Learning from Ethiopia’s ‘MacGyver’ doctors


From left, Tikur Anbessa’s Dr. Mersha, neurosurgery chief, and Dr. Ebenezer with Ohio State’s Dr. Eric Sauvageau and Dr. Andrew Shaw as they enjoy coffee before making rounds at Tikur Anbessa (Black Lion) teaching medical center at Addis Ababa University. (Photo by Rick Harrison, Ohio State University Communications)

By Andrew Shaw
Clinical House Instructor at Wexner Medical Center, Ohio State

Since returning from Ethiopia I am filled with excitement. The people there are incredibly welcoming, warm, and giving. They invited us to see their patients, wards, and hospitals. The doctors there exhibit such passion for medicine, learning, and are always wanting a lecture.

Establishing a long term relationship with the Neurosurgery Department at Black Lion hospital will be mutually beneficial.

Upon our arrival, I believed we would be the teachers, but I often found myself on the learning end. The pathology they see is often advanced and requires much skill to treat.

You might recall the show MacGyver. As Wikipedia says, “Resourceful and possessed of an encyclopedic knowledge of the physical sciences, [MacGyver] solves complex problems with everyday materials he finds at hand, along with his ever-present duct tape and Swiss Army knife.”

Our Ethiopian partners are the “MacGyvers” of medicine doing amazing things with limited resources.

Data collection, shoulder dancing, and tailored suits

By Korbin Smith
Student, Ohio State College of Medicine
School of Health and Rehabilitation Sciences

The initial data collection for the project has been finished.  Our group was unable to blog or access the internet over the last week due to traveling in small towns throughout Ethiopia that don’t have internet.  To catch up, we traveled from Gondar to Woreta where we conducted interviews before moving to Debre Tabor.  It is crazy how different the climate can change Imagehere with a 40 minute drive.  Woreta has a warm climate with temperatures probably averaging around 80 degrees.  A 40 minute drive to the highland in the mountains and Debre Tabor was probably around 55-60 degrees.

Luckily for me, this means I now have a cold.  I am beginning to think I have a weak immune system, as I am always the only one to get sick.  From Debre Tabor we met with Dr. Gebreyes, who brought a photographer and Dr. Sauvageau, a neurosurgeon from Ohio State. It was good to see others from Ohio.  We drove to Bahir Dar which is the city that borders Lake Tana, the biggest lake in Ethiopia.  Being a fishing connoisseur, it was very neat to see the traditional fishing methods.

We celebrated finishing the data by going to a traditional Ethiopian club in which we saw many styles of “shoulder dancing.”  I think I can dance better in Ethiopia than in the U.S.  As long as you can move your shoulders to the music you can be accepted as a dancer here.  People are less inclined to judge me on my overall lack of rhythm (or if they are judging me it is in Amharic and I can’t tell).


Once we returned to Gondar I was happy to pick up the suit that I had ordered in the city aweek ago.  Since I am a rather tall, skinny, and lengthy individual, the suits already made did not fit me.  Dr. Tamiru, a partner we have been working with, took me to his tailor who agreed to make me a suit from the cloth of my choosing for 1,900 birr.  While that might seem like a lot in the U.S. that is equivalent to 100 USD.  This is extremely inexpensive for a customized tailored suit. The suit fits excellently.

In addition to completing the data collection, I have appreciated experiencing different aspects of the culture here in Ethiopia.

Dancing in Ethiopia

By Ally Sterman
Student, Ohio State College of Veterinary Medicine

After a week of traveling around the Gondar region, our travels brought us to a city named Bahar Dar. Here is where the Nile River begins, Lake Tana (the largest lake in Ethiopia) is located, and the Blue Nile Falls are located. Our partners wanted to show us what a traditional Ethiopian dance club looked like, so after dinner we headed out on what would be one of the most memorable nights of my life.

We arrived at the club and there was a small stage with four musicians. They were playing a few traditional Ethiopian instruments and a few modern ones like the electric keyboard. The more traditional instruments included a kraar, which is five- or six-stringed bowl-shaped lyre. There was also a masenqo which is a one-stringed lyre. The instruments supported the vocalists who came out and sang a variety of songs.

Ally Ethiopia pic

However, the highlight of the evening was the dancing. One set of dancers were two brothers who we had seen dance before in Gondar. During one of their songs they grabbed Laura (another student working on the rabies project) and took her up on stage to dance. After another few songs, a different dancer came out. We had the chance to watch him for a short period of time before he danced over to where we sitting. He again grabbed Laura and tied her to him, and then grabbed my hand. The two of us were pulled on stage to dance in front of everyone. Another gentlemen from Israel was also grabbed and brought ally dancingon stage. Laura and I soon found ourselves being tied together to have a dance-off (pictured left). This style of dancing is not quite what my years of dance had prepared me for but I tried anyways. After a few minutes it was over and we headed back to join the rest of the group. Our partners were proud of us going up there, though it was clear our dancing skills left something to be desired and more practice is definitely necessary. This was one of my most embarrassing experiences yet here in Ethiopia, but also my most memorable.

Winner Winner, no more cheeseburger for dinner

By Korbin Smith
Student, Ohio State College of Medicine
School of Health and Rehabilitation Sciences

If there was a competition for the first Ohio State student to get sick during the summer research project, I came out victorious.

I have tried many different types of dishes without getting sick. However, I figured I would give their American equivalent to a cheeseburger a try, and it was a bad decision. Unlike when I feel ill in the U.S., getting ill here is more serious. The majority of our Ethiopian collaborators have reached out to me in one way or another to make sure I am OK. They are all truly compassionate and caring.

Since the rest of our research team changed cities, I am the only one left in Gondar until tomorrow. I immediately noticed people are more willing to practice their English on an individual rather than a group. My waitress for dinner tonight was practicing with me and I could tell she was very excited when I understood and responded.

I understand what it feels like to try to have a conversation in a language you aren’t familiar with. Anytime I can say “Hello” or “Thank you” in Amharic, I do so.

I have also noticed that most conversation stops briefly when I walk into a room.  There aren’t a lot of 6’3” blonde, blue-eyed males walking around in athletic shorts and an Ohio State T-shirt.

All-in-all, as we continue our stay here in Gondar, I am constantly impressed with the class and generosity of the people of Ethiopia.

If generosity equaled power Ethiopia would control the world

korbin smith

By Korbin Smith
Student, College of Medicine
School of Health and Rehabilitation Sciences

As we began our interviews with the locals I was amazed how easy it was to get people to volunteer. Everybody in this country wants to talk and help.

My group consisting of Dr. Atnaj Alebie and Tadele Atinafu have been more than helpful. They are brilliant professionals as well as very kind and humble people.

Together we were able to collect our first set of data in rural areas successfully and efficiently. Hearing what the rural adults and children believed caused rabies was truly incredible.

While many answers cause me to be concerned about their safety in an area where rabies is prevalent, it is inspiring to know that our work is needed.

Show and Tell: Our “First Kits” in Ethiopia’s Simien Mountains

tim landers 3

By: Tim Landers, RN, PhD
Ohio State College of Nursing

This past weekend, we had a chance to take a hiking tour of the Simien mountains in Ethiopia.  This has to be one of the most beautiful places on earth – the landscapes are gorgeous, the people are smiling and proud, and there is plenty of wildlife.

I have done quite a bit of hiking with my two sons and friends from Boy Scout Troop 33 in Columbus.  As we were hiking across the Simien mountain pass, our guide and I chatted about our experiences hiking and guiding groups.

Melese Beza (of www.outstandingsimienmountainstours.com) grew up tending livestock as a shepherd and works as a professional tour guide through the mountains as he completes his bachelor’s degree in tourism management.  He speaks English quite well and we began to talk about the types of health problems he encounters as a professional hiking guide.

We took a break as it began to rain and started a “show and tell” of our first aid kits.  He had a basic kit ready for the main emergencies from African trekking – including what he adoringly called “potions” such as acetaminophen, wound disinfectant, and diarrheal medications.

Simien Mountain tour guide Melese Beza of Outstanding Simien Mountains Tours and Tim Landers, RN, PhD do a show and tell of their first aid kits during a rain break while trekking through the Simien Mountains north of Gondar, Ethiopia.

Ohio State’s Tim Landers and Simien Mountain tour guide Melese Beza do a “show and tell” of their first aid kits during a rain break while trekking through the Simien Mountains north of Gondar, Ethiopia.

The two take turns with their "show and tell" on first aid.

The two take turns with their “show and tell” on first aid.

He used somewhat different terms, but described several conditions which would be expected – ankle “dislocations” (strains/sprains), altitude sickness, injuries from rock falls (abrasions and cuts), and blood sugar emergencies.  He also described unfortunate drowning victims he recalled from last summer and that they had attempted “breath blowing” with success in one victim.

In my training back home, we’ve prepared for emergency evacuation of wounded hikers by helicopter transport, extricating from deep woods by foot and by vehicle, and most of our Scouts have completed training in first aid and CPR.

In this region of Ethiopia, there is no such option.  There are no helicopter evacuations from the Simien Mountains.  Guides call for help and it will come as soon as word can reach the village by foot and a jeep, configured as an ambulance, can make it to the wounded person.

As we discussed how injured hikers are treated and our own experiences, I was impressed with his solid grasp on these conditions.  He has been working with several other guides trying to organize a more formal training in first aid and CPR for Simien Mountain guides.

Because our group is exploring the possibility of working with nurses and health extension workers to do health education, I was able to direct him to some excellent training resources developed by my friends at Columbia University School of Nursing. They have developed a fine first aid training curriculum in first aid for health extension workers.

I left him with some supplies from my kit and he reciprocated by sharing knowledge of local plants and remedies.

He left me with an appreciation for the training and preparation it takes to safely enjoy the outdoors – whether it is in Ohio or in Ethiopia.

Hand-in-hand on hygiene in a hospital setting

Tim Landers, RN, PhD, from Ohio State’s College of Nursing and Nora Mohammed, MSc, from University of Gondar -- an infection prevention hero!

Tim Landers, RN, PhD, from Ohio State’s College of Nursing and Nora Mohammed, MSc, from University of Gondar — an infection prevention hero!

By Tim Landers, RN, PhD
Ohio State College of Nursing

“Are you from Ohio? Will you talk to me?”

Nura stopped me in the courtyard of the University of Gondar hospital. She was waving my business card that had been given to her from a School of Nursing instructor who knew that my work centers on infection prevention.

She had just defended her Master’s thesis on hand hygiene at the University of Gondar in which she completed an audit of hand hygiene practices by nurses and other health care workers at a local hospital. When she told me about her project, I was very excited to learn more, so we met the next day to review her findings.

Improving hand hygiene saves lives. Reducing transmission of germs on the hands of health care workers is the most important means of preventing infections.  A recent article of mine on patient-centered hand hygiene is here. Another important article on the subject is here.

Effective hand hygiene programs use a multimodal approach, including strong administrative support, education, training, monitoring of hand-washing and feedback. A critical element of hand hygiene programs is providing products and supplies in the health care setting, and I’ve worked on the best approach for years.

But I had forgotten how critical the provision of products is in our hand hygiene efforts. Without a sink, running water, soap, or alcohol-based hand rubs, hand hygiene is simply not possible.

Quite frankly, I had come to take this for granted.

Until I met Nora.

In her study, Ms. Mohammed showed that in more than half of the “hand hygiene opportunities” – times when workers should perform hand hygiene – no soap, running water, or alcohol-based hand-rubs were available at this hospital. As a former nursing matron, or director of nursing, she saw the impact this had on patient outcomes.

By demonstrating the need to improve access, her study provides an important first step in improving hand hygiene practices.

I was really excited to meet someone who shares a passion for infection prevention and hand hygiene. She really is making a difference at her hospital and helping to save lives in Gondar. In the U.S., we call them “heroes!”

Yes, I am from Ohio, and I would love to talk to you!