Aira Hospital

The hospital’s struggle to survive financially continues. As you remember there has been no regular financial support to the running budget since more than 3 years. The recent donation from Betel Mission in Turku (Finland) is now being used to purchase drugs and medical equipment and has saved the institution from immediate collapse.

The poor fund is empty. Last year’s earmarked grant is consumed, and the grant for 2010 has not arrived yet. Since January 1’st we have not been able to give free treatment to poor patients. That is ethically a very difficult situation for a Christian nonprofit charity (?) hospital.

In spite of serving an impoverished rural population in one of the poorest countries in the world the hospital is able to cover 75 – 80 % of the budget. That is a remarkable achievement. The EECMY hospital in Gidole never raised more than 30 % of its budget. The catholic hospital in Attat, which is very similar to Aira Hospital in terms of size, staff and budget receive 50 % of the budget as financial support from the (catholic) church abroad. Aira Hospital would need only 20 – 25 % of the budget as financial support to survive. But from where?

A nonprofit charity hospital providing medical treatment 24 hours around the clock can never ever be self supporting – nowhere in the world - and the least in a poor country like Ethiopia. No community hospitals in the rich western world manage their budget without heavy subsidy from the government so why do people insist that this should be the case for our hospital?

Three poor patients came to the hospital the other day.

The man with the congenital cleft lip is living in Aira town, 10 minutes by foot from the hospital. He is a poor farmer who during his 26 years long life never had been able to raise enough money to be operated although the fee used to be only 300 birr (150 €).

Thanks to our partnership with Smile Train we are now giving free treatment for cleft patients. He heard the announcement in the church and came with his son as attendant to have his cleft lip corrected surgically.

The young lady with the large tumor like growth on one leg is suffering from the special form of elephantiasis called podoconiosis which affects people who walk bare footed. It is caused by the minerals in the red soil which penetrates the skin and blocks the lymph system. It is easily prevented by wearing shoes, but as the lot of people around she never could afford to buy herself a pair.

How could she ever find money for surgical treatment? She was very lucky that Sr Christel passed by to supervise a local elephantiasis project in Dilla where the lady is living. She covered the expenses for her treatment – 887 birr (45 €). Otherwise the girl would never have got the chance to a better life.

The third patient with a large intra orbital tumor is in desperate need of life saving surgery. She was told to come for admission but never turned up. Either she is trying together with her husband to raise enough money for the deposit – 800 birr (40 €) - or she has given up and accepted her fate as a poor women in a poor country. She is by the way 3 months pregnant and a mother of two.

We are repeatedly being told by aid organizations from the rich world that we have to run our hospital more businesslike.

My elder brother is running a private hospital in Copenhagen. I asked his advice.

First of all - he told me – it is very difficult to make money on health care. People like to save money for a car, a new fridge or a summer residence, but when it comes to health care money is tight. If it is difficult to run a private hospital in the richest part of the world such as Denmark, how on earth can it be done in the poorest part such as Ethiopia?

Move the hospital to the capital Addis Abeba where the money is was his first advice. Don’t give emergency care – that is not profitable. Check the credit value of your patients before admission; if not high enough send them away. Do not engage in any major, risky or complicated surgery. Stay with minor surgeries which make the best profit and don’t bring any costly complications.

The best advice is to marry a wife who is a plastic surgeon. She can do face lifts, breast augmentations and nose corrections which will make the business go around.

Is that what we want for Aira Hospital?

Don’t forget that what Jesus said was “Heal the sick and spread the Gospel” not “Heal the sick and make business”

One congregation in Minneapolis is a great supporter of Aira Hospital. They have sent a large container filled with medical equipment, brand new and some second hand.

Our fear was always that the container would be hijacked by Somali pirates, but to our great joy it eventually arrived safely to Addis Abeba via Djibouti. But only to fall in the hands of the Ethiopian costumes authority - the Gumruk. There the real trouble started. The container was unloaded brusquely and every item scrutinized. Some very valuable equipment was damaged. Other items were left in the open exposed to heavy rains.

A lot of much needed high quality operating theater drapes, scrubs, nurses’ uniforms and other clothing were not accepted by the costumes inspector because it was second hand, although cleaned, ironed, packed by gentle hands and blessed. It was destructed on the spot with fire. It could otherwise have brought fleas, lice and other pests into this country!

It would have been easier to deal with Somali pirates – at least they are willing to negotiate.

After finishing the hardships at Gumruk the next problem aroused. The clearing agency refused to bring the container to Aira unless a crane was hired at huge expenses. Another agency had to take over and finally yesterday morning the container arrived at the hospital gate early in the morning.

We started unloading around 9 am and before 1 pm the container was empty and steady on the ground.

VIDEO ← click here to watch video clip

How could it be done without a big crane? Well it is not the first time Aira Hospital receives a container, although we never had such a large on, so the expertise was there.

With a strong wire the container was fixed to a steady and chubby mango tree and the truck drove ahead. With the aid of two wooden poles to prevent the container from tipping it came nicely to the ground, exactly on the spot which had been prepared with stone foundations to receive the container.

Look and learn Mr Teddy and AKAKAS! This is how we do things in the countryside of Ethiopia!

All the equipment is by now reloaded into the container which functions as an extra store. Piece by piece the items will be examined and registered except some urgently needed ones which are already in use or being installed, like operating theater lamps, autoclave, operating theater tables and anesthetic machine. All the rest equipment will follow successively.

We are all very excited and extremely grateful and happy for this generous donation which will improve the quality of our service tremendously to the benefit of our many patients.

THANKS TO ALL OF YOU WHO HAVE CONTRIBUTED AND PARTICIPATED IN THIS PROJECT! MAY GOD BLESS YOU!

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.