Long Live The Sar

http://www.kare11.com/sports /prep/prep_article.aspx ?storyid=268335 (story adapted from email by Rick Hodes) In summer, 1994, Rick Hodes was in Goma, Zaire and stopped his pickup truck late one afternoon as he drove out of Kibumba Refugee Camp to pick up a small kid covered with blood who had been hit by a hit-and-run driver. Contrary to what is reported in the Minneapolis story, it was Dr. Dawit Welday and Rick who picked up Taka. They drove to the Israeli field hospital where Taka had the first of many operations to save his life and reconstruct his skull. When they closed the hospital months later, he moved into Rick's personal tent. Every night, he'd shake Rick at 3AM, Rick would open the flaps and Taka would go out and pee. JDC funded him to come to the states for his surgery, which was arranged by Dr. Andre-Jacques Neucy of NYU. "I vividly recall writing a letter saying he is allergic to all eggs, so that the Kenyan authorities would not require him to show proof of

I have been relaxing for the last 3 weeks or so, taking it very, very, very easy (including blogging). I hope to pick it back up once I get back to GSO, but I am currently vacationing in Southampton, NY (not too shabby). But driving by the Hampton Coffee shop I was overwhelmed by the smell of coffee being roasted and a flood of memories came back - coffee ceremony, macchiatos while rain pounded the tin roof, Abebe, and a million other images. Funny how a smell triggers these intense memories. On another note, saw this editorial on Foreign Policy's website discussing how African countries that don't have oil or other major natural resources may be better off in the long run "Sudden cash flows in unprepared countries, he says, lead to unsustainable public consumption, rising inflation, soaring inequality, trade protectionism, and a real danger of civil war." Ethiopia doesn't have to worry about any major sudden cashflows but they most certainly fit into the &quo

It's funny how 5 days in the USA will erase any memory of the world outside of this little bubble. I still find it hard to believe that there aren't beggars on every corner, my house is the size of my hotel, and everyone around me is faranji . The latest news coming from Ethiopia is good, bad, and weird. After sentencing 38 main opposition party leaders to life in prison on monday for their role in inciting election violence in 2005, the government reversed the court's orders and released all 38 convicted ( link ). Continuing their (justifiable) crusade against Ethiopia, the NY Times is running an article about how the gov. is blocking food aid from reaching the rebel region near Somalia - sounds like the famines of the 1970's all over again ( see Mengistu ). Will keep updating on this but things look like they are slowly slipping out of control...hopefully PM Zenawi can right the ship. In news from my fellow americans still in Addis - Meningocele man had succes

A great last few days and only 1 more to go! Saturday we had Rick's regular saturday clinic. Lots of spine patients (TB and Scoliosis), heart problems (mitral/aortic stenosis/regurg), a case of Dermato Fibrosarcoma Protuberans, and one case of Lympho-Epithelial Carcinoma. Lunch consisted of a fried tortilla filled with lentils (11 cents on the street) and soft-serve ice cream from a fancy italian restaurant near the mission...best ice cream in addis. On the walk home we ducked into a "gym" off the main road. The sign for the gym should have been an omen of what was to come (faded, cartoonish, and nearly hidden), and maybe the treacherous staircase/mud slide down the hill was a warning, but the gym consisted of a shipping-container-sized room full of guys, benches, free weights, and an unspeakable stench. Not interested in embarrasing anyone with the size of my muscles, I kept my shirt on but did notice that the weights used for bench pressing consisted of a metal bar

Nearly every day someone asks me if I'm sad to be leaving Addis in 4 days, and I always have mixed feelings. One month was a perfect introduction time for getting acquainted with the city. My hesitation lies in the fact that I'm not sure how much of my love for the place is for the place itself, and how much of it is for the mystery that is Ethiopia. It is not easy for a culture to seem as disjointed, inefficient, and quasi-modern and so trying to figure out how it got this way, and how it works at all, is a daily fascination. I have loved my last 4 weeks here but even now, I am unsure how much of it is my love for the city and how much of it is my love for the adventure and the mystery of Ethiopia. I am excited to get home and spend some time just sitting and relaxing and relfecting (and not having to deal with beggars every 10 seconds), but I will miss it here. The pace of life, the kindness of the people, the friends I've made, the exchange rate, and my friends at

The Jewish Federation mission trip arrived in Ethiopia yesterday. I was lucky enough to be invited to have dinner with them @ the Sheraton Hotel - delcious - and got to reunite with some greensboro folks. Great evening. Also got to tag along while Rick gave a tour of the JDC clinic in Addis; it was my first visit to that clinic. It is a small, well-staffed, clean clinic that is definitely one of the nicer medical facilities I've seen here. They are in a tough spot right now because they are charged with medically evaluating and treating anyone who has an open immigration file with the Israeli Embassy; all of the Falash Mura in Addis have been denied immigration by Israel. But the clinic still treats them and their role in the future is hazy as to whether or not they'll continue to see these people or how they will transition to their new role. It was also interesting to watch the 50+ gathered Ethiopians play their political games - they were all wearing their kippahs when the

I've been meaning to write a post on this topic for a while, but it's a daunting subject. Expect revisions to come! To understand the practice of medicine in Ethiopia, you first have to understand the country's condition. My take - Ethiopia has been in the dark for the last 30 years and is now trying to match modern innovations with the old technology/infrastructure. This feeling is prevalent everywhere in the country, from the Mission, to the internet cafes, to the hospitals, and the banks. They build 10 story buildings, but the scaffolding is made from tree branches 20 feet long nailed together, not a single one thicker than my arm, and some as crooked as a question mark; it sways in the wind and it's amazing that it stands up at all. Internet cafes are everywhere with brand new computers, but internet no faster than 40 kbps (slower than old dial-up). Government officials drive brand new Cadillac Escalades but there are holes in the street 2 feet deep. MRI's

are the ~5 euro volunteers helping or being destructive? tough to tell if you are being facetious. I don't know that they're being destructive, but I'm sure that their dressing skills, especially at the beginning were sub-par. I say this only because they didn't watch at all before jumping in and starting to touch multiple patients w/o changing gloves, not using new forceps for every patient, and other things of that nature. I'd imagine they're better now (I haven't spent much time watching them lately) ( update: They seem to be doing just fine and will be working at the mission for the next 6 weeks, so they'll be pros by the end) what are the international ngos that are helping fix the infrastructure problems? Don't know of a single NGO that is making a huge difference here, especially not in infrastructure ( update: Save the Children, UNESCO, USAID , and a few other NGO's are doing good work according to Rick) . The bureaucracy prevents a

Unbelievable morning. It is mornings like today's when you think this country may have a future after all. As the European volunteers worked their magic in the dressing room again this morning, Zev , Jake, Abebe , and I decided to walk over to the nearby Yekatit 12 Hospital. The GW students had visited and highly recommended us meeting Dr. Thomas who runs the burn unit at the hospital, supposedly the most advanced burn unit in all of Africa. I haven't seen any other burn units, but regardless, Dr. Thomas is an unbelievable individual. What follows is his short biography, a synopsis of our visit, and the bits of information I remember clearly enough to put down here. Born in Ethiopia, Dr. Thomas did his medical training in Norway with additional training in India and Scotland. He is a trained plastic/reconstructive surgeon and built the burn unit @ Yekatit from the ground up. He has now trained 8 doctors from Ethiopia to work in/run similar units and has a competent nursing

I haven't been doing too much work in the dressing room in the last 3 days because of the sudden presence of ~5 british/french/european volunteers. They have kind of taken over the dressing room (we won't discuss the new level of patient care) and so the last two days have been an interesting departure from the routine. Yesterday, Jake, Zev, Mekais (an Ethiopian starting his 2nd year @ Harvard Med), and I followed Dr. Germa on his rounds through the mission. His cases aren't as complicated as Rick's but he sees the more severe cases of some of the more unique diseases. A short list of the things we saw yesterday: ~Parkinson's ~Leprosy - as with everything else here, a text book example. ~An Abdominal Cyst that dominated the lower half of her abdominal cavity - It was so large such that looked pregnant, but b/c it was so large they were unable to find where it originated from in the ultrasound, maybe the ovaries ~Scabies ~A Leopold exam on a lady who was 30+ weeks pr

The weekend was very relaxed with a busy morning @ the mission on Saturday. Saturday afternoon we (Jake, Zev, Berhanu, Ilana, and I) went to the Merkkato. A sprawling complex of stalls, shops, indoor "malls," and with more people than you can shake a stick at, it was a little overwhelming. The size of the area, the number of goods being traded, and the never-ending shouts of "hello" and "faranji" were enough to make one go insane. If I were to try and answer everything shouted at me, my head would surely fall off from the constant snapping side-to-side to answer everyone. In general, it was less like a market and more like too many stores crammed into pillboxes and stacked together. Two hours there was enough to make me want to go and sit in my hotel room for hours, simply so that no beggars, shoe-shine boys, vendors, or random people could bother me. So that was my saturday (topped off w/dinner in the hotel). The first item on the agenda for sunday

Rick's son, Semegnew, and I after Shabbat dinner friday night. The improvised kippah's are a highlight.

Today after work/lunch, Jake, Zev, and I decided to sample 3 cafes on our way home.  The first was a local joint, my favorite of the 3, where they served local tea (w/the mandatory 1/2 in. of sugar in the bottom) for 1/18 of $1 USD (7 cents or so).  The 2nd stop was a cafe built into a hillside overlooking our small section of the city which was nice and quiet, and a great place to observed the slow but steady pace of life here.  The final cafe was a chic, pink, modern cafe near our hotel that served a variety of cakes, teas, juices, and cookies.  The sub-par tiramisu was over-priced and the ambiance felt a little too much like imitation America.  Tonight is another small shabbat at rick's and then sleep before an anticipated very busy morning tomorrow.      

The past two days have been relatively quiet, with a lot of exploring the city.  Work at the mission has been pretty quiet, and we were mentally preparing for the ~30 nursing students departure after today, and the rush that will be tomorrow morning.  Additionally, all three of Rick's main oncology patients started another round of chemo, a new regimen of medicine, or had some other tweak in their care every day.  The afternoons have been especially quiet and so I've been leaving around noon for lunch, internet, macchiato, and juice, and then some wandering.  Yesterday after work, lunch, etc...i decided to drop into the National Museum down the road from the mission.  I saw many interesting things including: Lucy's skeleton, Haile Selassie's Throne, and other cool, old items.  The most interesting/frustrating/amusing part of the visit was when I became an exhibit myself - 50-60 first-year history students at some university way up in the north were visiting Addis and I

To reply to the newest set of questions: ~Internet costs between .15-.40 birrh/minute ~13 birrh/hour ~$1.5 usd  - it's probably tied with food for my second biggest expense (hotel is #1 @ $13.5 USD/night...expensive!) ~I am receiving calls from skype (other ppl. calling me), but there is nowhere with fast enough internet to skype.  All of the internet places advertise 'broadband', or as it would be known in the US - 33 kb/s ~There is not much italian influence outside of the delicious macchiatos and cafe culture so readily apparent.  ~I may try to go to Lalibella for a few days (lots of gorgeous rock-hewn churches), but I'm hesitant to spend time away from the mission because I enjoy working there so much.  Also, any trip to Lalibella would take ~4 days, and finding a good 4 day window is tough ~I did see the NY Times article about Ethiopia the other week and I feel as though the NYT is actively trying to negatively portray Ethiopia b/c of the the issue w/their writers

to answer some of the questions asked in the comments (thank you ari): ~I am not taking pictures of the gory stuff...yet, but I do want to document the range of things we see every day ~My amharic is poor, but I can greet, bid adieu, order some food, and other things like that....i'm trying to learn but it's a wee bit difficile ~I am working 6 days a week, 9-12 & 3-5.  The mission shuts down around 6:30-7 for the night. ~I usually give to about one beggar/day or <1% of all the beggars I encounter each day ~Most nights I get back to the hotel around 7, spend an hour reading and then go out to find dinner.  Then I usually go back to the hotel, read, write, and asleep by 1 AM.  ~I went out for the first time Tuesday night...interesting.  Was by myself but quickly met Daniel, an Ethiopian who has either emigrated to Israel or is going to visit...he had lots of hebrew inside his passport.  The 2nd bar we went to was a hotel/brothel (the prostitues aren't very subtl

One of the most interesting things about practicing medicine here is that you see a lot of textbook cases. Because most of the patients don't seek care until their disease/infection has progressed to a very severe stage, most of the cases we see, when we look it up in the Merck Manual, are exactly what the textbook describes (if the disease goes untreated). With the two newly arrived med students - zev and jake - we've been looking up many things in the Merck Manual, which is only mildly helpful because the cases are only covered by the last sentence of every entry that starts, "if left untreated..." It is very interesting to see what can happen to the body if nothing is done to help heal it.

~The people are genuinely kind, respectful, and friendly. ~I feel very safe. ~The juice store beside the mission sells the world's greatest manguo chemaki (mango juice/pulp/puree) ~There are more places to buy pastries here than in France, and delicious, fresh bread is available all day long. ~There are palm trees growing in the alleys behind the storefronts and the city has lots of greenery (too bad you can't see it when a car drives by leaving you in a cloud of black fumes, thinking that inhaling the exhaust from a greensboro bus would be fresh air) ~The rain as it pounds away at the tin roof...it makes me feel like i'm living in 1800's usa (or so i imagine) ~a steaming macchiato with a big scoop of sugar, while I watch the people walk by. ~The mini-taxis which can get you pretty much anywhere in the city for <$.25 I could keep going but I'll leave more for later. To let you know that not everything is peaches and cream here, the things I dislike about Addis (

I went to the Mission for the first time at night, last night. I know I've written about what the mission is like during the day, but at night, the main difference is that on every empty space of cement under a roof, people are sleeping on thin mattresses, packed so tightly together that they overlap. As I've said before, the conditions here are like something you would see in a picture, but not in real life...it's amazing what the people consider a normal standard of living here.

The people here are nice. very nice. one of the best things about the mission is the area surrounding it. As Abebe told me, Piazza and Bole are the only parts of Addis that are like a city, the rest is like a village. My hotel is in Piazza and on my short walk (200 yds) from the hotel to the taxi stop, I pass at least 10 different bars and countless people. But when I get off the taxi and start walking towards the Mission, it feels more like a village. There is Tza'ai, the girl who works at my internet cafe where I go every day for part of my 3 hour lunch. There is Daniel, the guy who works at the "pool hall" (1 table) and he gives me a big hug every time i pass by (~6x/day). He has also made it his mission to teach me amharic, so every day he tries to teach me a new phrase of general conversation. So far, I know the first 2 lines of any basic conversation (hello and how are you? - i'm a slow learner). And then there is the lady at the restaurant who told me

As usual, this saturday morning was extremely busy. Even with Rick gone (in LA for 10 days), there was more than enough dressing to be done by the 3 teams working - Dr. Solomon (an orthopedic surgeon I was told), the GW students, and Jim, 2 other volunteers from Lyston (a 23 yo kindergarten teacher from raleigh and a 17 year old girl from morehead city), and the other nurses normally staffing the dressing room. The GW students invited me to scrub up with them (i.e. putting on gloves) and when I told them I only knew what we had been doing the past week they said I knew more than them. When I saw the teacher and the 17 yo helping dress wounds, I realized that I will probably turn out to be much more effective than even I had hoped possible. It was a welcome discovery that maybe I do know what I'm doing, at least in a the setting of the dressing room/opd @ the mother theresa mission.

I've been referring a lot to "the mission" but realize that I haven't given an idea of what it's like. The Mother Theresa Mission is located down the street from Sidist Kilo. Keep in mind that there are only about 10 streets in the whole city with names so it is difficult to give good directions. The Street Both sides of the street are lined with storefronts selling laminating-copying-faxing services, camera film, fruit, convenience store items, and restaurants (and that just what I can see out the window of this internet cafe/office supplies store). Parked blue Toyota Taxis (think 1980 style sedan) line both sides of the street waiting for passengers and dumptrucks (sometimes filled w/people sitting on the rim), buses, SUV's, personal sedans, and donkeys/cows/goats share the road. The sidewalks consists of uneven bits of broken concrete, jagged rocks, and dirt. There is a gate with the words "Mother Theresa Mission" and inside a little dr

My first day of work is now done and over.  Starting @ 9 AM this morning, I was working in the outpatient clinic @ the mission.  So what exactly did this entail?  Well today was a little different than normal (or so I'm told) because there were ~15 nurses in training working at the mission for the last day of their 4 day rotation.  The examining/dressing room is about 10' X 10' with cabinets full of supplies lining the walls and 4 nursing students + me + 2 patients at all times...it was cozy.  I saw lots of gory stuff...the kind of stuff that scares you when you open up a medical textbook.  If anyone wants the details, let me know and I'll embellish but for now we'll leave it at that.  For "lunch," I had a macchiato with one of the full-time nursing students @ the mission, Abebe.  Quick Abebe bio: one of 11 kids, grew up in southern ethiopia, 27 yo, not married, first year nursing student (of 4 years), wants to be surgeon eventually, incredibly nice guy. 

To answer the questions of my grandparents: I am still communicating mostly in english and sign language but studying amharic every night (the 50 useful phrases or so I'll need) so hopefully I'll at least be able to say some things.  I think the city is safer than it feels to me right now.  I am always walking around on high-alert, watching out for pickpockets and the like, but so far so good.  I have not been taking many photos yet because I have heard that if you take a lot of photos in the street people think you're CIA, but I think once I feel more comfortable here it won't be a problem.  I believe Rick has legally adopted 5-8 of the boys and the others stay with him either temporarily or permanently but they still have other family. Today I went to the mission around 10:00-10:30 with Bogut where I met up with Rick and gw students doing some rounds, but it was a very very very quiet day at the mission.  When Rick left around 11:30, I introduced myself to Sister Brid

I forgot to put this in the last post, but I also got to experience one of Ethiopia's "different" (to be polite) traditions...last night bogut invited me to eat injera with him and Rick's night guard.  So we went outside and the way you eat the injera is, essentially it's a big thin bitter pancake (think in between crepe and pancake) with vegetables cooked in oil and spices heaped on top, so you tear off a piece with your right hand and then you dab it in the veggies in the middle, pick some up, and try to get it all into your mouth without spilling...sounds easy enough.  It gets a little more complicated though when your ethiopian host insists on feeding you.  so sure enough, last night the night guard didn't think i was eating enough and so he proceeded to feed me two fistfuls of injera and veggies.  I felt like my ethiopian culture education had formally begun. 

i am finally settled in the taitu hotel and have so much to tell from the day.  this morning rick went out to meet his boss from jdc i believe and so it was very quiet around the house and too nice outside to stay indoors.  with one of rick's boys, bogut, i walked around the neighborhood for about 5 hours.  We started off just walking, then when he said he used to live in the area i asked him to show me where he had lived and so we started walking in that direction.  we stopped for a lunch of injera and tibs (pieces of lamb cooked with onions and peppers) and then we continued to one of his friend's houses.  these friends are also friends with rick i believe and they invited bogut and i into their one room hut (think a square room made entirely of cinder blocks that is may 10' x 10'.   After sitting and talking for a bit, they invited us to have a traditional ethiopian coffee ceremony.  they start with green coffee beans, and then on a tiny bowl with glowing embers they

I have had an amazing 2 days here in addis.  rick and his boys are extremely nice and i've been spending all of my free time hanging out with them.  there was a huge shabbat dinner here last night w/ thirty to forty people including 12 2nd year med students from GW; they'll be here for the next 3 weeks and spending 2 days/week at mother theresa's.  went to the clinic 2x yesterday for 30 minutes to check up on Rick's 2 most interesting cases - 1 16 yo boy w/MALT lymphoma and another boy ~13 yo w/Burketts lymphoma.  will sleep at rick's again tonight and probably go to hotel tomorrow.  had a great dinner tonight with friends of my aunt and uncle's who work here in Addis. It's been great so far and I"m very excited for the next few weeks!  saw some AMAZING cases today including retina blastoma, mitral regurgitation, and many cases of tb of the spine and congenital scoliosis.  as rick said, it's a pretty amazing learning curve and I"m learning tons

I thought I'd be writing this post from ethiopia, but unfortunately US Air had other plans. Weather problems all up and down the east coast meant that my flight to JFK was cancelled and I had to change my separate ticket to Addis on British Airways. After 2 hrs. on the phone w/BA I have the privilege of trying again tomorrow morning, which means that hopefully I'll be in Addis by 2:30 AM June 15...but we'll see.

My brother told me today that I should write about what I am expecting to see during my time in Ethiopia...so here goes... I honestly don't know what to expect. In an email I got from Dr. Rick Hodes (who I will be working under), he told me about how he sends certain kids to Ghana for special operations, but the hospital there occasionally loses power for 30+ min. during an operation and the generators only run to power the ventilators so the doctors either operate by flashlight or they wait until the power returns. I am not expecting the clinic to have dirt floors (but it might) and I am expecting to see many flies and other flying insects inside the clinic. I don't know how much medical work I will be doing (I hope a good amount) but I am sure that whatever I do see will be unlike anything I could imagine here. I recently finished reading "Just Here Trying To Save A Few Lives" by Pamela Grim , M.D. It was a quick, easy, interesting read that was your typical ER

It's Sunday morning (2 AM) and I am busy trying to tie up my loose ends here in Greensboro before heading off to Africa. I am going to Addis Ababa, Ethiopia for 5 weeks to work in the Mother Theresa Mission Clinic. Hopefully I will get to help out with caring for the patients, playing with the orphans, and whatever else the nuns need help with. In all honesty, I have absolutely no clue what I'm getting myself into. In my mind I imagine Ethiopia to be somewhere in between the Belgian Princess's B&B lodge my family stayed in during our first night on safari in Tanzania in 2002-3, and pictures of refugee camps in Zaire (now DRC) following the Rwandan Genocide in '94. So somewhere in between these two extremes, I imagine Addis falls. During my gap year (now two years ago, '05-06) I traveled the globe, hitting 3 continents, 5 countries, 1 ski resort, and 1 chinese lady on a moped. I lived in the Hamptons and I slept on the muddy floor of a chinese hut with 3 pigs