Bahir Dar Mission Fall 2009

2009-12-03T14:39:00.001-08:00

2009-12-03T14:30:00.001-08:00

December 3 2009

This is our final entry. Several of our team arrived home a few weeks ago, but most of the Kelowna team stayed longer to go on a safari in Tanzania (a totally different adventure).

Because internet access and availability was unreliable we decided to summarize upon our return and quite honestly, one needs time to reflect upon everything we experienced and accomplished.

We were a team of 28, 23 Canadians, 15 from Kelowna and the balance were from Vancouver, Calgary, Nelson, and Comox. We did 85 operations over the seven surgery days. Approximately 75% were cleft lips and palates and the balance were much lengthier operations (sometimes 5-6 hours) repairing contractures from burns, mostly on the hands; some unusual surgeries such as a tumour around the ulna nerve which affected the young girl’s ability to use her arm, partial removal of a hemangioma on a young woman’s head which was encroaching on her eye and affecting her ability to see, and as mentioned earlier, a gunshot wound and a severe dog bite.

The surgical days were long, arriving at 7:00 am; several staff not leaving until the last patient was out of recovery and settled in the ward, which would often be around 7:30. The local health authority had loaned us a bus and a driver so they made several trips at the end of the day making sure we left no one behind!

The work days seem longer than at home because of the difficult hospital conditions, equipment breakdowns, shortage of supplies ,the need for translators to solve the simplest problem , compounded with the lack of sleep due to the poor accommodation - bedbugs , malaria mosquitoes ,and various other sundry pests . The change in eating habits also contributed to everyone having at least one bout of tourista - some survived on granola bars and peanut butter. (It was handy travelling with Drs and nurses, as they came prepared with various remedies –so we all survived!). In fact these challenges seemed to gel the team as we all worked extremely well together! Consider that many of us had never met and were thrown together for the first time.

Thursday November 12 was “clinic day” where we hoped to see the results of our work several days post op. Some of the children stayed the whole 7 days in hospital or nearby (maybe under a tree) because they lived too far away and /or their surgery had been complicated, i.e. skin grafts. About 35 children returned for clinic which was a joyous and tearful occasion to see the smiles on everyone faces. We also performed 3 dressing changes under anaesthesia that day.

Dr. Solomon (an Ethiopian plastic surgeon now living in San Francisco who travelled with us ) was able to organize follow up care with Dr .Merku from the local hospital – so return appointments were made for several of our burn surgeries.

After the clinic we said our goodbyes - to the patients and their families (many we had a special bond with); the Ethiopian hospital staff from the cleaners to the nurses; and our Rotaracts – the young people who were invaluable ,who made our job so much easier and fun. A very emotional time for everyone .

I know I am speaking for everyone on the team - we not only changed the lives of 85 children and their families but our lives have been changed forever and somehow the world seems a little bit smaller.

Most important of all, we could not have done this without YOU our donors!!

Ameseginalehu (thank you). Jean Bird

2009-11-12T02:35:00.001-08:00

Wednesday November 10, 2009

Tomorrow is our last day of surgery – 14 cases booked. Our recovery room is overflowing; some children on mattresses on the floor, other pre-operative patients have to find their own accommodation for the night, maybe camping on our doorstep, returning for surgery tomorrow morning.

We had two interesting cases arrive late in the day as we were finishing our slate. We decided to stay late and fit them in. One was a young woman from the border of Ethiopia and Sudan. She had traveled over 300 kms and had severe facial deformities. Though an interpreter we determined that her neighbor brought her hoping we could repair her deformity so could be traded to the brother of his potential bride. The second case was a small boy rushed in by his father with serious facial injuries caused by dog bites. After several hours of surgery they were able to save his eye and close his wounds. It is yet to be determined if the dog has rabies and there is no treatment available for rabies in Ethiopia. If we had not been on site, this child probably would not have received emergency plastic surgery - a lucky boy.

We have had many challenges running patient admission with medical records, a 3 bed operating room, recovery room and post-operative beds. Every day we have water and power outages. It has kept our quartermaster and assistant team leader busy being inventive to keep these systems functioning. One day the scrub team was scrubbing up out of a barrel and a bucket. Today, we ran our Oxygen and it is being delivered from Gondor about 3 hours away. We are constantly short of very basic supplies and drugs and forces us to be very innovative and resourceful. Despite this, these kids are little miracles. We have done good work – thanks to your help.

Tomorrow we do 14 operations. Thursday is clinic day when we do our post-op visits for all surgical patients and then we pack up. We hope to gather for final dinner late Thursday evening. We leave Friday morning for Addis Ababa. Some of us are returning home, others are going on the Tanzania for a 5 day safari.

We will post pictures and more thoughts when we return. Extremely slow internet access here has prohibited loading any pictures.

Tuesday November 9

We had a day off yesterday and the Rotaracts planned a variety of tours for us to choose from - a boat trip on Lake Tana to visit the island monasteries , a short trip down the Blue Nile , a hike to visit the Blue Falls (spectacular) and/or a trip to Gondar to see the ancient castles. It was a welcome relief for fresh air, sunshine and some beautiful scenery. Now we are rejuvenated and ready for tomorrow’s surgeries.

We have seen and assessed 107 patients ranging in age from 8 months to 72 years. As of the end of today, we completed 54 surgeries. We have an additional 24 surgeries slated over the next two days for a total of 79. Our numbers are fewer this trip but several of the surgeries have been long repairs of burn scars which take many hours to complete. We have had two children with malaria and one with possible typhoid which we treated prophylactically.

In rural Ethiopia, the women tend to do the work on the farms so it is often the fathers or uncles who bring the children to the clinic. They are great caregivers. One young father was helping all the children in our very crowded post op room.

Many children arrive in rags ,filthy dirty-the showers are not working so we try to do sponge baths before surgery and give them the children’s clothes we have brought with us .We have been giving some of the adults our own shirts to wear.

Our post-op patients often have no water, juice or food for their children as all their Birr was used to travel here, often very long distances. Thanks to your donations we are able to provide juice and water. Most of the babies don’t have diapers so they pee and poop on the floor which creates havoc for the other children and staff.

It is now 7:30 pm, many of our team are still with our patients. They often don’t get back to the hotel until 8 or 9 pm.

Some of your cash donations have gone to purchase the apple juice and water. One of the biggest hits has been the soccer balls that were purchased prior to the trip. Soccer is “the” national sport evidenced by the large crowd in a makeshift theatre across from our hotel, with rows of wooden benches and a sheet for a screen.

Every day there are “happy tears” from staff, patients and families. One 12 year old boy was so excited that he can now go to school! Long days but well worth the outcome – so rewarding to see young children, even toddlers see their new smile in the mirror with expressions of disbelief. The operative word here is KONJO (beautiful).

We are grateful to be able to make this happen. Your donations have changed the lives of 79 children, many families and all our staff.

AMESEGINALEHU - thank you in Amharic

2009-11-06T09:30:00.000-08:00

Friday November 6, 2009

A short note tonight as we were late getting the last of the patients out of recovery. We have done a number of quite large cases. Interesting for our medical team and wonderful for our patients who may never have had this opportunity.

The local Rotaract team put on a lovely candle light garden party, with Ethiopian entertainment, for us last evening. This evening was a more formal dinner with the local Rotary Club. Not all of us were able to attend because we were still caring for the last of the surgical patients.

We have lots of great pictures but have been unable to post due to internet issues. We'll try later when we are in Addis.

Thanks again to all of you for your support.

2009-11-06T09:20:00.001-08:00

9 pm Wednesday November 5, 2009

Out first day of surgery in Bahir Dar – despite many challenges, a success! Thirteen patients had surgery; many more are booked into next week. Forty-eight patients have been assessed. Not all are candidates for surgery. Most present with cleft lip or palates but we are seeing several children with severe burns and contractures to their hands – they fall in open cooking fires. One young woman had been shot in the neck about 1 month ago. She has bone fragments from her jaw lodged in her neck. This is causing severe infection and ulcerations. She is slated for surgery. Apparently, the shooting was intentional. Another young mother brought in her very handicapped 5 year old. After many questions through the interpreter, the child was diagnosed with cerebral palsy. The mother then admitted that she had been told that by a local doctor but hoped for some better diagnosis from our western team. Very sad to send her home with no hope.

The local Rotoract and Rotary members were again our live savers, making miracles happen when we need supplies or help. They are providing all our interpretation – at admission, assessment, surgery, recovery and home. Our work would be impossible without them. The local families are also an inspiration. Many travel, often by foot, for 50, 100, 150 or more kms to be seen. They are waiting on our door step in the morning when we arrive at 7am. They often camp for several nights waiting to be seen or for surgery. They come with so much hope in our abilities. It is difficult when we can’t fulfill those hopes.

We have experienced many challenges. After arriving in Addis on Sunday night, with almost 40 boxes of medical supplies and equipment, customs held back all the boxes. It took major negotiations until 8 pm Monday ( a day and a half) by Sandra and Brian to get the boxes released and on their way to Bahir Dar – a 9 hour drive. They finally arrived during the night on Monday ready for our set up Tuesday morning. Our accommodations have been difficult to adjust, as well. We are a very run down guest house – showers not working, screens missing (malaria in endemic here), towels and toilet paper difficult to get, food almost inedible, etc. We are learning to cope but it is difficult when we are putting in 12-14 hour days. Much of equipment is malfunctioning as well – lots of technical glitches that eat up precious time. Gas tanks required and the anaesthetic machines we have don’t have compatible fittings. One of Rotoractors (a young dentist) came to rescue. He along, with our intrepid and creative anaesthetists, got 2 machines running; a third OR table operated using local anaesthetic.

Tomorrow we have 10 cases slated, many 2-3 hours long. We have a great team, everyone generous with their time and help.

It is now 8 pm, the final patient is just coming out of surgery. Some of us will wait until they come out of recovery. Local nurses will watch over them through the night. The bus will be at our compound at 6:30 am to start again.

Wonder what’s for supper!

2009-11-03T08:14:00.000-08:00

6pm Tuesday

Hi everyone,

We arrived yesterday (Monday) after almost 3 days of travelling. After checking into our guesthouse on Lake Tana (a backpackers hostel!) we spent the rest of the day at the clinic cleaning. The building we were assigned had not been used for several months - dead bugs, cobwebs, cockroaches, left over supplies, dirty floors, etc. So, we all went to work and in a few hours we made a difference and felt ready for setup the next day.

Upon arrival at the clinic, we were greeted by several families with their children eagerly waiting to be seen. We also had a tour of the adjoining hospital - the only hospital in western Ethiopia. We saw the waiting room - at least 100 people waiting to be seen by a doctor. All had appointments but would have to come back every day for several days before they could be seen. The physician situtation is very poor here - a brain drain occurs. They are educated in Ethiopia but leave for greener pastures abroad. The emergency room is one single room. The pediatric ward was very crowded - 6 to 8 children in one small room - one infant dying of malaria.

There is also a Fistula hospital next door which we have not yet toured but hope to visit in the coming week. It is staffed by Autralians and funded initially by Oprah. We will report back on this visit.

Today was our first clinic day. Lots of technology issues initally but by the end of the day we had successfully assessed and slated for surgey 32 children over the next few days.

We have an incredible team; good comraderie. Out of a team of 29, 23 are Canadians. We would not have accomplished this without the help of eager young Rotoract members (Rotarians under 30 years of age) who have acted as our translators and liaised with hospital administration.

Tomorrow is our first surgery day with 13 patients. We get an early start at 6:30 am.

As technology permits, we will try to post some pictures.

One week to go.....

2009-10-25T16:45:00.000-07:00

Team Bahir Dar 2009 is into the final countdown for our upcoming Rotaplast mission to Ethiopia!

We leave Kelowna on Friday Oct 30, arriving in Bahir Dar early on Monday, Nov 2. Monday will be our set-up day with surgeries commencing Tuesday. We hope to complete 10-12 surgeries per day for a total of 100 over the 2 week mission.

We plan to post updates on our blog once per day depending on internet access.

Many thanks to all our generous donors and supporters.