Author Archives: Children's Surgery International

“Wisdom at the source of the Blue Nile” is the official slogan of Bahir Dar University.

Our CSI team, along with our Ethiopian surgical partners, were recognized by the president of Bahir Dar University, Dr. Baylie, and his leadership team at a farewell celebration tonight. It was a great way to end an exciting, productive and collaborative surgical week in Ethiopia!

Our team performed 33 life-changing surgeries on children from the region.

Hands-on training for ENT surgeries and post-operative nursing took place each day. Four Ethiopian surgeons have new skills, confidence and wisdom to serve the needs of their local community.

CSI volunteer Dr. Woubeshet Ayenew led six cardiovascular lectures for Ethiopian medical residents and initiated a diagnostic technique for endoscopy and cardiac imagery that the local physicians had the equipment for, but not the training.

More than 60 patients were evaluated for various medical concerns in our ad-hoc outpatient clinic.

Thirty-one children are on a waiting list for screening at our upcoming trip in April 2018. We performed initial surgeries on some of these children this week, and they will require an additional procedure at that time.

CSI’s goal is to make a lasting impact in the communities we serve.

• Performing a transformational surgery affects one child’s life, their families’ life, and thus their community.
• Refining and teaching new pediatric skills to local surgeons, nurses, and anesthesiologists affects children, families and communities for years to come.

Link to photos here!

Thank you to our dedicated team!

Dr. Woubeshet Ayenew
Haley Bye, R.N.
Mary Bye, R.N.
John Chauss C.R.N.A.
Dr. Siva Chinnadurai
John Erlandson C.R.N.A.
Cindy Halverson
Sarah Hartnett, R.N
Evan Keil
Tammy Lester, R.N.
Dr. Saira Mitha
Nolan Morice
Jodi Pelkey, R.N.
Dr. Jon Robitschek
Megan Sparks
Dr. Dave Tetzlaff
Dr. Zipporah Wagathuya
Norie Wilson, R.N.

A day in the OR.
Evan Keil, CSI Ethiopia team member

Transitioning from a nation of abundance to Ethiopia has not been easy. We are performing around 35 surgeries over 4.5 days. To accomplish this, many things are needed. At the forefront – collaboration and fluidity. These two stand out the most when walking around our surgical ward. Working through challenges with oxygen tanks, sterilization techniques, anesthesia, electrocauteries, recovery room beds and more, our dedicated team has found a way.

Each surgical day, the process for the patients begins in the pre-op room. Once cleared here by one of our pediatricians and our nursing staff, the patient is brought into the OR. From here, our OR nurses and anesthesia staff take over. They ensure that the patient’s vitals are stable and do the final preparations for surgery. Enter the surgeons: Dr. Siva Chinnadurai and Dr. John Robitschek (with their first names conveniently labeled with tape on their foreheads) begin their process. With headlamps glowing, gloves on, 15 blade in hand and a sterile field, the first cut is made. With decades of experience between them, these surgeries could be done fairly quickly. However, speedy procedures is not the focus for CSI.

At the core of our mission statement is promoting “self-sufficiency through professional training and support.” As mentioned in previous posts, four Ethiopian doctors (Drs. Wudie, Teshome, Birara and Sintayehu) are receiving expert training this week with the hope that they become confident enough to perform ENT surgeries that come through their doors. Each of these doctors come from different clinical backgrounds and thus require different training – something that our two surgeons have been addressing with each new day. They have each been making a lot of progress, and we still have two full days of surgery to go.

Check out all our trip photos here!

A special case for us today was 9-year-old Asnake. His surgery was a huge success that will have a dramatic impact on his life trajectory! Asnake’s large, complete cleft lip was a source of much shame for him, and he has been bullied and teased mercilessly. He constantly wore a scarf around his head and neck that he would hold over his mouth. Until tonight.   

CSI surgeon Dr. Chinnadurai and Ethiopian surgeon Dr. Sintayahu were able to repair Asnake’s nose and lip. He looked like a completely different person after surgery. His father tells us that as soon as they get home, which is a 90-minute walk to catch a 4-hour bus ride, Asnake will begin school because there will be no more shame. He now has a bright and exciting future living a full life with confidence.   

Meanwhile, exciting collaboration and training is happening in the cardiology area as well. CSI team member Dr. Woubeshet Ayenew gave another lecture to the cardiology residents. Today’s topic was focused on EKG Manifestations of Acute Coronary Syndromes (ACS). The students were engaged and had many questions.  With Dr. Woubeshet’s guidance, tomorrow they plan to see more patients and perform a TEE (transesophageal echocardiogram) for the first time ever in Bahir Dar. The hospital has the tools to do this, they just need the training, which Dr. Woubeshet is happy to provide. Lasting impact indeed!

See all our trip photos here.

Smooth Sailing on Surgery Day 2, and Happy Birthday to Trsit!

Meet Trsit – today is her first birthday, and today she gets to go home with her loving parents after having cleft lip repair yesterday. Needless to say, they were eager to get home. Just before their departure we were able to celebrate with cake and a wonderful rendition of traditional U.S. “Happy Birthday” by CSI nurses Haley Bye, Sarah Hartnett, Norie Wilson and Mary Bye along with pediatrician Dr. Saira Mitha. We are all very close and cozy in the same small hospital ward – patients, parents, CSI and local staff –  so everyone shared in the celebration. The kind staff at our hotel made the cake and even delivered it to the hospital.

Trsit’s family learned about CSI from an ad in the local paper. They arrived on our first day of surgery. Trsit was evaluated and promptly added as the final patient on our Day 1 surgery schedule. No matter where you live, two of the hardest things on surgery day are waiting and not being able to feed your baby. At one point, Trsit’s family was ready to give up and come back the next day. We encouraged them to stay, as they had come this far and were so close. “If it were my daughter, I would stay,” said a CSI team member.

So they waited. When Trsit wasn’t sleeping, cozily wrapped on her aunt’s back, her loving father comforted and entertained her. CSI team members played peek-a-boo and showed pictures to Trsit and her family. Lucky for us, Trsit’s father’s English is excellent; he even helped by interpreting for other families. We talked a lot as we waited. “I have learned many things today about how you serve the patient,” he said. “There is so much need in my country. Thank you for showing our doctors this.”

Along with singing and cake, there were hugs, kisses and tears of joy as we bid Trsit and her family farewell this morning. On to living life – eating, playing, talking and laughing and growing in her community.

Today, Drs. Birara and Wudie performed significant parts of surgeries alongside the CSI team. They got more experience with cleft lip and palate repair as well as the opportunity to remove a complex neck mass on 6-year-old Temesgen. Tonight, he and the other children are in the packed recovery ward room and hallway, resting with family and doing well. It’s 8 p.m., and finally time to head to the hotel for dinner and some sleep.

Enjoy our trip photos here.

Surgery day one complete!

We are off and running. It took a little extra time to get underway this morning – part of the process of getting organized. We arrived at the hospital early to find a courtyard full of families waiting for us. Some were those scheduled for today. Others were waiting for tests or confirmation about surgery. And still more were coming for the first time. Fifteen patients asked to be seen for the first time today after hearing that we were in town. They had a variety of inquiries – some things as simple as clearing wax from ears. We did screen five new patients, who have been added to the surgery schedule.

Today we performed six life-changing surgeries. Ethiopian Drs. Wudie, Teshome, Birara and Sintayehu were in the OR with our teams the entire day. Each doctor had a chance to work alongside CSI surgeons Dr. Chinnadurai or Dr. Robitschek. It was exciting, and they were clearly proud to complete some of the surgeries independently. By the end of the day, Dr. Birara was even coming from surgery to update the families – a practice that is not as common in Ethiopia.

While the children are in surgery, the families wait in the same outdoor corridor where we do our check-in and screening. The families are so worried and scared. Imagine what it must have been like to be the first mom who gave her child to the Americans for surgery Monday morning? That was the mother of 7-month-old Bizhayu. When she finally came out of recovery a few hours later, mom almost did not recognize her with her repaired cleft lip! Bizhayu was getting post-op care from CSI nurse Hayley Bye and the Ethiopian nurse interns, and mom was so relieved. “Biz” was breastfeeding and eating in no time. We expect her to go home tomorrow!

Ten-month-old Amanual was born with a bilateral cleft lip; it was repaired today. Mom and dad were so anxious and worried for him. We reassured them that the surgery often takes time, especially because of the teaching that is taking place in the OR, but that he was doing great! I’m not sure how much our reassurance helped, until mom had him in her arms. It’s scary to see the swelling at the site of the repair, and Amanual was (understandably) still very sleepy. It didn’t take long before he had porridge all over his face and was eating well! His mom was relieved.

Three-year-old Zenaw was so patient while waiting all morning for surgery. She is a beautiful girl with a large cleft palate. When Dr. Robitschek, along with Dr. Birara and Dr. Wudie, started the surgery, they discovered the cleft palate repair was more complex. With some extra time and the great skills of our collaborative OR team, she came through like a champ. Needless to say, she was not quite as bubbly immediately after surgery. She had some juice and fluids and was resting comfortably when we left the hospital at 8:30 p.m.

With six families in recovery, Dr. Saira Mitha and Haley Bye, R.N., did evening rounds with the local nurses, with lots of support from our friend and key CSI team member Dr. Ayenew. The surgeons, along with CSI anesthesia lead Dr. Gathuya and medical records volunteer Cindy Halverson, made revisions and additions to the full Tuesday surgery schedule and it is complete. We are ready to head back to the hotel for a late dinner and some rest.

We can’t wait for day two to see our patients and families from today and to help create lasting change in the OR for seven more children and this community.

View photos from the trip here. 

Screening day is complete!

Patient and loving families – flexible and creative volunteers – dedicated and enthusiastic staff.

This is the recipe that made today successful. After working through some space changes, our screening team got right to work. Thirty-six patients were evaluated for surgery, and we are expecting several more later in the week. Included in the group were babies, toddlers, adolescents, young adults and even some older adults. We saw a 27-day-old child with a cleft lip. Our surgeons, Dr. Siva Chinnadurai and Dr. Jon Robitschek are hopeful that in 6-8 weeks, when the baby is old enough, she can get this surgery from the local doctors – especially after the practice they will get this week.

While the medical records crew, floor nurses, pediatricians and surgeons were screening, the OR team was busy unpacking and preparing the operating room. The nurses and scrub technicians talked and readied the tools needed for surgery. The anesthesia team members also connected with their Ethiopians colleagues. CRNA John Erlandson shared some books and educational materials he brought from home. Our Ethiopian partners were excited and grateful.

In all, we screened 36 patients and plan to do 26 surgeries. CSI surgeons Dr. Chinnadurai and Dr. Robitschek worked alongside their three Ethiopian colleagues to prioritize cases, order the necessary labs for further screening, and set the schedule of the week. The plan is to focus on cleft lip and palate surgeries early, so by weeks’ end each Ethiopian doctor will have completed at least one surgery independently with consultation available as needed.

There is a little room in the schedule to accommodate some of the families we know are on their way. In addition, the team will get to help some patients with complex masses and other facial deformities that are keeping them from living their lives to the fullest. More on those patients later in the week.

After the long day of preparation, we enjoyed some time at the busy Bahir Dar market, where you can find spices, textiles, artwork and much, much more! Tomorrow we will have an opportunity to explore the community a bit, and have a Nile River experience.

It is a joy and privilege to work with this amazing team of dedicated volunteers – totally committed to collaboration and engaging our local colleagues in all aspects of patient-centered care. They are tremendous advocates and outstanding problem-solvers! The only thing more rewarding is to see the beautiful faces of these children and families, knowing we will be able to help them this week. The work we do to help our local colleagues build their skills means that the families who come next week, and all the weeks after we leave, will also be able to get the life-changing help they need.

See photos from the day here.

Our lengthy travels are complete, and we have arrived in Bahir Dar. Our partners from Bahir Dar University and the Felege Hiwot Hospital graciously met us at the airport. After they transported the team to the hotel we had a great lunch, where we met and got to know three of the ENT doctors that we will be working with this week.

Dr. Wudie and her team have prescreened 30 patients, and we expect more to arrive tomorrow on our official screening day. Our surgical focus this week will be on cleft lip and palate surgery and training. But when you get a bunch of surgeons together, they get very excited about the possibility of other cases as well, along with potential learning opportunities!

After our lunch, we had the great privilege to observe the Ethiopian Coffee Ceremony, or at least a shortened version of the ritual, which typically lasts more than two hours. We all had a chance to enjoy the delicious coffee, served with popcorn at the conclusion of the ritual.

Lastly, we held a short team meeting to strategize and plan for screening day on Saturday. We are very excited to get to work tomorrow!

View our travel photos here.

Time to Go Home!

After our third and final day of surgery, it’s time to do final rounds, give care instructions to parents, exchange hugs and say farewell to Hermosillo for another year.

Most patients spend just one night in the hospital, and after being examined by their surgeon and pediatrician, they are sent home with detailed care instructions and necessary medications. They are also given gifts of food, diapers and toys from the Hospital CIMA volunteers.

Most importantly, a detailed plan is made for follow-up and possible subsequent surgeries. This is what makes this trip so unique: When CSI returns to Hermosillo annually, we can follow up on past patients and perform further surgeries as necessary. It’s THIS aspect that can really make the difference for a child to grow up with a normal appearance, normal speech and full self-esteem.

Dr. Jon Grischkan, our surgical team lead this year, brought up Ana Karen – introduced to you in our first blog post. “This young woman, now 19, has had her complete cleft care treatment: cleft lip repair, cleft palate repair, speech surgery, alveolar bone graft and rhinoplasty. She’s beautiful, amazing and a great representation of the work that is possible when strong organizations come together! Kudos to Children’s Surgery International, the CIMA Hospital volunteers and St. Andrew’s Children’s Clinic.”

CSI depends on support from private donors in order to continue offering this continuum of care. Thank you so much for your support! With your gifts, along with the moral support you offer CSI team members, YOU are changing children’s lives, one smile at a time.

Click to make a donation today.

Click for photos from the Hermosillo surgical trip.

Day Two in Hermosillo brought us 20 more beautiful children ready for surgery: Babies and toddlers needing cleft lip repair, several children in need of cleft palate repair, and four older kids who will undergo surgery to replace missing bone in their palate, using bone taken from the hip.

One of the many special patients is Blanca. Since birth, she has already undergone several surgeries to repair cleft lip, cleft palate and more. This year Blanca, now 14, is ready for rhinoplasty, a surgery that will correct the defects to her nose and sinuses. We all know about the dramatic change in appearance that comes from surgery to repair a cleft lip, but the additional surgeries are often critical to the child’s development, speech and self-esteem. A rhinoplasty is often the final surgery a cleft patient will need.

In many areas of the world resources may be severely limited for more complex surgical procedures, making this type of ongoing, and often more complicated, care impossible. This is where CSI steps in, partnering with St. Andrew’s Children’s Clinic and Hospital CIMA Hermosillo, providing free surgical and medical care to children in great need.

In December, Blanca will have her Quinceañera, the Hispanic tradition of celebrating a young girl’s coming of age on her 15th birthday. It’s an incredibly special time for a girl, her family and friends. There is a special church service, receptions and parties, all to honor and celebrate this important turning point in a girl’s life.

Dr. Michael Fritz performed the successful rhinoplasty for Blanca, and the day after surgery she and her mother were all smiles. She is now at another turning point: the likely completion of all necessary surgeries, ready to get on with her life. We are so glad to have been a part of this process for this sweet girl. Feliz Quinceañera, Blanca!

View photos from the CSI surgical trip here.

Day One of CSI Hermosillo 2017 trip is in the books, with 20 beautiful children receiving cleft lip and palate surgeries. There are so many stories of love — along with fear, worry, sadness and ultimately hope. We are especially moved by the story of one 4-year old boy, Brayan.

Brayan and his family are members of the Yaqui tribe of indigenous people in Sonora. The Yaqui are very private. They speak their own language, have their own cultural traditions and live in their own communities apart from most of Mexican society. But when Brayan’s aunt, who is the only member of his family who speaks Spanish, by chance heard about the “Rostros Felices” mission, she took the unusual step of reaching out for help.

Brayan was born with both a cleft lip and palate. Because of his appearance and speech patterns, he has been bullied mercilessly by other children and has suffered emotionally and mentally as a result. Brayan arrived at the hospital after traveling with his mother and aunt by bus from their home nearly five hours away. You could see both hope and wary distrust in the women’s faces as they approached us to register him at the hospital. After waiting all day, Brayan was approved for repair of both his cleft lip and palate.

On Sunday, Dr. Brianne Roby performed the surgery. She says he came through it like a champ, and everything went very well. After the procedure, and just one night in the hospital, Brayan has a new appearance. He smiled shyly at us from behind his mother’s skirt before beginning the journey back home this afternoon.

The volunteers from CIMA tell us that they will continue to work with Brayan and his family to assist him with further developmental needs. We are so grateful for the chance to be part of a team of people helping this young Yaqui boy look forward to a normal childhood. It’s days like this that remind us: We really are making a lasting impact.

The first two photos below show Brayan before and after his surgery. Click here for more photos from the day.

Day Two is here, with 20 more surgeries coming up!