Ethiopia, the land of thirteen months of sunshine

Project: Surgical Capacity Assessment in Ethiopia
Partners: Harvard Humanitarian Initiative, MGH Department of Surgery, Harvard Program in Global Surgery and Social Change, Global Surgical Consortium


Ethiopia, the land of thirteen months of sunshine, is big.  Huge, in fact.  I spent this past October in  Ethiopia, crossing huge distances in planes, cars, and buses, visiting hospitals to administer a surgical capacity survey with the Harvard Humanitarian Initiative.

Visiting one of the hospitals in Debark with one of my co-researchers

After spending a couple days at the Ministry of Health and at Black Lion Hospital, working with the MoH Medical Director, Mr. Abebaw, and our local author, a pediatric surgeon named Dr. Miliard Derbew, we plotted out a rough idea of our country tour and then set about figuring out what combination of plane, bus, and car would get us where we needed to go.  It turns out that we needed to fly a LOT; I ended up taking eight domestic flights this month!  Fortunately, Ethiopian Airlines is quite good and, more importantly, inexpensive.

One of our many domestic flights required to reach hospitals around the country,
which is over one million square kilometers!

What we discovered through our travels is that hospitals in Ethiopia are distributed unevenly throughout the regions and city-states, with resultant disparities in physician:patient ratios in different areas.  Unfortunately, this limits the ability of many patients to access hospitals, particularly hospitals where surgery was available.  Though they frequently had access to primary care, the limited availability of surgical capacity translated into huge problems regarding obstetric care and trauma emergencies.  When patients are traveling by foot and camelback, the huge distances prove a problem.

Camelback is an acceptable alternative to an ambulance

While we also discovered infrastructure deficits, we were impressed by the creative workarounds that were developed.  Not only did we find the typical adaptations like electric generators and headlamps in areas without electricity, but we found air conditioners used to refrigerate medications, or living blood banks in areas without blood banking ability.  The ingenuity of the doctors and hospital administrators certainly was to be applauded.

Other than that, the country was a great pleasure to travel around.  We were able to experience a lot of wonderful things in Ethiopia, notably the wonderful coffee ceremonies.

Coffee ceremonies involve roasting green coffee beans, grinding them, and then cooking them over coals

Of course, no story would be complete without mentioning the incredible hospitality of the Ethiopian people we met, particularly the families, patients, and all the medical personnel we were able to meet with!

A gift from an Ethiopian family to keep warm; Ethiopia was surprisingly temperate!

Now that I'm back in Boston, I'll be taking some time to reflect on our experiences, but I will never forget this incredible month I spent in Ethiopia.

Tiffany E. Chao, MD, MPH
MGH Dept of Surgery PGY3