By Sarah Woodrow, MD
Cooper Neurological Institute
This is part three in a series of updates from Dr. Woodrow’s mission to Ethiopia. View additional posts from her on the Inside Cooper blog by clicking here to view all posts tagged “Ethiopia.”
Less than 12 hours on the ground and I am rounding at the hospital with the residents. They are excited. With my subspecialization in spinal surgery they have been saving the toughest cases for me in hopes of learning a few tricks while I am in town. While I am thrilled by their enthusiasm I am secretly scared as they start introducing me to the patients and the enormity of the task at hand.
Many of them are accident victims having fallen from various heights. Most have been paralyzed by their injuries. Each has at least one family member by their side who sleeps on a mat by their bedside, providing the majority of their basic nursing care. All have been admitted for surgical treatment. Unfortunately I can offer little hope to those that have become paralyzed – the injury they sustained to their spinal cords is permanent. The role of surgery in these patients is only to stabilize their broken spines so that they can sit upright. The difficulty will be in determining how.
All have xrays of their injuries sitting as pictures at their bedsides. One is an image of a completely dislocated spine. I don’t think I have ever seen anything like it except in a textbook. None of the patients have any advanced imaging. The CT scanner at the hospital broke down years ago and has never been fixed. Those that can afford it are sent for MRIs or CT scans at one of the many private radiology clinics around the city. Given that there are few ambulances in the city I can only imagine how these patients are transported.
At the end of the day whatever information we have, their spines need to be fixed. The big question is how. Back home we have access to all of the most advanced equipment and technology. Here there is none of that. The screws and rods that I would normally use, cost thousands of dollars and just aren’t readily available. Over the years surgeons like me have brought over odds and ends – the question will be is if there are enough matching bits and pieces to fix a few spines.