Category Archives: Ethiopia


Trip reflections from Ellen Reynolds, CRNP

As I sit at the gate waiting to board my last plane home after a week in Ethiopia with CSI, my mind is starting to return to thinking at a less intense and focused pace. The details about people met and goals accomplished are becoming more rich and clear.  This happens to me every time I work on a medical mission trip. In the moment, success is often measured by tasks completed, mistakes averted and “thank yous” received. For me, the bigger picture often takes time to reveal itself.  

When Dr. Jesse Hennum and I gave a talk about cleft lip and palate to the nurses in Bahir Dar this week, we discussed the psychosocial implications to a family of having a child with a significant facial defect. There were a lot of nods, and after the talk one of the nurses continued to voice his experiences with families who had been ostracized by their village for having such a child. For those of us who are parents, the thought of one of our children being shunned by society because of how they look is incredibly painful. We all know the impact of judgment and prejudice, along with the limitations to self concept they can produce in a person’s mind – as well as opportunities often missed in society. 

In our one- or two- day snapshots of the families we worked with, we saw loving, caring and compassionate parents. We saw kids who were curious, charming and engaging with people and the world. We saw Ethiopian doctors who were smart, talented and willing to go the extra mile to help these kids achieve their best selves. This week, CSI was the needed resource that helped put the pieces together to make a happy, successful life possible for these children. A life where, hopefully, the kids will be judged on their personalities, effort, kindness and integrity rather than the shapes of their faces. CSI removes barriers for children in ways that last for years to come, both through individual surgeries and the education of medical staff that can keep them going. Honestly, this is REAL success! 

  

Education for lasting change in Ethiopia

We are so excited that our CSI surgical teams are back to sharing hands-on education and training with our local partners – this time in Ethiopia! Local ENT surgeon, Dr. Kassaw, said today: “Now I know how to do this for the rest of my life. No one takes this much time to teach us”. After a full day of hands-on training with CSI, Dr. Kassaw completed his first cleft lip surgery start to finish. Think of all the children he will serve in the future thanks to collaboration with CSI volunteers.

Arriving in Bahir Dar, Ethiopia

It takes about a day and a half to get from the U.S. to Bahir Dar, Ethiopia. Our small volunteer group is made up of surgical mission veterans – all quite familiar with the long flights, immigration lines, long layovers and other challenges of international travel. Something felt a little different this time. One member of our team got held up by a delay in getting a visa granted. Our luggage was thoroughly inspected by customs (a nearly 2-hour wait). Team members were randomly held back at security checkpoints to double check passports and identity. 

So what’s happening? Two years of a pandemic plus an ongoing security situation in Ethiopia. Even though the areas of conflict are far from Bahir Dar and Addis Ababa, we are still experiencing the effects. Thanks to our host team led by Habtamu and Taitu Tour and Travel, we are kept safe and moved across the country as efficiently as possible. 

We had a few hours free Sunday morning for a short tour around the city of Bahir Dar. We visited a market and a hilltop with great views of the city, the immense Lake Tana, and the source of the Blue Nile. We were frequently greeted with children’s smiles, many jubilantly shouting “Farengi! Farengi!” (“Foreigners!”)

The afternoon was spent at the hospital, unpacking and beginning preparations for surgeries starting tomorrow morning. Melesse Gebeyehu, M.D., gave us a tour of the hospital and the surrounding campus, which is evolving into a state-of-the-art medical university. A basic science research building is being completed, and we also saw lecture halls, a library and housing for students. 

Dr. Melesse proudly shared that they now have a full otolaryngology training program. He shared, “the knowledge and training that you at CSI bring to us, will soon be passed on to our students and residents.”

Jesse Hennum, M.D. Pediatrician 

To see more photos, visit our Flickr album.”

Arriving home with full hearts

As we wait at the airport for our departure from Ethiopia, we reflect on the full and successful week of surgeries. Our team was 22 members strong. The numbers:

  • 118 children evaluated on screening day

  • 50 additional children came throughout the week and were put on our screening list for March 2020

  • 53 surgeries performed – 13 cleft palate repairs, 25 cleft lip repairs, 15 urology cases

  • 2 nursing lectures

  • Daily surgical teaching and collaboration

  • 2 cautery machines and box-loads of medical supplies donated

Our bodies are exhausted, our hearts are full – and we are inspired. Thank you to all of our supporters who make trips like this possible. We sign off with trip reflections from some of our team members.

 

John Chauss, CRNA:
There are not enough words to describe how beautiful, inspiring and heartbreaking this mission has been. If we had the opportunity to use our gifts to give to this wonderful country every single day for the rest of my life, I would say “yes” unconditionally. 

Theresa Philbin, nurse:
Final day and this child is the perfect example of why We do what we do. With permission from him and his father….

Yihune is now 15 but was 14 when I met them last March. His complex urological problem meant that he had never been “dry.” He was incontinent and large diapers are cost prohibitive as well as difficult to find. He had stopped going to school but was taught at home by his father because he loved learning. In March he had a large surgery on his bladder, and I took care of him for 3 days, said goodbye and hoped.

November screening day Yihune walked in smiling, in a pair of jeans and told me about being in school. He had his second and final surgery. He is one of the many many reasons why CSI does what it does.

Megan Sparks, CSI Executive Director:
Grateful families, outstanding collaboration and so much sharing of information and experiences. We all are learning and growing. Today I was reminded just how kind, patient, loving and open Ethiopians are.

What a day with so many emotions. Overwhelming need – loving families – powerful partnerships – incredible volunteers. We have a full surgery schedule ahead of us, utilizing all the dedication and skill of all our CSI team and Ethiopian colleagues.

Malane Thelen, CRNA:
The last several days have brought such love and fulfillment. Ethiopia and its people are beautiful. To have worked beside such driven, talented and caring professionals who make such a life-changing difference for children has been an incredible honor. Thank you, Children’s Surgery International for the second opportunity of a lifetime.

Zoe Reker, RN:
Today’s theme: Community. A room with eleven beds and many family members/siblings means not a lot of alone time for anybody. Today, families made the most of this by sharing meals, toys, attention to the little ones, communication and even helping with post operative cares. We all gathered around a map … and learned where everyone was from. The natural cameraderie among strangers is heartwarming.

Jessica Driscoll, OR nurse:
I can’t thank Children’s Surgery International and their donors enough for the opportunities I’ve been given to make such a difference in these children’s lives.

Nshimiyimana Emile, CSI volunteer CRNA from Rwanda:
I had three objectives when I decided to join the CSI team:
1. Give my best to help people in need.
2. Learn from your professionals and gain experience in pediatric anesthesia.
3. Travel to Ethiopia.
I have done all three. The people on this mission were motivated, enthusiastic and hard workers. They are all from different places but the came together and do their jobs for the patients.  


Judy Mutuku, OR nurse volunteer from Kenya:
This was my first trip with CSI. I learned so much from the Ethiopia staff and my volunteer teammates. If you ever think about doing something like this, just go ahead and do it! It’s and interesting and rewarding thing to do and a good way to give back to the community. I wondered how it was going to be with people from different places being on a team. Am I going to meet their expectations? Everyone was supportive and involved in the whole process. I never felt alone.

Linda Sedgwick, Team Clinical Leader:
I’m so grateful to be in Ethiopia with CSI! Our awesome team is providing transformational surgical care for so many precious, beautiful children!

The persistence of one strong and loving mother was incredible to witness. Two long days of travel – pregnant and carrying her infant – she arrived at the close of screening day only to find that the surgery schedule was entirely filled. Despite considerable deliberation, the team couldn’t find space to include little Yohannes. Tears were definitely shed. There would be a space held for him on our spring trip. Despite this recommendation mom returned, pleading to be included. Another family didn’t show up, making a space available for this sweetie and everyone went from sadness to smiles!! Mom said she was lucky – we knew it was less about luck and more about her tenacious love for Yohannes.

Welcome home CSI Ethiopia team!

Explore more photos from CSI’s Ethiopia mission on our Flickr album.

A mother’s love and resolve

By Amy Fischer
CSI volunteer and board member

A mother’s love and resolve is a powerful force. This week, I have had the honor and pleasure of witnessing this in a powerful way. 

In March, Abuzer Said and his mother traveled more than two days by bus to Bahir Dar in hopes of getting surgery for Abuzer’s cleft lip and improving his future. Unfortunately, her infant son was too young to be considered for Children’s Surgery International’s schedule, and she was told to come back for our November screening day. She did, but the arduous travel prevented her from arriving on time to be considered for surgery this week. 

Undeterred, she came to the hospital on Monday, our first day of surgery, hoping for an opening in the schedule. Again, we told her our schedule was full and that she should go home and come back in March 2020. Tuesday when we arrived, she was still at the hospital. Again, she was told to go home. Yesterday, our ENT surgeons said they would be able to add on one more surgery. We went to the lobby to see if by chance Abuzer and his mom were still waiting. They were! You can only imagine the smile on mom’s face when we were told that surgery was possible. 

This is my third trip as a non-medical CSI volunteer, and I have been fortunate to be welcomed into the OR to observe surgeries. I have always wanted to follow a patient from check-in through surgery, and I  knew this was my opportunity, because little Abuzer and his mother captured my heart. The surgery, performed by CSI volunteer surgeon Greg Kelts, was a success, and after Abuzer’s anesthesia recovery, nurses Dody Barr and Jan Gauger gave me the honor of returning Abuzer to his mother’s arms. We both had tears of joy! 

 

This morning, I went to visit Abuzer in the ward, and through an interpreter spoke to his mom. She said: “I was happy when you said he could have surgery. I never cried during his operation because I had faith in your doctors and I knew they would do a good job.” Abuzer’s father is a farmer and was unable to accompany them to the hospital because it is harvest season. He has been told that his son’s lip has been repaired, and he says thank you to the CSI team; he can’t wait to see his “new” son. 

His mom says, “We were very sad when our son was born with a problem. But now he has been born a second time. We say here that ‘we give birth again’.” When I complimented her on her strength and persistence, she said, “When a child is born with a problem, it makes you stronger. May God bless you all.”

Abuzer Said is a lucky little boy to have such a mother. 

Explore more photos from CSI’s Ethiopia mission on our Flickr album.

Education for lasting change

By Dr. Greg Kelts, ENT-Otolaryngologist

 

ENT surgery training with Dr. Greg Kelts

We are more than halfway through our surgical mission at Tibebe Ghion Specialty Hospital in Bahir Dar. Over the course of the campaign, our team has helped provide life-changing surgeries for 33 children. This is great in and of itself, however, I am most impressed with the blossoming relationship between our organization and the dedicated staff here at Tibebe Ghion.

From a surgical standpoint, Drs. Melesse and Asnake have continued to improve their robust expertise in cleft lip and palate surgery. Both have been doing cases from start to finish with guidance from our surgical team, and their results have been excellent. In addition, as word of our campaign spread, we have oral surgeons from Tibebe Ghion and an ear, nose and throat surgeon from Gondar joining us in the operating room. As a result, we have been able to train five surgeons in surgical management of cleft lip and palate.

The post-surgical wards at Tibebe Ghion have also been a fertile training ground for this campaign. In previous missions to Bahir Dar, we have provided most, if not all, of the post-operative medical care to our patients. This campaign, we have partnered with the nursing and pediatric staff to help educate and train them on the care of post-operative pediatric patients. Dr. Jesse Hennum and CSI’s pediatric volunteer nurses created a post-operative care training program for the pediatric residents and nurses at Tibebe Ghion and have incorporated these local professionals into our care team. While repairing a cleft lip is a dramatic intervention that changes the life of a child, it is education programs like these that can affect the lives of hundreds of patients after we leave.

 

While we still have work to do this week, we already are seeing the impact of these CSI missions. I expect the final days will be just as productive and exciting.

Explore more photos from CSI’s Ethiopia mission on our Flickr album.

 

 

Working together on day one

 
We had a great one!  After the usual day one challenges, 11 children received life-changing surgery. Today at every turn our team members showed their incredible focus, resilience, patience, compassion and skill:
  • The anesthesia team working to secure the necessary medications and fluids to prepare a child for surgery.
  • The medical records team organizing each chart and preparing the families for pre-op.
  • The OR nurses making sure instruments were sterilized and ready for the surgeons to do their craft.
  • The PACU team ready to support the unique needs of each child as they woke up after surgery.
  • The ward nurses and doctors securing the rooms, beds and tables needed for families as they spend the night recovering.  
 
We can’t wait to get back at it tomorrow!
 
Dody Barr, RN; Jan Gauger, RN; Dr. Bruce Ferrara; Dr. Jesse Hennum; Linda Sedgwick, RN
Tetee Urey-Morris, RN and Zoë Reker, RN

See more photos from our Ethiopia surgical mission on Flickr.

If you build it, they will come—A word from Zoë Reker, RN

Today was screening day. My first week as a CSI volunteer is finally getting started, and wow, did it begin with a bang! Twelve hours later and I am still trying to find words for my thoughts from the day.

 

ENT screening – Zoe Reker, RN; CSI surgeons – Dr. Greg Kelt, Dr. Alonso Carrasco, and Dr. Jon Robitscheck.

I worked in ENT screening with CSI volunteer surgeons Dr. Jon Robitscheck and Dr. Greg Kelts. We met with somewhere between 70 and 80 children. Kids of all ages arrived with hopes for cleft lip and palate repairs, as well as other ENT needs. It was a busy day, full of collaboration between the CSI and local medical team on planning the week as well as future visits.

Here we are as a group, providing mass surgical intervention, but also creating educational opportunities for growth of Bahir Dar’s current staff and developing medical students. It is empowering and inspiring to see everyone working hand in hand.

A favorite memory from today was seeing both Greg and Jon recognize children who had been CSI patients in the past. Numerous times, I admired how Greg would take one look at a child or parent and remember the cleft lip, immediately scheming how the palate could be fit into the surgical schedule. How amazing it must feel to see a child one year post cleft lip repair, back with parents, smiling with big eyes, ready for the next step in their surgical journey.  


Families, I learned quickly, travel hundreds of kilometers to make it to screening day in hopes of securing surgery during this week. Not only are these families dealing with the challenge of specialty surgical needs, the travel is extensive and intense. Getting to Bahir Dar is a journey that so many families are willing to take in the hopes of bettering the health of their child. Their travels alone are humbling.


Zoë and interpreter Desie announcing surgery schedule.

The mindfulness the team practiced while building the surgical schedule was astounding. Having a goal to create the most meaningful impact on the greatest number of children is no easy feat. At the early and later part of screening, I wondered how we could even start to make a dent in a place that needs so much. Today proved to be equally challenging as rewarding. For every “yes” to a scheduled surgery, there was also a “no.” I am impressed by the considerations that went into account: the type of surgery, physical health, length of operation time, resources, follow-up, length of travel. All of these factors played challenging and meaningful roles in the surgical schedule for the upcoming week. As a new team member of CSI, I see that these trips are more than quantity: they are quality, significant and intentional. 

As we packed up our supplies and walked out of the hospital today, a phrase came to mind: “If you build it, they will come.” This statement could not feel more true tonight. It speaks to the parents, who traveled by any means they could over vast distances, and the volunteers, who have donated their time for the love of a child. It speaks to those who have donated time, resources and money to build what CSI is here to do. With each of these trips, children, families and medical professionals from around the world are coming together to challenge, inspire and empower one another. I am so thankful to get started and be part of a week of miraculous work!! 

Medical records table – Cindy Halverson, Amy Fischer, Daniel (interpreter) and Linda Sedgwick

View more photos from the Ethiopia surgical mission on CSI’s Flickr site.

Preparations in Bahir Dar

The full Ethiopia surgical team has arrived! We had a good day of preparations with our partners at Bahir Dar University Tibebe Ghion Specialized Hospital.

We toured the hospital and also learned about a wonderful anesthesia training program collaboration through imPACT Africa (Improving Perioperative & Anesthesia Care and Training in Africa), Vanderbilt University, and Bahir Dar University. They hosted a two-week train-the-trainer program for anesthetists using their new anesthesia simulator—very cool! Tomorrow is screening day, and we are looking forward to helping about 60 kids during our stay. More updates to come!

Bahir Dar University Tibebe Ghion Specialized Hospital
ImPACT Africa (Improving Perioperative and Anesthestic Care Training)

Heading Home – Ethiopia Spring 2019

We certainly finished the week on a high note! Yes, it has been a challenging mission in some respects, but we are constantly reminded of all the good that can come of it. This was never more evident than with our last two patients on the last day of surgeries. Both are teenage boys with severe facial deformities, who have experienced a lifetime of shame…. up until now.

One of those young men is 15-year old Ayeengida, born with a severe bilateral cleft lip. His caring and anxious older brother told us that Ayeengida has never been to school because he was too ashamed, and even would hide when extended family came to visit. All he wants, he says, is to go to school. He and his brother nervously waited all day, and their excitement was contagious! When it was time for Ayeengida to go with nurse Ana to the operating room, we were all smiling and laughing and cheering.
The surgery went very well, and the difference apparent immediately. When Ayeengida woke after surgery, we held up a mirror to his face. His eyes widened, then filled with tears, and he just stared at himself, shaking his head as if he couldn’t believe it. The room erupted in cheers as we wheeled him out to the waiting area and to his brother. When asked what he wanted to do next, Ayeengida immediately said “go to school,” followed by “I want to be a doctor.” More happy tears were shed by everyone in the room. No more shame, and a life full of promise for the future.

What a fabulous and emotional finish to an incredible week! 136 children screened, 58 surgeries performed, and so many lives changed forever. We are tired, we could use some more sleep, we are excited to come home, AND we eagerly look forward to returning to this beautiful country and people in November 2019.

See more photos from Ethiopia on Flickr