Monday, January 25, 2010

Follow-up on Child with Ischemic Contracture (Jan. 13 Post)

Dr. Barden operated on the little girl's arm, releasing the scar tissue. She now has much improved position of her hand and fingers. As healing occurs, she will then be able to stretch her hand, and we anticipate almost normal range of motion.

-- Don

Sunday, January 24, 2010

Em & Glen Barden

Em and Glen Barden left on KLM for Amsterdam last night. They should be in the states heading to their home in Lakeland, Florida, as I write. They spent two weeks with us here in Addis Ababa at the Korean hospital. Glen is a hand surgeon, and it took a week before we got into any hand surgery, but when we did Glen did some fine stuff. Unexpectedly the first week was a course for Sign Nail certification followed by the Ethiopian Society of Orthopaedics & Traumatology 4th annual meeting at the Ghion Hotel. Glen, Dr. Hailu, and I attended and made many new friends. Em shared her experiences and strengths. Their gentle and sweet personalities endeared them to the staff, patients, and the many new international friends. We thank them for giving of their time and sharing of their experiences and hopes with us, and we all would gladly welcome them back in the future. (See slideshow in sidebar.)

-- Don

Timkat, January 19

Timkat is the celebration of Epiphany in Ethiopia. It is big national holiday, and thousands fill the churches, Meskel Square, and other sites around Addis. Mid-morning we took a taxi to Janmeda, a large military training field on the northern side of the city. There were thousands streaming into the grounds. For the most part, the men, women, and children were dressed in their fancy white clothes. Sermons were preached, followed by parading the Ark of the Covenant replicas under colorful large umbrellas. Masses of people were in this field, milling about with their families and friends. It was a time of celebration.
    Em, Glen, Barbara and I left to reconnect with our taxi driver; he never responded as a recording on his cell indicated he had turned his phone off. Not surprising as this is common when they don’t want to be bothered. We hired another taxi, and Mr. Lee from MCM picked us up at Friendship Shopping Center and took us to the Rainbow Korean Restaurant. I saw Mrs. Park, the restaurant proprietor in the clinic the other day, and she had invited us to her restaurant. It was down some unpaved side streets, lined with vegetable and fruit stands, a surprising bustling area of agricultural products, and tucked in there was this cozy, delightful restaurant. We were joined by Mr.& Mrs. Kim, the Koning twins and Einar. The food was magnificent. We will certainly be back. This meal was a “thank you” by Mrs. Park for attending to her medical needs. And Thank You Mrs.Park for the wonderful meal! (See slideshow in sidebar.)

-- Don

Excursion to Wenchi Crater Lake, January 17

A last minute phone call put the Bardens and ourselves in one of two SUVs. Sven Kiplisund and Joey Johnson joined us, with Einar driving and Peer, Gru, and the Koning twins, 11 adventurers in all. We headed to Ambo, 110 kilometers from Addis, with decent paved roads. We stopped at a restaurant for coffee and then arrived at the Wenchi Crater Lake in early afternoon. We had to stop and tend to one of the cars when it overheated at the high altitude. This is Oromo tribal country, and our Amharic speakers could not communicate verbally. We parked and climbed up 50 or so meters to reach the rim of the crater. As we peered over the rim with each ascending step, it was breath-taking to look down into the crater and see the lake with islands in miniature from this height. It had an ethereal feeling in the stillness of the afternoon. The paths around us were flush with fragrant wild oregano. It was well worth the lengthy drive for these moments of visual and olfactory stimulation.
    Our car had cooled and decided to behave for the time being. We loaded up and drove on unpaved roads without incident to Negash Lodge in Wolliso. The road was under construction, and we had to wind through some unpaved and rough village streets, but then came upon this inviting lodge compound with bougainvillea and other horticultural delights. We had an incredible lunch on the veranda and then headed for home. The second car just went dead about 50 kilometers from Addis, in a small village. The mechanically minded members of our group could not diagnose the problem nor could anyone get the beast to advance one meter further. Villagers came from everywhere and were perplexed to see our men pushing the car to the side of the road (that’s a woman’s job!). After some discussion with the village elders, the car was left, and all 11 of us piled into the remaining car! It was cozy and cramped, but we were all happy to have had a wonderful day of sightseeing and adventure and were joyous of a safe return home together. (See slideshow in sidebar.)

-- Don

Mobile Clinic Day

Saturday the 16th was designated as mobile clinic day. Seven doctors (neurosurgeons, orthopaedists, vascular surgeons, etc.) participated, along with many nurses and non-medical people, including translators. A bus picked us up at the guest house, drove for about 45 minutes to the periphery of the city, and deposited us at a local church in a poor neighborhood. The church house was a rather large structure built out of mud with a tin roof and gravel-rock floor. Tables, each with a bare-bulb lamp, were set up around the periphery of the interior. It was quite dark in the building as there were no windows. Some of our group would triage the patients outside, and a hostess would direct them to the docs at the various tables. We saw over 400 patients and prescribed medications after the most primitive of diagnostic techniques. These were poor people with no financial means to obtain medical care. I gained a new perspective on the patients in this doctor/patients relationship. These folks were struggling to survive from one day to the next. They didn’t ask for my medical credentials or certifications. In their world, that was a meaningless abstraction. To these folks the important thing was that someone was there to care for them, whether it met the “standard of care” or not. They were appreciative. It was a tiring day. Reflecting on the bus ride home I had a feeling of disappointment in that we did not provide the latest and best diagnostic and therapeutic medicine; however, I was reaffirmed knowing this group of volunteers had offered the fundamental tenet of medicine, that of comforting and caring for your patient and fellow man. (See slideshow in sidebar.)

-- Don

Wednesday, January 13, 2010

Settled In

We are settled in our old apartment, again. Barbara has made it cozy with her personal touches and has been using her little Italian oven. Last night she had a dinner party for five with candlelight and a wonderfully prepared “home cooking” meal. It was a delicious meatloaf. Someone (Laura Fitzpatrick) asked if she brought the meat with her from home! Can’t you see Barbara going through security at the airport with a pig under her left arm and a turkey under her right arm!
    Em and Glen Barden arrived on the 9th. They are from Lakeland, and Glen is a hand surgeon who teaches at the University of South Florida. He has seen some interesting cases; for example, a four year-old girl who fractured her forearm several months ago, and the family took her to a local bone healer who wrapped her arm with sticks and banana leaves. The circulation was cut off to her hand and she now has a Volkman’s ischemic contracture. The wrist and hand are flexed, and she cannot open her hand to hold anything. It is useless. Glen will operate on her next week. We are thankful that he and Em have come to share when there is such need as this.
    We received our Sign nails, and all is in order. My colleague, Dr. Hailu, registered Dr. Barden, me, and himself for a Sign conference at Black Lion hospital led by Dr.Yiheyis. We have been there daily, and the next few days we’ll be at the annual meeting of the Ethiopian Orthopaedic Society here at the Ghion hotel. This is not what I had planned for Glen, but he’s a trooper and enjoys meeting new friends from a different culture. Em and Barbara have made their contributions in non-medical ways.
    Dr Richard Koenig (surgeon) from Portland, Oregon, came with a bundle of supplies, and his twin brother from Holland arrived last night. They have been very supportive of the mission work here. They have arranged for the mobile-clinic vehicle to go out this Saturday to a rural area where Glen, myself and our wives signed up to spend 10 hours seeing 500-700 patients! I’ll report on that next week--after I recover!

-- Don

Journey Back to Addis Ababa, January 6, 2010

As readers may have noticed from our Christmas Newsletter post, we returned to our home in Orlando for a few weeks to enjoy the holidays with our children and spend time with our friends.
    Our journey back to Addis Ababa began at 4:30 AM, January 6, as we left our Orlando home for the airport. We were having unseasonably cold weather for Orlando, temperature about 31 F, which made for a very frosty send off. Our friends, Dr. Tom Allerton and Jake Dominey came to help us get to the airport. Kim, our daughter, came to see us. She brought her van over the night before, and we loaded our four pieces of luggage and two large boxes we were asked to bring. With the van and the car we were off to the airport.
    We were concerned about the amount of luggage we had as we were certainly over the limit and were expecting to pay $600 for extra luggage. The organization sending the boxes had given us a check to cover the anticipated fees. A skycap helped us unload, and Don told him why we were going to Ethiopia; he asked us to wait outside while he got his supervisor. Shortly, the supervisor appeared and asked for our passports and tickets. He left us standing in the cold morning air while he went to speak with a manager about our mission. After some time he returned and said the fees had been waived, tagged our luggage, gave us our boarding passes and gate number; we could hardly believe our miracle. The lines inside were exceedingly long, so we were most fortunate for a curbside check in. The security lines were also long, but we moved quickly through and now had a two-hour wait for our 8:00 AM departure. We had no complaints, however, as we were grateful for the ease with which we were able to check in.
    Our next good fortune came at O’Hare airport in Chicago when I asked for boarding passes for the Frankfort to Addis leg of the trip. I was given those passes and then handed two more. Not knowing why, I asked, “What are these for?”, and was told we were being bumped up to business class!! He got no arguments from me!! Don could hardly believe it when I told him what had happened. It was a wonderful flight, and as this was the longest part of the journey, we enjoyed the great seats and service.
    Our journey from Frankfort got off to a late start. We had to wait in the airplane for over an hour for a tour group that arrived late for their connecting flight. They came on board and after some time the captain told us we were now waiting for a gentleman to leave the plane who had decided he didn’t want to take this flight, and his checked baggage had to be located and off-loaded. This was a bit unsettling as I wondered if this passenger knew something the rest of us did not. With such heightened security I was hoping the flight attendants would really search around where he had been seated. At this point the entire plane load could have gladly given him a piece of their minds.
    Because of our late departure from Frankfort we arrived in Addis over an hour late. Our luggage was very slow being unloaded, and after about 45 minutes our last three pieces appeared. Now to get through customs. All our baggage was required to through the security machines and the piece with medical equipment opened. Don had to leave that at the airport, and Mr. Kim, the hospital administrator who came to meet us, said someone from the hospital would retrieve it later. We certainly hope so as it is wonderful equipment.
    It was good to see Mr. Kim and others who came to help us with transportation. They were a very welcome sight; I was once again reminded of how kind everyone has been to us. Soon after we arrived in our apartment, others began to come to offer greetings and gifts of food. These gestures were special touches, especially since we were leaving some very dear ones back in Florida. It was so wonderful to be home and visit with family and friends, but so hard to say goodbye again.
    And if I needed any more reassurance about coming back to Addis, I received it on Wednesday morning, Christmas Day in Addis. Jeeon, the eight year-old next door, knocked on our door about 9:00 AM and gave me such a huge hug and began to jump up and down in our little hallway. I have never been greeted with such excitement that would cause someone to jump up and down. She certainly “made my day.” Her sister, Heeon, soon joined us and juice and peanut butter crackers were offered, followed by Jeeon reading me a book. I was really tired with jet lag, but these little girls helped brighten my day and gave me some renewed energy to tackle unpacking and reorganizing our apartment.
    Lunch time in the dining room brought more special greetings from Korean hospital staff and the Ethiopian ladies who help prepare our food. After lunch, Mr. Kim took us to see the new apartments, but we think it will be sometime before they are ready to move in. The Internet connection is not installed, appliances aren’t in place, and the closet has no bars for hanging clothes. We are quite fine and comfortable in our present apartment, so are happy to wait until all is ready.
    In the evening Mr. Kim took us for a quick trip to the grocery store and then to get pizza and soup. A good ending to our first day back in Addis, January 7, Christmas Day for the Ethiopians. (See slideshow in sidebar.)

-- Barb