Yates Family In Soddo

 Here is a video that my wonderful pediatric partner, Dr Saron, and I made about our experience using surfactant donated by ONY biotech, called infasurf. We have have many, many babies cured from neonatal respiratory distress syndrome with this medication. For many years I have watched so many premature babies die of respiratory distress syndrome (surfactant deficiency), it has felt like a miracle drug to see how well our babies have been doing with this medication. Thank you ONY biotech for your generosity! I do not have words to adequately express my thanks!

  This year we have been blessed by a grant that allows us to increase our number of screening opportunities and help to cover training for local government officials and staff. We have realized that as a hospital based program there is a lot we can do, but with the community involved we can expand our reach and deepen our impact. This last week felt like a culmination of this in many ways! We had 80 people attend our training/working group as we thought of ways to attack the problem of rheumatic heart disease from primary prevention and secondary prevention. We discussed the results from screening over 21,000 Ethiopian school children! There is an Ethiopian proverb that goes like this:  When the spider webs unite, they can tie up a lion! The morning of the event God reminded me of Psalm 126:6-7 Those who sow with tears      will reap with songs of joy.     Those who go out weeping,      carrying seed to sow, will return with ...

 Memorial. The name given to this child. She was born at 33 weeks via c-section. Her mother came to the hospital very sick with breathing difficulty. The mother was taken to the OR for cesarean delivery with the hope that the delivery of the baby would help with her breathing... but it didn't help much.  One day after surgery, we found her breast mass, and found that her breathing problems were likely metastatic breast cancer. She was 33 years old. She has a husband and two other daughters ages 5 and 3. This was an emotional time for all of us, especially the family. Through the act of grace and the help of many, we were able to bring the new son, Memorial, to see his mother from the NICU to the ICU on CPAP. He was able to be held by her. We were able to get a picture for the family of this sweet family. Later that night, the nurses told me that the mother said, "that was the best gift she had had in her life. She could die in peace now."  That afternoon, I found out that...

 This year Adam received in invitation to be a speaker at The 42nd Annual Continuing Medical and Dental Education Conference . He was invited to join American surgeons from around the world working cross culturally to talk to them about how to keep things running in the OR! Adam has faithfully served behind the scenes in our hospital for almost 10 years to keep many of the hospital's facilities and equipment working. He was a great fit to give this presentation. He discussed the importance of team, building a biomedical department at your hospital and practical tips and tricks to keep equipment working and maintained in the hospital and operating room.  After many years of working quietly behind the scenes to see him be able to share with many the things he has learned through his work at Soddo Christian Hospital.

 Yadiel Tegene.  She has been my friend and partner for years. She joined us in 2016 as a GP. She was sponsored by our hospital with the help of our supporters for pediatric residency in 2018. She completed residency and joined the pediatric department in 2022. She has been a hard working, faithful, loving, kind partner that has encouraged me to be a better person and a better physician. With her by my side I have felt that I could do anything. March of this year, 2024, it was with great sadness and great joy that she left for pediatric interventional cardiology fellowship in Bangalore India at Narayana Health. She has been sponsored through Edwards Life sciences Every heart beat matters philanthropic initiative. (https://www.edwards.com/about-us/every-heartbeat-matters).   We are so thankful for this organization and their partnership over the last year to make this possible!  And we are already thrilled to welcome you home when you are done!!!

 Meet Yeab and Hiyab These two babies born at 31 weeks gestation (or 9 weeks early) are pictured here doing simultaneous Kangaroo Mother Care and Kangaroo Father Care.  Yeab and Hiyab mean which mean Belonging to God and Gift from God in Amharic.  They were born at the same time from the same mother, but were born at very different sizes. Yeab was 1.9kg (4lb and 3 oz) at birth and sister Eyab was 630g (1lb and 6 oz) at birth. Eyab is our smallest surviving baby in our NICU to date!  I am so proud of the hard work our Neonatal staff has done to keep these two babies alive and growing! I never grow tired of seeing God's creation, watching his beloved children grow and mature right before my eyes and see the love between the mother and father and their precious children.

  "Not by might nor by power, but by my Spirit,’ says the LORD Almighty.” Zechariah 4:6  In March of this year, we invited a consultant team from the christian academy of African physicians to come to Soddo Christian Hospital to perform a feasibility study on starting a family medicine residency. You can read more about the organization here (https://www.caaphome.org/).   We toured all over Ethiopia meeting with representatives from the two other premier family medicine residency programs in Addis Ababa at Addis Ababa University and at St Pauls Millenium Medical College. We met with the federal ministry of health, and representatives from several other possible affiliate hospitals for this program.  We learned from the MOH's National specialty roadmap that in the next 10 years Ethiopia wants to deploy over 5,000 family medicine physicians to their primary hospitals to be the consultant to the primary care physician. Most primary care hospitals currently do not h...

This week was an emotional week for me. We accepted a transfer from a local primary hospital for a 30 week neonate born there, but with significant breathing problems. We received the child after a long ambulance ride (about 2-3 hours). He was on oxygen, but cold, hypoxic and having a really difficult time breathing. Thank you so much for the generous donation from ONY biotech we were able to provide this child with a life saving medication called Infasurf (a form of surfactant). This medicine is a protein given directly into the lungs. Premature babies are born without this protein and it makes their lungs very stiff.  With this medication, the lungs become more compliant and able to diffuse oxygen into the blood stream better. This medicine is very difficult and very expensive to find in Ethiopia and we have been able to provide it free to our patients.  This child has had a long road of recovery, but is doing well and getting stronger every day.  But the hospital's ben...

A few weeks ago, I attended a conference in Tanzania called Every Breathe Counts. It was me, two of my colleagues from Soddo Christian Hospital and a general practitioner from St Mary's Catholic Primary Hospital.  One of the most interesting parts of the conference was looking at the data from the "Global Burden of Disease" as published by Lancet. This is what I have seen, but didn't have numbers to describe it. Out of all the deaths per year documented in Ethiopia, the LARGEST box, which indicated the largest number of deaths per year, is from neonatal causes.  This is what motivates us each year to keep getting better, keep learning, keep improving, keep teaching, keep expanding.   This conference was amazing! It was 200 neonatal medical providers from 9 countries in Africa. It was a dream come true. This walk of caring for tiny babies, that some believe have no hope for life, is sacred and precious. The deep sorrows and the high joys of this journey taking care ...

Last December, the medical director from a local primary hospital, St Mary's Dubbo Catholic Primary Hospital, contacted us about helping them start a newborn unit at their hospital.  We were honored to be able to help them. In their hospital they have up to 10 deliveries a day, and didn't have a dedicated newborn unit/NICU. They also only have general practitioners at their hospital. There is no family medicine physician, pediatrician or obstetrician at their hospital. Their medical director coordinated with us to send on of their general practitioner doctors, who was only a few months out of medical school, and three nurses. After being trained at SCH they would be tasked to run the newborn unit in their hospital. We have been able to help with their training, donate some supplies, and bring their GP for further training to an excellent NICU conference in Tanzania.  They launched their new department earlier this year. It has been such an encouragement to see the work of our ...

Last week we started on the foundation of the New Hope Women's and Children's Center. This was a really special day to celebrate all God has done in our women's and children's center and the celebrate all God will continue to do.    It reminded me of the song: God of Revival by Bryan Johnson  'Cause there's no prison wall You can't break through, no Mountain You can't move, all things are possible There's no broken body you can't raise, no Soul that You can't save, all things are possible   The darkest night, You can light it up You can light it up, oh God of revival LET HOPE ARISE , death is overcome You've already won, oh God of revival God of revival   On that day, I was standing there on this empty property and saw these beautiful Meskel flowers, which means flowers of the cross. I picked them up, root and all. Lord willing, I will return them when the new building is complete. Til then, they will have a home in my backyard waiting, h...

  Last year, we completed screening all 11,000 students ages 8-18 years old in Soddo town. This in itself is quite an accomplishment. Our team is very proficient at screening for early signs of rheumatic heart disease. The team is comfortable with the process caring for those students in Soddo, but now we are increasing our distance from Soddo. The area right outside of the city is called Soddo Zuria, it is essentially the ring of communities around Soddo. Getting started has been a challenge. We had to get additional letters of support from the zonal ministry of health and the school board. Getting permission from each of the schools has been hard work for my team, but I am so thankful to have such capable and dedicated staff. The school year just started a month ago and we have had four outreach events, one per week for the entire day. When the team comes back, they are tired and have been screening up to 270 students in one day using bedside echocardiography! That is over 1000 p...

4 years ago we suffered a very difficult and very real infectious outbreak in our NICU that resulted in many neonatal deaths. It was a very difficult time. One of the moments that sticks in my mind was when we had preterm triplets born in our hospital (it was our last viable set of triplets). It was a small space and we didn't have any room for these babies, but we did the best we could at the time and put these babies in our acute care NICU, all three in 1 bed in the middle of our small room surrounded by 3 other babies on the outside. Unfortunately, due to hospital acquired infection, which is difficult to control in a very tight space, two of the three triplets died. I can still remember when the family brought back the one on this babies birthday thanking me for saving their child. Fast forward to this week, our OB department has many babies ready for delivery, 18 to be exact with SIX sets of twins, and TWO sets of triplets. Twins and Triplets are often born prematu...

 A sweet friend and co-worker of mine, Dr Dereje, was pregnant with his first child. He and his wife had prayed and prayed for this child and offered him and his life to the Lord. In honor of this, they decided to call him Samuel, God has heard, even before the delivery.  As his wife approached her due date, she was induced for low amniotic fluid. I remember the day so well. It was one of those days, I don't think I will ever forget. His wife was rushed to the OR for a cesarean section because the baby's heart rate dropped. I ran to the OR to meet the OB team there.  At delivery, we saw that Samuel had stooled in the amniotic fluid and at the time of delivery, aspirated some of it into his lungs. This is called meconium aspiration. This started a very difficult and complicated recovery. We placed a tube down his throat and he was placed on a breathing machine. Multiple times he nearly died with a very very low heart rate and a nearly obstructed breathing tube. He required...

Now over a year ago, Soddo Christian Hospital started a sustainable prevention program for rheumatic heart disease. It involves school based ultrasound screening for early detection of rheumatic heart disease. A group of 6, that grew to 8 nurses were trained on how to do the screening ultrasound. They are now proficient to go on their own to do the screening. After the children are screened, one of our Ethiopian specialists confirms the changes in the heart valves and the child gets started on monthly penicillin injections. The injections prevent further strep throat, which then prevents the scaring on the heart valves.  This chronic cardiac problem not only causes a short life for the child, but often the families pay a lot of money for medications, travel far to doctor’s appointments, other children may not get what they need and it can cause a medical I can’t count the number of tears that I have cried over sick children destined to die of rheumatic heart disease before their ...

As most of you know, I (Michelle) am the head of our pediatric unit and neonatal intensive care unit (NICU). Neonatal care is separated into the normal babies who may need a few days of breathing support or antibiotics but are otherwise stable, and the high acuity babies who are often suffering from many complications of prematurity and need a high level of cares for weeks or months. We have put a lot of resources into making the best space we could to care for these fragile babies in a safe manner. We have had many many sweet "wins" sending home healthy babies, but we also see death regularly. This has been a especially difficult year in our NICU. Starting in November we started to have a significant increase in our neonatal admission rates and also our neonatal deaths, especially the babies in our acute care room. After much investigation and consultation, we concluded that we have been having an outbreak of hospital acquired infections. By God’s perfect timing, one of ou...

On the heels of a very difficult week in the hospital, I was making my usual rounds. Baby Beniam was a one-month-old boy who had infantile pyloric stenosis and had received a lifesaving operation at our hospital by our general surgery team. He was a few days post-op and still not tolerating all of his feeds. Hid dad approached me and said they could not afford any more medical care because they had already spent all they had on this boy’s life. As the head of the pediatric department, this is the hardest thing I face, and it happens regularly. The baby still needed hospitalization to complete his antibiotics, receive a blood transfusion, and be fed enough in order to gain weight. If I let him go home, he would get sick, dehydrated and die, which would be a waste of the money the family had already spent and the care we had already worked so hard to give.  I consulted the hospital’s Benevolence Fund Committee, and we decided the fund could cover the rest of the patient’s hospital ...

Sometimes we have those days or experiences that drastically change the way we think of life. Sometimes I’m aware enough to realize it, and other days I’m too dense to see what is right in front of me. An encounter with a special family has rocked my faith and my medical world view. This story has two unique parts, the medical amazement and the personal story. As a human being we cannot disconnect the two, but let me tell it as it was revealed to me. A 12 year old boy from a rural area of Ethiopia (12-15 hours transport to get to Soddo) arrives nearly comatose, unable to sit, unable to move his entire right side, unable to eat, barely able to speak. Upon examination he had a fever and a rigid neck. He had signs of increased pressure in his brain, so I couldn’t do a lumbar puncture to confirm my suspicion of meningitis and our CT scanner, the only within 3 hour drive, was not working. He had already been on IV antibiotics for 2 weeks and didn’t get any better. His father, in de...

Medicine in Ethiopia is often difficult. None more difficult than watching many children and young adults suffer and die because of preventable causes. As a physician, it is easy to spend my time working hard to save the lives of the critically ill and hospitalized. As a family physician, there is the constant question, “what can I do to impact and prevent illness?” Ethiopia already has a structure in place for vaccinations and other public health projects, so figuring out my part in the greater pictures has been slow going. When we moved to Ethiopia three years ago, we had this vision of starting a community health program with Kavi and Taylor, but the demands of the hospital have not given us the full opportunity to figure out how and where to do such a project. Our RHD screening team in action Two years ago at the CMDE conference, a cardiologist, Ron Johannsen, cast a vision during his talks on Rheumatic heart disease (heart disease caused by recurrent strep throat infect...

Merry Christmas from Ethiopia! መልካም ገና (Melkam Gena)! Christmas cards are usually about all of the amazing things from this past year, but let’s be real: It’s not always like that, and it has not been like that for us this year. I was reading my favorite missionary community blog and I was reminded that even the first Christmas, the day God gave his best gift to mankind, was a day of “violated expectations”. “The very first Christmas was also greatly anticipated. Prophesies about Jesus had been spoken for centuries. The world was awaiting the “long-expected Jesus,” but how he made his arrival violated many expectations.” You can read about Mary’s, Joseph’s, and Israel’s violated expectations at the Velvet Ashes blog. We are excited to celebrate this Christmas season in Soddo. But that excitement isn’t without our own “violated expectations.” The weather is dry and sunny, not wintery. Some of our teammates have left Soddo either for a short visit home for the holidays or forever and so ...