DEPARTMENT OF PLASTIC SURGERY
International Outreach
Addis Ababa, Ethiopia, March 2006
Zewditu Hospital
Cherrie Heinrich, MD
Allen Gabriel, MD
5th Year Plastic Surgery Residents
Loma Linda University Medical Center
Operation Good Samaritan, in partnership with Adventist Health International, maintains relationships with hospitals throughout the world. One of the hospitals is Zewditu Hospital in Addis Ababa, Ethiopia. Built in 1974 by the Seventh-day Adventist church, it is currently managed by the Ethiopian government who has approached Adventist Health International to consider managing the hospital. At the hospital's request, a surgical team was assembled to provide plastic surgery and to train the general surgeons at the hospital in plastic surgery techniques.
Zewditu hospital was the most modern hospital in Ethiopia in 1974. Since then it has deteriorated, but still remains a very solid structure. Presently the hospital is staffed with general surgery, obstetrics and gynecology, internal medicine, pediatrics, and basic dentistry. It also serves as a teaching hospital for residents from the main university hospital Black Lion.
Our team consisted of 2 attending plastic surgeons, Andrea Ray, MD, and Norman Sogioka, MD, an attending anesthesiologist Mike Fischell, MD, and 2 plastic surgery residents, Allen Gabriel, MD, and Cherrie Heinrich, MD. In addition to the physicians, a registered nurse, Debra Heinrich, MSN and a surgical technician Shay Thomas brought an added level of support to the team. This was Operation Good Samaritan's largest team in recent years.
Goals
The primary goal of this trip was to educate the local surgeons and residents in burn surgery and cleft care so they could continue to treat these complicated patients after our departure. The secondary goals were to provide care to the patients in Ethiopia and to provide us with experience in international health care.
The Trip
On arriving in Addis Ababa, Ethiopia, Dr. Gemechu a retired general surgeon from Riverside, California, took us on a tour of the hospital 
where we would spend the next two weeks. He had arrived the week before and had arranged for patients to attend our first clinic on Monday morning. From clinic, patients were screened and pre-admitted for surgery that week.
An average day began with ward rounds to evaluate patients prior to their surgery and to check on the patients who had already had surgery. Dressings were changed and wounds assessed. After 
rounds, we headed to the operating room where we spent the rest of the day. In the late afternoon one resident would attend the clinic for screening additional patients that arrived daily.
The hospital had limited supplies and resources primarily for general surgery and gynecology procedures. In order to assist in providing plastic surgery care, we brought supplies and surgical instruments not only for our use but to leave for the local surgeons to use. Most of their instruments were overused and they were ecstatic to receive the donated replacements.
Our Patients
Each patient we treated while we were there made a lasting impression on us. Although individually unique and bringing their own story, they were all similar in their need for help. We were able to treat 25 patients and perform 60 procedures. This is but a drop in the bucket, but the education we left behind will echo for years to come.
BATI
Bati Mohammed is a four-year-old boy who sustained a burn injury to his left hand. He had never been treated which resulted in his fingers scarring into the palm of his hand.
MISETE
Misete Shafi is a 12-year-old boy with an incomplete cleft lip who lives 500 kilometers outside of Addis Ababa. He and his dad traveled for several days to reach the hospital. This was the first opportunity he had to have surgery on his lip.
LINGER
Linger Liyew, a 12-year-old girl, had been burned by scalding water 10 years ago. Similar to many children she was never treated and developed severe contractures. In the entire country there is only one surgeon who is trained in burn reconstruction.
Personal Reflections
One of the reasons that we both chose Loma Linda for our plastic surgery training is the strong emphasis on whole person care that extends to providing medical care in third world countries. This experience is unique at Loma Linda as it is a formal part of our training. Both of us feel a strong pull to provide care to underserved populations as we each spent part of our growing years in third world countries. This instilled in us a desire to serve and donate our time and experience. The trip to Ethiopia made us realize how privileged we are to work in a modern hospital that has more than adequate supplies and instruments. In addition, we recognized how much we have learned during our residency. We gained confidence in our increasing ability to plan for and execute complex surgeries while working with limited resources.
In conclusion, we consider ourselves very fortunate as residents to have had exposure to medical care in a third world country. Not only was this a learning experience for us, but we were able to share our knowledge and education with the surgeons and residents at Zewditu Hospital. The smiles on the faces of our patients provide all the reinforcement and constant reminders of why we chose plastic surgery. It was a life changing experience for both of us and continues to remind us that our worst day here at home will never come close to the best day in third-world health care.
This outreach program was supported in part by a generous contributions from
KCI - USA and the Neil Family Trust.