosurgeons, his role as Honorary President of the World Federation of Neurosurgical Societies (WFNS) and the possibilities provided by its foundation of purchasing neurosurgical equipment at reduced prices in order to offer professional training and development programmes. The International Neuroscience Institute in Hannover is going to support the Foundation Zuversicht für Kinder as a project partner. The Director of the Clinic for Paediatric Neurosurgery at the INI, Prof Dr Concezio Di Rocco will act as contact person and main medical adviser. Prof Dr Di Rocco is not just an internationally respected authority in the field of paediatric neurosurgery but also Co-Chairman of the Education and Training Committee of the WFNS. During this first mission in Bishkek he was accompanied by the neurosurgeons Prof Dr Shizuo Oi and Dr. Wolf Lüdemann.
Start up: Kyrgyzstan
In 2016 the Foundation Zuversicht für Kinder started the project at the tried and tested National Centre for Maternity and Childhood Protection in Bishkek/ Kyrgyzstan in Central Asia where, over the past years, an interdisciplinary treatment centre for children with facial deformities has already been successfully established.
Kyrgyzstan is considered to be the second poorest country within the Commonwealth of Independent States (CIS), an association of former Soviet Republics, with a poverty rate of 33.7 per cent (three quarters in rural areas). Since the collapse of the Soviet Union, the living conditions of many sections of society have continued to deteriorate in the wake of economic development. The most urgent problems are poverty, unemployment and a lack of social protection.
Unsurprisingly, this difficult economic situation has had a detrimental effect on the health system itself - despite reforms that have been introduced in the meantime and despite the support of international donors: The current health system in Kyrgyzstan goes back to Soviet structures. It is becoming increasingly obvious that everywhere the infrastructure, in terms of building stock and instruments, is falling into disrepair, that the equipment of the medical facilities is antiquated and that the level of knowhow about modern methods of healthcare among the medical staff is low. The departure of qualified specialists (due to low salaries) has reduced their availability in the public health system. Apart from the neediness of the children concerned, the situation is made more difficult by the fact that, at most state hospitals – including the National Centre for Maternity and Childhood Protection –, the neurosurgical clinics lack the necessary equipment.
Local neurosurgeons estimate, that every year 400 to 500 new-born infants in Kyrgyzstan are going to be affected by hydrocephalus; to this, we must add other malformations of the central nervous system (spina bifida, cysts, brain and spinal marrow tumours etc.) and those cases that can ensue intracranial haemorrhages and infections or head trauma. Conditions affecting the central nervous system are the most frequent infant pathologies in Kyrgyzstan.
So far most hydrocephalus children in Kyrgyzstan have been left untreated for too long because the financial resources and the necessary medical infrastructure was missing. This will change now.
The National Centre for Maternity and Childhood Protection in Bishkek is the only hospital in the country that can provide neurosurgical care for children under the age of 13 and that deals with around 200 to 250 hydrocephalus children every year. It is safe to assume that, due to a lack of financial means, all other hydrocephalus children do not even get to the capital to receive the potential care that may be available. Until 2016 there was no separate operating theatre. The surgeons carried out the surgery in a general operating theatre. No dedicate neurosurgical instruments were available for the paediatric population. In particular, due to a lack of a neuroendoscope it was impossible to carry out the neuroendoscopic opening of the floor of the III Ventricle which nowadays allows treating the hydrocephalus avoiding the shunt insertion in about 40 per cent of the cases. In Kyrgyzstan the doctors only used shunts.
This will change now: In cooperation with WFNS the Foundation Zuversicht für Kinder arranged the procurement of complete new and modern neurosurgical equipment (endoscope, microscope, neurosurgical instruments, 200 shunt devices etc.). Furthermore, the Foundation built and equipped this brand new separate operating theater.
The affected parents of children with hydrocephalus have new hope: With the help of the Foundation Zuversicht für Kinder their children can be treated adequately in the future.
A twice-a-year deployment of specialists is planned now. These will be coordinated by Professor Di Rocco. Step by step, the Foundation Zuversicht für Kinder wants to set up a functioning neurosurgical paediatric care centre of which the afflicted children (in particular the orphans) of the entire country could benefit. This will be combined with efforts to qualify local paediatric surgeons. The establishment of a new neurosurgical rehabilitation and training centre in Bishkek/Kyrgyzstan for the treatment of children with hydrocephalus and other congenital malformations of the central nervous system (and ideally also for the implementation of preventative programmes to prevent the occurrence of neonatal malformations) is supposed to become a reference project for the phased initiation of a worldwide campaign that is aimed at establishing a comprehensive network of hydrocephalus treatment centres.
Proud of this new project: Prof Dr Madjid Samii, Prof Dr Concezio di Rocco and Prof Dr Shizuo Oi.
We need volunteers!
We want to create a base of regular supporters. If you are an experienced pediatric neurosurgeon or anesthetist and if you feel that this is a worthwhile and interesting opportunity that you would like to take part in, please do not hesitate to contact Prof Dr Madjid Samii and Prof Dr Concezio di Rocco via our project office: Please feel free to phone or e-mail our project-administrator Dr Martina Adam with any questions you may have: firstname.lastname@example.org
We need funds!
We would of course be delighted and very grateful if you inform your friends, family and colleagues of our commitments and in order to generate donations and sponsorship for the hydrocephalus-project of Foundation Confidence for Children; also informing local and national press for media coverage and publicity.
A gift, large or small, can and will make a lasting difference to a hydrocephalus child’s quality of life. Of course, a small regular donation made by standing order enables us to plan ahead.
You can use this website www.stiftung-zuversicht-fuer-kinder.org to make online donations to help us fund our missions to Kyrgyzstan and to buy the necessary disposals.
For example: 40 EUR (costs of a shunt system) can save a child´s life!
A global campaign programme for children with hydrocephalus
Our German Foundation Zuversicht für Kinder is going to initiate a global campaign programme to assist with the surgical treatment of hydrocephalus children.
I hope that many internationally respected neurosurgeons will not just accept to be actively involved in this project by training colleagues in so-called development, transition and emerging economies and by carrying out operations themselves but also to act as ambassadors and fundraisers in their own countries.
Prof Dr Madjid Samii