Rotaplast Missions

Tomorrow is our last day of surgery – 14 cases booked. Our recovery room is overflowing; some children on mattresses on the floor, other pre-operative patients have to find their own accommodation for the night, maybe camping on our doorstep, returning for surgery tomorrow morning. We had two interesting cases arrive late in the dayas we finishing our slate. We decided to stay late and fit them in. One was a young woman from the border of Ethiopia and Sudan. She had traveled over 300 kms and had severe facial deformaties. Though an interpreter we determined that her neighbour brought her hoping we could repair her deformity so could be traded to the brother of his potential bride. The second case was a small boy rushed in by his father with serious facial injuries caused by dog bites. After several hours of surgery they were able to save his eye and close his wounds. It is yet to be determined if the dog has rabies and there is no treatment available for rabies in Ethiopia. If we had not been on site, this child probably would not have recieved emergency plastic surgery - a lucky boy.

We have had many challenges running patient admission with medical records, a 3 bed operating room, recovery room and post-operative beds. Everyday we have water and power outages. It has kept our quartermaster and assistant team leader busy being inventive to keep these systems functioning. One day the scrub team was scrubbing up out of a barrel and a bucket. Today, we ran our Oxygen and it is being delivered from Gondor about 3 hours away. We are constantly short of very basic supplies and drugs and forces us to be very innovative and resourceful. Despite this, these kids are little miracles. We have done good work – thanks to your help.

Tomorrow we do 14 operations. Thursday is clinic day when we do our post-op visits for all surgical patients and then we pack up. We hope to gather for final dinner late Thursday evening. We leave Friday morning for Addis Ababa. Some of us are returning home, others are going on the Tanzania for a 5 day safari.

We will post pictures and more thoughts when we return. Extremely slow internet access here has prohibited loading any pictures.

We had a day off yesterday and the Rotaracts planned a variety of tours for us to choose from - a boat trip on Lake Tana to visit the island monasteries , a short trip down the Blue Nile , a hike to visit the Blue Falls (spectacular) and/or a trip to Gondar to see the ancient castles. It was a welcome relief for fresh air, sunshine and some beautiful scenery. Now we are rejuvenated and ready for tomorrow’s surgeries.

We have seen and assessed 107 patients ranging in age from 8 months to 72 years. As of the end of today, we completed 54 surgeries. We have an additional 24 surgeries slated over the next two days for a total of 79. Our numbers are fewer this trip but several of the surgeries have been long repairs of burn scars which take many hours to complete. We have had two children with malaria and one with possible typhoid which we treated prophilactically.

In rural Ethiopia, the women tend to do the work on the farms so it is often the fathers or uncles who bring the children to the clinic. They are great caregivers. One young father was helping all the children in our very crowded post op room.

Many children arrive in rags ,filthy dirty-the showers are not working so we try to do sponge baths before surgery and give them the children’s clothes we have brought with us .We have been giving some of the adults our own shirts to wear.

It is 7:30 pm now, many of our team are still with our patients. They often don’t get back to the hotel until 8 or 9 pm.

Our post-op patients often have no water, juice or food for their children as all their Birr was used to travel here, often very long distances. Thanks to your donations we are able to provide juice and water. Most of the babies don’t have diapers so they pee and poop on the floor which creates havoc for the other children and staff.

Some of your cash donations have gone to purchase the apple juice and water. One of the biggest hits has been the soccer balls that were purchased prior to the trip. Soccer is “the” national sport evidenced by the large crowd in a makeshift theatre across from our hotel, with rows of wooden benches and a sheet for a screen.

Every day there are “happy tears” from staff, patients and families. One 12 year old boy was so excited that he can now go to school! Long days but well worth the outcome – so rewarding to see young children, even toddlers see their new smile in the mirror with expressions of disbelief. The operative word here is KONJO (beautiful).

We are grateful to be able to make this happen. Your donations have changed the lives of 79 children, many families and all our staff.

AMESEGINALEHU - thank you in Amharic

A short note tonight as we were late getting the last of the patients out of recovery.  We have done a number of quite large cases.  Interesting for our medical team and wonderful for our patients who may never have had this opportunity.

The local Rotaract team put on a lovely candle light garden party, wth Ethiopian entertainment, for us last evening.  This evening was a more formal dinner with the local Rotary Club.  Not all of us were able to attend because we were still carign for the last of the surgical patients.

We have lots of great pictures but have been unable to post due to internet issues.  We'll try later when we are in Addis.

Thanks again to all of you for your support.

First Operating Day

Our first day of surgery in Bahir Dar – despite many challenges, a success! Thirteen patients had surgery; many more are booked into next week. Forty-eight patients have been assessed. Not all are candidates for surgery. Most present with cleft lip or palates but we are seeing several children with severe burns and contractures to their hands – they fall in open cooking fires. One young woman had been shot in the neck about 1 month ago. She has bone fragments from her jaw lodged in her neck. This is causing severe infection and ulcerations. She is slated for surgery. Apparently, the shooting was intentional. Another young mother brought in her very handicapped 5 year old. After many questions through the interpreter, the child was diagnosed with cerebral palsy. The mother then admitted that she had been told that by a local doctor but hoped for some better diagnosis from our western team. Very sad to send her home with no hope.

The local Rotoract and Rotary members were again our live savers, making miracles happen when we need supplies or help. They are providing all our interpretation – at admission, assessment, surgery, recovery and home. Our work would be impossible without them. The local families are also an inspiration. Many travel, often by foot, for 50, 100, 150 or more kms to be seen. They are waiting on our door step in the morning when we arrive at 7am. They often camp for several nights waiting to be seen or for surgery. They come with so much hope in our abilities. It is difficult when we can’t fulfill those hopes.

We have experienced many challenges. After arriving in Addis on Sunday night, with almost 40 boxes of medical supplies and equipment, customs held back all the boxes. It took major negotiations until 8 pm Monday ( a day and a half) by Sandra and Brian to get the boxes released and on their way to Bahir Dar – a 9 hour drive. They finally arrived during the night on Monday ready for our set up Tuesday morning. Our accommodations have been difficult to adjust, as well. We are a very run down guest house – showers not working, screens missing (malaria in endemic here), towels and toilet paper difficult to get, food almost inedible, etc. We are learning to cope but it is difficult when we are putting in 12-14 hour days. Much of equipment is malfunctioning as well – lots of technical glitches that eat up precious time. Gas tanks required and the anaesthetic machines we have don’t have compatible fittings. One of Rotoractors (a young dentist) came to rescue. He along, with our intrepid and creative anaesthetists, got 2 machines running; a third OR table operated using local anaesthetic.

Tomorrow we have 10 cases slated, many 2-3 hours long. We have a great team, everyone generous with their time and help.

It is now 8 pm, the final patient is just coming out of surgery. Some of us will wait until they come out of recovery. Local nurses will watch over them through the night. The bus will be at our compound at 6:30 am to start again.

Wonder what’s for supper!

We arrived yesterday (Monday) after almost 3 days of travelling.  After checking into our guesthouse on Lake Tana (a backpackers hostel!) we spent the rest of the day at the clinic cleaning.  The building we were assigned had not been used for several months - dead bugs, cobwebs, cockroaches, left over supplies, dirty floors, etc.  So, we all went to work and in a few hours we made a difference and felt ready for setup the next day.

Upon arrival at the clinic, we were greeted by several families with their children eagerly waiting to be seen.  We also had a tour of the adjoining hospital - the only hospital in western Ethiopia.  We saw the waiting room - at least 100 people waiting to be seen by a doctor.  All had appointments but would have to come back every day for several days before they could be seen.  The physician situtation is very poor here - a brain drain occurs.  They are educated in Ethiopia but leave for greener pastures abroad.  The emergency room is one single room.  The pediatric ward was very crowded - 6 to 8 children in one small room - one infant dying of malaria.

There is also a Fistula hospital next door which we have not yet toured but hope to visit in the coming week.  It is staffed by Autralians and funded initially by Oprah.  We will report back on this visit.

Today was our first clinic day.  Lots of technology issues initally but by the end of the day we had successfully assessed and slated for surgey 32 children over the next few days.

We have an incredible team; good comraderie.  Out of a team of 29, 23 are Canadians.  We would not have accomplished this without the help of eager young Rotoract members (Rotarians under 30 years of age) who have acted as our translators and liaised with hospital administration.

Tomorrow is our first surgery day with 13 patients.  We get an early start at 6:30 am.

As technology permits, we will try to post some pictures.

The Language Barrier

Chinese is an opaque language. Instead of an alphabet they have several thousand characters. Each character represents a different word. For example over an exit sign there are four characters, which mean safe exit, but individually the four characters have a different meaning. There is no chance that an English speaker can guess a printed word’s meaning. Our team is dependant on our translators in order to function. On a medical mission there is no room for error, so everyone has been vigilant to be sure they are understood.  For everyday communication pointing, gesturing, and smiling has become our an important part of our communication.

October 20th

Today started cool and cloudy, with smog. Now we have sun and smog. Three operating rooms, and 17 surgeries on the docket, make for another long day. Our ward has 38 beds total for pre O.P. and post O.P. Today we hit max occupancy with 38 children which plus all the family members so we are adding several cots. It will be a full house tonight. 

I sat in while Marlene our team speech pathologist interviewed a 19 year old young man. He has soft palate issues that currently let most the air in his speech escape through his nose. The result is a soft nasal voice without definition between syllables. He works and lives at home with his parents. In China there are more boys than girls, so the girls can be choosy.  I spoke with his parents after they ducked into our break room to dodge the media. They wanted to show their thanks by presenting us with a banner which thanked Rotaplast for helping their son. Since their son is a young adult they do not want him to be used by the media for publicity purposes. How refreshing! So I will just call him 163. He is a strapping young man, and stands well over six feet tall. I told his parents that I wished for a successful surgery and that he would find a pretty girl. At last word the surgery went well and he is in the ward now.

October 19th

Back to work. By the second week even the non-medical volunteers know what a Dingman clamp or a fistula is. This afternoon Dr. Granger is going to be the surgeon for a little boy named Jia Hao. He has what is called a bilateral lip, meaning it is split in two places. A single tooth projects  beyond the gap in his lips. Nan explained to his mother that the next time she saw her son he would look different, and sometimes a parent will get used to the appearance of their child with the cleft. The mother smiled and said she was looking forward to seeing him without the cleft.


One can only imagine the anxiety a mother has while she waits to see her infant after surgery. I was in the recovery room when Jia Hao was wheeled into recovery, and his mother came to see her son. Little ¬¬¬¬Jia Hao had an extensive procedure to rejoin the huge gap in his lip. Mom was upset when she saw her child with all the swelling, and discoloration that accompanies this type of surgery. Mom is only 24 and this is her only child, so she may have had different expectations. Everyone tried to comfort her, but we needed to get our translator to tell her that the swelling would subside, the natural color would return.

October 16th

Dr. Granger arrived at the team hotel at dawn, so we will run three OR’s today. The hospital is very large with the ward on the second floor, and the OR on the 5th floor, and Michelle’s orthodontic workroom on the 4th floor. A convoluted five minute walk will get you from the ward to the OR. More than a dozen members of the Chinese media arrived in today to follow the story of 4 year old Lipling Wang. Lipling is an orphan who was abandoned at birth by her parents because of her cleft lip. She was adopted by the woman you see in the attached picture even though she had a daughter of her own and is 80 years old. Lipling lives in a small village in the mountains several hours from here. Lipling brought a bunch of yellow wildflowers that she had picked from her yard to present to her doctors. Lipling was a favorite of our team before she became famous in the local media with an open smile, and gregarious personality that transcends the language barrier. I spoke with Lipling’s grandmother, and I asked what she wanted for her adopted daughter when she grows up. Her response was, “to be a doctor!”  Why not?

October 15th

The weather has been very pleasant with blue skies and high temperatures in the 70’s.  Our first day of surgery started early with two operating rooms as Dr. Granger is still in transit from the United States. Most of the cleft lip procedures are revisions as the most of the children had prior surgery. Marlene our team speech pathologist examined a year old girl Jinxlao who required palate surgery. Jinxlao’s open palate reduces her ability to speak. Her voice is very soft and when you can get her to talk she talks like a six year old. Your heart goes out to think she has not been able to express herself like other children her age. I spoke with her father with the help of a translator. Her father said she is not a good student, which is not a surprise considering her limited ability to talk.  On a brighter note, our head nurse Sandra who has been on 10 missions reported that it was a good first day overall. The 10th and final surgery of the day left the ward by 6pm.