I have now passed the two year mark of being in Ethiopia. The last two years have been, well, nothing like I expected. I thought I would be in language school for 3 months and then be buried up to my eyeballs in work at the hospital. Little did I know, a whole different path was set out for me.
I didn’t think 4 months would be spent debating over being able to get a medical license or that I would have to spend another year in training at a government hospital and then still not be able to get a license without more arguments. I had no idea that my heart would be stolen by two little street boys.
But, here we are two years later. I have grown and I have changed in many ways. My heart doesn’t bleed at the things that used to make it bleed, but it still bleeds. My view on death has changed after seeing so much of it, since it is an almost daily part of life here. A neighbor, a friend’s relative, a patient, a baby… Even if you don’t know the person that died, you can hear the wailing and you know someone else has passed. The things I am doing are just a drop in the bucket. I cannot and will not be able to make much of a change, but I can make an impact in a few individuals. I still get frustrated by cultural differences, but I also have a respect for many of the things that I didn’t previously understand.
Today, I went to the government hospital to finish making a list of procedures I did in my time there. When you are working it always feels like you have done more than what was written on paper. You spend hours in a surgery for an advanced cancer and it is one little tally mark on your paper. Honestly, I was a little surprised at how little I did. I was certain I had done more cases, but when I compared the numbers of my first 6 months in the government hospital, I had done more cases there than my entire four years of residency. And that was only working in the hospital 4 days a week, every other weekend and no nights on call. I literally have no idea how many normal, vacuum, forcep or destructive deliveries I have done. They just aren’t recorded.
Here are a few cases that are things you just don’t normally see here or in the states.
A 40 year old came in complaining of abdominal pain, vomiting and not feeling the baby move for a week. She thought she was about 8 months pregnant. The staff tried to find fetal heart tones and could not, so they induced her assuming the baby had died. I came in the next morning checked her and her cervix was open, but the uterus was empty. We did an ultrasound and could see very little because of her distended bowel. The uterus was empty, but I could not see anything else. We did a pregnancy test and it was negative. The general surgeon brought her back for a bowel obstruction… he found a mummified baby in her abdomen and the placenta adhered to the bowel. He took the baby out, but left the placenta because it had grown into the bowel. She recovered very slowly. After surgery, she was very confused. She pulled out her NG tube and IV. About 7 days into her recovery she would shake my hand and mumble. At ten days post op she would appropriately greet me and finally knew her name.
An 18 year old came in with a cut from her bottom to the opening of her vagina. She had been impaled with the horn of a bull. It was the holiday so every one was slaughtering bulls to celebrate. Her surgery went well and she went home a few days later.
A 3 year old was brought in for vaginal bleeding. The family assumed she had been raped and even had a man arrested. They brought her to the hospital. Diagnosis: Leeches in the vagina. They had been there long enough to cause a severe anemia. Salt water washes of the vagina several times and the leeches decided it was not such a nice place to live.
Ruptured bladders, ruptured uteruses, fistulas… The stories could go on and on. And each story has a person behind it. The numbers say nothing of what I have experienced here. Even though these last two years are nothing like I expected, they have been richer than I could have ever dreamed.