Monday

I would like to begin this blog post with both an apology and a disclaimer. While Jeff is regularly fascinated by the various gross medical oddities that pass our clinic steps on a semi-regular basis, I am wholly content to avoid most descriptions and pictures of a graphic nature. I therefore feel that I should warn you that the blog post below will be less than appealing for those who are squeamish about graphic medical descriptions. Moreover, the medical picture is somewhat disturbing. If this does not sound like your cup of tea, then I recommend that you don’t read on. There, you are warned.

Monday was the first day in which I was the only expat managing our medical clinic. Our project director had traveled to Addis for a meeting, and Jeff left early in the morning for a medicine run that would take about 48 hours. So as I opened the clinic gate, I was hoping for a quiet, uneventful day…

The morning began with a case that shocked even our most seasoned nurses. An adolescent girl had traveled for many days from a distant region in Western Ethiopia in hopes that we could help her. Her jaw, mouth, and chin were grossly deformed by what appeared to be a huge tumor—a tumor that has been growing for eight years. I am including her story and picture in the hopes that others might have thoughts on options of how we can help this child. We have identified an Australian surgeon working in Ethiopia who is willing to examine her and determine whether he has the capacity to operate on her. But we fear that Ethiopia, as a country, lacks the medical expertise and resources needed to fix such a case (If you click on the picture it will enlarge).

The afternoon brought two measles cases. The week before, we identified our first case of measles in over a year. Now we feared that we had an outbreak on our hands. Since Monday, many more cases have been identified and it is now clear that we are dealing with a full-on measles outbreak. A problem most in the US will never experience.

Then the clinic closed, the staff left, and everyone when home. But the clinic never really closes. Two nurses stay on duty overnight to treat the many emergencies that show up at our gate. That night we had sick children, pregnant women, and one small child who had been attacked by a baboon. Her abdominal cavity had been ripped open and her stomach and intestines were perforated. We tried in vain to start an IV, but the child was in shock. We called in an expert health officer trained in surgery, but there was nothing that could be done. After hours of trying the save her, the two year old girl seized and died.

As the child lay dying on the table, and I leaned against the wall visibly upset, one of our nurses looked at me and said, “Erin, this is our life here. This is our everyday.” And it is true. Everyday here, families die from problems that we just don’t have in the US. If she lived in the US, the girl with the tumor would have been treated years ago. As children we are vaccinated against measles. Many clinicians in the US will never see the disease. Parents don’t have to worry about dangers from animals and diseases living at their doorstep. This is Africa. And, sometimes, it feels a long way from home.