Jack Broom, Seattle Times: When Steve Sands walked into the overcrowded Black Lion Hospital in Ethiopia in late October, he knew it would be poorly equipped.
Just how poorly, he hadn’t anticipated.
“It was actually kind of scary,” says Sands, a Seattle-based clinical engineer. “Exposed wires. Equipment that looked like it was out of the 1950s — some of it held together with tape.”
Laura Adiele, a registered nurse on the same trip, also was shocked by conditions at the only public hospital in Addis Ababa, the Ethiopian capital, an urban area of 5 million residents.
“They are warm, beautiful people,” said Adiele, “but their hospital is in shambles.”
Story after story of tragedy and loss can be traced to the lack of equipment considered basic in the United States.
A 2-year-old boy, for example, died at Black Lion while undergoing a relatively straightforward hernia surgery. Cause of death: hypoxia — lack of oxygen — after a breathing tube became dislodged. No one on the surgical team noticed in time to help, though his condition might have been readily detected and corrected by equipment U.S. hospitals have used for decades.
Because Black Lion also lacks an equipped recovery room, serious or fatal complications that develop after surgery often go undetected, such as a drop in blood pressure, a change in heart rhythm or lack of oxygen in the bloodstream.
In a country where the life expectancy is just older than 50 and only about a third of the population can read, the challenges are immense.
But great need also can be viewed as great opportunity.
In that spirit, Sands and Adiele will soon head back to Ethiopia, along with 26 other volunteers — doctors, nurses, technicians and more — from the nonprofit group Seattle Anesthesia Outreach (SAO).
Most of the volunteers, including Sands and Adiele, work at Seattle’s Swedish Medical Center, as do two of SAO’s founders, anesthesiologists Mark Cullen and Richard Solazzi, also headed to Ethiopia.
Some members of the group will be in Ethiopia 10 days. A few will stay a full month.
In that time, they’ll install anesthesia machines, monitoring devices and dozens of other pieces of equipment they hope will save lives and improve patient care, especially during and after surgery.
And perhaps more importantly, they’ll train Black Lion Hospital staffers how to use and maintain the equipment themselves.
“We want to do something sustainable,” Cullen said, “something that would make a difference when we are there and not there.”
More than $500,000 worth of equipment and supplies for the mission has been donated by Swedish Medical Center and its suppliers, including eight anesthesia machines, 17 patient monitors and six electrical-surgical units.
Swedish CEO Rod Hochman helped SAO secure hospital equipment that’s not being used, or was due for replacement but is still serviceable. “They’re a phenomenal group,” he said. “This was a great way to expand our reach and do the right thing.”
Through its own $60,000 fundraising campaign, SAO purchased other equipment, including five new Army-surplus operating tables, eight gurneys and 20 field-hospital beds.
The logistics of getting more than 7 tons of equipment and supplies from Seattle to Addis Ababa are daunting.
The answer: cargo space on two brand new Boeing 777s, courtesy of Boeing and Ethiopian Airlines.
“That’s been a godsend for us,” Cullen said. The transport is part of Boeing’s “global corporate citizenship” program in which cargo space for humanitarian efforts is made available on aircraft delivered to airlines around the globe.
One of the 777′s flew to Ethiopia last month; the other is due to depart this week. Similar Boeing delivery flights, benefiting other relief groups, last year carried supplies to Pakistan, Chile and Indonesia.
A lasting change
The origins of SAO can be traced to a medical mission to South America in 2007, in which Cullen and Solazzi spent a week in Ecuador, assisting in surgeries.
Although they view those missions as important and continue to make similar trips, they wanted to do more.
“We’d bring our gear and we’d help about 30 or 40 patients and we’d feel pretty good about it,” Solazzi said, “but at the end of the day it just didn’t seem satisfying.”
To create a lasting change in an underprivileged country, the group sought to connect with an establishment with stability and commitment — one that could act as a partner with SAO, not just a beneficiary.
An obstetrician at Swedish who had traveled to Africa with a church group told Cullen, 53, about Black Lion Hospital.
Despite hosting Ethiopia’s largest medical school, the hospital lacks modern equipment and the knowledge to run it.
Black Lion was a good fit for SAO, said Solazzi, 57, because it treats patients who otherwise couldn’t afford health care. In his contacts with the hospital, he asked what its staffers viewed as their greatest need.
“What they said they wanted most was to get technology into their OR’s [operating rooms]. We said, ‘Great. Swedish is a high-tech place. That’s what we do.’ “
As part of its commitment, Black Lion Hospital will house and feed the SAO volunteers at a university dormitory.
Lessons part of plan
When Solazzi first visited Black Lion Hospital last February, he was surprised to see the hospital didn’t have a single working ventilator, which moves air in and out of the lungs of a patient who cannot breathe on his own during surgery.
Instead, one Black Lion staffer must manually operate a bellows that mechanically provides oxygen to the patient, while another staffer monitors the flow of anesthetic. In contrast, a well-equipped American medical center might have hundreds of ventilators.
In preparation for this trip, Sands, 51, has been gearing up transformers, power strips and other equipment to convert the hospital’s 220-volt power supply to the 110-volt electricity needed by the equipment SAO is bringing.
He and two other volunteers will leave for Ethiopia Thursday, to being setting up equipment for use by other members of the team, who will arrive throughout February.
For Adiele, 28, a major focus will be teaching Black Lion nurses how to use recovery-room monitors and recognize patient’s symptoms of potential problems after surgery.
Cullen hopes to show Black Lion staffers how to use a localized spinal anesthesia for women having cesarean section births, currently done under a general anesthetic at Black Lion. Benefits in such a case could include an awake patient who can experience her child’s birth, a more vigorous newborn, shorter recovery time, improved safety and decreased risk of certain complications.
At each step, SAO is trying to understand the Ethiopians’ needs, priorities and ways of doing things, not impose what is done in this country. “We’re trying not to blow it,” said Solazzi. “If they don’t like us, it’s not going to work.”
Down the road, SAO would like the connection between Swedish staffers and Black Lion to become a model for sister-hospital relationships pairing individual U.S. hospitals with ones in developing countries.
“I’d like this not to end in my lifetime,” said Solazzi. “I’d like it to still be going in 40 years. It’s a challenge, but you have to start somewhere.”