Category Archives: Ethiopia


Final Impressions – Ethiopia 2018

This is my first CSI trip, and it was an experience I will never forget. While performing surgery for cleft lip and palate was certainly rewarding, the best part of our visit was working with our Ethiopian partner surgeons, Dr. Melesse and Dr. Asnake.  Both were extremely talented surgeons and eager to learn techniques for repairing cleft lips and palates. They are enthusiastic and ambitious about learning even more. Both surgeons have completed advanced training in otolaryngology. Dr. Melesse completed a head and neck oncology and reconstructive surgery fellowship, and Dr. Asnake completed an otolaryngology residency in Addis Ababa, Ethiopia.  While we may have been helping them perform craniofacial surgery, both surgeons are extremely proficient.  Dr. Melesse performs advanced head and neck oncologic surgery regularly at Felege Hiwot Hospital in Bahir Dar. In fact, on our last day he performed a revision radical neck dissection for a patient with recurrent spindle cell sarcoma. Dr. Asnake, who just completed his training, will be performing the first ear surgeries at the new Bahir Dar University Hospital next month and will be the only ear surgeon in the region. He will perform surgery for chronic ear disease for patients in Bahir Dar and the surrounding provinces. In addition, they plan to start the first otolaryngology residency program at Bahir Dar University next year. It was truly a pleasure to be able to work with these talented individuals.

      

On our last day we toured the new University hospital with Dr. Melesse. This new facility will add significant medical capabilities for the region and increase access to medical care for the people of Bahir Dar.  The current hospital at Felege Hiwot is busy. There are 130,000 outpatient visits every year and 6,000 inpatient admissions every quarter. The new hospital building will significantly increase bed availability and access to outpatient care.  The new University Hospital is a 600-bed facility and houses 20 major operating rooms and 10 minor operating rooms, along with state-of-the-art neonatal, pediatric and adult intensive care units. In addition, patients will be admitted to four-person and two-person rooms, a significant upgrade from the 8+ patient rooms at their current hospital. The new hospital is situated within the campus of the new medical school, creating a state-of-the-art graduate medical education center for the region.  

While it is sad to leave Bahir Dar because of the amazing experience I had, it is exciting to see the growth of both the providers in Bahir Dar and the medical infrastructure in which they work.

Greg Kelts, MD ~ CSI Surgeon

Click here for more photos from Ethiopia – Fall, 2018

Play is Medicine – Ethiopia Fall 2018

You don’t need to share the same language, live in the same country, or even look the same physically to play. Play can start from something so simple, like a smile, and become contagious to all those around. As a child life specialist in Minnesota, play is the at the core of what I do.  Here in Ethiopia, I realize the power and influence of play – not only on the kids but the adults too. It is something that is therapeutic for everyone – play is medicine. 
      

Eleven-year-old Kidus had to wait the longest for his urology surgery at the end of the schedule today. At first, he just watched as the younger kids played with bubbles and colored. But after a few invitations he joined right in. Age doesn’t matter. Kids want to be kids. His favorite thing was to create a mini basketball hoop out of pipe cleaners and tape. After some modifications, we were able to shoot baskets and even come up with trick shots to perform. It was entertainment for Kidus as well as our cheering section of parents and families. 

              

Today 3-year-old Natanael loved playing with everything we had. We spent hours doing stickers and coloring, laughing, trying to catch the bubbles, and playing with little wood cars. Right before he went in for surgery, Natanael was playing with a small beach ball. Fast forward a couple hours to once surgery was done, the one thing he was crying for was the beach ball. Play is powerful and integral in helping kids understand and cope with their medical care. 
      

The local surgery team is getting a chance to perform what they are being taught from the CSI surgery team and at the same time, kids are getting a chance to practice what they are learning through play. Play is the work for kids. Our CSI team is changing lives in more ways than one, one surgery and one activity at a time.

Sarah Stenson ~ CSI Medical Records Volunteer

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Changing Lives One Procedure at a Time – Ethiopia 2018

When we first arrived at Felege Hiwot Hospital in Bahir Dar, Ethiopia, the amount of assistance required needed no clarity or introduction, as it was obvious that these gracious people needed help. The despair in the eyes of the families who came to us seeking help was overwhelming. We are very glad to be here and glad to help. We are changing lives one procedure at a time, and the gratitude and impact that we’ve made here is evident on the faces of the family members who greet us, shake our hands and hug us. Their smiles need no translation.

Our team has cared for many small children, many who were ridiculed for their conditions, and their parents were distraught over their child’s situation. We worked hard preparing them for surgery, in the operating room, and in recovery. I had the chance to leave the operating room today to visit the patients and their families in the recovery ward. The parents had smiles so big they could not hide them, and they showed their beautiful babies off to me and thanked us for our help.

One special case today was 6-year-old Mednekia, with a bilateral cleft lip. Yesterday, she and her father traveled 1.5 hours to Bahir Dar in hopes of receiving help from us after being turned down six times by other organizations. Because of her cleft lip, Mednekia has not attended school. She is a sweet girl who waited patiently for hours for her surgery.

      

Local surgeon Dr. Melesse performed her surgery under the guidance of CSI surgeon Greg Kelts. While she was in recovery, Dr. Kelts came to talk to her father and showed him a picture of Mednekia. Through our translators, he expressed doubt that the photo was of his daughter. He was finally convinced, and his joy spread to the other parents as we showed them the photos of Mednekia before and after surgery. When she finally got out of surgery, the waiting area erupted with excitement. We know the future has improved for this young girl, and I was happy to have a role in her transformation.

        

We are grateful to be here and want nothing more than to exhaust ourselves of supplies, energy and time to help change the lives of these children and their families. Thank you for the support back at home – I wish you could be here.

Josh Kenzie, CRNA ~ CSI Anesthesia Volunteer

New Hope – Ethiopia Fall 2018

Dr. Melesse took a rare pause from his hectic schedule to take a selfie with CSI Clinical Lead Linda Sedgwick and team members Maria Rubin and Amy Fischer.  CSI’s work in Bahir Dar would not happen without Dr. Melesse – He works tirelessly to prepare his staff for our visits. He is a leader and clearly also the heart of Felege Hiwot Hospital, carrying a heavy surgical schedule along with his teaching duties.  He is the go-to physician, frequently stopped in the halls by patients seeking a consultation. His calm demeanor and compassion are inspiring and impressive.

      

Yesterday, on our first day of surgeries, we were still adding patients to the schedule.  Twelve-year-old Cikeradis and her father came at the end of the day seeking surgery for her cleft lip, which she covered with her scarf and which often kept her from attending school.  She and her father had traveled a full day with no guarantee that she could be helped. We were able to screen and clear her for surgery almost immediately – She was added to the end of our full day of surgeries. The results are dramatic! 

The educational component of the CSI mission was in action today. CSI operating room nurse Tina Nelson, with the help of our Ethiopian translators, offered training to a local nurse colleague on the proper technique to share instruments with surgeons. And CSI Nurse Educator, Maria Rubin taught CPR and choking rescue to a group of hospital nurses.  But the education and training did not stop there.

         

Dr. Asnake was a key partner and colleague during the very first CSI trip to Bahir Dar in 2016. He has been away gaining valuable training, but we are thrilled to again have the opportunity to work with him this week. Dr. Asnake has experience with the less complex cleft lip surgery.  Today, with training and support offered by CSI surgeon Dr. Jon Robitschek, he performed a cleft palate surgery. We hope he will have the opportunity to further strengthen these skills during the week and when CSI returns to Bahir Dar in March. Our twice-yearly trips allow us to work closely with local surgeons to learn new techniques and improve their skills.

     

Our very first patient this week, six-year-old Nathael, was discharged yesterday but came to the hospital this afternoon with his dad before heading home to Addis Ababa. They wanted to say goodbye and thank you to CSI surgeon Dr. Alonso Carrasco and other members of the team who helped give him new hope.

Amy Fischer ~ CSI Logistics Lead

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Camaraderie and Trust – Ethiopia Fall 2018

As I walked into the operating room this morning, I was met with many emotions. The most significant was the excitement to care for children whose lives would be forever changed and to work beside those who would make that happen.

As a nurse in a small rural hospital, there is a feeling of camaraderie with those I work with. I can tell you that the feeling here is much the same. To work with people of varying specialties and background, who wish to improve the lives of children, along with the willingness to share this knowledge in order to reach even more, is remarkable.

Today, as I held the hand of a little girl as she drifted off to sleep for her surgical procedure, I realized how different life would be for her when she woke. It is humbling to know what trust patients and their families have in another’s ability to make that happen. It also validates how important it is that this kind of work continue in order to change as many lives as possible.

         

I am just as excited for the following days and the thought of the very same wonderful and life-changing events to come for so many more little ones. I know that they have certainly changed mine.

Malane Thelan ~ CSI OR Nurse

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Screening Day – Ethiopia Fall 2018

My first trip to Bahir Dar, Ethiopia, with Children’s Surgery International was two years ago. Today was the first day of CSI’s fourth trip here. We started with all the excitement that the screening day brings. Do we have all the supplies? Are our interpreters here? Are our patients here?

Yes, we had supplies, and the few we were missing we could buy in one of the many tiny pharmacies surrounding the hospital. Yes, the interpreters were present and eager to help us. Yes, the patients had arrived, and the waiting area was full of parents and children. It was quite a surprise for me, because two years ago there were probably a quarter as many patients.

       

I started the day helping with vital signs on our young patients. As screening progressed, we identified infants who could not have cleft lip or palate repairs because they were too small for their age or because they were too young, including a three-day-old baby. Feeding children with cleft palates in particular is challenging for parents. This is when my role as a nurse educator with the team became necessary. Education is a key part of CSI’s mission – education for health care workers and also for families, to provide access to learning that may otherwise be unavailable to them. With the help of a trusted interpreter, we started teaching moms how to feed their babies with special nipples. The moms fed their babies and the dads were very supportive, asking questions and assisting the moms. We discussed that babies had to be a bit larger for surgery and would be seen at CSI’s next visit in less than six months. Although it was not the outcome they wanted, they understood why we had to wait. We will be eager to see them again next time.

   

After evaluating 80 children, our three surgeons have scheduled about 60 surgeries, which will begin Monday. Tomorrow, we have a day of rest to enjoy beautiful Ethiopia, so our team will be energized for the week ahead.

Maria Rubin, RN ~ CSI Nurse Educator

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We are Ready – Ethiopia Fall 2018

The Ethiopia CSI team – 19 strong – has safely settled into Bahir Dar after hours of travel. Today the leadership team met with officials at Felege Hiwot Hospital to firm up plans for screening day tomorrow. We have noticed that the number of people waiting for services at the hospital has steadily increased over the years CSI has been coming to Bahir Dar, an indication of the significant needs here.

           

We were thrilled to learn that tomorrow is graduation day for approximately 150 medical students as well as the inauguration of the new hospital. Two important milestones which will help meet the growing needs in this region. Leaders from three neighboring countries are here to observe this happy occasion. The team capped off the day by dining together and forging new friendships and professional bonds. We have a strong team and are ready to get to work.

Wrapping up an amazing week… until next time!

Sally Lannin ~ CSI Team Member

What a trip! A huge success in every way possible and a perfect example of what CSI strives to do: come to an underserved country, find committed local medical and nursing staff who are literally starved for skills and training, model quality health delivery on all levels, and help build capacity. And here at this site, we have it all. Thanks in large part to Dr. Woubeshet Ayenew – a Minneapolis-based Ethiopian who knew of Felege Hiwot Referral Hospital and its needs – we found Dr. Melesse Gebeyehu, a surgeon born and raised in Bahir Dar, whose mission is to gain surgical excellence and impart it to other surgeons at Felege Hiwot Hospital.
        
Tonight the entire team was invited to a thank you dinner hosted by top administrators at the College of Medicine and Health Sciences at Bahir Dar University which sits right next to the hospital. Medical students, residents and nurses in training have observed and participated in care as much as possible. There is a large shortage of Ethiopians going into nursing and some specialty areas which affects care. For example, in a U.S. post-surgical recovery area we have 1 or 2 medical staff assigned to every patient coming out of surgery. Here it’s 1 to every 8 patients. The farewell dinner was a great chance to discuss what could happen differently on our next trip to make CSI’s time here even more helpful. 

If you had the chance to spend 15 minutes with us as a family walks up in the only clothes they own, with the child they value and love as much as we do our children, you would be shocked at the need. Mostly they live on rural farms without access to television and often even radio. They are farmers, and their hands tell the story of years of hard labor. Somehow, they get word of surgeries provided by teams of CSI volunteers working side by side with their Ethiopian counterparts. And it is free?!?! They take whatever transportation is available to make the 30-275 km trip, navigate the chaos in the halls of the hospital to find, finally, the right people to ask. This in and of itself is a miracle. 

 

Take Metadel, a 15-year-old young man who after years of relentless mocking in school, dropped out altogether. His ‘friends’ said “…don’t get near Metadel or you will catch the contagious disease he got as a curse from God!”. Thankfully his 27-year-old brother asked a friend in Bahir Dar to let him know when CSI and the free surgeries were next in town. He got his younger brother Metadel to promise to return to school if he got surgery, took time off from his own work as a teacher, and travelled 80 km from their rural home to the ‘big city of Bahir Dar’ to find our screening line. After surgery both young men were speechless, with an outpouring of gratitude. Imagine – access to this surgery is the best thing that has ever happened in their lives and hopefully the turning point that gets Metadel back in school.
            

On our last day, as we wind up this mission of 59 surgeries, we refelct.  We evaluated 88 patients on screening day and another 30+ who walked in each day.  We especially want to thank our partner, Dr. Melesse – This soft-spoken surgeon is the backbone of our ability to weave a system of education and training here. He is skilled enough at this point to work in many places with far more prestige and pay, yet Dr. Melesse is fully committed to giving to the poorest people in his hometown of Bahir Dar. He works every day in utter chaos, with 50-60 patients waiting to see him in his clinics, for $600/month. Moonlighting a bit on the side to be able to afford to send his children to a private school, this fellow is amazing. He spoke of his gratitude to CSI at the dinner by saying “I just have no words to express how grateful we are for you people with whom we share nothing but a common caring for humanity, especially for these people of Ethiopia who have nothing.”  Dr. Melesse was a product of public schools up until medical school and is ‘of the people’. He’s working on building the skills of his colleagues too – He has found fellowship opportunities in South Africa for 3 hospital surgeons to speed up their skill acquisition along with CSI’s visits twice a year.

  

Our bags are packed, and we leave for the flight to Addis before our very late-night flights to various connecting cities to get back to the U.S. Every one of us has benefited from the ‘reboot’ this trip has given our own lives – perspective, appreciation and a commitment to do everything we can for these beautiful Ethiopian people.

A Picture is Worth a Thousand Words

From CSI Team Member and photographer, Tom Northenscold

A face I will never forget. This teenage girl suffered taunts all her life over her cleft lip. While the surgeons cannot take away that pain, they can repair her cleft lip in a masterful way.

        

Wednesday – Lube Tech Brings Smiles

Margaux McClure ~ CSI Team Member
Philanthropy Coordinator at Lubrication Technologies Inc. 

It’s truly another world here in Bahir Dar.  Today we saw a man come in with an arrow going straight through his arm. He sat the entire day patiently waiting for help. Being non-medical, I have never seen anything like this, let alone watch a surgery take place. I feel so blessed to be here and have this experience.  Each day I think it will become less shocking, less miraculous – and each day never ceases to wow me. I watch in awe as our unbelievable medical team nonchalantly changes lives – brushing it off like it’s no big thing. They’ve been giving me small jobs like holding the babies after surgery and calming them as they wake up, yearning for their mothers. They want me to feel important, they’re the real heroes though.

Today marks the kick-off of our official Lube-Tech Half-Day of Smiles. Employees at my company have been hard at work for the past month to raise enough money to sponsor a half day of CSI’s week here in Ethiopia.  This amounts to about 9 life-changing surgeries plus the medical training that goes with them.  I need to give a shout out to Lube-Tech employees, husband and wife, Cathy and Mark Morse. They selflessly put on an entire fundraising lunch for our company with a free-will donation option. Cathy and Mark worked tirelessly, staying up nearly all night to purchase and prepare all the food; spending their own money; and using their personal time off to execute the lunch. They were able to raise a total of $1,200! Cathy also put together a Lube-Tech Cookbook that employees could buy – the proceeds all went towards our fundraiser to help these kids and families here in Ethiopia. Thank you, Cathy and Mark – I wish you could be here to experience the difference you are making in these children’s lives as it is something quite special!

Celeste, one of the CSI nurse anesthetists, made huge strides with two Ethiopian anesthesia providers today. The two Ethiopian anesthesia providers worked side by side with Celeste, who was pleased with the opportunity to work with them. Celeste says their collaboration will help to enhance patient care in the long run!

                     

I’ve always hated going to the doctor, but after this week I see how much respect I owe the medical profession and how fortunate we are in the U.S. with our healthcare system. I strive hard to not fall for the perpetual curse of American ethnocentricity, but when it comes our medical knowledge and expertise, we are doing something right!