• Ethiopia

The Kind cuts for Kids Foundation visited Ethiopia in January 2008, developing a relationship with the Addis Ababa University and the Black Lion Hospital. Ethiopia has a long history of medical development, and a rich history of culture and religion, Abyssinia having been the focus of the development of the Christian religion, with the country having the oldest Christian Church. 

The Black Lion (Tikur Anbessa) Hospital covers an entire city block on a street named after Sir Winston Churchill.  Both new and old buildings make up the hospital complex, in a city that has pollution and a huge population.  Progress and development are indicated by the large number of cranes atop partly finished buildings, and the soon to be open 23 story building, locate not far from the Black Lion Hospital.

Tikur Anbessa University Hospital is a 560 bed central referral hospital that  provides general medical services for a city of over 3 million people, and those referred from other parts of a country of 75 million people, 44% of whom are less than 15 years of age. One hundred and thirty of beds (23%) are dedicated to Paediatric patients, 40 which are for elective Paediatric surgery admissions. The Black Lion Hospital is the only hospital providing tertiary Paediatric surgical services in Ethiopia.

The Department of Surgery of the Faculty of Medicine, which is responsible for the training of general surgeons and undergraduate surgical education, has around 18 staff surgeons, one of whom is a Paediatric Surgeon and one of whom is trained in general surgery, but who helps provide the service. In 2004 there were only a total of 158 practicing surgeons in Ethiopia, compared to 48,000 doctors (240 per 100,000), and around 5,500 surgeons in Australia. These data show how far Ethiopia is from the minimum acceptable ratio of surgeons to population and indicates the need for specialty training in general, and subspecialty training in particular.

Medical development has been hampered by a number of conflicts and government changes, but even more-so by the brain drain that has come from the trained medical and nursing staff leaving for developed countries.

The visit of the Kind Cuts for Kids Foundation followed a request to assist with a young girl with spina bifida, a condition in which there are consequent neurological, orthopaedic, Urological and bowel problems.  When details of this little girl were presented to the Australian team, it was recognised that a one-off surgical cure was not possible, and it was considered that educational input to the Ethiopian team would assist beyond developing a solution for the one child. 

We dealt with the same group of doctors and nurses in Ethiopia as on the previous visit, with only the anaesthetist being a different team member for the Australian contingent.  Prior to the visit in January 2008, Professor Milliard Derbew, Head of Paediatric Surgery and the Dean of the Addis Ababa, was contacted regarding the prospects of including Ethiopia in the Kind Cuts for Kids program, to which he eagerly responded.  Subsequently, a visit of a team of a Paediatric Surgeon, an Anaesthetist, a theatre nurse and a Paediatric Radiologist was assembled.  The Ethiopian team developed a program of teaching and clinical work, which included identifying patients appropriate to the education program, mainly focussing on difficult cases of Paediatric Urology.