On our first day in Ethiopia we met Dr. Rick Hodes who runs one of the largest spine clinics in Africa. We then met Birhanu. As we toured the hospital, Stephanie and Francis were telling us about all the improvements compared to the previous year. This included things such as a scrub sink which we simply take for granted in this country.
At the clinic, we evaluated a number of patients and decided which ones needed surgery. Of those, we had to decide which surgeries would be performed by our team. The more complex cases would be sent to Dr. Boachie’s team in Ghana. The goal is that as this hospital improves and the personnel become more knowledgeable, they will be able to keep all cases in Ethiopia. Ghana is also very valuable for personnel training. The operating room as well as the intensive care unit staff travel to Ghana for a few weeks at a time for more specialized training.
Within a few hours in the clinic, we had most of our surgical schedule filled. I have never seen so many cases of unsegmented bar, hemivertebrae, and diastematomyelia in one place. An unsegmented bar is a congenital defect in that one side of a number of vertebrae do not separate from each other. Therefore, that side is fused and does not grow. But the other side of those vertebrae will grow normally, therefore causing scoliosis. A hemivertebrae is when only half a vertebra is present, resulting in asymmetric growth of the spine causing scoliosis. Diastematomyelia is a congenital split of the spinal cord either by a fibrous band or a bony bar. Unless corrected, it can limit the degree of scoliosis correction.
Some patients needed additional testing. They would be evaluated on Saturday evening to see if they needed to be added to our surgical schedule. Otherwise, we had a list of other patients waiting to fill those spots. I learned two words: Gombes which means bend, and Kana which means stand up straight. I also learned a few points of etiquette. One is that if their hands are dirty or wet, they will stretch out their forearms instead to shake hands.