Category Archives: Ethiopia


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!

 

Waiting, Hoping, Praying

Sally Lannin ~ CSI Team Member

Surgery day two: We arrived again to a jam-packed hallway – a combination of our registered patients, hopeful potential patients, and an assortment of supportive fathers, grandmothers, best friends who helped those in need find their way to us.

At the gateway point here the Medical Records station greets each person who comes through; today a man and his daughter with a cleft arrived after walking 9 hours to reach a bus which took them most of another day to get to the hospital.

  

Eyayaw, a 25-year-old young man whose aunt lives in Bahir Dar heard CSI was coming to town. He came by bus despite living 200 km away. He was born with a partial cleft and has been mocked since he was a child. He said he feels “lots of happiness” now that his lip will be fixed. He said “kids here give you all kinds of names like “split lip”. His father is a priest who accompanied him, praying for a safe and positive outcome while his son was in surgery. After surgery the first thing he asked for was a small shard of mirror to see the results. Eyayaw hopes to go to University of Bahir Dar and study Economics.

   

Waiting – Hoping – Praying

 

Today we also had a mother, who’d given birth just hours before, arrive with her baby boy and his cleft lip and palate. Too young for surgery this week, patient educator Jan Gauger taught the family how to feed the newborn using a special bottle.

Tiny miracles are many per hour in a place like this. But so are the heartbreaks. Very poor, in threadbare clothes, these beautiful Ethiopian people work very hard for things we take for granted: clean water, electricity that stays on, clean hospitals are all not part of their lives. I saw a hospital patient have the head of his bed raised by putting a giant rock under the flimsy foam rubber that was his bed. But despite the hardships, people readily share, say “hello” as you pass by, wave and smile.

And what smiles! Absolutely amazing.

 

Surgery Day 1 – Complete

Karen Jordan ~ CSI Team Member

Whew the last two patients are in surgery as I type at 4:45 pm.  The first day of surgery is coming to an end and it has been overwhelming yet fulfilling, chaotic yet successful, and heartbreaking yet heartwarming.  The day started bright and early after a night of sporadic electrical outages.  The surgical teams headed over first to get ready for the day, followed by medical records and the pediatric team.  We were greeted by a crowd of patients and their families, in addition to dozens of people hoping to be added to the surgery schedule.  As we were trying to get everyone organized, the surgeons and nurses were trying to find basic items like sanitary wipes while testing their spur of the moment solution to missing shoe covers (shower caps over their shoes).

                                

The first operations started around 8:45. While it eased a bit of the chaos outside, we were still dealing with figuring out who was who and tracking down missing patients.  My heart went out to the little ones who hadn’t eaten or drank anything since midnight and you could see how difficult it was for their mothers to not breastfeed them.  With 13 operations scheduled, we had to complete intake for the day then turn our attention to the more than 20 families who arrived hoping to be added to the week’s schedule.  Unfortunately, many of them had to be told to return for CSI’s next trip in the Fall, however 12 were screened and the surgeons will try to add them to an already full week.  Many of these families were waiting for us when we arrived at 7:20 and we were finally able to get them seen by the surgeons and pediatricians at the end of the day.  It was amazing to see how patient these young children were with no toys or video games or iPads to keep them occupied.

I took a break from the medical records charts to spend a couple of hours playing with the waiting children.  They are all adorable, smart and willing to make friends at the drop of a hat.  I was cranking out origami balls and birds and even the youngest wanted to help make them while the older ones quickly learned how to fold the shapes themselves.  We moved on to cat’s cradle and, the universal smile-getter, bubbles.  It was wonderful seeing their smiles and hearing them laugh given the grim surroundings of the hospital environment and the concerned families.

                     

I was nabbed by one surgeon who had been referred to a current patient in the hospital—a 25-day old baby in NICU who needed attention from our urology surgeons.  We went to NICU which turned out to be a gurney in the outdoor hallway.  Thankfully the surgeons were able to add the baby to the schedule at the end of the day.  His mother sat across from me with tears silently rolling down her face; can you imagine giving your 25-day old baby to a set of strangers who don’t even speak your language for an operation?  Her joy and relief when he emerged sleepy and safe were memorable.

The surgeries aren’t the only value CSI brings to the Ethiopians.  One young mother brought her baby who had been born yesterday but couldn’t nurse because of its cleft lip.  Although the baby was much too young to be operated on, the team mobilized to produce special bottles designed for cleft lip babies who can’t produce enough suction to nurse successfully.  James, CSI logistics lead, ran into town to buy some formula for the baby and Jan, CSI nurse educator, spent 45 minutes instructing the family how to mix the formula and use the bottle.  The relief on the family’s faces when the baby could finally drink the formula was evident.  Although this sounds simple, we had seen a seven-month old baby on Saturday when we were doing screening who hadn’t gained any weight since birth due to its cleft palate.  It brought home to me the many ways CSI impacts lives here.

                               

We barely had time to eat or drink but I wouldn’t have traded today’s experiences for the world.  I’ve had an intimate glimpse into these families lives and I have seen firsthand the impact CSI’s dedicated medical team make for these patients.  The best feeling was watching the doctors walk out with babies in their arms after a successful surgery and hand them into their parents’ arms, safe and sound and healthier than before.  I remain deeply impressed by the CSI team here—their dedication and hard work under very difficult conditions, their flexibility and creative solutions to challenges, and their warm and deep compassion and care for the patients and their families are inspiring.  I can’t wait for day two!

Karen Jordan, CSI partner and volunteer, assigned to support Medical Records and loving the experience!

Sunday – Time to plan, rest and explore

Wyn Huynh, CRNA ~ CSI Team Member 

On most CSI trips, especially where teams travel a great distance, we try to build in time to rest and explore the local sights and culture.  Today we did just that.  

Through my experience of living in different cultures that speak different languages, I have learned that a little effort in learning to speak the local language, even a few words, and understand some of its culture and traditions will get you a long way.

We know that in healthcare, trust is an important aspect between the provider and the patient. Could you imagine what it is like for these parents to hand their beloved child over to a foreigner like me – a nurse anesthetist, who speaks not a word of the local language, to put their child under anesthesia? I have found through my years of giving direct care to patients who do not speak my language, that if I can utter simple words of “hello,” “how are you” and “thank you” in their language, a whole world will open up and the trust relationship will soon be a reality.

On mission trips with CSI, team members occasionally have the opportunity to learn and immerse in the host country’s culture during the trip. Before our long surgery days in the week ahead, we had a chance to tour the city and visit a couple of monasteries, located on islands on beautiful Lake Tana. Lake Tana is a large body of water on the shores of Bahir Dar City – it is the origin of the famous Ethiopian river, the Blue Nile, and flows north over 900 miles, to join the White Nile at Khartoum in Sudan.  Visiting the monasteries was so interesting – Faith is an extremely important part of Ethiopians’ lives. Nearly half the country is Christian Orthodox, mostly in the northern regions and about 40% are Muslims, mostly in the eastern, western and southern lowlands.

                                    

As of today, I was able to greet people in Amharic (one of the most widely used language in Ethiopia) and introduce myself – ready for the week.  I feel good and a little closer to my Ethiopian people when I see their eyes perk up or giggle as I utter “selam”.

 

Screening Day – Ethiopia Spring 2018

Ellen Reynolds, CRNP ~ CSI Team Member

Families – parents and children.  All over the world, there is a bond that surpasses culture and is visible to anyone who wants to see it.  Today was our first glimpse into the bonds between Ethiopian parents and their kids. 

There were parents and kids waiting for us today when we arrived at the hospital at 6:30 a.m.  Some of them had traveled great distances and knew they were likely to be spending the next several days at the hospital, perhaps sleeping in a single bed with their child, or maybe sitting in a chair as their child recovered in a bed shared with another patient.   They were proud of their children, often giving a big smile as we complimented their child on a pretty dress or a cute t- shirt.   When they saw cameras come out, parents smiled and pointed to their child – “Take his picture!”.   The parents as well as the kids delighted in seeing themselves – It was obvious that some had never before seen their own face in a photograph. The concern on their faces was evident when they were ushered into an exam room to see the surgeon, wondering if their child would be found healthy, strong, or big enough to go through the surgery they hoped would be life-changing.  

Our team’s goals for today were to identify those children who could safely undergo specialized surgery to correct facial abnormalities which often cause delayed growth or social humiliation, as well as those children with urologic problems that not only cause embarrassment, but also the real possibility of kidney disease.  These parents are so hopeful!  They are sensitive to their child’s fears and, at times – terror, regarding the strange white faces, examination, and use of everyday equipment such as stethoscope, thermometers, and blood pressure cuffs. 

 

There were tears – From parents of the 6-week old baby too small to undergo complex urologic surgery, to the parents whose child was found to have significant signs of a heart disorder and would first and foremost need to see a cardiologist. 

But there was a lot of joy.  We screened more than 80 children and scheduled nearly 60 surgeries.   We worked hard to show our respect for these families – to show we appreciated them and to share our confidence that their child would be on a path to a healthier and often happier life after this week’s surgery.  There was play, with children chasing after bubbles and holding tightly to a squeaky duck toy or a plastic zebra.  There was laughter and smiles.   The hope was palpable.   Parents and children. All over the world.  We have more in common than not – it’s going to be a great week. 

All together and ready to roll – Ethiopia spring 2018

Our team has safely arrived at Bahir Dar, Ethiopia! Team members hail from eight different states, but today, after nearly 25 hours of travel time and an overnight in the capital city of Addis Ababa, we are all together in Bahir Dar. Many team members are veteran CSI volunteers; eight volunteers are new to CSI. What a treat it is to welcome enthusiastic new volunteers.

Joined by our incredible partners at Taitu Tours, Bahir Dar University and Felege Hiwot hospital, it’s going to be an exciting week. This is the third CSI trip to Ethiopia, building on previous relationships with local professionals. Our team members will be working side-by-side with local surgeons and nurses, and our CSI nurse educator will be leading classes all week for local students and possibly families.

A few team members met with local hospital administrators and clinical supervisors today to discuss the details of the week, making certain that they can accommodate the patients we will be seeing and the care they will be receiving. We understand that our work may challenge their resources, as they are already extremely busy meeting the needs of their own patients. We are honored to be the guests of Bahir Dar University Hospital – Felege Hiwot. This teaching hospital is associated with the university and serves 5-7 million people in the Amhara region.

About 80 children have been identified by local surgeons as potential candidates for surgery. Tomorrow is screening day, when we will evaluate these children and determine which are ready for surgery this week. We are excited to be doing both ENT and urological surgeries. We also plan to deliver much-needed tools and equipment to our surgical and medical partners items essential to performing these surgeries that are readily accessible in the U.S. but not in Ethiopia.

Sunday is a rest day and a chance to explore the beautiful city of Bahir Dar and some of its rich history, including the open-air markets, Lake Tana and more. This is an arid environment, located on Lake Tana at the headwaters of the Blue Nile River. The weather is lovely, sunny and about 85 degrees.

This week in Bahir Dar is all about transforming children’s lives and empowering local medical professionals through education and training. Life-changing surgeries will allow children to flourish in their communities, without the stigma that often accompanies birth abnormalities. Working closely with medical and surgical professionals will allow the work that has begun here to continue even after our team leaves.

Final notes – Ethiopia 2017

“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.

Notes from the OR – Ethiopia 2017

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!

Transformations and lasting impact – Ethiopia 2017

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.