Day 4: 1/22/2020

Another bright and early day of getting ourselves prepared for what surprises may come our way was upon us. Today I was super excited because they had oatmeal for breakfast. It really is the little things. We all congregate in the lobby and furiously check our phones and update our families because it is literally the only place where we can talk to the outside world. The hospital, my hotel room nothing. And I have to say I have the greatest parents in the world who even in Ethiopia text me a good morning, an I love you and well wishes for the day ahead. My parents are the best. I pretty much update them and my 5 closest friends each day to let them know how things are. 

We hoped on our bus after breakfast and made way to the hospital. When we got there we rounded on all of the patients from the day before and they were doing beautifully. Our speech and swallow therapists are awesome and working with all of them so their outcomes can be the best possible. I am very much the chart queen and keep a very tight watch over making sure all the patients information and charting is done before they leave. The documentation is important for us and for tracking even after we leave.

Today I started with a unilateral cleft repair and worked alongside a facial plastics surgeon from Virginia. The Millard technique was used and the repair came out great. There are multiple techniques that have been published on cleft lips with many coming as modifications from the Millard. The cleft lip was very wide on this child and getting a good advancement and rotation without distorting the nasal

Architecture is tricky but always a fun surgery to tackle. It’s very much an art

The second was a palatoplasty for a cleft that was pretty straight forward and did very well. Our last case was our longest though and quite the story

Well there are two stories to it as we may know. One is that the child hit a hyena over his head and the hyena got mad, the second story was that he was bathing in holy water and was attacked. Either way 5 months ago a hyena bit his entire ear off sparing the lobe. The parents came in with the ear and begged for someone to just simply reattach it. I wish it were that simple but the ear would die. So the Residnet’s in Ethiopia banked the ear cartilage under the skin behind his ear so it could be salvaged for reconstruction.  And that is exactly what we did. It took 5 hours, but we were able to save his cartilage and reconstruct a whole new ear  which was amazing. He is going to be so happy. Halfway through the case the power went out, we worked under some generator lights and battery working headlamps and were the only ones let in the hospital OR. It was quite the romantic atmosphere operating under the moonlight with our music playing. At one point our entire team was in the room to see this amazing case.

We got back super late, the bus almost left without us and did threaten to not pick us up but our team leader From Ethiopia managed to get us some sort of ride back. We thought at one point we would be camping in the hospital. It’s not that safe to walk around after dark here and the cabs can be unreliable (and apparently dangerous as well) if you don’t know the drivers. But we got lucky, our bus drivers came and we got back safely. To pizza and beer nonetheless.  Apparently work hours are pretty restricted to a certain time and people tend to go home before dark. It’s not like America and our work hours. The residents here get a lunch break to go home every day from 12-1:30. Getting lunch at all is pretty much a luxury for us Residnet’s in the states. I am slightly envious. Anyway, The bus drivers may quit and not pick us up tomorrow but I’ll guess we will find that out in the morning. 
OR organizationTeaching he anesthesists PACU recovery Teaching how to intubate effectively I Our PACU
My mission mom
The superhero of our trip!Moonlight surgeryHyena bite (cartilage is banked behind the ear)
After our reconstruction 

Day 3: 1/21/2020

I finally got a full nights rest which was amazing and the alarm did not make me happy at 7am. I needed it, as the altitude yesterday was really starting to get to me. I kept getting these altitude headaches which were annoying and which I ignored like the person I am. If you don’t know me, I never complain about these things. They are mere nuances that don’t stop me one but from going About my day.

We ate breakfast which pretty much was some tea and eggs for me before we headed out to the hospital. One of our surgeons daughters is with us on the trip and I feel like my palate very much matches hers. The complex spices and injera is really not my favorite so I tend to keep my diet pretty simple. 

The days are split up so we are switching off operating and teaching the ENT residents. Today is my day to teach and I had a few sessions split into 5 residents each. I lectured them on suturing techniques, wound healing, scar revision and the reconstructive ladder which mostly consisted of local flap reconstruction. I threw a small simulation course for them where they learned all the different types of suturing techniques and played around closing defects with different types of local flaps. It was equally as much fun for me since I really do love doing all of this. And I feel like they really got a lot out of it since facial plastics and reconstruction is not commonly seen in their program.

One of the Residnet’s, in her senior or Chief year as we call it was just the brightest of the bunch and really impressed me. From what I have heard she tends to hide her intelligence or purposely get answers wrong to not outshine the guys in the programs. That breaks my heart but goes to show you how far we have to go in the world with women equality. Her surgical skills as well are by far superior compared to everyone and she has tested the highest on the exams. I’m rooting for this girl, and I really do hope she breaks free of this shell to really shine. Her coresidents could learn a lot and really benefit from her knowledge.

After my teaching sessions I did sneak into the OR to get my own fix of some surgical cases. We had some cleft lip repairs in the AM and a palate repair I got to do in between the teaching sessions. The day finished with another lip and a nasal reconstruction which turned out amazing. These patients are incredible and it’s such an honor to get to help them the way they do. The mothers are so happy to see their babies with normal lips and palates again, it’s a feeling one can’t even begin to describe. 

The lecture hall

Teaching the residents about local flaps
Lecture hallBanana Rhomboid flapOur OR
These shoes againCleft lip repairCleft lip repair

Day 1: January 18-19, 2020

So here we go again, and I cannot tell you how excited I am. My second trip to Ethiopia with Healing the Children Northeast. They are one incredible group of people and I am so fortunate to get to go on this medical mission with them again. It was a little hairy the last few weeks, and we almost had moments where we thought we would have to call it off or postpone. With all the conflict in Iran that infiltrated over to Kenya, it wasn’t completely clear whether this would be safe for us. But we stayed diligent and like the good doctors we are did our homework, and the State Department noted the safety to be at about the same level it was last year. I always tell people, the things you worry yourself sick about are never the things that actually happen in the end, it is the unexpected. And let me tell you we hit a few speed bumps before we arrived in Mekelle. None of which were what we planned for. 

I got up bright and early, had my Uber driver stop by Dunkin Donuts for that one last moment I could have savoring my favorite coffee and reminisced about my hot shower. Because most likely that would likely be the last one for the next week. I definitely take that for granted. The airport was easy to get through and they let me keep my carry on with me this time, which was nice. I lied when I said the Dunkin Donuts coffee in the car on the way was my last, because I totally got another at the airport. The poor man who is in the aisle seat. He would likely be getting annoyed by me the entire route. The first leg is 12 hours to Dubai, then 5 hours to Addis Ethiopia and then a 4 hour layover before heading to our final destination that is 1.5 hours by plane, Mekelle. Another saving grace, or so we thought was the fact we checked our heavy OR and medical supply bags all the way to our final destination. Last year we had to pick them up in Addis, go through customs, recheck them and walk a country mile to another terminal all in the same leg. But I am 8 years younger so whatever physical challenge comes my way I should be fine right? It is in fact May 9, 2012 today according to the Julian calendar they follow here. 

There were a few snow storms along the way where it was questionable if one of our group leaders coming from Toronto would make it. He is an integral part of the trip as he lived in Ethiopia for a year training the residents and knows this place better than anyone. But nevertheless, the weather did not deter our group and we all made it safely. I couldn’t sleep a wink on the 12-hour Dubai flight and divided my time up between residency work, one Movie “Once Upon a Time in Hollywood” which was pretty good and doing a quick leg workout in the back of the plane. I was the crazy girl doing squats and lunges yes, but does my back hurt as much as everyone else’s? No.  Will I get a DVT? Not today! I did get tired on the other flights, but I swear Emirates is very concerned about me eating because every time I try to go to sleep, they wake me up from my slumber to try and give me more food. The do not disturb sticker does not work, they will wake you up. 

 I can say that I was exhausted by the time we got to Mekelle, and there we encountered yet another surprise. Our checked bags never made it. Part of the group stayed back to wait for the next flight and some of them came but again not all. So here I am, sitting in the hotel wondering if we will have all of our bags tomorrow. Either way, we will make do and be the amazing team we area. Nothing can really stop us.  We got lucky to stay in the main part of the hotel this year, and the rooms are a little bit bigger. I am rooming with an OR nurse from California. She is Polish like myself, so we are quite a blonde dynamic duo. Most importantly this year the water in the showers.... WAS LUKEWARM! Oh my goodness what a blessing this was. I was able to actually somewhat tolerate my entire body in the shower this time, instead of carefully washing each limb from the outside of the shower like last year. I even washed my hair because I am not sure how long this will last and I don't want to get my hopes up. 

We met for a group dinner together, most too tired to even chew at this point, but it was an incredible feeling being back with the original crew and a few new additions. It feels like family, and we are one heck of a group. Tomorrow we work toward finding the rest of our bags, (5 left) and setting up shop at the hospital. It is a holiday tomorrow in Ethiopia (probably not MLK)...and when I figure out which one it is I will let you know. 

 Back in time! Welcome to 2012

 Mekelle Airport

 Airport runway where we landed

 Mekelle Airport (we spent a lot of time in airports yesterday)

 Our room

View from the hotel

Day 9

Another bright an early wake up in Lalibella and one more day of waking up to the beautiful views of the mountainside.  My roommate went to dry her hair last night with the hairdryer provided by the hotel andon plugging it in the wall to use and turning it on we started noticing smoke coming from the outlet and the wire completely melting. So to say we got out before burning the hotel down was a success. Not sure why it did that but hey it’s Africa. You can’t expect hot showers AND working outlets for hairdryers. One of the things that I found was interesting in Ethiopia, especially on the streets of Mekelle is that some people had scales that they required people to pay to weigh themselves. Merchants had high tech digital scales on the street corners, and requested money to be able to use them. Yes you heard me. They pay to weigh themselves. You couldn't pay me enough to weigh myself right now, especially after the holidays and my all carb diet I have adopted on this trip. 

We grabbed a quick breakfast before taking our bus with our guide Girmo to the airport, 45 minutes away. The pleasantly bumpy dirt roads overlooking the beauty of Africa is still a novel sight for my eyes and has yet to lose its excitement. The children, even at the ages of 2 can be seen running in the roads unaccompanied but aware to move to the side when a car comes. The animals roam the fields and roads also scurrying to the side when they see our van coming through. We get waves and smiles everywhere we go of excitement. The homes that they live in are very small, made from ether stone, bamboo or what appears to be hardened mud. But everyone has a job whether it’s plowing the fields with the oxen, picking up grass, maintaining the animals, or weaving baskets. Even the Donkeys with packs of goods on their backs are keeping a pace going down these roads with their purposeful jobs. One of our group members tried to pet one as it passed us hiking up to the church yesterday and he was one mean donkey, almost kicked her. We call him the “after Christmas” donkey.

When we got to the airport it was packed. Scott Pelley was there boarding a plane so it’s official either he is stalking us or vice versa. Or probably it’s because there are very select flights out of the local airports, and you got to make it on time or else you may be waiting a few days for the next. The flight was quick and easy to Addis Ababa, and the hotel wasn’t too far down the road we were staying at since our flights home aren’t until tomorrow. It’s not an easy trek to these parts of Africa in case you haven’t noticed. The traffic was crazy getting to our hotel. The 7 minute drive took about 30 minutes. Addis is the NYC of Ethiopia. There are all sorts of restaurants, shops, and even some American fast food joints. The hotel when we got there was AMAZING. Well, let’s just say your appreciation becomes exponential toward the end of the trip as little things like western toilets, Toilet paper,  and warm showers become 5 star hotels in your mind. The room was great with 2 nice beds and a normal bathroom. We dropped everything off quickly including all of our medical supply suitcases and went back in the bus to head to lunch. We as a group are pretty comparable to the pack mules at this point carting all our supplies around the country. 

Lunch was at the oldest hotel in Ethiopia. They made it buffet style (please stomach you have lasted this long, don’t fail me now) which was very good. I wasn’t extremely hungry from all the traveling so I kept it light. Our first adventure was over to the Museum in Addis where Lucy is! I got it all wrong in my other post. The arc of the covenant is in Aksum, Lucy is in Addis. Lucy was indeed found

In Hafar 3.2 million years ago. Her predecessor, Ardi who is 4.4 million years old was also found in that region after her discovery. Lucy was believed to be a young adult when she died whereas Ardi was about 5. The recent discovery of a child Selam was in 2000. She is the most recent and complete skeleton of a human child. It was incredible how preserved these fossils were and how much of the history of hominids lies in not only Africa but Ethiopia. Most every skeletal remain they had found was identified as a female in the museum. So it goes to show women as we know it came first and rule the world. Or we have yet to excavate the prehistoric bar on an archeological

dig where likely the earliest men will be found. It’s not called a man cave for nothing. The museum in addition had lots of African art and cultural pieces that we were able to look through including the Crown Jewels of some of their past emperors and empresses.

After the museum we went to some of the markets in Addis. The first local market was insanely packed we could barely every drive through. It was very overwhelming and pick pockets are everywhere. We decided to go somewhere more tourist friendly as the items at the local market were targeted for household needs rather than souvenirs. We found a less chaotic local area to peruse through. They have beautiful hand made scarves, baskets, woven plates, and jewelry. I picked up a hand carved elephant and giraffe (in case you don’t know I love elephants and maybe my next mission will be to save them haha!), and some beautiful paintings on a wooden canvas. It was dirt cheap. I didn’t really even bother haggling since the prices were absurdly low they gave me. Plus they could use it all I figured more than myself. 

We went back to our hotel to get ready before dinner. My anesthesiologist friend and roommate went out and walked down the street a little to a bakery and the mall. We picked up a few cupcakes from the bakery. Ethiopia is not known for its sweets. Everyone is all about the coffee and people brought back some bags of their beans. They don’t seem to eat many sweets and I asked our guide who confirmed. Well now I know how they stay so fit. Damn my American cravings for something sweet. The mall was small and built vertically much like Manhattan malls and buildings. They had a little local grocery store where some people brought back items. I ended up haggling for a Chanel bag I have heard my best friend back home talking about constantly. Apparently it’s listed at around 7000$. Well the mark up in Ethiopia is like 500% off. Is it real? You’ll never know.

Dinner was incredible. We had a patient of Healing the Children's join us who lives in Addis. He had a surgery back when he was 6 years old (he is 32 now) and has gone on to live a prosperous and successful life without any further medical problems. He has attained higher level education and is pursuing a career in hotel management. These are the moments, seeing the impact we can have on people's lives that really makes a difference. What a story and incredible dinner we had with him as our guest. 

I did some work at breakfast on my computer before packing our things to go to the airport and continue on our journey back home. I really can’t believe this trip has come to an end. I couldn’t have asked for a better group to work and travel with. The stories we have and the moments that include laughing so hard we can’t breathe were endless. I had the time of my life and I can’t wait to join them again for another mission. 

We got to the airport 3 hours before our flight to Dubai. The bag checking went seamless, they didn’t get fussy about the weight of the bags and they are checked through to Newark. Our layover in Dubai is 7 hours so any suggestions to pass the time will be taken. I did a lot of administrative documenting and chart organizing on the flight to make sure our database on what we accomplished is complete. But whatever happens in Dubai stays in Dubai. I’ll see you soon New York City. 

Thanks for everyone following along on my journey I hoped you enjoyed my little medical mission adventures. The before and after a I included a few below. These medical missions really always take me back to why I love medicine and surgery so much. It puts a lot into perspective, and they end up being some of the best trips I’ve taken in my life. It’s not about the resorts, the materialistic items or having everything go according to plan. It’s the journey and the story you leave with.  So Remember to strive to be kind to others. Especially in the world we live in today, and even medical field. Days can be long, and things can be frustrating but it’s important to be above that.  Be kind, have patience and appreciate everything you have. Until next time we try and save the world, this chapter is finished.

Healing the Children Northeast is a nonprofit volunteer organization dedicated to providing medical and surgical care to those less fortunate.  We send surgical teams to various underserved areas of the world all based on donations which all go toward medical and surgical supplies and continuing education for health centers in their areas. All medical personal volunteer for Healing the Children with their own time and expenses so all goes toward the needs of the patients. Please consider giving to this amazing organization to continue to help fund these incredible trips that truly have an everlasting impact on these patient's lives. 

https://htcne.org/campaigns/donate-to-htcne/

Lucy

Day 8

So if yesterday was Christmas is today Boxing Day?it was nice sleeping in. My poor roommate planned to take a shower this AM and we had no water. Couldn’t even flush the toilet. So much for getting excited about that. If anyone knows me you’ll know I’m an obsessive clean freak that needs to take a shower every night before going to sleep. It payed off since I had some water. 

I started my day with a nice bowl of porridge and the strongest thickest coffee you can imagine. I think I’ve started growing hair on my chest after drinking that. Starbucks has nothing on this stuff. We got in the bus again and took a short trip to stop at our tour of some of the other historical churches and sites in the area. 

The first church was St George, a very famous church in Lalibella where the roof and church itself is shaped like a cross. Overlooking the mountains this high up and seeing this cross in the ground is just a beautiful site of history. The inside of many of these churches are similar. It takes quite a hike down into them, through narrow passageways over uneven rock ground till you reach the entrance. There again you take off your shoes to enter inside. I’m  amazed by the Ethiopians to be able to get to these churches given the complex uneven terrain and hiking it takes to get to them. Even the elderly make their way into the churches. But then again, most of the common toilets require them to squat to the ground so their balance and leg strength surpasses that the common American any day. They are acclimated to this lifestyle and climate, wearing their shawls to keep covered and the sun off of them. You’ll see many of them not even swatting away the flies and other unidentified bugs of Africa away when they land on their faces and body. Where here I am doing an interpretive dance trying to kill any speck of dust that resembles a bug off my body. 

The climate is very dry and hot during the day. Once the sun is gone it becomes pretty cool at night requiring us to bundle up. Although Lalibella isn’t as high altitude as Mekelle you really do get tired fast. My lips and oral mucosa gets very dry so I’m constantly drinking water. Somehow I have miraculously avoided the squatting toilets and scopes out the few western ones in the area. I’ll work on squats when I get home. 

Well I went off on a tangent again about the toilets. Back to the churches. We saw 60 minutes and Scott Pelley doing a story on one of the churches and some of our group members got a picture with him. I look forward to his excerpt and maybe a guest appearance by me in the episode haha. I’m kidding. If there’s one thing I couldn’t be it’s a celebrity. Everywhere I have gone so far I’m asked to take a picture or I see Ethiopians trying to take my picture. They were very fascinated with our group. No more paparazzi though please. I barely did my hair! 

My favorite church was Bethlehem and Emmanuel. Once in Bethlehem have to go through the tunnel from hell to heaven to get to heaven and then the church of Emmanuel. It’s a very narrow, low set ceiling tunnel that is pitch black to walk through. And let me tell you it was a little bit scary. It felt like forever before we reached the light at the end and climbed up these ladder like steps to the top. The sun beaming down on my claustrophobic body was for sure looking like heaven to me. We explored the last few churches of Emmanuel and Abalibinos before heading back to grab lunch at the Lion King restaurant. Masses start at 12 and last 2-3 hours from which you cannot leave once you enter the church. Before heading to lunch we went to a few market stores to haggle for some goods we can bring for ourselves and friends back home. Got to prove we actually went to Africa you know. We met a group of kids who loved talking with us and asking questions about America. One was a 13 year old boy naked Yulios (again probably spelling that wrong) who wants to be a dentist and one day see Washington DC. He gave me a necklace with the cross of St George as a late Christmas gift and exchanged emails. I now have a pen-pal from Ethiopia. 

We went back to our Lion King bar for lunch. I have been craving fruit since being here and was excited about their fruit and yogurt option. I eat fruit every day so I’m really missing a good apple. After lunch overlooking those amazing views of the mountains we hopped in the bus again to venture to the town of yemrhane kirstos where the church of yemrhane kirstos lies. It’s a long hike up the mountain when you get there which I must say felt very difficult and I was definitely winded. Do I even workout? Man I was beat by the time we got to the top. At the top there is a natural cave made from volcanic rock with a wooden barrier opening into the area that hides the church. It was quite an incredible site with bamboo floors. This was the only church made from wood and stone that we had seen. In each church an area hidden by a curtain which only the priests can enter. It holds the replica of the arc of the covenant. The original made from solid gold was stolen in the 90s and returned a few years later but resides now in Aksum.

Inside the church are also the remains of hundreds of pilgrims who made the trek to yemrhane kirstos church so they could die there. The remains of these human bodies are over 600 years old. Pretty spooky if you ask me. 

The trek down the Mountain wasn’t as bad and the sun started getting low in the sky so it wasn’t as hot. We booked it back down the dirt roads to get to our favorite Lion King restaurant (ok it’s called Ben Ababa) to watch the sunset and we made it just in time. Even Scott Pelley was there, so I’m sure he thinks we are stalking him now. The views again were beautiful as we watched the sunset over the horizon through dinner. We even had the chance to watch the moon set over the hours we were there. The sky here at night has no words. I’ve seen my fair share of starry sky’s but here in Africa it’s amazing. I even saw a shooting star across the wide open sky. 

After dinner we went to an Ethiopian bar with our guide Girma. I don’t know how much of this I should post or leave for the imagination but it was one hell of a time. Again our group was quite the noticeable crowd and we gathered at our own table in a very crowded bar. They have a gentleman playing a string like instrument (African guitar?) and a woman singing throughout the night. They only seem to play and sing one song over and over again. It was like hearing Despacito on repeat....oh wait that’s amazing! I got pulled up to make a fool of myself and try to dance with one of their guys to this Afrikan dance. I’m sure I looked like I was doing the funky chicken. The facebooks pages in Ethiopia are going to be blowing up tomorrow....I felt a lot of cell phones pointed in my direction. Honey wine is the local drink which came in these erlenmeyer flasks. The novelty was better than the actual taste. Much like the smells and some of the other things in Ethiopia I can’t quite describe its taste or compare it to anything else I have ever had. One of our group members befriended a group of young college kids who were very interested in our group. They had ordered a plate of tibs and injera and attempted to handfeed it to her and I.....very forward move. We danced and had a great time before heading back, taking some wonderful hot showers and heading off to bed.

It’s our last day tomorrow before heading back on the trip home. It’s difficult to get to these small areas because of their plane schedules. During Christmas the planes have more flight options, but quickly simmer down after. Sometimes they’ll have one flight to the main city of Addis Ababa every 3 days, so scheduling wise we have limited options and definitely can’t be on Ethiopian time that would cause us to miss the flights. Here’s to the long trip with long layovers home.