Frequently Asked Questions
What are NEURAL TUBE DEFECTS (NTDs)?
Spina bifida and hydrocephalus are neural tube defects (NTDs), which are birth defects that affect a baby’s spine, spinal cord, or brain.
Normally, a fetus’ neural tube develops into their brain, spinal cord, and spinal column, but if a mother does not have sufficient folic acid in her diet during pregnancy the neural tube does not fully form or close completely.
Spina bifida, “open back,” occurs when the spine has failed to close properly during the first month of pregnancy. Surgery is needed to close the defect immediately after birth to prevent infection and preserve the existing function in the spinal nerves. Approximately 90% of babies born with spina bifida are also impacted by hydrocephalus, “water on the brain.”
Babies born with hydrocephalus suffer a fluid build up in their brain, which causes an enlarged head and, if untreated, will cause brain damage and death. Treatment of hydrocephalus consists of implanting a shunt to drain the excess fluid. When treated in a timely fashion, the overwhelming majority of these babies can go on to lead healthy lives.
What causes hydrocephalus and spina bifida?
The main cause of NTDs is the lack of folic acid in the mother’s diet. In its natural form, folate, a vitamin, is found in leafy vegetables and fruits. Many countries also add folic acid to the flour as a way to provide sufficient levels of folic acid to its entire population.
In Ethiopia, a typical diet consists mainly of meat, beans, potatoes, other non-green vegetables and a local grain called teff. Most women do not have enough folic acid in their diet and do not have access to folic acid supplementation before and during pregnancy.
Another common cause of hydrocephalus is meningitis. It is then called post-infectious hydrocephalus.
What is ReachAnother’s approach to solving this problem?
The cause for neural tube defects is simple, but the solution is complex. ReachAnother focuses on a 3-pronged approach: Prevention, Treatment and Aftercare.
We are currently working with a coalition of international partners to offer a solution for country-wide food fortification through a fortified salt project. We establish and work with Centers of Excellence in Pediatric Neurosurgery to build the knowledge and capacity to treat and care for babies affected by NTDs.
NTDs are by and large preventable and treatable and we are committed to helping Ethiopia build the knowledge, infrastructure and prevention activism so that all babies can live healthy and happy lives.
Why spend time, money and resources in Ethiopia when there is so much need here at home?
At ReachAnother Foundation, we believe that the world is a big village, that we are all connected and that all lives have equal value. We believe that small targeted investments in knowledge, time and money can produce big results and change the world. Americans and Europeans have always been very generous with charitable donations, yet there is only a small percentage of those donated funds that supports goals abroad. For $150, ReachAnother can support one life-saving surgery in Ethiopia, while the same surgery would cost close to $30,000 in the United States. Our support in Ethiopia has a multiplier effect that enable us to have a greater impact for babies born with spina bifida and hydrocephalus.
Will that problem ever go away?
Not entirely, but we are optimistic. We know that 70 to 80% of NTDs can be prevented with sufficient levels of folic acid. In Ethiopia, this means that tens of thousands of babies could be born and live without the burden of life threatening birth defects.
However, there is no easy way to reach all women of childbearing age and only food fortification through a staple food source can achieve this. While flour is typically used as a fortification vehicle in many countries, it is not a viable option in Ethiopia because families do not typically eat wheat products. Instead, they grow their own teff, a cereal used to make injera (an Ethiopian bread).
Therefore, ReachAnother is focused on fortification of salt, an innovative approach to solve the problem
Read our story and learn how it all started.
In 2009, when our founder, Dr. Marinus Koning, first went to Ethiopia, the neurosurgery program was in its infancy but provided an incredible opportunity to help babies born with NTDs. A booming economy and population, a newly formed neurosurgical society and 44,000+ pregnancies affected by NTDs each year created a unique chance to make an impact. Dr. Koning’s skills fit perfectly with the need. When his Ethiopian friends asked him to help and he knew he had to help.
Watch this video to understand the details of spina bifida
“Meeting the Ethiopian children and their families that have been impacted by spinal tube defects was an intensely emotional and also fulfilling experience. Helpers and healing hands have made a huge difference there.”