ENT Surgery in Ethiopia

Wednesday, July 26, 2006

The surgical work we will be performing in Ethiopia will mirror the work performed earlier this year by SELAM partner global ENT Outreach and SELAM director Dr. Richard Wagner. The Following Article which appeared in the online newspaper - The Ethiopian Reporter - on June 2, 2006, provides an in-depth summary of the type of surgeries that will be performed and the great need currently for such services in Ethiopia.

Life & Art: Restoring hearing to the deaf

A group of surgeons and nurses work tirelessly in two operation theaters at Yekatit 12 Hospital, going from room to room and performing ear surgeries.

They fix their eyes on the microscope and skillfully cut through tissues and drill bones to repair ear drums, and clean out bones to treat infections. The three American doctors and their Ethiopian colleagues skip lunch as they rush to meet a tight schedule of six surgeries a day.

These surgeries are carried out in one of the newly-constructed blocks at the hospital. This mission of four Americans - three surgeons and an audiologist - intends not just to help Ethiopians who suffer from ear infections and hearing impairments but also has a wider aim of training Ethiopian doctors. They plan to transfer the best ear surgical procedures that technology has made available to the medical world.

The two-week surgery program that began last Monday at the Yekatit 12 and [due to continue at the Black Lion hospital] is an extension of a program conducted last year by Dr. Richard Wagner, from ENT Global Outreach, US, who is also here in Ethiopia this year with three other specialist colleagues.

But what is more disturbing both to the American team and their Ethiopian comrades is that there is no institution in the country to train ENT specialists than the severity of most of the ear disease cases.

The fact is that there currently are nine Ethiopian ENT specialists for 77 million people in the country.

“Figures from the World Health Organization (WHO) show that 10% of the Ethiopian population suffers from ear diseases, roughly an equivalent figure of those infected by HIV/AIDS,” Wagner said.

“But all the money from local and international donors is going to HIV/AIDS. I don't mean to say that you don’t have to give HIV/AIDS the due attention and finance,” he adds. “However, it needs to be recognized that there are other diseases as well which are causing people disabilities and minimize their contribution to the society.”

The American doctors and Dr. Gebeyehu Kassaye, head of ENT (ear, nnose and throat) department at the Yekatit 12 Hospital have expressed concern on the scarcity of ENT professionals whose number has gone down to only nine currently from twelve last year following the retirement of three veterans in the field.

Forty surgeries are scheduled to be performed at both hospitals for those who suffer from perforated ear drums, cholesteatomas, and ear tumors.

Speaking of the cases they have diagnosed for the surgeries, Dr. Wagner said, “most of the cases are results of neglect and lack of care. The conditions of the patients have gotten worse because there is no care available.”

“Europe and America are draining the fewer health professionals trained by the government here,” Dr. Wagner said. “The brain drain is disastrously going to hit the country unless the healthcare system puts more resources to train doctors soon.”

Dr. Yitsak Bedri, ENT specialist and a private practitioner in Addis Ababa, says that hearing impairment caused by treatable ear diseases is hurting the society more because “it is not visible”.

“Loss of hearing is an impairment and the victims are bound to live in far more difficult circumstances as their disabilities are not physically visible, like polio or blindness,” said Yitsak, who is also performing the ear surgeries along with Dr. Gebeyehu and the two male and two female American team.

The surgeries are destined both to stabilize the conditions of some of the patients and to restore hearing for others.

“We stabilize disease so that the patients don’t get complications and restore hearing ability for some of the patients who are already deaf,” Dr. Wagner said.

But the need for the country to set up an ENT department at the medical schools is what the professional suggest could be the answer. It will, the specialists say, lay the foundation for more effective and permanent ENT treatment in the country.

Dr. Gebeyehu revealed that his plea and that of the Ethiopian ENT Professionals Association for the Addis Ababa University Medical School to facilitate the establishment of the first ENT department has borne no fruit to date.

“We have the equipment that we acquired from different donors to start up the specialization program,” he explains, “and we can get the rest of the needed materials gradually. We just can’t wait for another year, or for more equipment while over 70 million people outside of the capital remain with no access to ENT doctors.”

"This American team brings advanced techniques and equipment for us that have improved in the last eight years since I came back to Ethiopia," says Dr. Yitsak.

“We need some help from the government to turn their attention to a training program with a lasting effect.”

Through two American surgery missions as of last year, more than a hundred patients have so far benefited at Yekatit 12 and Black Lion hospitals. But the most effective help that Dr. Wagner's surgical and audiological team can give Ethiopia will depend on the support it anticipates to get from partners here.

“I have got all the support from the US. But I need travel and accommodation support here for the physicians to be able to continue,” says Dr. Wagner. “Then we will get the specialists who will volunteer their time, their equipment and supplies.”

Considering the great deal of contribution from the Ethiopian side to materialize soon, Global Outreach plans to work together with Ethiopian resident doctors through a two-week program that will run over three to four missions a year. “We hope to perform 200 surgeries and training sessions here which will culminate in 1,000 surgeries and intensive training schedule for Ethiopian doctors over a five-year period.”

The news of a continued training mission from the American team is good news for Dr. Gebeyehu, who says the promised assistance from Global Outreach could spare millions of people of hearing impairments, a disability that harms the social communication of its victims and deepens poverty.

“I will probably work for ten years or more but I can’t continue after I grey entirely,” he says. “That should explain why we are urging the university to open up a department for ENT doctors. It is for the young physicians to benefit from long-term and generous trainings.”

With some amount of will and partnership from Ethiopian private and public institutions, the help that could save the future of millions of Ethiopians from abroad seems only to be a step away.

Members of the American ENT specialists' mission are Dr. Richard Wagner [Global ENT Out reach state of Washington], Dr. Joni Doherty, House Clinic, House Ear Institute, Los Angeles California, Ashkam Monfared, Stanford University Stanford, California, and Daniell Zubak House Clinic.

By Nolawi Melakedingel