SCH Graduate Makes History

Recently, the very first graduate from the PAACS program in Ethiopia did something unique in his own country. He led a team that separated conjoined (“Siamese”) twins. To our knowledge, nothing like that had ever been attempted in Ethiopia. Dr. Frehun Ayele, who trained as a pediatric surgeon at the BethanyKids at Kijabe Hospital PAACS program after graduating from the general surgery program in Ethiopia, led a team of surgeons from Myungsung Christian Medical Center to perform the incredibly delicate and complicated operation. The baby sisters were born at a health center in the countryside and were abandoned by their mother. They were given to a Catholic mission group here who then brought them to MCM. One of the twins had a severe, fatal heart defect and it soon became clear that she could not survive. This made transfer abroad impossible because of time considerations, so Frehun made the difficult decision to take them to the operating room to separate them. It was clear that one of the twins would die, sacrificing her life for her sister's. Dr. Frehun concluded that if he did not intervene urgently, both babies would die. The surviving twin, Mariam, is doing well. Please pray for her as she recovers. We praise God for Frehun's faithfulness in serving Him as he serves the sick children of Ethiopia.

Frehun Ayele watching the preparation of the two children prior to their separation
Conjoined twins at Myungsung Christian Medical Center were lovingly cared for

Hot Zone in Soddo

Last week, we had some pediatric patients come in with upper respiratory symptoms.  A few of them had a rash and had been given antibiotics, so there was a thought that maybe it was a "drug-related rash."  But it wasn't long before a few more kids came in, and it was clear that this wasn't a medication-induced rash.  Yep, this was measles.

photo 1
Typical measles rash
Sometimes the spots coalesce into larger lesions like this one.
Sometimes the spots coalesce into larger lesions like this one.

It didn't take long before our entire pediatric ward was full of measles patients.  We were in the middle of a genuine outbreak.  The feared complication of measles is pneumonia, and indeed most of the patients we were getting had it.  Many have them were requiring oxygen.  In the picture below, the machines on the floor are oxygen concentrators.

Pedi ward full of measles patients - most with pneumonia and on oxygen.
Pedi ward full of measles patients - most with pneumonia and on oxygen.

The health department was notified, and they began taking measures.  Much of the outbreak was centered on an orphanage down the street from us.  So we contacted them and gave them specific instructions.  First, isolate any kids that were showing symptoms.  Second, send any kids to the hospital that were showing signs of pneumonia or respiratory distress.  We took a trip down to the orphanage ourselves to see the patients who were not sent to the hospital and check on them.

Dr. Mehret checking out one of the babies.
Dr. Mehret checking out one of the babies.

By God's grace, the outbreak seems to be relenting.  Our hospital has admitted around 15 kids.  Sadly, a few of them have succumbed to the disease.  The thing about measles in outbreak settings, is that it affects the very young.  Children are vaccinated against this virus between nine months and one year of age.  So the most vulnerable are the babies less than nine months.  Formula-fed babies (like the orphans) are particularly vulnerable because they don't get protective maternal antibodies.  Fortunately, some who were very sick are pulling through.   The situation itself feels like a war zone.  Our doctors and our nurses are tired, but they are doing an amazing job - rising to the occasion and providing excellent care.  We praise God for using us in this situation, and hope to bring Him glory through it.  As it says in 1 Cor 15:58, "Be steadfast, immovable, always abounding in the work of the Lord, knowing that in the Lord your labor is not in vain."  Pray that we will be steadfast.  And that no more of these precious little ones will die.

The other thing about situations like this, is that it stretches our thin resources to the maximum.  We don't have enough oxygen concentrators.  We don't have enough pulse oximeters.  And we can't mechanically ventilate kids with severe pneumonia.  We hope to buy non-invasive ventilator machines, and perhaps one or two mechanical ventilators.  We'd love to be even better prepared the next time this happens.  Would you consider a donation today that would help us do that?  Just click donate in the upper right corner of the site.  Thanks for your support and prayers.


What? You don't have Idraparinux?

rx-medsWhat kinds of medications are available at an African mission hospital, and from whom do you procure them?  These are questions that we get asked a lot.  Here are two lists.  Five things we have, and five things we don't!  Most of our medications are imported from Europe and Asia.  A few are made locally in Ethiopia.  One thing we can't use is expired meds - it's prohibited by law - so even though we'd like to take these off your hands, please don't send them to us!

Five medications we have:

  1.  Most antibiotics!   We have penicillins, 3rd generation cephalosporins, macrolides, aminoglycosides, fluoroquinolones.  We even have vancomycin most of the time.
  2. Pain meds:  For mild pain, we carry ibuprofen and tylenol. We also have stronger IV pain meds for our surgical patients, and fractures.
  3. Blood pressure and diabetes medications.  We have oral calcium channel blockers, ACE inhibitors, diuretics, and some beta-blockers.  We use metformin and glibencamide for diabetes control, and we also have insulin.
  4. Albuterol multi-dose inhalers.  These are key for our chronic asthma patients, and COPD patients.  We don't have nebulized albuterol (which we'd like to have), but we can substitute these MDIs, and they work quite well.
  5. GI problems?  We've got proton pump inhibitors (Prilosec for example), and we even have Zofran for nausea and vomiting.

Five medications we don't have.  We are hoping that in time, our access to some of these meds will improve:

  1. Fancy antibiotics.  Anti-pseudomonal penicillins like Timentin and Zosyn.  These are great for severe infections.  Also, we still lack a good IV first generation cephalosporin.
  2. Artesunate.  This is the WHO-recommended standard for IV treatment of severe malaria.  It is difficult to find however, and we rarely have it.  Instead, we use Quinine which is an acceptable but less desirable medication.
  3. Newer blood pressure and heart failure medications like Carvedilol.   Also, newer diabetes meds like long-acting insulins.
  4. Low-molecular weight heparin.  Ever heard of Lovenox?  It makes treating deep venous thrombosis and pulmonary embolism so much easier.  But alas, it is rarely available on the African market.
  5. IV calcium and sodium bicarbonate - rarely we will have these.  It does create problems managing a hyperkalemic patient or profoundly hypocalcemic patient.  We have other therapies that we can use though.

Others you are wondering about?  Ask in the comments and we'll respond!

One in a Million Babies

tripletsOne in 729,000.  That is the odds of having quadruplets naturally - without the aid of fertility medicines.  And for this young Ethiopian lady, it happened 5 days ago.  With no prenatal care, and no knowledge of the multiple babies she was carrying, she made the trek from her rural home to the local health center.  There she gave birth to four babies, one of whom died soon after birth.

She was advised to seek further care at a hospital, and found her way to us.  The mother herself is being treated with antibiotics for a suspected uterine infection, but she is expected to make a full recovery.  The three surviving kids are doing well.  Two of them have a mild omphalitis (an infection of the umbilical cord stump) and are being treated with IV antibiotics.  They are expected to do well.

The three celebrated the Ethiopian New Year yesterday on their fourth day of life.  The new family is the talk of the hospital as we ring in the New Year.  A multiple gestation pregnancy is high-risk in any country, but especially here where over 90% of the women have no access to prenatal care.  Though we mourn the loss of one of the babies, we praise God for the miracle of a healthy mom and three healthy infants.

6 Ways We Are Reaching the Poorest of the Poor

woman-and-sonBeing a mission hospital means taking care of the poor.  We are commanded to do this by Jesus, and it is something we desire to do.  If we offer free care, we will be inundated with patients.  How could we possibly treat them all?  If we charge for the care, we may overlook many who are very poor.  What can we do?

  1. First, everyone is expected to pay something.  Even if it is only a few cents.  It is simply not sustainable for us to provide free care.  Indeed, most Africans have a social safety net made up of family, friends, church members, etc. who can contribute to their medical expenses.  However, we recognize that this will not be enough for some patients.  For them, we have a Benevolent Fund that can cover their costs.
  2. We have a committee of nationals who evaluate patients and their eligibility for the Benevolent Fund.  In a country like Ethiopia, where many in the population live on less than $1 per day, it can be difficult to sort out who are the poorest among the poor.  Particularly for Westerners working here.  Relative to our background, everyone seems poor, and we would likely put everyone on the Benevolent Fund.  That is why it is so crucial to have nationals evaluate these situations on a case-by-case basis.
  3. We lower costs as much as possible by using expatriate specialist staff who are funded separately through their respective mission agencies.  We still have to pay for all the operating costs of the hospital, the nursing staff, our national doctors, and supplies.  But we offset these costs with donations and some volunteer staff.  Much of our equipment is donated which lowers capital expenses for the hospital and this is passed on to patients.
  4. The rural poor in Africa have less than a 10% chance of seeing a doctor in their lifetime.  The medical services simply do not exist for the vast numbers of people.  (Ethiopia alone has close to 100 million inhabitants.)  Ultimately, it comes down to training.  We are training surgeons, physicians, medical students, and nurses.  If we are truly going to expand our reach to the poorest of the poor, we must increase capacity in the face of such great need.
  5. We are going out into the community with Community Health Evangelism, Helicopter Outreaches to the T'ara people, and rural prenatal clinics. These initiatives are taking the Gospel and quality medical care to rural poor who would otherwise never see a a doctor.
  6. Your donations make a difference.  As we have written on here before, 96% of the money you give on this site, goes directly to Ethiopia.  A significant portion of that goes to the Benevolent Fund.  Which in turn pays for care for the poorest of the poor.

Click here to give today, and know that you are giving to an organization that is doing all it can to reach "the least of these."






The Best Hospital in Ethiopia

ribbonSo I'm a little biased, but I think that Soddo Christian Hospital has a chance to be the best hospital in Ethiopia.  Does that matter?  Is that something we should strive for?

In the United St.ates, the Christian church pioneered health care.  If you look around your town, chances are the hospitals are named things like St.. Luke's or Baptist Medical Center.  The reason is that Christians have always been at the forefront of caring for the sick among us.  It is the natural outworking of our faith.  When Jesus's disciples asked him, "Lord when did we see you sick and visit you?", he tells them that whatever they did "for the least of these" was done unto Him.  So Christians have often been found caring for the sick and disabled.

Now, when we look at the landscape of hospitals in Ethiopia, why shouldn't Soddo Christian Hospital be the best?  Our mission and vision states that we desire to provide excellent medical services.  This striving for excellence is an effort to glorify God in all we do (1 Cor. 10:31).  We want people in Ethiopia to look to Soddo Christian Hospital - a medium sized hospital in out-of-the-way Wolaitta - as raising the bar for health care in Ethiopia at the same time we are expanding God's kingdom.

When people ask me, why does a hospital in rural, southern Ethiopia need to be the standard bearer for the country, I point them to the Mayo Clinic in Rochester, Minnesota.  At around 100,000 inhabitants, Rochester is not even among the top 200 most populous cities in the US.  Yet many patients flock to receive care at the Mayo Clinic, and it has consistently been ranked as one of the top hospitals in the country.  It is also considered one of the best places to work in the St.ates.

So, Soddo Christian Hospital could be the Mayo Clinic of south Ethiopia!  Soddo, like Rochester, has close to 100,000 population.  And out of the 150 or so hospitals spread across Ethiopia, patients are choosing to come all the way down here to get their care.  We are proud to be setting a new standard for health care in Ethiopia, and pray that it will give us opportunities to treat more patients and witness to the glory of Christ.

What's Your Specialty?

At Soddo Christian Hospital, we offer all types of general and specialized care.  Here's a sampling of specialized services that we offer at Soddo Christian Hospital:

  • We have an outpatient department with an emergency room and non-urgent primary care.  We see pediatric and adult patients.  Our general medical staff includes a US-trained pediatrician, emergency physician, family nurse practitioner, and tropical disease expert.  We have a European-trained geriatrician, as well as a national internal medicine specialist who sees clinic patients and inpatients.
  • We have two, that's right TWO, US-trained general and trauma surgeons.  They serve as the primary faculty advisors for the general surgery residency program at the hospital.  (Yes, we are a teaching hospital affiliated with the Pan-African Academy of Christian Surgeons).  This team performs other surgeries as well including a fair amount of urologic procedures.
  • Orthopedic Surgery - we have a US-trained orthopedic surgeon and perform a full gamut of bone and joint surgeries with pediatric and adult patients, including arthroscopic surgery!
  • Obstetrics & Gynecology - our US-trained obstetrician and team of midwives perform deliveries and C-sections as well as expert gynecology services.
  • Subspecialties are available on an occasional basis.  Through World Medical Mission, we have plastic surgeons, ENT (ear, nose & throat), urologists, and neurosurgeons come and work in Soddo on a frequent basis.

As you can see, we are well staffed to take care of all types of emergent and non-emergent conditions!

Does a mission hospital treat everyone?

This is a question that we get asked a lot.  So we wanted to address it.  And the answer is... yes!

Our hospital is a mission hospital.  You can read all about our mission and values here.  But suffice it to say, that we exist not just to treat people with excellent medical care, but to proclaim the Gospel of Jesus Christ and make disciples.

But do we treat anyone who comes in the door, no matter what their faith or background?  Of course we do!  We are proud to serve the people of this part of Ethiopia.  Fortunately, as our reputation has grown, now we are also seeing patients referred to us from all over the country.  And these patients come from all types of backgrounds.  Some are Ethiopian Orthodox, some are Muslim, some are animistic, and some are Protestant.  We see and treat them all.

In the hospital, our staff will offer to pray with patients regardless of their background.  We believe that a person's health should be attended to physically and spiritually.  We find that our patients really respond to the fact that we care about them in this wholistic manner.

Often, if a patient is open to hearing about it, we will share with them the life-giving message of the Gospel.  We don't force it.  But we do give them the opportunity to hear.  We play the Jesus Film in the hospital.  We will often provide a Bible in Amharic.  By God's grace, we have seen over 500 patients profess faith in Christ since the hospital opened its doors.  But even for those that kindly decline, we aim to provide excellent care just the same.