Category Archives: Ethiopia

Today is our last day of surgery in Ethiopia. This week has gone by fast and I cannot believe it is the last day of surgery already. I am always awed and inspired on trips with CSI, during which a team of people who have never worked together as a unit, come together and provide the best possible care for children with orofacial clefting and urologic disease. These trips are soul saving for me in that I get to do what I love, without the daily bureaucratic tasks that are ever present in my daily life. The things that I love about my career are providing necessary surgical care for children and educating others to do the same. The Bahir Dar site provides both of these opportunities.

It has been a pleasure working with local surgeons, Drs. Melesse Gebeyehu (head and neck surgery) and Asnake Bitew Kassa (otolaryngology/ototlogy), and their trainees. They are not only talented surgeons who have quickly learned how to perform cleft surgery but are also passionate about what they do and building programs at this site. These are things that align with my own career interests, and it is wonderful interacting with like-minded people who share similar visions on a different continent.  We have talked about formal programs for cleft care that could be built here, especially since they have the drive and training for it.  They have great ideas about further building their skill set and adding subspecialists to their practice. I am proud to be a part of a CSI team that can help provide additional training. In addition, they are wonderful people who are a joy to be around.

We have had a busy week with some long days early on, but we have been able to help many more children than just the ones we operated on by continuing to train our local partners.  It is a testament to the team to carry on the mission during chaotic times in a new hospital setting.  We have had power outages that we had to operate through. Thank goodness I was wearing my battery-operated headlight when it happened during a case. It was an interesting experience operating in the dark. Everyone in the OR remained calm and got all the things we needed to keep the patient safe, and we were able to finish the case.

These trips make me realize how much we can do without the optimal conditions. When we run out of supplies, we improvise, and through the ingenuity of our team members, we always find a way to move forward and continue doing our work. It is a testament to the talent of our local surgeon partners that by the end of the week, I was able to scrub out and supervise from the background.

Part of me always feels a little bad that I go to different parts of the world to perform and teach surgery, but never really see much beyond the hospital and my hotel room. But traveling the world is not why I go on CSI trips. Providing education to local surgeons while being able to provide free surgery to children is why I do this. The icing on the cake is being able to work with the great people, now friends, I’ve met on various CSI trips.

Everyone who works with CSI is passionate about the mission of taking care of children and educating others to do the same in a high-quality fashion. I love that the group is committed to building long-term local partnerships at our sites. Drs. Melesse and Asnake are very skilled surgeons, and it is amazing working with them. I consider them friends and colleagues, and look forward to continued collaboration with them, whether here in Bahir Dar or remotely.

Raj Petersson, MD

More photos here.

Ethiopia is full of contradictions: a beautiful and also a difficult place. I walked two blocks today from the hospital to what I thought was a print/copy shop make copies of medical forms. In that two blocks, I saw examples of extreme poverty, destruction, and need. Even at the “copy shop,” which was basically an 8′ x 8′ open air room with a a dirt floor, the employee didn’t know how to operate the small printer on a table in the middle of the room.

But also along the way, I was met with smiles and people willing to help me find my way. When I reached the shop, a little girl smiled shyly up at me. She was beautiful. By the time I left, there were four girls and three boys crowded around the doorway, smiling and very curious about me. We had a great time taking pictures together, and then they followed me most of the way back to the hospital. I smiled the whole way.

At the new hospital, people often travel hundreds of miles to be evaluated by medical staff, either ours or theirs, or both. They sleep in every available space, and wake each day with renewed hope and persistence to get the care they need. It can be disheartening to see so much need, and to come face-to-face with the knowledge that it’s impossible to help them all. That’s the reality, and it can be a hard pill to swallow. 

And then I met Kalkidan and Zabisira, two little girls with huge hearts, immense joy, and incredibly giving spirits, both on our schedule for cleft surgery. They breezed into our pre-op area, smiling, dancing, and blowing kisses to us all. Sure they were nervous about surgery, but they didn’t let that stop them from making connections with every person they met. Having each girl willingly put one hand in a nurse’s and the other into mine, smiling up at us with trust and love…. just because. The beauty that shines through each of these girls transcends language, place, and the harsh surrounding conditions.

Being around such beauty makes this trip wonderful, and I’m so privileged to have met both girls.

Melanie McCall, CSI Board Chair and Medical Records Volunteer

more photos on our Flickr page.

Day 1 of surgery for the CSI Ethiopia team today. It was a LONG day, but productive! It is amazing to see how people, some who have just met, can problem solve and provide care as though they have worked together for years. The kids and families make it all worth it. Our team is so very grateful.

Despite it being a long day, we’ve got things dialed in now. We have a sweet OR set up, except for the fact that it’s 85 degrees! We get to work with a great CSI and local team.

This little guy was one of twelve patients that were operated on and cared for today by a hard-working group of committed volunteers.

We are off to sleep as fast as we can, preparing for another full day tomorrow……

See more photos here.

Today is surgical pre-screening day. The anesthesia team and OR nurses will be setting up our operating rooms while the rest of the team evaluates our patients and schedules surgeries for next week.

Screening is a super busy day, especially for our two medical records teammates, as well as the surgeons, pediatricians, and nurses.

Our team saw over 110 kids for screening. People walked as far as 2 days and waited as long as 4 months for this surgical evaluation. The first 10 patients were patients who weren’t big enough or strong enough to endure surgery during CSI’s last visit. The families were grateful and patient; some waiting nearly all day in line to be seen by our ENT and Urology team.

The hardest part of the day was announcing the surgery schedule knowing that not everyone would be able to be on the list. In contrast, the enthusiasm of families learning their child will get life-altering care is reason for celebration – not just for families, but for all of us. We have a busy week ahead – with 55 kids scheduled so far.

We left today feeling grateful and excited for the week ahead knowing the transformation to come will impact patients, families, and medical providers alike.

~ Monica Banach, CRNA & Emily Hall, MD ~ CSI Ethiopia Team Members

To see more photos from Ethiopia, Spring 2019, click here.

And they’re off! This team of amazing volunteers is on their way to Bahir Dar Ethiopia to change lives and make a lasting impact. This is the fifth Children’s Surgery International trip to Bahir Dar – we have made tremendous progress with our partners. This diverse team has members traveling from the U.S. – California, Kansas, Minnesota, Ohio, Philadelphia, Tennessee, and Virginia – as well as Italy and Liberia. Our focus will be to continue the training to help our Ethiopian colleagues build their surgical and medical skills as well as providing free craniofacial and urology surgeries to children in need. We have more than 30 families who’ve been waiting since our last trip in November.

Were very excited to be conducting the work at the new Tibebe Ghion Specialised Hospital on this trip. This project has been in the works the entire time CSI has been traveling to the region and it’s ready for us. Tibebe Ghion, which translates to “wisdom of Ghion” is a new facility operated by Bahir Dar University Medical School and will add significant medical capabilities and increase access to medical care for the region. Last fall several CSI team members had the opportunity to tour the new space.

We can’t wait to get going. After a little more travel and some rest, that is…

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

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

Click here to see more images from Ethiopia.

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

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

Click here for more photos from Ethiopia!

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

Click here to see more photos from Ethiopia