Long Live The Sar

Looking back, I realize the tone of my initial post about the epidemic may have seemed a bit alarmist. To clarify, the disease we were dealing with was not ebola, bubonic plague, or malaria (even though a few of the prisoners may have had that too). Administering fluids was sufficient treatment for almost all of the patients; the issue was when the nurses neglected to check the patients' fluid bags, IVs, or other basic vitals. Now back to the story... Thursday morning, Dr. Aelaf stopped by the prisoners' ward before morning rounds. During the night, 3 patients had become unstable and the rest were doing ok, not great. Of course vitals had not been checked in about 5 hours and patients were running low on fluid. The situation got fixed and patients returned to borderline stable condition. We went on morning rounds and then I went back to my hotel for a nap and an extended (but ultimately victorious) battle against slight bout of food poisoning. The highlight of the night...

A quick note about the hospital and its response to the outbreak: The Debre Berhan Referral Hospital is a compound of ~30 single-story buildings with nearly 115 beds. There are wards for medicine, pediatrics, surgery, and OB-GYN as well as an emergency department, an outpatient clinic, and an ophthalmology department. There are close to 10 senior physicians on staff and more GPs (General Practitioner – graduated 6 years of university/medical school but no further training) overseeing patient care. Dr. Aelaf and the GPs live on the hospital grounds in 15'x15' single rooms. We visit the hospital's shai bet (tea house) at least 3 times every day. As for the outbreak: Only a handful of people seemed to care about the fact that we were in the midst of dealing with an epidemic or that the patients were at serious risk of death if not managed correctly. The Chief Clinical Officer, a caring, well-intentioned physician, works hard to improve the hospital and often considers ...

I haven’t written in a few days because there has simply been too much going on this week in Debre Berhan. I arrived on Monday afternoon and met my host, Dr. Aelaf Worku. A former Mt. Sinai student and resident, Aelaf has been working in Debre Berhan since February on a joint project with Dr. Joseph Mascii, head of ID at Elmhurst Hospital in NYC. Although initially a slightly intimidating figure, it became quickly apparent that he is a driven, passionate, and thoughtful person who is burning it at both ends here to affect some of the change he knows is possible. To be sure, there is no shortage of room for improvement. Likewise, there is no shortage of things that I could write about my experience here. However, the true excitement began yesterday (Thursday) around 10 AM… Wednesday night, two prisoners from the town prison had been brought to the hospital for uncontrollable, watery diarrhea. Dr. Aelaf was able to stabilize his patient, giving him 8 bags of fluid in or...