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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