I got involved with Health Volunteers Overseas, a private nonprofit organization dedicated to improving the quality and availability of health care in developing countries through the training and education of local health care providers. This spring, I served as an instructor for Ethiopia’s first nurse anesthetists master’s program, which services Black Lion Hospital, the largest tertiary hospital in Ethiopia, and Alert Hospital, the largest leprosy and tuberculosis treatment site in Eastern Africa.
I found Ethiopians to be a kind and generous group with an amazing sense of pride in their culture and heritage. The nation claims to be the birthplace of coffee, and the people have traditional coffee ceremonies in their homes. When you are offered coffee, it is very rude to decline.
Although Ethiopia is considered one of the most progressive African countries in medical care, standards are not congruent with what is found in an American operating room. With frequent power outages and the overall lack of resources, it was a real exercise in creativity. We had to learn to do the very best with what was available.
The nurses taught me nearly 50 alternative uses for IV tubing. Truly amazing! Power outages often left us using cell phones as light sources for the surgeons. There indeed is never a dull moment abroad.
Duringmy stay, Idevoted themajority ofmy effortsteaching Ethiopiannurseanesthetiststo perform regional nerve blockades.More commonly knownas a nerve block, this techniqueinvolves local anesthetic injectedaround nerves for the temporarycontrol of pain. Used in the U.S.extensively for years, this was anovel technique for the studentsand represented a large step forwardin anesthetic management.
Due to limited operating room availability, many simple procedures were not being completed. Introducing regional nerve blocks meant the patient no longer needed to undergo general anesthesia. This allowed the surgeon to perform the surgery without a formal operating room. We started completing the procedures in the hallways and making procedure rooms out of what were once closets.
Interestingly, the Ethiopian calendar currently reads August 2003. However, their medical acumen is far more than seven and a half years behind that of the U.S. Leprosy and polio are still prevalent, and salaries are very low. Most of the nurses I instructed had jobs after we were done training in the operating room. They would work overnight at private clinics to handle emergencies. Their salary would be 200 birr for this effort, which is roughly $12. In the United States, the same shift would pay more than 100 times that. Without funds to increase the education of the medical professionals in the country or provide better accommodations for patients, an increase in the quality of patient care is not likely to be immediately forthcoming.
After completing my month-long stay in Ethiopia, I returned to the U.S. with a renewed sense of professional commitment and appreciation for the tremendous opportunities available to help those less fortunate. I have lived a very lucky life. I was born into an amazing family in the right geographical location and time. I have had opportunities that are absolutely uncommon to those outside the developed world. One way to show this appreciation is through giving back, and strangely the rewards are far greater than you give. That’s why I encourage others to also share whatever training, resources or time they can for causes both foreign and domestic. I hope the inspirational nature of my journey will compel others to find a cause they feel strongly about and do their best to improve the lives of others.
Karl Disque, D.O.’07, R.Ph., became interested in international medicine after the January 2010 earthquake devastated Haiti. A senior anesthesia resident at Rush University Medical Center in Chicago, last year he spent 10 days in Port-Au-Prince, Haiti, as part of 20-member Rush medical team that treated up to 1,000 patients a day in hospitals, refugee camps and makeshift clinics. With one month left of his residency, he decided to again take his skills across the globe to help people desperately in need of more effective medical care. You can contact Disque at fritzdisque@gmail.com for additional information on volunteer opportunities or with questions about his experiences.
