Imagine having a painful ear infection and no access to medical care within many miles. Imaging struggling to find transportation across long distance and rough terrain to one of only two large, overcrowded hospitals in your nation.
“In all of Ethiopia,” says Jay Luft, M.D., “where 88 million people live, there are not as many doctors practicing as there are in Delaware, home to less than a million people.”
Dr. Luft, former chief of the Department of Surgery’s Otolaryngology Section at Christiana Care Health System, says a colleague called on him late last year to join an otolaryngology team heading for Black Lion Hospital in Addis-Ababa, Ethiopia, on a 2011 spring mission for the Philadelphia area chapter of Healing the Children, a non-profit humanitarian organization. Christiana Care’s OR at Wilmington Hospital helped support the mission with donations of surgical instrument trays and soft materials, such as bandages.
The scarcity of health care providers in Ethiopia enables the advance of many diseases that probably would be corrected in early childhood in the United States, Dr. Luft says.
“The majority of the surgeries we performed were done to help children hear better and decrease infection by closing chronic perforations, which are caused by recurrent ear disease without treatment,” he said.
Healing the Children’s mission was two-fold: to treat as many children as they could handle, and to improve medical education. “The teaching is more beneficial in the long term than doing the work ourselves,” Dr. Luft says. “We taught a soft-tissue course, using pigs feet to show their residents how to do local skin flaps.”
During his time in Ethiopia, he learned a lot about practicing medicine without the tools and support to which he is accustomed. For example, at Black Lion Hospital he took part in a surgical procedure on a 12-year-old girl to correct bilateral cholanal atresia, a birth defect marked by bone growth blocking the nasal passageways that prevented the girl from breathing through her nose. In countries with advanced health care, the condition usually would be addressed on the day of birth. Dr. Luft said he learned how the procedure is done without high-tech instruments, such as the VTI/CT scan available at Wilmington Hospital that would enable the surgeon to navigate easily to the blockage and use other high-tech equipment to remove it. “They don’t have that,” he says. “They do a great job with what they have. But there’s no finesse. The surgeon at Black Lion, Abebe Melaku, M.D., showed me how they do it with very little equipment. He got it done quickly, because he had to. You do what you have to do.”