Stacia Neale, Fundraising Operations for HealthyKids International (HKI), is blogging on her experiences as she accompanies the SickKids No Boundaries team to Ethiopia to oversee the filming of a documentary. Read all her posts here.
Note: Due to insurmountable internet problems, I was unable to post the rest of my entries while still in Ethiopia.
Tuesday was our first official day of surgery. Although it was Timkat, Ethiopia’s Orthodox celebration of Epiphany, both the Ear, Nose and Throat (ENT) and Orthopaedics teams had procedures scheduled to make up for Monday’s delays. The bags containing our medical supplies were delivered to the Hospital in the morning from a hold up in customs but each item still needed to be checked and rechecked by the Ministry of Health.
Once the bags were released, we unpacked so the teams could set up their ORs and the recovery room efficiently and expeditiously. While nurses arranged the rooms to their liking and the anesthesiologists set up their equipment, Dr. Andrew Howard and Dr. Blake Papsin reviewed their list of cases with their respective Fellow and Resident. As he waited for the patients to arrive, Dr. Papsin began pumping up some of the 20 or so soccer balls that the ENT team brought from home to hand out to patients in post-op.
Before I continue, I want to try and describe Black Lion Hospital to you. Obviously, it is very, very different from SickKids. Its architecture is similar to many other buildings in Addis Ababa, with its angular beige Communist-era, Eastern-block construction. Unlike the brightly decorated walls and immaculately clean spaces at The Hospital for Sick Children (SickKids), Black Lion has very few embellishments and a much-less-than-what-I-am-used-to level of cleanliness. With the exception of the newly donated cardiac unit (which, according to one of the No Boundaries anesthesiologists who was invited for a tour, apparently rivals SickKids), most of the wards are hot and stuffy, cramped and run down.
Walking the halls is an assault on every one of your senses. The beds and equipment are antiquated and inadequate. There are people everywhere – sitting on benches waiting for loved ones, sleeping in the halls waiting for treatment and visiting with in-patients. Some people are laughing, others are crying. Some people are well and others are sick, some with illnesses and injuries that gave me pause, to say the least. All of the hallways on the ground floor open to a green space filled with tables and tents, where people have congregated to wait, eat and pray. The waiting room for the Emergency Room is outside. In the OR unit, the sterile spaces are separated from the non-sterile ones by a green line painted on the ground. We are all required to wear scrubs and caps and booties in the sterile areas (even outside the ORs) and yet they perform operations with the windows open. 
They do so much with so little here. They are understaffed, undertrained and undersupplied. During my visit, I watched many of the Black Lion doctors and nurses stick like glue to their SickKids counterparts, who patiently explained procedures and fielded questions. One such memorable example was during the ENT surgery where Dr. Papsin and his team created an eardrum and ear canal for a young girl named Hana who was born with an underdeveloped ear. It was an amazing opportunity for knowledge transfer, and for the SickKids team to learn about the challenges that the Black Lion teams face every day.
Stacia Neale, Fundraising Operations for HealthyKids International (HKI), is blogging on her experiences as she accompanies the SickKids No Boundaries team to Ethiopia to oversee the filming of a documentary. Read all her posts here.
We still didn’t have our supply bags on Monday morning, so Graeme (our videographer) and I set out to do rounds at the Black Lion Hospital Ear, Nose & Throat (ENT) clinic with Dr. Blake Papsin, SickKids staff otolaryngologist. With us was his team consisting of fifth-year ENT resident Dr. Jane Lea and nurses Lisa Papsin and Vanessa Chu. PACU nurse Ruth Doerksen joined us as well as Black Lion’s ENT expert, Dr. Abebe Melaku.
Photo: Me with a new friend
As we approached the ENT clinic, parents hurried their children along to keep up with us so they could be among the first in line. Most of the kids we were going to see were referrals from Dr. Abebe (here, it is customary to use a person’s title and first name when addressing him), patients who had been waiting for months in anticipation of “Dr. Blake’s” arrival.
When we arrived at the clinic, we were greeted by an ocean of people. The crowd standing outside was overwhelming and their expectations were high. We wedged ourselves into a tiny office along with Dr. Abebe’s residents, third-year Dr. Assefa Tesfaye and second-year Dr. Alene Meshesha as well as an ENT nurse. We stayed in that hot little room for hours, seeing well over 30 patients, many with complex cases. Dr. Papsin confirmed he would be operating on four of them the following day. One boy and his father travelled two days from the Sudanese border to be seen by the doctor from Canada.
At one point, needing some air, I let myself out into the waiting room full of people. It seems nothing breaks the ice better than a camera. Soon I was swarmed by kids wanting to be in our pictures and video. Many were eager to try out our cameras. It was one of the most fun times I have ever had. Graeme eventually came out and the two of us played with kids for over an hour. By the time the team was ready to go, almost all of the families had received a consultation.
Being in that clinic was one of the most moving experiences of my life. Everyone was treated with kindness and dignity and the kids were so hopeful for treatment. Parents sat patiently by and waited for the translation of Dr. Papsin and his team’s diagnoses. Even if the children were in pain, they allowed all of the doctors to perform examinations so that everyone could provide their medical expertise. Any worry I had about HealthyKids International not affecting real change immediately vanished. This was real. The help was real. The collaboration was real. The difference we made was instantaneous.
The kids all left with toys. Their parents left with a sense of calm and reassurance. Dr. Papsin and Dr. Lea left with a full day’s roster of surgical patients. Graeme left with amazing footage. I left with a heart full of hope and a sense of satisfaction that HKI is on the right track.
After an inspiring morning, we left the clinic and headed over to the OR to set up for the next day’s surgeries. Much to our relief, we heard our medical supplies had been released by customs but still needed to be audited by the Ministry of Health at the hospital before we could have access to their contents.
For me, even a major administrative inconvenience couldn’t diminish what I experienced in the morning. There are so many people here who need help. They manage to do so much with so little here. The success of the clinic wasn’t a socio-economic issue it was an issue of humanity. And I was so proud to be a part of it.
Stacia Neale, Fundraising Operations for HealthyKids International (HKI), is blogging on her experiences as she accompanies the SickKids No Boundaries team to Ethiopia to oversee the filming of a documentary. Read all her posts here.
Some members from this year's SickKids No Boundaries Team in Dubai, waiting for our flight to Addis Ababa. I am second from the left.
A view of Addis Ababa, Ethiopia.
The sign outside Black Lion Hospital in Addis Ababa.
Dr. Blake Papsin, SickKids staff otolaryngologist, at Black Lion ENT clinic. On his right is third-year Black Lion ENT resident, Dr. Assefa Tesfaye.
Dr. Andrew Howard, SickKids orthopaedic surgeon, at Black Lion Hospital Ortho clinic. Dr. Howard saw about 35 kids in less than three hours. There were at least 35 kids who still had to be seen when we left.
Research nurse (here on the PACU team), Carolyne Pehora, teaches a class of nurse educators on how to care for a paediatric surgical patient.
Dr. Blake Papsin with the Head of Black Lion's ENT Dept., Dr. Abebe Melaku.
Punctured eardrum caused by infection? Not anymore!
Dr. Blake Papsin performs ear surgery while Dr. Abebe Melaku (seated), resident Dr. Alene Meshasha and Dr. Jane Lea (SickKids Resident) observe. Note the soccer balls that came with us to be handed out in post-op.
Some PACU carts are set up in the recovery room. All items were donated.
Having a laugh while we wait for the Department of Health auditors to re-check our bags.
Unless otherwise specified, all photos are courtesy of Stacia Neale. Copyright 2010.