ReachAnother Foundation

ReachAnother makes a difference through prevention, treatment and aftercare.

1.Prevention through a national food fortification program
ReachAnother is part of an international coalition (Nutrition International, Food Fortification Initiative, Spina Bifida Institute of Rollins School of Public Health in Atlanta , and the International Federation for Spina Bifida and Hydrocephalus), which supports the goal of food fortification of salt with folic acid to reach all women of childbearing age in Ethiopia. This solution was presented to the Ethiopian Ministry of Health in April 2019 during an expert conference held in conjunction with the Ministry of Health and the Society of Ethiopian Neurological Surgery Professionals. The coalition proposed to fortify the only staple used by all people in Ethiopia, salt. The proposal was accepted in May 2019 by the Ministry. ReachAnother supports the needed preliminary studies of the salt supply chain, the creation of doubly fortified salt, and its acceptance by Ethiopians. These studies are in progress and will be followed by an iodized salt with folic acid feeding study. After the completion of the feeding study, the national food fortification program will begin.

2. Building neurosurgical capacity and expanding care for SBH children
Since 2009, RAF has specialized in building neurosurgical capacity by training neurosurgeons and providing surgery for children with SBH. In 2009, there was only one neurosurgeon at Addis Ababa University. Today, 40 neurosurgeons have graduated and over 6,500 children with neural tube defects have received surgery. As these neurosurgeons spread to other universities in Ethiopia, ReachAnother helps them begin their practices by donating equipment and supplies. ReachAnother has selected six hospitals to become specialized pediatric neurosurgery, known as Centers of Excellence (CoE). The goal for each CoE is to provide 1,000 surgeries for children affected by NTDs each year by 2025. The current capacity of all six CoEs is 2,500 surgeries per year.

3. Aftercare and high-risk prevention
Care after surgery is scattered and scarce in Ethiopia. RAF addresses this issue by building specialized SBH teams at each CoE, where coordinated, cost-effective, multi-specialty care is provided by specially trained professionals. SBH-focused teams seamlessly work together to ensure patients have their needs met in a single visit. ReachAnother is coordinating communication lines with the patients’ primary care village health extension workers to keep track of and provide care for any complication that may arise. As part of the treatment, ReachAnother will strive to treat all mothers with folic acid, which reduces their risk of future SBH pregnancies. ReachAnother aims to provide necessary follow up treatment to children impacted by spina bifida and hydrocephalus, and make every attempt to give them a chance to live happy, healthy, and productive lives.

Prevention: ReachAnother works with coalition partners (Nutrition International, Food Fortification Initiative, Spina Bifida Institute of Rollins School of Public Health in Atlanta , and the International Federation for Spina Bifida and Hydrocephalus) to raise money and implement the national food fortification program. ReachAnother is funding the initial studies, which have already started. Funding for the feeding studies is expected by the end of 2020. ReachAnother will work with Ethiopian ministries to pave the way for legislation, standards and implementation procedures to ensure effective implementation. A completed feeding study will be a major breakthrough, not just for Ethiopia, but also on a global scale. Fortification experts predict that salt is a vehicle that can reach 68% of the world population and prevent over 300,000 spina bifida related deaths annually.

Building neurosurgical capacity and provide surgery for SBH children: Moving forward, 10 new neurosurgeons will graduate per year, which will increase surgical capacity by 1,000 operations annually. ReachAnother will work with international neurosurgery organizations and funding agencies to continue to build expertise in pediatric neurosurgery in Ethiopia. ReachAnother expects to increase capacity to 5,000 operations per year by 2025 and that the CoE will mature to meet the growing needs of pediatric neurosurgery by that time.

Aftercare and high risk prevention: Aftercare means the care that patients receive after surgery and discharge from the hospital. To provide this care, a very specialized team of care givers is needed. At the request of the Ministry of Health, ReachAnother developed a training curriculum for Pediatric Neurosurgery Nursing Certification that was implemented in fall 2020. Aftercare starts with teaching mothers the knowledge and skills needed to provide optimal care. This currently is a huge problem in Ethiopia, where phone communications and internet frequently are interrupted and unreliable.

ReachAnother's position in the healthcare market is that of being a catalyst for social change. RAF's primary task is to network, build partnerships, encourage the development of new solutions and possibilities, and generate interest and support for continuous quality improvements of pediatric neurosurgery care in Ethiopia.

ReachAnother has successfully helped train all of Ethiopia's neurosurgeons in pediatric neurosurgery. There are now three training programs, which will steadily increase the supply of neurosurgeons to meet the growing need in Ethiopia.

ReachAnother will continue to build the capacity and specialization of the CoEs. ReachAnother has provided medical equipment (valued at over $1 million to date) and expertise (over 150 expert visiting consultants) to Ethiopia. These experts have traveled from the US, Canada, the Netherlands, Great Britain, and New Zealand to support ReachAnother's work. ReachAnother is currently working with established US and Dutch children's hospitals to create learning opportunities and bring new procedures to Ethiopia. Additionally, ReachAnother has provided a fellowship for endoscopic surgery for hydrocephalus and expects to provide two additional fellowships in 2020. This surgical fellowship will train the surgeons and provide them with the needed equipment to support neurosurgery at their prospective medical center.

ReachAnother works closely with its sister organization, ReachAnother Nederland, as well as with CURE Neuro and Child Help to accomplish its treatment goals. ReachAnother has helped found and fund the HOPE SBH parent organization in Ethiopia, while also building excellent relationships with Ethiopian neurosurgeons, the Ministry of Health, and local universities. RAF has attracted interest from international organizations, such as Rotary International, the Phillips Foundation, and the DSM chemical company. RAF works closely with Light for the World and the University of Nijmegen, Netherlands, to develop physical therapy and rehabilitation possibilities for Ethiopia. Additionally, RAF works closely with Rotary Clubs in Ethiopia and has strengthened its partnership with the Center for Disease Control (CDC).

ReachAnother has become an active participant in the Global Neurosurgery community. ReachAnother is currently working with Harvard University's Program for Global Surgery and Social Change and collaborating on the development of a World Health Organization (WHO) resolution to prioritize worldwide food fortification with folic acid. These partnerships have expanded ReachAnother's influence, reach, and fundraising capacity.

In 2009, there was only one neurosurgeon in Ethiopia and no possibility of treatment or care for children born with spina bifida and hydrocephalus--nearly all these children died as a result. ReachAnother has played a central role in changing the landscape of care. RAF's partnership with the neurosurgeons has grown and strengthened over the years. Thousands of children have received surgery and many are living healthy and happy lives because of ReachAnother’s dedication to care. ReachAnother's relationships with local hospitals, Ministry of Health, universities, individual physicians, and especially Ethiopia's neurosurgeons, are expanding.

The key to this progress is ReachAnother's ability to envision and create workable solutions, build capacity from the ground up, strategic collaboration with dozens of organizations and NGO's in the field, and engage a wide network of individuals, hospitals, Rotary Clubs, organizations, and institutions. ReachAnother has delivered critical instruments and technologies to Ethiopia and continued to build international partnerships to create capacity building opportunities within Ethiopian communities.

ReachAnother is establishing competent programs for aftercare that focus on high-risk prevention for mothers.

Success is can be defined as country-wide implementation of the folic acid food fortification program in Ethiopia, which will lead to a complete disappearance of folic acid sensitive spina bifida. Food fortification coupled with the continued improvement of care at ReachAnother's six CoEs, will provide more opportunities for complete, holistic care for the few children born with non-folic acid spina bifida, so that they can live healthy and productive lives. We expect this to happen before 2030.

We will work with our partners to expand food fortification programs worldwide to ultimately see the few remaining persons with "non folate sensitive" spina bifida as having an 'ordinary' medical condition that is accepted and treated with compassion and excellent, inclusive care that enables them to have full and productive lives. They can be ordinary scientists, social workers and even world class Paralympic athletes.