We can help Solomon walk for the first time!

DSC00242Friends – we need YOUR help to change Solomon’s life.

Solomon had polio as an infant and has always been in a wheelchair. He has a very twisted spine and has lost over half his lung capacity.

Solomon is from a town in S. Gondar called Debre Tabor. He was a solid high school student and has just registered to study computers and database management in college, a good field for someone confined to a wheelchair.

Solomon reports that his classmates were helpful and friendly, and he was never teased. We see amazing kindness here. He is the 4th of 6 kids. His dad is a government worker, and his mom a housewife.

The family assumed there was no treatment, and he never consulted a doctor. However, Solomon’s niece was born with a cleft lip and came to Addis Ababa for surgery. They asked if there is any spine doctor in Ethiopia and were referred to our clinic.

On exam, we were happy to see that while Solomon has the thin legs of a patient who has survived polio, he does have some working muscles, and he’s able to lift 1 leg against gravity and move the other side-to-side.

We immediately saw that this is a kid we can really help. What he needs – and has needed for a decade – is to spend a couple of months in ambulatory traction and then have corrective surgery.

He has good upper body strength and is very flexible, a good sign that his traction will be easy and short – about 2 months – and then have surgery.

Because he has upper arm strength and some leg motion, there is at least a possibility that they can put braces on his legs (making them inflexible) and he could walk for the first time in his life with crutches or with parallel bars. Walking with straight legs and crutches takes a lot of energy, but it may give him mobility which he does not have now.

Certainly, even if he can’t walk after surgery, he will be better because his back will be straight and his lungs expanded.

One of the problems which polio patients face in the second half of their lives is post-polio syndrome which weakens the muscles. If this happens, then having his back straight and lungs expanded may well save his life.

I am excited to be able to send him for surgery. Now we need your help to raise funds for him!

This is a kid whom we can really help and completely turn around his life. Wouldn’t that be amazing – walking upright for the first time at age 18?!

We need your help to send Solomon to FOCOS Hospital in Accra for traction and surgery by the great Dr. Boachie and his team. We need to raise $20,000. Every gift helps, please join in.

All my best,

Rick
Rick Hodes, MD, MACP
AJJDC-Ethiopia

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Huge News: Mushida went from paralysis to walking!

17In medicine, things don’t always work out as planned, we all know that.

On the other hand, sometimes we simply feel like we hit a home run.

In early January of this year, Mushida showed up at our clinic, carried in piggy-back by her mom. What unfolded was an unexpected story.

Mushida is the youngest of 9 children in a rural Oromo Moslem family from Jiru, north of Addis Ababa. She lives a 5-hour bus ride away, followed by an hour on a donkey. Her dad is a farmer, they grow maize and some wheat. All 9 children were born at home, delivered by local women with limited knowledge of childbirth. All are alive and healthy, except for Mushida.

The family lives in a mud home with no electricity. They wake when the sun comes up, work in their fields, and return as the sun is going down. They eat dinner to “kuraz,” oil lamps, at 8PM. They pray at a local mosque 5 times a day. Their diet is based on injera made of maize and shiro (beans). They eat meat twice a year, on holidays.

As a child, they noted that the lower part of Mushida’s body was darker than the top. Because she had not been to a doctor, nobody knew that this was the sign of a genetic disorder, neurofibromatosis. Her back began deforming as a young girl and was getting worse.

One day in July 2016, Mushida woke up paralyzed. They prayed for health and waited several months, but there was no improvement. The family had no extra money, but her caring dad made a tough decision – to rent half his land, for 3 years, take this money and bring her to Addis Ababa for medical care. He found a taker and rented the land for a total of 4000 birr – about $175. They took a bus to Addis Ababa and went to an orthopedic doctor. They were told she could be treated for 40,000 birr – over $1700. This was impossible. They asked around and were directed to AaBET Hospital where we see patients.

Dr. Rick was out of the country at that moment, so they waited 5 days, sleeping on hospital benches until he returned. On January 11 he drove her to a CT scan and MRI. They noted that she had a terrible spine deformity they nickname a “gamma,” – it has a Z-shape with a right spine, a middle spine, and a left spine. Technically this deformity is classified as “complex multi-planar transpositional deformity, alpha type.”

Though she had been paralyzed for 5 months, she still had some bowel and bladder function, and she still had a great spirit.

15A few days later, Rick brought her and another patient to FOCOS Hospital in Accra, where she went into traction, 23 hours a day. After several months of traction, she underwent a 6-hour surgery led by Dr. Oheneba Boachie-Adjei. She had spinal fusion from T3-L4. She had 3 vertebrae removed (VCR from T9-11) with a cage placed. She had bone grafting and instrumentation. She now has 4 rods and 18 screws.

This was followed by physical therapy. Amazingly, Mushida started walking again.
And walking easily! After 2 months of therapy, she returned to Addis Ababa. After a week in the capital, her brother came and they returned home this week.

Mushida is profoundly grateful for her health. Her goal: “I just want to go to school and finish high school, then I’ll figure out what I want to do.” Mushida – we know you can make it!

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Semegn has a big tumor and needs our help!

Semegn is a 16-year-old orphan with a benign tumor, a tumor which will kill him. But he can still be cured. We need your help.

Sem has been my patient for several weeks. Yesterday, I sat with Sem to take a long history. He is from Wello, 10 hours away by bus. He never knew his mother, she died when he was a baby. His father died when he was 5, and he moved in with his grandmother. Together they do basic farming to support themselves. They live in a mud home with no electricity or running water.

Sem was a top student. But he has a 3rd-grade education. He stopped school several years ago because he was getting severe headaches and his head was expanding. He came to the outskirts of Addis Ababa 2 years ago to go to a holy water site, seeking a cure. He moved onto the site and would shower in holy water in the morning, and drink it in midday. They provided food and shelter to him and others. He saw others get better – mentally ill and patients with eye disease. But his head was expanding. Holy water was not helping.

He heard of someone getting treatment in Addis Ababa, so he sought care in a center for poor patients, where he met Dr. Rick. We sent him for x-rays and a CT scan.

Rick writes:
“I sent the CT scan to eight experts and got eight opinions about what it represented. Some felt it was likely to be bone cancer. Some felt that it was a tumor called fibrous dysplasia, which has a better prognosis. But all agreed that it was potentially fatal, and he needed urgent care.

Clearly, he needed a biopsy to be able to come up with a detailed plan. At that moment, renowned German facial surgeon Dr. Peter Cornelius arrived in Addis Ababa to operate on a patient with a facial deformity. Dr. Peter performed the biopsy, itself a difficult operation.

We sent the biopsy to the United States. After two weeks of analysis, I got the answer: it is a benign tumor called a meningioma.

Next step – I sought the opinion of the experts in how to approach this.

Some medical details:

Dr. Peter wrote: “Rick, this is really good news. It will need a tailored approach via a fronto-temporal craniotomy…the orbital walls (area around the eye) will need reconstruction. …You’ll need a team of neurosurgeons, craniofacial and plastic surgeons, and oculoplastic surgeons. Reconstructive options include autogenous bone (split calavaria), titanium meshes, or a specifically designed alloplastic implant.”

And an academic department of neurosurgery in Washington had a meeting to discuss this and send their advice: “It will take a lot of work to accomplish the needed surgery: Before surgery, he will need an angiogram and embolization of the feeding vessels. The operation itself would be a tour-de-force, requiring neurosurgery, ophthalmology, ENT, and plastic surgery.”

Here is a summary: this is an area with a lot of blood vessels. He’ll need to have the blood supply to the area cut down (embolization) a day before the surgery. And then a team approach with a 12-hour operation which has a very good chance of success.

After removal, he should be fine.

But this cannot be done in Ethiopia. Ethiopia does not yet have the surgical expertise, or the technical ability to embolize the area. We can’t get all the pre-surgical studies done.

Dear readers, WE NEED YOUR HELP! In the USA, a surgeon estimated this would cost a half million dollars. But we have a fine hospital in South India, with superb surgeons, which will do it for about $10,000. I have seen their embolization in another patient of ours with a bone tumor. He had a superb result and is back in school.

I sat with Sem and asked how he feels. “I worry all day long about my future,” he said. “Will I die? Is there treatment?”

But Sem still has hope. Learning that he does not have cancer was a great morale boost. And now that he has hope for surgery, he is ready.

I asked what he wants to do once his surgery is complete. “First, I want to go back to school,” he said, “it’s been too long that I can’t go. Next, I want to study the bible and become an Orthodox priest. But I don’t want the church to support me, I want to do business and support myself.

Please start by supporting Sem’s surgery!

Thank you all!

Rick Hodes, MD, MACP
AJJDC-Ethiopia

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Meet Meseret, a young lawyer who perseveres despite her spinal deformity

Look at this determined woman!

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Meseret is not only a survivor – she is an example of how far a woman can go in Ethiopia! A native of a rural area outside Bahar Dar in NW Ethiopia, she is the daughter of a farmer and housewife. Her dad has an elementary education, and her mom is only able to sign her name. She grew up in a mud-walled home. But she was determined to do something more than simply stay in her village and get married in her teens as many around her do.

Around age 12, she developed a spinal deformity and was bullied in school. She was called “gobata,” a very strong insult, meaning hunchback. Classmates would say “You’re always carrying something on your shoulder, put it down.” After school, she would return go home and cry. But the next day, she’d be back in school. Even as she recounted this history to our team, she stopped and cried for several minutes, then reached for a tissue and continued.

“Ninth grade was the worst. I was depressed and had no appetite. I went down to 22 kg (48 pounds). But I kept going. And every year I was in the top 10 of my class. Even in 9th grade, I ranked #5.”

She studied continuously. She graduated from 10th grade #7, then went to preparatory school. From there, she went to Jimma University, where she studied law. Meseret returned home to Bahar Dar, and entered a 2-year training to be a judge. After the training, she was assigned to be a federal prosecutor in Gondar province. After 2 years she wanted to support her family better, so she opened a private practice. She had about 20 new clients a year and made enough money to help her parents, send her brother and sister to school, and even help some cousins. But her spinal deformity was getting worse and she was in constant pain.

Earlier this year, Meseret entered a masters degree program in human rights. A friend in Addis Ababa let her move in with her.

Medically, Meseret has a severe kyphoscoliosis. Her angle from front to back (AP) is 140 degrees. And her angle from the side (lateral) is also 140 degrees. This complex scoliosis is compressing her lungs – lung capacity is down to 39%. However, she is still operable. Meseret needs to travel to FOCOS Hospital in Ghana for several months of traction (23 hours a day) followed by an 8-hour surgery. With traction and surgery, a lot of her deformity is correctable, and it she would have a much better life.

I asked what she’d like to do in the future. With hesitation, she said “I want to finish my master’s degree in human rights and help Ethiopian women, especially the handicapped and those with spinal deformities. Our women need to be stronger and more independent, and I can help them,“ she said with a determined smile.

 

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Senia’s emergency trip to Ghana

IMG_4533In mid-June, 9-year-old Senia was carried into our clinic in Addis Ababa. She is from the “Silte” ethnic group, a unique group numbering about 750,000 – less than 1% of the Ethiopian population. She only speaks Silte language. Her dedicated parents are farmers. Her dad said to me “I have very little money, but I’ll do anything I can to help my daughter to walk again.”

They told us that she could not walk for about four months. First, one leg stopped working, then some weeks later, a second leg stopped working. She has difficulty controlling her urine, and upon exam, has sustained clonus and an upgoing toe.

Her CT scan shows that she has a severe deformity that we characterize as a “gamma.” With traction and surgery, it is possible that she may walk again. Without this, she will certainly remain paralyzed and lose more function. In that case, she can easily die in the next year.

We jumped into action. Last Friday, Dr. Rick flew with her and another patient to FOCOS Hospital in Accra, for traction and surgery. Fortunately, we have a boy named Mohammednur already in Ghana who speaks both Amharic and Silte language, so he can translate for her.

FOCOS is filled with Ethiopian spine patients, and we present photos of them. We are delighted to see their progress. Several months ago, Dr. Rick brought Beshir (blue shirt), a paralyzed boy, back to Ghana for intense physical therapy. Now he has some control of his right leg and is fully continent.

We greatly appreciate your help and ask for your continued support for Senia and the rest of our patients. And keep praying for all our patients!

All my best,

Dr. Rick

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These amazing brothers walked 400 miles to get to Dr. Rick!

1A few weeks ago, two brothers came to see me in clinic. Standing in front of me, I observed by his headgear that the elder is an Ethiopian Orthodox priest. The younger brother was clearly the patient, with a severe kyphosis and right-sided scoliosis.

I looked down and saw that the priest’s shoes were nearly torn in half.

“What happened to your shoes?” I asked.
“We walked here,” he answered.
“From the bus station?” I asked. The bus station is 5 miles away.
“No, we walked from Gojjam,” he answered.
“Gojjam?” I said in astonishment. “That’s nearly 400 miles from here.”
“Yes,” he replied, “it took us 8 days.”

I needed to get to know these amazing people. “Tell me your story,” I said.

Bires sat down and spoke: “I come from Gojjam in northern Ethiopia. It takes a long day by car to get to Addis Ababa. I attended school until 8th grade, but I suffered in school so I quit in order to support myself as a shoe shine boy. One day, one of my customers saw I had a bad back and told me about a government program to train disabled people to become tailors. That was in Gondar, about 100 miles away. I thought that would be a better life than shining shoes, so I went to Gondar and learn to sew shirts and trousers. But I had no money to purchase a sewing machine, so my new skills were not very useful. But going to Gondar was actually very helpful because it got me here.”

“My dad was a farmer. He died suddenly when I was 11. My mom could not plow the land herself, so she had to hire a farmer to plow our land and pay him half of the money we made. It was very difficult. I have 2 brothers and 2 sisters. My older brother is a priest and lives with his wife and children.”

“My spine deformity started when I became a teen – it’s why I quit school. The students mocked me by saying ‘are you carrying a football on your back? Take it out, let’s play.’ My life became unbearable, and I quit school.”

“You see, I started life as a poor boy and strived to get a good education, like every other kid around me. Later, I was a poor, sick boy who was mocked by everyone around me. I had nobody to help me. I could not afford to go to a doctor. Instead, I went to holy water every year. I would go for the two weeks before Easter, and one week while we fasted for St. Mary (Filseta). We fasted (ate only vegan food), helped the monks, and went into the water every day. I observed people with evil spirits and mental illness get better, but we who had deformities never improved. My spine continued to deform.”

“There was a student in Gondar named Temesgen, also training to be a tailor. After a few days, he approached me and told me a story. ‘I used to be like you,’ he said. ‘I had a terrible back.’”

“I could not believe him. He looked normal! We went to a private place and he removed his shirt, and showed me a long, thin scar on his back, and told me that was what remained of his disease. He explained how a ‘ferenj’ (white) doctor named Rick helped him.”

“I was amazed. It never occurred to me that I could be cured. He said ‘This doctor may be able to help you.’ This seemed like a dream. But it was worth a try. I spoke with my brother, the priest. He did not believe it either. But I told him I had met Temesgen and seen proof with my own eyes. He suggested we should travel to Addis Ababa to find this doctor. But we had no money for the bus. He wanted to sell a cow, but his wife refused.”

“‘OK, we will walk,’ my brother said with determination. ‘We will rely on the Almighty to help us.’ We left Gojjam at 5AM when the birds started singing. It was a Saturday – we had a lot dried injera (staple food) and 50 birr – $2.16 between us”.

“We were lucky that we were in Gojjam, and the Christian tradition includes hospitality towards guests. You have only to show up at a stranger’s home and say “I am a guest, sent by God – ye’egziabeher engida. ” They will welcome you.

“As it was getting dark, we were afraid of hyenas, and we could not walk any longer. We would simply knock on a door, we would greet them and say ‘Hello, we greet you sincerely. Have you been well? We are walking to Addis Ababa for medical treatment. We are “God’s guests – ye’egziabeher engida,” please help us.” They would let us in and we would explain that we are walking from Gojjam to Addis Ababa. They would say “Please show us your ID.” We would take the ID, and return it in the morning. They would put animal hide on the ground, and we would sleep there. Sometimes we’d sleep in the house, sometimes on the veranda.”

“Only once there was a woman who was alone and was not comfortable to take us in, so we went to her neighbor. We would leave just as the sun was starting to come up.”

They always gave us a lot of food. They would give us a basin and cold water we would wash our feet. I always offered to wash my brother’s feet, but he never agreed.”

“We spoke with people as we walked. We ate dried injera and with the 50 birr we had some drinks, “tella.”

“When we got to Addis Ababa, we were so hungry, and my brother paused to pray at the roadside. A stranger asked us what we were doing and we said we had walked from Gojjam – he gave us 100 birr. We used this to buy a real meal. ”

“We arrived in the capital and went to a hospital, looking for Dr. Rick. They sent us to another hospital. It was getting late, we went to Giorgis church to sleep. There were a lot of people there. They gave us a flattened box to sleep on, and fed us all. God bless my people. The next day we found Dr. Rick. He asked about my brother’s shoes, and we told him the whole story. He did exam and x-rays. My curve is about 160 degrees. He told me several of my vertebrae are fused together. And that I need to go to Ghana for traction and surgery at FOCOS Hospital.”

I asked what he’d like to do in the future. “If I can raise money, I’ll buy a sewing machine and move back to my home and open a tailor shop.”

I felt humbled to be in the presence of these amazing, determined people. To have a terribly deformed spine and having lost about half the lung capacity, and then set out on a 400-mile walk with a few dollars in pocket and some dried injera, relying on the kindness of strangers was clearly a journey of faith. I assured him, we’ll try to get him traction and surgery. Please help us.

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It all started with Tesfaye, now help us Bring Back Hope!

Eleven years ago, Tesfaye met Dr. Rick at Mother Teresa’s Mission in Addis Ababa. He had come in from the countryside, in hopes of getting care for his terrible spine.

SpTB Tesfaye Negussie 2-2006 - 5-2010 - 39A bio written in 2009 stated:

Tesfaye was born in the Gojjam region of Ethiopia to farmer parents. He grew up in a one-room, thatched roof, mud hut, which he shared with parents, four brothers and one sister. His mother and father farmed grains, mostly tef and barley.

About nine years ago Tesfaye’s father died; leaving his mother to farm and care for the five children herself. Several years after his father’s death Tesfaye decided to come to Addis Ababa with his oldest brother to seek medical care for his misshapen spine.

His back problem began when he was eight years old, a result of untreated spinal tuberculosis. Growing up, his family took him to the local healer who blessed him with curative holy water, but the pain and deformity did not improve. By the time he was a teenager the pain was so severe that he decided to leave his village and travel to Addis Ababa, in hope of treatment. Tesfaye traveled three days by bus with his brother, neither of whom spoke any Amharic, the national language and dominant language in the capital city. Tesfaye and his family are from the Agau tribe, a small population in the north of the country that speaks their own language, known as Agau.

They arrived at the bus station in the large market area, the Mercato, and went immediately to Black Lion Hospital, where the hospital staff told him they could not treat him, promptly sending him and his brother away. Talking to some street children Tesfaye and his brother heard that the Alert Leprosy Hospital may be able to help him. They went eagerly, but were turned away for a second time.

The brothers rented a small room for 1 birr per day, about 0.10 USD and stayed in the capital hoping for a miracle. One day a woman stopped them on the street and asked Tesfaye what was wrong with his back. He told her that he had no idea but that he was in a lot of pain and was trying to find treatment but no one was helping. She told him that the Mother Teresa’s Mission may be able to help him, and gave directions to the mission. Tesfaye went to the mission early the next morning and the nuns admitted him without hesitation.

For two months Tesfaye lived at the mission where he received tuberculosis treatment. After two months he was discharged from the mission but returned each day for the next six months to complete his eight-month TB treatment. After leaving the mission Tesfaye shared a room with his brother who had begun work as a day laborer in order to stay in Addis with Tesfaye. To contribute to his brother’s earnings Tesfaye began pushing a wheelbarrow filled with various novelty items, such as BIC pens, Kleenex travel packs, sunglasses and chewing gum. He peddled—almost literally—his wares around the large marketplace, earning between 5-10 birr per day, about 0.50-1.00 USD.

Several months later Tesfaye contracted scabies, a result of squalid living conditions, and went to the mission to ask the nuns for treatment. He was given the proper medication and was on his way out of the compound when another nun stopped him and asked him if he knew a Dr. Rick. Tesfaye replied that he did not know any doctors, especially not a faranje—or foreign—one. The sister told him to return the following Saturday to meet Dr. Rick, who, she explained, helped Ethiopians with deformed spines. Tesfaye came early Saturday morning and waited patiently for his turn to meet with Dr. Rick, during his usual Saturday morning clinic.

Dr. Rick not only accepted Tesfaye as a spine patient but also arranged housing for him, and funding for school. Six months later in 2007, Tesfaye traveled to Ghana with eight other spine patients to undergo spine surgery performed by renowned Ghanaian surgeon Dr. Oheneba Boachie-Adjei. All eight other patients were operated on, but Tesfaye’s case was too complicated and the anesthesiologist did not want to risk operating on him. Tesfaye returned from Ghana unchanged. Tesfaye traveled to Ghana two more times to no avail. He went with each new group of patients every six months for the next year, but still no anesthesiologist wanted to take the risk. Finally, disheartened, he gave up and resigned himself to the fate of living his life with a back shaped like a Brontosaurus or Quasimodo. (That was before the FOCOS Hospital opened, which has superior capabilities).

Tesfaye became everyone’s favorite person, if he were to run for office, it most certainly be a landslide victory. Tesfaye is kind, patient and helpful. He is always doing his homework or helping the younger children with theirs. In anticipation of his trip to Canada, Tesfaye has been diligently attending English class four days a week to supplement his 5th grade curriculum. I asked Tesfaye what he is most excited and nervous about for his trip. He answered that he is most nervous about people making fun of his back and that he is most excited about being with people who show him love.

Last fall I took a social history of each of patients Rick was assisting. Tesfaye politely told me, “I do not want to talk about my history until I know what the ending will be, I still hope thanks to God, and Dr. Rick, that my back may be healed.” Now, we pray, that time has come, and so, Tesfaye has shared his story with me. We all look forward to discovering the end of the story. I know he will live happily ever after.

Tesfaye now has hope. He met Canadian philanthropist Gary Segal and his amazing wife Nancy. They arranged for him to have surgery at Vancouver General Hospital in 2010 by Dr. Marcel Dvorak. Take a look at this story here:

http://tesfayesjourney.blogspot.com/

From that came a tremendously successful fundraising dinner called “Bring Back Hope” in 2012. Now it’s time for more hope.

Since that 2012 dinner, we have gotten about 1,500 new spine patients, including 6 new patients this week alone! And we’ve done hundreds of surgeries.

We need your help to fund surgeries and expand our reach.

More information: https://www.bringbackhope.com/

American Registrants: https://donate.jdc.org/events/-/e123942

We need your help! Thank you, thank you!

Dr. Rick, Gary Segal, and the JDC-Ethiopia Spine team

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