Greetings from Ethiopia!! The weather is cool, unlike Al Ain. I am enjoying a thick, rich, almost muddy cup of Ethiopian coffee. When I walked outside, I could see trees, hills, and green grass. I first went to Ethiopia in 2006. At that time, the hillside had a few carved pathways but no serious building yet. I had the opportunity to return and help out during the waiting time; I thought this would be a great way to help and also be prepared for Al Ain.

CURE Ethiopia is in the large town of Addis Ababa. The hospital sits on land close to the American Embassy. CURE opened this facility in 2008. Initially there were both orthopedics and plastic surgery physicians working here. Currently, the surgical staff are orthopedic surgeons. CURE Ethiopia has been approved as a part of the COSECSA orthopedic training program. Currently, Dr. Mesfin, an Ethiopian doctor training in Kijabe, is taking an ‘away’ elective here for six months. Two Ethiopians doctors have been in the CURE Kijabe COSECSA orthopedic residency the last four years. Both will finish this coming December, and fully trained orthopedists will return to Ethiopia in the future.

My trip to Addis was unremarkable. I think that is the very best compliment to give international travel. After a hour long wait in passport control, my passport was stamped and I exited to find my suitcase had arrived as planned. Waiting in the customs line, I saw the same young lady who was ahead of me at check-in in Dubai. This woman had two of the largest suitcases, stuffed to bulging, on her cart, along with major-sized carry-on pieces. The man behind the counter just shook his head. Even with help, the bags were a challenge to place on the weigh track. The man quietly pointed out the total weight allowed was way less than what she had in the bags. After a few minutes of animated discussion she shook her head and agreed to pay for overweight charges. She rolled her eyes at her friend and reluctantly went to the fee counter. Now here I was behind her at customs. Sure enough she was stopped. In Ethiopia, the bags go through x-ray as a part of the customs review. The young guy watching the monitor called out as she struggled to lift the first bag from the rollers. The second bag brought the viewer to his feet… “Three computers!” My bags slowly appeared from within and I pointed. He just waved at me and headed to stop the other bags from leaving the customs area. I quietly grabbed my bag and put on my small backpack and dodged through the now very loud impasse. This woman was not happy! My bags had nothing special within, but to be stopped would have been an additional nuisance I did not need. I wonder just how long this young woman would be there at customs discussing her treasures. Exiting the area, I entered the crowded arrival hall. A man carrying a CURE sign greeted me, and we were off.

Coming in later on a Sunday does have the advantage of less traffic. We wound through empty roundabouts and through sharp turning streets.  I had no idea where I was, nor could I offer any reasonable directions back if asked. We arrived safely at the hospital, and I was shown to my “penthouse.”

Morning arrived, and I found my way down to the ward. Seeing no real activity, I continued on to the operating area. Where else would a surgeon go… administration? I met Dr. Mary, the anesthesiologist. Mary showed me a couple of kids for surgery and asked if I was going to perform the operations. I told her that I guess that is why I was there. Dr. Mesfin was on his way. He had a long night with family illness.

CURE Ethiopia was opening after a New Year’s closing time. Monday, we had a teenager with a very crooked foot to straighten and then a 4-year-old girl with a dislocated hip, most likely from birth. Neither would be easy, but let’s start 2012.

The surgeries went well. The first foot required bony fusions to straighten the twisted club foot. Dr. Mesfin and I managed to get the foot looking much better.  Now came the real challenge. This rather chubby young girl had been limping for some time but had never been diagnosed and treated. Reducing a dislocated hip in a child is a challenge for sure. The surgery was planned within a staged decision process. I was pretty sure the entire plan would need to be done (hip – pelvis – femur – hip capsule – cast), but hope springs eternal, as the saying goes.

After the child was asleep and prepared for surgery, we opened the hip approaching from the front. The ball was rising very high above the poorly developed cup. Preparing the cup to receive the ball was done, and the hip was given a trial reduction. Nope, not good enough yet. The pelvis wing was then divided and the cup reoriented. This improved the hip appearance, but the tension was high and the tendency for instability still unacceptable. Onward. The thigh femur bone was approached and cut. The ball was now able to relax in the redesigned cup. The femur was shortened and detonated and fixed with a plate. X- rays confirmed the reduction and position. The capsule of the joint was then repaired and the wounds closed.

Now for the nasty part for the parents. We placed a plaster cast we call a 1 1/2 spica. The cast comes from the lower ribs to the pelvis and all the way down the right and to the knee on the left. We try to make sure all vital parts are available for care. Imagine the hassle to care for your little child in such a thing. I always feared one of my children would need one of these creations. But, on the other hand, a good hip is very important.

So the week started out well. We ran clinics, made rounds, and worked in the operating rooms throughout the week. I discovered an exercise bike in the therapy room I could adjust and then use. Every morning I received a steaming hot cup of dark Ethiopian coffee to kickstart the day. I am having a good visit.

Jana made it safely to Kijabe. We are able to email each other. Jana has been surprising many people with her visit. Over the month, she has several projects in line as well as many friendships to catch up on.

Both of us look to be facing a busy month. Seeing patients and working again in the operating rooms has been a joy. Although I often can not understand a word a patient and family says here, the problems are very similar to those of Kenya and, really, the world. The parents come seeking assistance for their child. Sometimes we can correct the impairment the child has; sometimes we are powerless to improve their function. All children can be given love, a smile, and attention. We try to support the families of children with severe disabilities. The families carry a heavy burden. I love to see the smiles of the families where the child has been restored to good function, but I mourn with those we must tell truthfully no medication or surgery will help. I do not know why such problems are allowed here on earth. I will never know this side. So, every day I give thanks for another day of life. I push on seeking the path of my call, knowing I am safe in His grip.