Friday, December 11, 2015

Tesfaye's village revisited Nov. 2015

After almost two week of non-stop meetings and activities concerning Dr. Rick Hodes' and JDC's amazing humanitarian work in Ethiopia and relating to "Bring Back Hope" related initiatives, I was feeling exhausted Thursday as I contemplated embarking on a gruelling 3 day trip to the Gojam region to visit Tesfaye's village. Yet Friday brought a new perspective -- how could I not follow through on my plan to revisit my Ethiopian family for the first time since that original Tesfaye "family reunion trip" 5 years ago, when they celebrated his post spine surgery "rebirth" as they saw him standing straight for the first time since he was 8 years old, some twelve years prior. (Click here for original post about the 2010 village family reunion experience.
Fanteye 12 years old (2010)
Fanteye and Tesfaye joyous first embrace
on seeing each other for the first time
since his extraordinary spine surgery
(Feb. 2010)
But one noteworthy difference this trip: in 2010 when I met Tesfaye's younger sister Fanteye for the first time, she was on the verge of getting married at the age of 12, as is not uncommon in the villages. However, on my trip to Ethiopia in December of 2012, I received a pleasant surprise in Addis -- an important ripple effect from Tesfaye's life transformation was Fanteye's courage to leave her marriage and the village at the age of 14 to come and live with Tesfaye in Addis and resume going to school. There is no doubt this was due to the persistence, encouragement and insistence of Tesfaye,  

Fanteye age 17, ready to
embark on the long trip
from Addis to Gojam
for my return visit to
their village
What a difference experience it was this time, returning to visit my Ethiopian family in the village with both Tesfaye and Fanteye.  Fanteye is now in Grade 11 studying sciences, looking to a bright future, instead of married with children and no education in the village. 

Fanteye with mother Yeshi catching up
You might call it a "ripple effect" from Tesfaye's life changing surgery. Fanteye's husband married a village school classmate of Fanteye's after the divorce, had a child with her and then divorced her.  There but for the grace of God goes Fanteye. Looking at her now, she looks like any typical teenage girl you would find in North America -- more importantly, she is a lovely young woman, smart and studious, with a sweet disposition and engaging smile. The entire extended family of theirs that I have met in the village are wonderfully warm and genuine people.

Another difference this village visit: five years ago they felt bad they could not cook me a sheep or chicken, as it was Ethiopian Orthodox Christian fasting season at the time. It is a very special honour of the highest nature, reserved for special guests and celebrations, to sacrifice and cook up a sheep.  Though it is certainly not something I am used to at home, I understood and appreciated the significance and honour of that gesture by Tesfaye’s older brother Semenye.

Click here to view complete Village revisited 2015 Highlights Album for additional background photo memories of my exhilarating yet exhausting village visit. The village hasn’t changed much in five years - still no electricity or running water, basic dirt/wood huts - but the noticeable change in the children certainly marked the passage of time. And I can tell you that although these people are certainly entitled to, and would no doubt enjoy, some of the modern rudimentary comforts of life that we all take for granted, they appear to live their life with a certain joy that often eludes us with our proverbial "first world" problems.

Thursday, December 10, 2015

JDC FIELD TRIP NOV. 8 - 12 2015

Sunday evening Nov. 8th

An opening dinner at the Sheraton marked the official start of the JDC (American Jewish Joint Distribution Committee) Field trip, organized by the International Development Program (IDP) Committee of the Board (of which I am a member). 

The Field trip included a number of Board members, friends, family, and interested supporters of the JDC/Dr. Rick Hodes/Dr. Boachie spine program, a couple of very nice outside consultants, plus a few senior JDC staff –around 25 in total.  At dinner we also had a few guests – Dr. Boachie; the Israeli Ambassador to Ethiopia (a nice story of a Jewish Ethiopian girl who made it to Israel at a young age and against tough odds became well educated and succeeded to the point of returning to Ethiopia as an Ambassador; and a representative from the US embassy. 

The dinner was an opportunity for everyone to get to know and get comfortable with one another, as we were about to spend an intense 5 days or so together.

Monday Nov. 9th


A two-hour morning briefing session for introducing and framing the study trip. Purpose of the Field Trip: to explore and evaluate the current IDP activities in Ethiopia, comprised primarily of Dr. Rick Hodes’ Spine and Heart program as well as a number of other ongoing and new projects in the areas of hygiene, clean water, pediatric outreach, a new Honey bee Centre for education and training of farmers, a Science and Technology Centre to encourage high school students to pursue such studies and careers, and support for “Women in self-employment” initiatives.  The ultimate goal is to understand and evaluate our current and future activities in Ethiopia, with a view to sustainability and capacity building.

The rest of the morning through lunch was spent at the Ethnological Museum exploring Ethiopian Ethiopian history and heritage, including viewing and learning about one of our ancient ancestors, Lucy, whose skeletal remains date back some 3 million years; we had a wonderful and colourful museum guide.  After lunch on the grounds, I encountered a few large tortoises that at first looked like sculptures, though not for long.

Following the Museum visit we observed Rick examining patients at a relatively new hospital called AaBET. One of the patients we saw was a little boy around 2 years old, accompanied by his mother; the toddler recently had both heart and cataract surgery in India.  He was very happy and lively, and he felt like clapping his hands frequently in, what I believe, was a display of how happy he was - blind from birth, he could now see.  

Dr. Ibrahim (front left in picture)

On the spine front, it is very encouraging that AaBET hospital appears to have been designated as the future site of a new spine centre of excellence in Addis intended to support Dr. Rick’s spine cases and to train and build capacity within Ethiopia to do more complex spine surgeries than currently possible.  The very serious cases would still have to go to Ghana for a number of years.  Chris, John and I did bump into visiting spine surgeon Dr. Kamal Ibrahim from Chicago, who brought a whole team with him to perform some spine surgeries and start the process of training some of the locals.  We were able to hear Dr. Ibrahim’s vision for developing this spine centre over time.

At the end of the afternoon before heading back to the hotel to get ready for dinner at a good Italian restaurant with our group and a few local program partners, we attended a special gathering with heart and spine patients
 of Rick’s that had received surgical treatments either in India for heart or in Ghana for spine at Dr. Boachie's Focos Hospital. There were acknowledgements of both Dr. Boachie and Dr.  Rick, and I was given the honor of presenting a small symbolic gift to Dr. Boachie in appreciation for the spine program partnership between Dr. Rick/JDC and him.  As I remarked, what a beautiful partnership for good between this devout Christian Dr. Boachie and observant Jew Dr. Hodes; how much better the world would be if only more people would use their religious faith to work together for the greater good of humanity rather than for intolerance, divisiveness and destruction.

Tuesday, November 10th

6:00am departure for Addis airport for our flight to Gondar. On arrival we check into the Goha Hotel, located on a hill with a beautiful view overlooking the city.  As with the Sheraton in Addis, it is my fifth time staying there and it feels like coming home each time, with many of the same staff I have become friendly with over the years.

We then had breakfast with introductions to the Gondar, Amhara region, and the IDP Chair also asked the two Vancouver spine surgeons accompanying me on the trip, Dr. Chris Reilly and Dr. John Street, to share their insights into spine disease and their observations of its manifestation in all the cases Rick is seeing; they also shared their observations as to the particular challenges Ethiopia presents in terms of building surgical capacity and the equal or greater goal of earlier detection and treatment.  
I can tell you that not only have Chris and John been a delight to travel with throughout, they are smart, analytical and insightful, and took the purpose of this trip very seriously.  I am happy, though not surprised, that their contribution to the JDC Field trip was considered valuable and much appreciated by the group.  By the same token, I know they found the trip to be personally and professionally interesting and stimulating.

After breakfast we toured Fasilidies Castle, “Africa’s only Camelot”. Chris, John and I had an abridged lunch as we rushed off to Gondar University Hospital on a parallel agenda to touch base with some of the senior surgical people regarding the Trauma care Partnership program established back in 2013 between UBC faculty of Medicine, Branch for International Surgery/VGH (as part of the 2012 “Bring Back Hope” initiative ). We hoped to also meet with some of the Pediatric outreach doctors to go over some of the issues in getting outreach into the vast network of villages for early detection of spine problems. We ended up going over  thematter with Dr. Solomon, head of the surgery department.  One major disappointment: the new Hospital that was well underway on my visit the end of 2012 had stalled just a few months short of completion, though I was assured more than once that the issue will be solved.

We then caught up with the group at the Gondar STEM Center (Science, Technology, Engineering, Mathematics) built and operated by JDC since 2014, where students attending after-school programs in laboratories presented their very impressive and sophisticated projects to us.

At the end of the day we made a brief visit to the construction site of the latest JDC project in sustainable development, the Woleko Ethiopian Honey Bee Centre. We distributed some colourful bee themed hats that were made by JDC board member Alan Rothenberg's son-in-law Kevin, who is in the hat making business. 

That evening we enjoyed a traditional dinner and dancing at the Four Sisters restaurant.

Wednesday, November 11th

I was sorry that Chris and John couldn’t experience this day of rural exploration, but they had to leave early for home due to commitments. After breakfast we departed for a day in rural villages of the Gondar region. We first visited a village in the Dembia province with our partners from the Israeli non-profit NALA 
piloting WASH (Water, Sanitation and Health) projects in rural Gondar.  

They are teaching basic things like washing hands before eating, not going bare foot through dirty waters or drinking from the rivers, defecting in the designated latrine areas, not eating raw meat etc.  It is a constant challenge to monitor and reinforce these lessons with both the children and their parents.

Next we visited a rural school which I also visited on my last trip in 2012 – it was fun pulling out my computer and showing a number of the school children surrounding me pictures I took at the school 3 years ago and seeing their reaction as they recognized many of the faces. 

After a picnic lunch stop en route
 -- consisting of boiled potatoes, eggs and a banana -- we made the long land cruiser trip over extreme terrain to the historic Jewish Beita Israel/Falasha village of Ambover. Now inhabited by others since the Jewish inhabitants abandoned the village decades ago to fulfill their traditional and religious yearning to get to Israel, Dr. Rick Hodes talked to us about the history of Ethiopian Jewry and their exodus to Israel in Operations Moses (1984) and Solomon (1991) and 
JDC’s historic involvement.  

We made our way to the area of the village where the old Jewish synagogue is reputed to be and sat in the hut which many believe may have been the old synagogue. Rick had some fascinating stories to recount about what it was like during Operation Solomon, the covert Israeli air force operation that airlifted over 14,000 Ethiopian Jews out to Israel over a harrowing 36 hour period as the oppressive Mengistu regime was being toppled.  Before leaving the village to head back to Gondar we looked at another Science and Technology after school Centre JDC is constructing in this village.

Dr. Sisay, Sam Amiel (JDC country
head for Ethiopia, me in the middle,
Dr. Mensur in the right of the picture
At dinner at GOHA Hotel a few of the Gondar University Hospital senior doctors attended including Dr. Sisay Yifru, Dean of the College of Medicine; and I was happy that Dr.Mensur, whom I first met in Gondar in 2012 and last saw in Vancouver with Dr. Solomon in 2013 leading up to the signing of the Partnership Memorandum with UBC Faculty of Medicine, also could join us. 

Thursday, November 12th
With my friend Alemu, senior JDC
field staff in charge of Ethiopia

In the morning flew back to Addis and on our way from the airport stopped in at the Women in Self Employment (WISE) Centre, a leading NGO that is helping vulnerable women across Ethiopia and is a partner of JDC. I noticed that WISE has support from a number of Canadian philanthropic organizations and other international support.  After learning about the program in some detail, we were able to buy different products produced by the women being assisted in developing sustainable cottage businesses.

Back at the Sheraton over lunch the group had a debriefing and sharing of thoughts and observations on what we have seen and what our future direction and strategies should be.  
Later, we had a special closing dinner at the home and gallery of talented Ethiopian artist Fikru Gebramariam, who had returned
to Ethiopia after spending 10 years successfully pursuing his art career in Paris.  
Fikru showing us his painting in
his second floor studio

As we arrived by bus, his lovely villa that he personally designed and built appeared like an Oasis in the outskirts of Addis and we were warmly greeted by him and his lovely girlfriend. 

We were treated to seeing many of his paintings completed or underway in his home art studio, and enjoyed an excellent buffet dinner well hosted by friendly staff.

That night or the next day most of the members of the JDC Field trip departed for home. As is usually the case on such trips, I enjoyed getting to meet a number of new people and establish some common bonds with them, as well as strengthen relationships with many of the others that I already knew to varying degrees.

But I still had the remaining three days I set aside in anticipation of revisiting Tesfaye’s village with him and Fanteye (as recounted in my post Tesfaye's Village Revisited Nov. 2015 ).

Tuesday, November 24, 2015



After our worthwhile introduction to Dr. Boachie's Focos Orthopedic Spine Hospital for just a couple of days, we bid farewell and caught our flight to Addis in the afternoon.  Dr. Boachie intended to join us on our flight, but due to a young patient emergency he decided to postpone his trip to Ethiopia by a couple of days.As I still had no real transparency into when I may receive my missing piece of luggage, the clothing items that Dr. Boachie kindly lent me were still coming in handy, though I was looking forward to laundering my own single set of clothing when I get to Addis.

On arriving in Addis the night of Nov. 3rd, I was pleasantly surprised to see that my tour operator friend Million had also brought Tesfaye to the airport to greet me.  It was very charming and amusing to see him wearing a t-shirt with my image on it that my son Justin had made a few years ago, together with a small bouquet of lovely roses.

                                                       NOV. 4TH CLINIC PATIENT EXAMS WITH DR. RICK
Our first full day in Addis we were spending most of it at one of Rick's spine clinics at his own relatively new JDC clinic, but we first had breakfast at our hotel. Naturally, on his way to meet me and my two spine docs from Vancouver, Chris Reilly and John Street, Rick saw a young man with a severe spine deformity on the street, so he picked him up and brought him to the Sheraton to find out the story. He was told to come to the clinic that afternoon, and we did see him there later.
I always find the clinic days seeing patients to be very interesting, though each case and story is as tough as the next. Because of so many extreme cases continuing to find their way to Rick, Focos hospital in Accra being the main outlet for corrective surgery,and the ongoing funding needs, it is necessary to make tough decisions about prioritizing the wait list and who to "invest in". Lots of factors to consider, e.g., age, severity,risk, available family support after surgery (or possible paralysis), etc. The old list of ranking from 1 to 5 had a new level of top priority created called 1*, but now there is even a need for a 1** level.
It was good to see the new permanent clinic set up for Rick. It became apparent that there are some information management improvements that can (and will) be made to make Rick's life a little easier in terms of managing and digitizing the patient records more efficiently. Each clinic day has a steady stream of old and new patients, and, of course, being in Ethiopia you have to also deal with the intermittent power outages and making do with natural light or firing up the noisy backup generator.

After coming from seeing Dr. Boachies' surgery setup at Focos hospital in Ghana, this was a good
"welcome to Dr. Rick's world" introduction for doctors Chris and John. With all the cumulative spine clinic time I have been exposed to over these years, I have learned more than I ever thought I would about spine disease.
At the end of the day Chris and John took in some of the streetscape while waiting to depart, and when we briefly stopped in at Rick's house I had the chance to say a quick hello to my old friends Balem Gebeyehu and Zemene Tiget.
Later that evening had a very pleasant dinner joining Rick as a friend, supporter and JDC Board member, with a very nice couple, Nick and Susan, that are supporters of JDC and Rick's work through a Foundation that Nick chairs.

THURSDAY NOV. 5TH was a “no patient” day. First I did some schedule rearranging on the fly for the two doctors Chris and John, and then I caught the tail end of a presentation Rick made to the local French chapter of Rotary International, which included slides of Tesfaye, Fanteye and Justin with the first school he initiated back in 2008. Rick introduced me to the group and I sat through a one hour lunch conducted in French.

Afterwards I sat with Chris and John discussing with Rick the anticipated steps for starting the research project on why there seems to be so much bad spine disease in Ethiopia, utilizing Rick’s 2000 patient records dating back to 2006, but the bulk of them from 2010 onwards. Using a general North American rule of thumb, the docs figure that based on Ethiopia’s population of around 100 million, you might expect at least anywhere from 20,000 to 50,000 spine cases, and Rick and Dr. Boachie have teamed up to fix about 500 of them. We talk about the need to catch the problem spines at an early age, but the challenge is getting to them in the countryside villages where 85% of the population lives. To do this we must train the rural health officers and educate the parents. Many villages don’t deal with bad spines as they feel the person is cursed and should be shunned.

Early evening I went by taxi to see Tesfaye’s new rental place, and when I arrived there the area was experiencing a typical power outage.  Tesfaye met me on the  street, and after cautiously weaving our way across the street through the dense traffic we walked up the dirt hillside path to his place with me illuminating the way with my phone flashlight app.  After entering their place in the compound I was warmly welcomed by Fanteye, Aselefew (another former spine patient they have been sharing a place with for 6 years, and Atsede, a 14 year old girl whom I first met in 2008 after returning from heart surgery in California, followed by spine surgery in Ghana; Atsede recently started living with them as her sponsor from the States could not continue supporting her at this time. They had candles going and made traditional coffee and popcorn, and I looked around their place, which has better features and is more spacious than their last rental I visited.

We had a nice time for a couple of hours until just as the power came back on I was picked up to go to the Airport to finally pick up my missing luggage.  After not having my suitcase for the first 5 days of my trip, we were happy to finally be reunited.


Chris and John spend the morning at Black Lion Hospital to meet with the surgical group and I went over to join Rick’s patient exams taking place at Cure Hospital, with Dr. Boachie  in and out between a few scheduled spine .  From time to time I step out and interact with crowd of waiting adults and children, and I seem to be an amusing distraction for them with my repertoire of Amharic phrases and tricks for children.

After attending so many patient exams over the years with Rick, I feel pretty accustomed to the various spine issues; as I say to Rick – “variations on a theme”.  Nevertheless, a number of cases present with extra complications, including polio cases that tend to have higher associated risks. 

Though the kinds of cases Rick sees are all very serious, given the sheer number of cases and the given capacity constraints at Dr. Boachie’s Focos hospital in Ghana, category 1 (out of 5) top priority cases have had to be divided into urgent subcategories of 1+ and now 1++. Lots of tough decisions.  One 14-year-old boy with all kinds of extra complications had a huge twisted “omega” spine that presented as a very high risk for surgery, but at the same time if not operated on then means a high risk of dying within 2 years.  He was a very sweet boy, an only child whose father had died recently.  At one point after examining another difficult spine case Dr. Boachie turned to me and said “you have got to find more money…these cases are endless”.

Friday night I attended Rick’s for one of his famous Shabbat eve dinners, and it was great sharing it with Tesfaye and Fanteye and seeing the whole gang of kids, many of them my old buddies.  As usual, with everyone wearing the colourful funny headcoverings we started with a few of the traditional Sabbath prayers, followed by Rick’s custom of everyone joining hands for the non-denominational group rendition of “If I had a hammer”.  I was exhausted and tried to leave early enough to pack and get a reasonable amount of sleep before catching the next morning early Saturday flight to Lalibela with Tesfaye, Fanteye, Chris and John. (see Lalibela trip highlights post above). Note: as usual, I didn't succeed in getting enough sleep.