Aira Hospital

Still fighting with a hopeless internet connection. That’s why the news on the blog are short and scarce.

This young girl was happy to survive one of the common car accidents on the roads around. High speed, overload and chat are the common factors behind the accidents.

She lost one eye and got severe fractures of the mandible and the maxillary complex, known as Le Fort III fracture system.

The maxillary complex is loose and the nose severely fractured as well

VIDEO ← click here for video

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A difficult case even in the first world.

We managed to get good alignments and fixation with our standard external fixation device made out of bicycle wires and Plaster of Paris

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.

Some time ago a young girl came to the OPD with the lower part of her face covered. Well inside the examination room she disclosed an enormous enlargement of the tongue due to a hemangioma – a basically benign vascular tumor – which had been growing slowly for years.

How she had been able to feed herself and breathe at night when asleep remains a mystery. When asked why it took her so long time before coming to the hospital, the answer was - as always - due to lack of money.

She was admitted and scheduled for surgery. The longstanding pressure from the tumor had destroyed all teeth in the lower jaw and deformed the jaw as well. After removing almost all of the tongue together with the tumor, the deformed jaw stood widely open. A bilateral resection (removal of a part of the jaw on both sides) had to be done before the mouth could be closed. The bone ends were held in place with an external fixation device made of wires from a bicycle wheel hold together with plaster of Paris. 

After the surgery she didn’t complain although she suffered a lot of pain.  She was extremely brave – and clever too! She couldn’t talk due to lack of a proper tongue, so when asked about her age she showed by counting her fingers one by one until the last finger. “So you are 10 years” we asked? She shook her head vigorously and grasped her big toe “11 years!”

The lower lip had to be kept up with tape for a while before she gained muscular control.

She never had the chance to attend school. During admission time she was taught her how to knit among other things.

After three months she returned to have the external fixation device removed. She looked tired and miserable. It turned out that she had walked 11 hours by foot to reach the hospital!

After removing the device we gave her 50 birr – less than 5 $ - for the bus ticket to Chanka. From there it was “only” four hours walk to reach home.

Slowly she regained the ability to talk.

VIDEO 2 ← click for video 

My heart still aches whenever I think of her – so poor but so brave.

The last three years we have been without regular financial support to run the hospital. Previously we received a yearly grant which made up 25% of the budget. But that grant was withdrawn as the donor agency decided not to support curative health care anymore. Easy to make decisions far away from reality, without having to face the dire consequences of decisions made. Had the responsible persons met this patient face to face I wonder if they had perseverated.

 Thanks to the Lord we still receive 200 000 birr (18 000 $) every year from the german mission society ELM, earmarked for the poor fund - as well as donations from individuals. Otherwise we would not have been able to help that girl by giving free treatment.