Category Archives: Ethiopia

From the Cardiology Team in Addis Ababa:
We had a very successful day today! We performed two cases and had great results for both of the children. They are recovering in the hospital overnight, and we are confident that they will already notice a difference in how they feel by tomorrow morning. Here are a couple of photos from the day.

From the ENT and Urology team in Bahir Dar:
With the exception of two patients who ate right before surgery and thus needed to be rescheduled for tomorrow, it has been a great day. Dr. Fran Schneck performed a lengthy, 6.5 hour surgery in the 95 degree operating room, basically re-routing the plumbing on a 3 year old who had lived with an external bladder since birth. Tomorrow Dr. Schneck will repair a similar defect for a 14-month-old child. Drs. Tim Lander and Andrew Scott are tackling cleft lips, removing a tumor on a palate, and a neck mass on a brave 12 year old girl named Narda. The local surgeons are so very pleased to have the opportunities to observe, learn and participate in these interesting procedures. Some say they feel as though they are “walking on water”!

We had a large lunch brought into a room near the operating rooms in order to share our midday meal with the Ethiopian team members. Molly McIntyre and Amy Erlandson are keeping peace in the PACU with Drs. Paul Melchert and Dave Tetzlaff. The ward is managed by Norie Wilson with Maria Rubin and Victoria Vandersteen. Tonight a few from our anesthesia team (Drs. Zipporah Gathuya, Kevin Healy, and CRNA John Erlandson) will return to the hospital to administer another epidural to the little girl recovering from bladder surgery. This will keep her comfortable while she is healing.

We’re off to bed to rest up for another busy day tomorrow!

Tuesday
We have had a very, very busy day! Given the severe lack of resources in this public hospital, the work their staff is able to accomplish is incredible. Our urology and ENT surgery schedules have been full, and lots of good teaching and training has taken place. Dr. Scott was able to allow one of the Ethiopian surgeons to perform a considerable amount of an entire surgery with him coaching and correcting. This was a great feeling for everyone involved.

Having enough interpreters is a challenge in most countries where CSI travels, and Ethiopia is no different. In addition to four 4th- and 5th-year medical students, we recruited an Ethiopian man who works at the hotel and also happens to be a patient scheduled for surgery with us at the end of the week. He speaks English well, so we asked if he could come back to help us if we are able to return later this year. He haltingly responded that he didn’t want to have to wait 6 months for his surgery. Of course we meant would he return to help translate, which he enthusiastically agreed to do.

Everyone is working above and beyond, showing terrific flexibility. Our Ethiopian partners are all in and asking great questions. One minor challenge is the squat-only “hole in the floor” toilet at the hospital, giving men a technical advantage.  The CSI women who haven’t been doing their squats in yoga back home are incented to not drink or eat all day, which is never a good idea when working 10-hour shifts in a foreign country!

The children and young adults we are caring for have the most beautiful eyes and ready laughs that make one momentarily forget how far apart our worlds are, yet hint at a surprising shared intimacy. When we take their photo and the flash makes them blink, others around them laugh and elbow them when we show the squinty result. The exact thing would happen to us at home. We blow a bubble wand and one lands on the dad’s nose, causing the child to erupt with laughter. Just like us. The mother starts to cry when told we cannot help her child’s affliction, and we immediately give her a hug because her response is exactly as ours would be.
These are all our children, and each one we see here cannot help but remind us of our incredibly good fortune.

Cardiology Team Update
Here’s a quick update note from Dr. Ron Johannsen and the cardiology team in Addis Ababa:
We had an exhausting but rewarding time with our cardiology colleagues at the Cardiac Centre – Ethiopia today.  We evaluated 22 patients with severe rheumatic heart disease, then chose and prioritized them for interventions starting tomorrow morning.  We had a wonderful mix of Ethiopian and U.S.-based cardiologists working and learning from each other.  The knowledge shared from our various experiences in Nepal, India, Ethiopia, and the U.S. with this devastating heart disease will go a long way in improving care not only now, but long term. A huge thank you goes out to Dr. Woubeshet Ayenew, who has been the glue necessary to make things run smoothly at our site.

Sunday

In an effort to accomplish our goals related to teaching and training, we are realizing the importance of connecting local professionals with CSI team members early in our mission. The success of our teaching model is contingent upon making certain as many local professionals as possible are ready to learn.

This week in Ethiopia, we hosted a wonderful dinner on the night before starting surgeries. CSI nursing, anesthesia and surgical staff were all seated with their Ethiopian counterparts from the Felege Hiwote Hospital to share a meal and make important connections. These early interactions will help us maximize our relatively short time here, so that we can share as much knowledge as possible with each other and make the biggest impact.  We are also making critical introductions throughout our entire CSI team, from the screening rooms to the surgical suites and on to the pediatric wards.

Monday

It’s Monday morning at the hospital, and the first day of surgery. Patients are checking in; others who weren’t screened on the first day have shown up hoping to be added to the CSI schedule. We are getting our bearings as to what is happening in our different patient care areas. This hospital is the largest local public hospital, and it’s hallways are teeming with  patients – sitting, squatting and lying down.  We are a bit short on translators, so we are working to get additional help from a local tour company.

The Asinuara Hotel has been accommodating, helping by delivering drinking water to the hospital, making our lunches to-go and transporting us. The Ethiopian people always say “thank you so much” when they learn we are here to help their children!

The cardiology interventional team will start their procedures on Tuesday in Addis Ababa. Their goal is to perform cardiac procedures on children who have suffered cardiac damage due to rheumatic heart disease and of course teach local cardiologists as well. We hope to get updates from them soon, and will keep you posted.

We have safely arrived in Ethiopia, and most of us on the CSI Ethiopia team finally have our internal clocks turned around after the long journey. During our one hour layover in Jeddah Saudi Arabia we saw several gentlemen making the long pilgrimage (hajj) to the sacred city of Mecca, garbed in traditional white sheeting.

After a night in Addis Ababa, we took a morning flight up to Bahir Dar, the 3rd largest city in Ethiopia on Lake Tana. We had a small snag with seven pieces of luggage delayed in customs, but after some terrific interventional work by our team member and cardiologist, Dr. Woubeshet Ayenew, the bags were released. Also, a big shout out to Habtamu of Taitu Travel for driving the final pieces of luggage 560 kms to Bahir Dar. His terrific efforts allowed us to proceed on without missing our flight.

Our hotel, Asinuara Hotel, is conveniently located just two blocks from the Felege Hiwote Hospital.  We were able to walk to there for a tour and introductions when we arrived yesterday. Drs. Asnake and Melesse have been our Ethiopian partners since the CSI site team made their first visit to Ethiopia 6 months ago to begin planning for this surgical and teaching mission. The hospital is a well matched partner for CSI. Not only are there enthusiastic physicians interested in being trained, but the entire hospital administration and staff is committed to our knowledge-transfer model. Apparently there is no shortage of service organizations willing to come to the region to perform large numbers of surgeries over a number of days, but what this hospital really wants is training. They ultimately want to be able to perform the surgeries independently, and this is a perfect fit for CSI.

After an evening of catching up on sleep, dining at the hotel, or riding tuk-tuks to a lovely local restaurant, we were all awake early and ready to roll for screening day at the hospital.

Set up was efficiently completed, and the patients started flowing in to either the urology or ENT screening room. The urology team is managed by Dr. Francis Schneck, new to CSI from Pittsburgh and a fabulous addition to our team. Medical records team member Katie Stewart, Victoria Vandersteen and others worked with Dr. Schneck to screen the urology patients.

The ENT screening room was shared by Drs. Tim Lander and Andrew Scott, with assistance from Medical Records team member Aliza Ameen. Aliza and CSI Partner Mary Moore demonstrated their resourcefulness by finding the mop closet where they grabbed a mop, bucket and soap to clean up an “oops” on the floor of the pediatric exam room. It was teamwork at it’s best.  Mary was also taking photos, and moving the patients from the surgeon’s screening area to the Pediatricians/Vitals area managed by Norie Wilson, Maria Rubin, Dee Vanderpol, Amy Erlandson and Molly McIntyre. CSI Pediatricians Drs. Dave Tetzlaff and Paul Melchert examined the patients, ordered labs, and made decisions about which children were ready for surgery this week. All in all it was a very successful screening day. Sunday will be a day off for the Sabbath, which is honored throughout Ethiopia, and we will start surgeries on Monday.