Hydrocephalus treatment: Gikonko health centre gives children a second shot at life

The Health sector in the country continues to make positive strides in treatment of complicated diseases that would otherwise devastate the lives of sufferers.

Tuesday, February 23, 2016
Some of the parents with children who have been treated of hydrocephalus. (Andrew Rugema)

The Health sector in the country continues to make positive strides in treatment of complicated diseases that would otherwise devastate the lives of sufferers.

One such disease is hydrocephalus, a condition that mainly attacks children between the ages of two and three. The neurological condition can develop within weeks of birth and requires surgery to cure.

Gikonko is the only health centre with facilities to treat the medical condition; University Teaching Hospital of Kigali (CHUK) also treats hydrocephalus, but the referal hospital always refers patients to Gikonko Health Centre where specialists are based.

Kibagabaga Hospital and King Faisal Hospital Rwanda, among others, also refer their patients to this health centre.

Located in Gisagara District, Southern Province, the health facility was established by the Catholic Church under German-based Institute of Saint Boniface.

According to the health centre director, Dr Uta Elisabeth Düll, the hospital mainly provides preventative care.

The facility has a staff surgeon, an anaesthesia technician, 15 nurses, two laboratory technicians, a social assistant, a nutritionist and 20 supplementary workers.

They receive between 70 and 80 patients coming from across the country. Although the number of patients is high, the health centre has managed to stand out with treatment of some cancers, cleft lip and cleft palate and hydrocephalus.

Dr Düll says the cases of hydrocephalus have gone up from 50 in 2011 to slightly above 90 in 2014.

What hydrocephalus is

Hydrocephalus is an abnormal condition in which cerebrospinal fluid collects in the ventricles of the brain; in infants it can cause abnormally rapid growth of the head and bulging fontanelles and a small face; in adults the symptoms are primarily neurological.

"It is a serious impairment affecting between one and three infants per 1,000 live births and has a prevalence of 4 per cent in Rwanda. It is a life-threatening condition to the quality of life resulting in severe disabilities; self-care, mobility and comorbidity, physical and mental retardation among others,” Dr Düll says.

She adds that the exact cause is unknown but a pregnant woman’s lifestyle may cause the disease because in the first trimester, a pregnant woman is supposed to eat food rich in Iron but if she doesn’t get the right body nutrients, the child may be affected.

The treatment of hydrocephalus has helped many children have a second chance at a normal life and parents are happy because after trying many big hospitals in Kigali, their solution came from a place traditionally known for rice production.

Cynthia Kayitesi, a resident of Kigali, is one such parent who is now relieved that her daughter looks normal.

"My daughter Briella developed this condition and I went to all hospitals in Kigali but nothing changed. I was later referred to Gikonko Health Centre by CHUK. I don’t think any hospital is equipped to cure this condition because I literally went to all hospitals but it was here that she was treated after I had lost hope. She is now fine and plays normally,” she says.

Treatment of hydrocephalus is quite expensive, which explains why most hospitals send patients to Gikonko Health Centre.

Low cost treatment

Most parents we found at the hospital are low-income earners because with a bill of Rwf2 million, using Mutuelle de Sante, they part with Rwf5,000. Its treatment consists of a small ‘drip’ sized wire that costs $1000.

"We are aware that most people can’t afford the exorbitant medical bills so we have partnerships with the manufacturers whereby they donate the wire and we also distribute them for free. With Mutuelle de Sante, the cost can range from Rwf2,500 to Rwf5,000 depending on the length of hospitalisation,” Dr Düll says.

All humans have cerebrospinal fluid which helps maintain the brain. For a normal adult, between 150 and 300 mililitres of the fluid are generated per day; the fluids from the brain go through the spinal cord and then get distributed to other body parts, Dr Düll says.

For those who have had patients with hydrocephalus, the fluids are there right from birth which affects the child’s sight, feeling weak and painful mobility.

"Every pregnant woman should constantly seek medical care during pregnancy so that they closely follow up on the health of the unborn baby because the condition can be detected while a woman is still pregnant but also, if the child develops such symptoms after birth, parents should seek immediate medical attention,” she added.

The medical care given to Hydrocephalus patients is a ray of hope for parents and their children. It further shows government’s efforts to improve the health system and also put in place long-term solutions for people with more complicated and complex ailments which would have otherwise required people to travel abroad.

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ABOUT THE CONDITION

Hydrocephalus is the buildup of too much cerebrospinal fluid in the brain. Normally, the fluid cushions the brain. When you have too much, though, it puts harmful pressure on your brain.

Hydrocephalus can be congenital, or present at birth. Causes include genetic problems and problems with how the fetus develops. An unusually large head is the main sign of congenital hydrocephalus. It can also happen after birth. This is called acquired hydrocephalus. It can occur at any age. Causes can include head injuries, strokes, infections, tumours, and bleeding in the brain.

Symptoms include headache, vomiting and nausea, blurry vision, balance problem, bladder control problems and thinking and memory problems.

Hydrocephalus can permanently damage the brain, causing problems with physical and mental development. If untreated, it is usually fatal. With treatment, many people lead normal lives with few limitations. Treatment usually involves surgery to insert a shunt, which is a flexible but sturdy plastic tube that moves the cerebrospinal fluid to another area of the body where it can be absorbed.

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