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Healing the Children

More Than a Surgical Mission

When Desi Ferrell, Executive Director of the Philadelphia chapter, visited Black Lion Hospital in Addis Ababa, Ethiopia a year ago, she was overwhelmed by the magnitude of the problems. The hospital, once the flagship of Ethiopia’s public healthcare system had fallen into disrepair. The pediatric ward was filled with well-appearing children. Each had a plastic tube in the neck (tracheotomy) to breath. The children had such severe problems with their voice boxes that they might die if the tube became clogged. In a country with few paved roads and unreliable electricity, it was unsafe to send them home. They were trapped in the hospital – some for years.

Desi recognized that helping these children would take more than a surgical mission. She contacted Glenn Isaacson, MD, a pediatric ear, nose and throat doctor (otolaryngologist) who had worked with Healing the Children for 15 years. Through a series of e-mail conversions with doctors at Black Lion, it became clear that advanced surgery, as HTC-Philadelphia delivers in Central and South America would not be enough. These children needed continuing care – the kind that can be delivered only by well-trained surgeons in the host country. The doctors at Black Lion needed equipment and supplies, but more important they needed on-the-job training in special surgical skills.

This is not the stuff of most surgical missions. Sure we can care for dozens of children on a one week mission, but Ethiopia has over 30 million children, most living in poverty, and only 6 practicing otolaryngologists. The hope for the future was a new residency that was training the next generation of ear, nose and throat surgeons. How could HTC-Philadelphia provide them with the surgical experience needed to care for a country full of kids?

Desi swung into action. She assembled a team of nurses, anesthesiologists and nurse anesthetists ready to care for children half a world away. And she found a partner in Ebba K Ebba, MD, an Ethiopian-born, US-trained pediatrician who was working to build a children’s hospital in Addis. Together, they made contacts, arranged for housing, and purchased and transported the large surgical microscope needed to fix the children’s breathing tubes.

In October 2009, HTC visited Black Lion and assessed their needs. This scouting trip was essential for planning future surgical missions. The team learned of Black Lion’s strengths and its weaknesses. They heard of ill-prepared medical missions in the past that led to poor outcomes and deaths. The next six months were spent assembling an experienced and well-equipped team – a team of caring professionals there to support safe surgery and to teach.

In March of 2010 HTC launched its most ambitious mission yet. It included 30 healthcare providers -- surgeons, and anesthesiologists as usual, but also an audiologist to do hearing testing and fit hearing aids (Amber Morgan, AuD) and a biomedical technician to fix broken anesthesia machines and monitors.   Clinics and surgery dates were planned as usual, but each was coordinated with otolaryngology residents and nurse anesthesia master students. Every OR session was a teaching session. The team gave lectures and provided hands-on training.

Mike Richtie an outstanding pediatric urologist and HTC-Philadelphia veteran gave grand rounds to the Black Lion pediatricians and pediatrics residents. He performed a series of surgeries for severe, neglected bladder and genitourinary disorders. Every case was a teaching case for the Black Lion pediatric surgeons.

HTC-Philadelphia reached beyond the surgical realm in other ways. Liz Drum and several of the nurse anesthetists went to a newly opened public hospital for neurosurgery to provide advanced anesthesia care for children with spinal cord defects and tumors. Amber Morgan worked at the Makanissa School for the Deaf fitting children for hearing aids and teaching the local technicians to be better hearing testers.

The mission was exhausting and elating. HTC cared for over 200 children and performed over major 30 procedures. More important, however, the  mission laid the groundwork for continuing education and training of Ethiopian surgeons, nurses and nurse anesthetists -- the best hope for Ethiopian children in the future.

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