Ethiopia Medical Mission July 2016

Rachel Werner- Save a Child’s Heart Child Life Specialist

July 10

We found out on the way to the clinic at 5:00pm, that it was a clinic day of follow ups. I wasn’t expecting to see children that I know and also those that I have read about and heard endearing stories of on the first day!

Walking up four flights of stairs to the ward was winding, but then arriving to see those smiling faces of what felt like old friends was a burst of fresh air. We all quickly said hello to the children and went inside the room to get to work.  Within about 7 minutes, what was an office room, turned into a dual echocardiogram room.

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Dr. Tamir and Yifat prep for the evening of screenings

Cardiac Technician Yifat Brosh and Head of Cardiology, Dr. Tamir did, what felt like, a choreographed and rehearsed dance to set up all of the necessary equipment, while Head Pediatric Nurse Nava,with the help of two nurses from the Black Lion Heart Hospital, began to get the children in order, assessing them and reading their medical reports from their time in Israel.

When I initially walked onto the fourth floor of the hospital, the first face I saw was six year old Helina.  For 7 months not too long ago, she was also the first face I saw at the SACH House when I arrived in the morning every day of the week. We both looked at each other, a little bit hesitant, as the last time we saw each other was for an emotional goodbye, and then we hugged so tight that I could feel her heart beating.

Being with a team that has been doing this for so many years and has such developed relationships with our partners abroad like Dr. Etseginet, reminds me of the wide span that Save a Child’s Heart has developed throughout it’s 21 years of existence. Dr. Tamir and Dr. Etseginet spent the van ride to the hospital catching up like old friends. Their relationship is based on the mutual desire to save children’s lives.

When I asked Dr. Tamir if it was nice for him to see the kids, he said “it’s nice to see them running and playing”

In just less than three hours the team saw 13 follow ups and 2 new screenings.

July 11

This is the day of good timing. So much has fallen into place for these children to come to this clinic. We had 9 children just today that were labeled urgent. Those who surely would not survive until our next visit in 2017.  These children are just here waiting to die.  They are sitting ducks so to say, and SACH is the group of kind strangers that are doing what we can to shuffle these innocent beings out of danger.

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This morning we met Rafaella, a 6 month old baby girl who was diagnosed with anatomical problems with the heart due to congenital heart disease as well as an arrhythmia, an irregular heart beat that can cause heart failure. She was sent to the ICU to be monitored and it was decided that Dr. Tamir would do a procedure tomorrow to help steady her heartbeat. It would not be possible to repair her heart defects if her irregular heart beat was not resolved. Even if we do this procedure tomorrow, there is no guarantee that it will work, but the team will proceed because it is the only option. We must have hope.

Today, we also saw Baby Dawit, a now one and a half year old boy who was in Israel for surgery earlier this year.  He learned how to walk at the SACH Children’s Home while he was recovering from surgery. When he was running through the halls of the Black Lion Heart Hospital today, other parents were asking about his time in Israel.  They asked how long he was in Israel for and I showed them videos of him learning to walk. This chubby little guy now has a healthy heart and a lot of energy to prove it!

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Dawit wrapped on his mother’s back

We have seen 31 patients today, 11 follow ups and 20 new patients. After this long day, we will go to bed and prepare for a full day tomorrow.

July 12

First thing in the morning we went to the ICU to do an electric conversion procedure on Rafaella to steady her arythmia. The baby was sedated to be kept comfortable and after the procedure, her heart steadied! She was awake and alert and sent home a few hours later. This was an incredible display of teamwork between the staff at the Black Lion Heart Hospital along with the Israeli based SACH team. There were multiple doctors in the ICU crowded around her bed, including the Pediatric Intensivist and Dr. Akiva Tamir who performed the procedure, as well as plenty of nurses and support staff. Because of their efforts to save her life, Rafaella will now be able to come to Israel for surgery to repair the congenital heart defects!

After we returned from the ICU, we got to catch up with Hawi. Hawi is a 9 year old girl with Down Syndrome who had her surgery in Israel on November 18, 2015.  Unfortunately,  while recovering from surgery, Hawi suffered a stroke and lost function of the left side of her body. Thankfully, it was only temporary and Hawi continued recovering at Wolfson, receiving physical therapy.  It was great to see Hawi walking so well and using her left hand properly. Right before going to Israel, she went to school for 3 months, but was becoming too tired so she had to stop going.  After surgery, 9 year old Hawi will be going to Kindergarten in September for her first year of school.  Until she begins to go to school in September, she will spend her days as she does now, with the children in the neighborhood, who are all around her age. I was so happy to hear that she is progressing and continuing to develop and grow.  Hawi came to the clinic at Black Lion Heart Hospital with “big” Dawit who she was in Israel with last year (along with Baby Dawit who we saw yesterday).  They sat together with their mom’s all day long and chased each other through the hallways.

It has been more than once that I have heard “I’m not sure how this child is still alive.” Today is the day that I realized how hard Dr. Etseginet’s job is. She is responsible for hundreds of little lives, and for many of them, there is nothing that she can do, except for hope. I’m sure I will see the same once we get to Jimma. There must be hope for the future or else why do any of what we are doing.

Dr. Etseginet does so much for her patients, but as in most medical settings, there are variables that can make her job much more difficult than it already is. She explained that the families of the children that she works with, makes everything a little more complicated. She went on to say that some things about her job can be hard to deal with, the kids are worth it. She said “the whole point is to make their lives as good as they can be.” We are glad to be partners with someone who shares our vision and mission.

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July 13

Today is our last day working at Black Lion Hospital, and we will head to Jimma in the afternoon. I have been warned that the living conditions in Jimma are worse than in Addis Ababa, so I am mentally preparing myself for what we will see when we arrive.

This morning, Israel Ambassador to Ethiopia, Belaynesh Zevadia visited us to see the work that we were doing.  We had the opportunity to show her how we assess children, both new patients and follow up check ups. She happened to be in our clinic when 3 year old Shalom and her dad came into the room. Shalom was treated in Israel when she was 1.5 years old. Dr. Tamir remembered her vividly as a child who was severely failure to thrive and underdeveloped. Shalom’s dad explained that before she went to Israel she couldn’t even stand on her own.

Shalom’s dad is a big friend of Israel and lived here for some time while studying. He named his daughter Shalom because he loves Israel and feels like Israel is one of his homes. Shalom began to walk on her own while still in Israel recovering from surgery, and today she was given a clean bill of health. Ambassador Zevadia was able to see Shalom and speak to her dad about what we are doing in Israel. It was a great gathering for people who appreciate our mission and our home.

Immediately after we finished up the clinic in Addis Ababa, we went to the airport to catch a plane to Jimma, where we will hold a clinic this afternoon and tomorrow.  We went from the airport in Jimma to drop our bags at the hotel and immediately go to the clinic to see a few patients who are waiting for us.  It is so clear that the priority of the mission is the children and the team will do whatever can be done to see as many children possible and to do whatever we can for those children.

The first patient we saw in Jimma was a 7-year-old boy named Robel. He was in Israel two years ago when he was 5. He greeted us by saying “Me, Israel!” When he saw cardiac technician, Yifat Brosh, he told Professor Abraham that he recognized her. He then pointed at her and said “You echo!” Yes Robel, Yifat did your echoes when you were in Israel.  When head nurse Nava Gershon came into the room,  Robel looked at her and said “You Nava!” Yes Robel,  that is Nava, the nurse that took care of you while you were recovering in the pediatric surgical ward at Wolfson Medical Center. It is safe to say that both Nava and Yifat were elated that he remembered them. Robel gave a clear reminder that our team makes an emotional impact as well as physical. And Robel now knows that we remember him too.

There is so much suffering here; so much inefficiency, that the hospital, somewhere that people go to get better, doesn’t even have running water.  SACH is something that people are doing for other people,  something that can reduce suffering. No child deserves to die because of where they live. If children in the developed world were diagnosed with these conditions, many of them would be treated as babies, here, they are treated whenever a doctor comes, and sometimes that is too late. SACH is not a small feat, and having thousands of children in the care of a handful of doctors, can weigh heavily, but I have seen this week a whole different side of why it is worth it. I have met follow up cases like Shalom, who was a severe failure to thrive baby who walked for the first time at the SACH Children’s Home while she was recovering from surgery. And Yared, who is running one of the most successful primary schools in Ethiopia, 17 years after his life saving surgery.  And Dawit, who at 1 year old, had a heart so enlarged from his congenital heart defect that is was the size of an adult man’s. All of them got a clean bill of health from the team in the last few days. These people are living because of SACH.

July 13

This morning we went to the newly constructed campus at Jimma Univeristy Hospital for the screening and it is so new that the electricity has not been completely ironed out yet.  We transported the entire clinic to the old hospital to make sure we got some power, and day 2 of Jimma was underway.

First thing in the morning, two past patients came to the clinic for their check ups. Eliyas and Kamil were both treated at SACH at the end of 2015. Eliyas had been treated once before 2015 as well. Both of them are spoken about often amongst the staff as generally good boys who were extremely loving, caring, and witty. Today, they came to the clinic for their check-ups, and brought a gift to present to Dr. Tamir for SACH. They gave him a wooden statue of a red heart that says Save a Child’s Heart, a new life!! They asked that this be kept in “Laura’s Home” referring to the SACH Children’s Home where Laura Kafif is the House Mother. She will be thrilled to present this beautiful gift in the SACH House. We were so happy to catch up with these old friends in Jimma.

When we finished the clinic at the old hospital, we drove across campus to get a tour of the new hospital from Professor Abraham, our partner in Jimma.  Professor Abraham is leading the project of building and took the time to show us around the new hospital he is building, where our Ethiopian cardiac team that is training at Wolfson Medical Center will be working when they return to Ethiopia. He showed us the pediatric intensive care unit, the operating rooms, the catheterization lab, the surgical wards, and the emergency room. The structure is extremely impressive and once complete, will serve Jimma and the surrounding communities. We are very excited to be able to utilize this facility when we send our cardiac team back home, as well as when we are on medical missions.

After our tour of the hospital, we had the opportunity to have a private tour of Jimma from a local. Dr. Demke is from Jimma and wanted to show us some of his favorite things about the city. We went to two different campuses of Jimma University, hiked into a forest of coffee trees to see where the famous Jimma coffee beans come from, and then went to sit for some spicy Ethiopian chai tea. We were so excited to see some of Dr. Demke’s culture and background since we get to show him ours everyday.

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