Aira Hospital

It took a while before the technical problem with the web site could be solved. No matter, because anyway I have been too busy to write on the blog for a while. We are overwhelmed with patients and although we are working hard and doing our best we cannot cope with the massive influx. Patients have to wait several days before getting on the operating program. That is very unusual for Aira Hospital where we usually can offer immediate surgery without any waiting list.

One problem we are facing is the avalanche-like increase of eye surgeries. The operating theater is overcrowded and we desperately need another operating room exclusively for eye surgery. Another and actually much more important reason for having a separate operating theater for eye cases is that eye surgery is “clean” and needs 100% sterility while the general surgical cases often are considered “unclean”. It is not appropriate to mix “clean” and “unclean” surgeries. An infected eye case is detrimental and will most often result in permanent blindness. The general surgical cases on the other hand usually tolerate some infection which can clear up without serious consequences.

We have already a plan for a separate eye surgical unit, but lack the money to build it. The estimated cost today is 700 000 birr (40 000 €). Having another operating theater will result in safer surgery and increased number of surgeries. That will bring additional income to the hospital and benefit more patients. In the end that is why we are here – to help as many patients as possible in the best and most efficient way.

One way to speed up surgery is to have appropriate and functional equipment. Unfortunately we are usually unable to purchase the real thing due to lack of finances. We have to find other solutions.

Here is the latest orthopedic equipment, a battery driven drill – cheap and appropriate technology.

The fracture is completely unstable and cannot be stabilized with plaster of Paris.

The application of external fixation is fast and easy with the new drill.

Note also the new high quality fixation devise. Another improvement from the previous “poor man’s external fixation devise” made of wood and plaster of Paris which we used before.

Web sidan har flytta´ts till en annan server och det har uppstådd tekniska problem. Jag kan inte lägga in bilder på siden. Ha tålamod! Hoppas problemen är lösta snart.

AIRA HOSPITAL CLOSES!

That could easily have been the title of today’s blog. Fortunately it is not.

As the regular reader of this blog already knows the hospital manages to cover 75% of the budget with income, mainly from patients’ fees. That is an extraordinary result in itself and even more when remembering that our patients are extremely poor.

The remaining 25% used to be covered by a yearly grant from a German aid organisation. More than three years ago however that organisation withdrew the financial support to the hospital, due to change of policy – not lack of money. Supporting curative (hospital) health care is not on the agenda of the majority of aid organisations anymore.

Since then the hospital has been struggling in a financial vacuum, surviving on bank savings and private donations. The money is so scarce that drugs and medical equipment has to be bought on credit and in insufficient amounts. The day when salaries cannot be paid would be the end of the affair.

The hospital signed an agreement with the regional health authority last year. The agreement includes financial support covering 30% of the hospital’s budget. Unfortunately it has not been implemented yet. According to available information 2, 3 million birr was allocated to support three non government hospitals in the region. Latest news is that 1,8 million of that money has already been transferred to a catholic hospital in the south, but Aira Hospital got nothing. The reason for this is not clear – might it be that God is catholic after all?

The hospital administration is of course doing its best to follow the matter and claim what has been promised, but it is not going to be solved easily.

In this desperate situation the hospital has been asking for an isolated emergency input of 500 000 birr (27 000 €) for purchasing enough drugs for one quarter of a year. The money would remain in the cash flow as the patients buy drugs with some percentages added for covering expenses with transport etc.

No one has responded until now.

But prayers are answered!

Today we got news that a congregation, the Betel Mission in Turku Finland has donated 38 000 € (684 000 birr) to the hospital. That will save the institution for the time being and make it possible to continue the work until hopefully the health authority fulfils the promises in the agreement.

GOD BLESS THE BETEL MISSION IN TURKU!

The website will be closed for some days due to transfer of the site  to another server.

The name Gumruk is feared. It makes even the most seasoned missionary tremble and sweat. Gumruk is worse than the purgatory. Gumruk is the Ethiopian costumes authority.

Getting through the airport costums is not very different from playing Russian roulette – with 5 bullets in the revolver.

It is usually an advantage to send controversial items with a large group of visitors. Often they will be treated nice and not scrutinized that much. However this time a second hand pulse oxymeter donated by a hospital in Sweden and brought by a large group of visitors from Sweden got stuck at the airport costums.

We started the procedure to get it cleared and released 3 months ago. As we cannot spend too much time in Addis Abeba at the time, it is done in stages. Gradually all requested documents are collected from different offices with stamps and everything. Whenever you think that it is completed there will be another request for an additional document, a supporting letter from some authority or something else.

Finally all papers are ready and approval is given to have it inspected by the health authority. When that is accomplished you are entitled to go and clear the equipment from the Gumruk.

At the Gumruk you are told to go to a counter and have the equipment evaluated. There is a small crowd of people waiting for he same purpose. The staff at the counter is chatting, laughing and joking but not working. The computer is out of order. One person is trying to push buttons and draw in the cables to make it work.

One “ferenji” in front of the counter is very upset. He has been waiting for 7 hours without having lunch. Suddenly the computer starts working and he is able to pay and get a receipt. He is smiling all over the face, showing thumbs up, thinking his troubles are over and walks away to collect his item only to return after a short while as upset as before.

The computer is already out of order again. For some hours it is working sporadically. Finally it is my turn. I am asked for an invoice. But this is a donation and there is a gift certificate among the many documents. I am told to approach the head of the department. He mumbles that I have to pay tax and scribbles something on the documents. Back to the counter the computer is down again. After a while it starts working again and I can pay the tax. My good luck is that even the printer is working so that we can get a receipt.

With the receipt I can go and take out the equipment at the store. Alas! The item cannot be found at first. Only after some tense waiting the donated pulse oxymeter is located. I only have to pay for storage and then the item is mine. But the name on my ID card doesn’t correspond to the name of the visitor who brought the equipment from Sweden and therefore it cannot be delivered to me. I need a letter of authorization written by the person who brought the equipment. That person is already back in Sweden since 3 months. What to do?

The head of the department solves the problem with typical Ethiopian flexibility by writing a permission to handle the item in my name. His name is actually “Terusew” which means “Good Man” and he certainly lives up to that name.

After only 3 days work the equipment is in my hands. The joy is great on both sides. I exclaim “Thanks to the Lord” and the staff replays “Amen”. The final step is to show the item and receipt to the staff at the accountant department. With a lot of smiles and congratulations I can leave Gumruk with the pulse oxymeter.

The staff is very kind, polite and helpful. They only want your best, but are bound by the bureaucratic system. So don’t blame the staff – blame Gumruk!

“Women should not die giving life!” A statement in a referral letter from one of our satellite clinics in which I can only agree.

That is also the “Millennium Goal” of WHO and other fancy international agencies.

But as top politicians and highly paid “experts” are consuming billions of dollars on high salaries, expensive secretaries, cars, business class, 5 star hotels and restaurants and not contributing with anything else but talking, we - the medical professionals in the third world - are fighting day and night to accomplish concrete results in spite of having nothing except our hands to work with.

The poorly paid, but dedicated (male) nurse who wrote the line quoted above is struggling day and night in a clinic with no resources, no equipment, insufficient financial support, no running water or electricity. In spite of that he is doing his very best to help the patients. At times things are just too complicated and luckily he (still) has a hospital to refer to.

In the referral letter mentioned he writes that the woman is referred from his clinic at 10 pm.

At 4 am the lady arrived at Aira Hospital in shock due to intraabdominal bleeding and sepsis from a ruptured uterus. It took 6 hours to carry her to the hospital and during that time the uterus gave up and ruptured. Why didn’t the family take her by car? Well it takes 2 hours’ walk to reach the main road, and how many cars are out there in the middle of the night? A part from that they might not have been able to pay the usually indecent demands from the car owners.

She was operated immediately after arrival. Thanks to a dedicated staff who bothers and are ready to work and save lives 24 hours around the clock. Not a given option in many other hospital where the staff would rather choose to neglect her and give priority to a sound sleep.

She recovered fast, as her two roommates who also came with ruptured uterus. One from nearby Guliso had to pay 300 birr to get a car ride (ordinary price 20 birr), but then she walked herself from the parking place to the maternity – with a ruptured uterus!

The third woman had paid 700 birr for a place in a car. Far more than the cost for the lifesaving hospital treatment. All three patients with uterine rupture are recovering fast. That means a lot.

Saving the life of a mother saves the whole family.

Then why is it considered so wrong by so many NGOs to support this kind of medical work financially?

Even our own Church of Sweden Mission does not consider medical work as their responsibility.

Women’s’ project – YES. Human rights project – YES. AIDS/HIV project – YES.

Medical work (apart from AIDS/HIV) - NO.

Recently the Church of Sweden Mission donated a second hand car to the women’s’ project in Addis Abeba (where there are so many cars at the head office that they are standing rusting in the parking lot) and one to the Bible Seminary in Nekemte. With all due respect it is indisputable that no of the women’s worker or the bible school students die from lack of transport, but our patients do.

Imagine how many lives could be saved, and how much suffering could be avoided if the hospital had a four wheel car which could bring women with complicated deliveries to the hospital at a reasonable fare. In that way the patients would not be skinned to the bones by greedy car owners, and the hospital would have at least some sort of income. Will that dream ever become true?