I’m a child of the ‘80s (hence the GNR reference) – and a partial product of the fraternity system. There’s a tradition of ‘Hell Week’ in the Greek system. It’s a rite of passage where pledges (potential members) are put through a series of difficult and harrowing activities that at the end result in their acceptance into the fraternity. Fortunately, Sigma Nu did not see fit to follow this particular tradition, but I felt like I was living in a delayed version of this over the last few weeks…
Editor’s Note – Guns N’ Roses (GNR) was a popular rock band from the late ‘80s/early ‘90s and each titled section below represents one of their more popular songs.
Sweet Child O’ Mine
3 weeks ago the week started with a bad phone call. It was early on Monday when a patient arrived in transfer from a hospital far away. She had been transferred to another hospital but she was redirected to ours with a big problem. She was 36 weeks pregnant and had started to bleed from a condition called placenta previa where the placenta is covering the cervix. It’s a medical emergency and by the time she reached our labor and delivery unit her baby had already died within her womb. And within minutes of her arrival her heart stopped as well. She had just lost too much blood. We did everything in our power to revive her – all while her family watched and prayed for a miracle. But that was not a miracle that would happen that day. As we finally stopped and prayed for her soul and for her family, I quietly cried. Knowing that this was the third maternal death of the month; but not knowing that yet another would happen by the end of the week.
Even as we were reeling from this terrible news we were unaware that the floodgates of labor were about to open up upon us. The local government hospital had shut its doors to new admissions and EVERYBODY started coming to us. Our hospital does around 80 deliveries per month and we’re adequately staffed and equipped for that type of volume. But with the closure of the major hospital in Soddo, our volume immediately shot-up 500%. For the next 5 days I experienced the most sustained medical chaos that I’ve ever experienced in the 26 years that I’ve been in medicine. They just kept coming, and coming, and coming… At one point we had 3 women pushing in the same room, at the same time, with delivery tables placed side-by-side. We ran out of rooms. We ran out of equipment. We ran out of staff. We ended up delivering 65 babies and performing 22 cesarean sections during those 5 days.
And during that time we experienced pretty much every type of high-risk pregnancy and complication that you can imagine. If you took one of our major obstetric textbooks you would literally have read the entire book to cover all that we saw. It was like an entire 4-year obstetric residency packed into 120 hours. I’m still not sure whether to be amazed by that or frightened. We had one more maternal death before the week was done – that time it was from eclampsia and the result of hours and hours of seizures before she came to us. The pediatric side had 5 neonatal deaths. Despite a week with a lot of death, the overwhelming majority of our patients did well and we celebrated the life and sweet children that were born.
The one thing that brought a smile to my face during that time, though, was my medical staff. Our pediatric team was superb. Our nurses and midwives worked tirelessly. They came in to work on their vacation. They worked extra shifts. And they never, not once, complained about any of it. They just did exactly what they needed to do and did it with excellence.
Paradise City/Welcome to the Jungle
There’s a current virus traveling our planet but I’m not sure if you’ve heard of it? Despite what the American President says, it is called “corona” or “COVID-19”. It arrived in Ethiopia in mid-March and we’ve been preparing and watching for it here at Soddo Christian Hospital, but we hadn’t had any cases. That was until RIGHT AFTER the obstetrical deluge had abated. Then it arrived. We had cases in our medical staff and most likely some of our patients as well. I had been exposed and was tested but fortunately have been negative to this point. It’s been a game-changer in our hospital where we have cancelled our elective surgical cases and many additional precautions have been taken.
Live and Let Die
After the crazy week of deliveries and then the arrival of corona, we felt like we needed a break. So we went for a very relaxing weekend to a town 2 hours away that sits by a beautiful lake and has amazing birds and monkeys. So that’s what we did, along with the remaining expat family, the Loves. It was a great weekend filled with the beauty of God’s creation, and a not-so-small amount of ice cream ingestion.
We came back last Sunday refreshed and ready (so we thought) to face the coming week. Within an hour of returning to Soddo we started to hear gunshots. We occasional hear gunshots from the prison across the street, but these were coming from another direction. Where they weren’t supposed to be coming from. And they continued… and continued. We all have a “safe place”, which for us is our storage closet, an internal room that doesn’t have windows. We prayed for God’s protection and we watched online as our church back in America prayed for us as well.
Then we got an alert that we had never received before. A ‘mass casualty’ alert from our hospital ER. We were having multiple gunshot victims brought in and they needed all the help that they could get. I’m just a gynecologist, and I have exactly no training in surgical trauma, but with only one other expat surgeon on the campus I figured I would go and try to help in whatever way that I could. I met Tim, the actual general surgeon, outside our houses and as we heard more gunshots he said “well, I guess we better run…” So… we ran to the ER – not knowing what we would see as we walked in.
There were 4 victims when we arrived. Some were calm, and some were not. We started to assess those that were there and as we were finishing our initial evaluations the doors of the ER opened with more arriving. They were not arriving by ambulance, they were arriving by “people” – friends were carrying victims in their arms for us to see. All of the beds quickly filled with young people shot by AK-47s. We moved some that were stable to the ICU, and the most critical were moved to the operating room. I scrubbed and helped Tim with the most badly injured victim. A bullet had gone through his chest, behind his heart, through his diaphragm, then through his stomach and finally his spleen which basically had exploded in his abdomen. Despite all that was done, this young man and child of God died before making it to the recovery area.
These were all things and scenes that I had never seen. And I never want to see them again. I mainly deal with with the beginning of life and before moving to Ethiopia rarely had to deal with death. It’s still hard for me to see death – especially death that seems preventable or unnecessary – and in many ways it’s haunting. I have a great and new respect for all those health workers that deal with trauma. It’s physically, mentally, and emotionally draining. All that I had seen on TV and movies about this kind of thing… cannot capture what it’s like. Over the course of a couple of days dozens of people were shot and an unknown of people were killed. It’s crazy to me that we’ll never know exactly how many people died.
Because of these events and some political turbulence in our area, we all decided to evacuate and left for safer areas on Tuesday. We even had our own police escort during part of the journey. We’re currently safe in the capital.
Things are returning to normal in Soddo and we’re looking at returning early this week. Despite the challenges and struggles that we’ve recently had we can’t wait to return to our friends and to rejoin the work that God has for us.
I kind of wish Sigma Nu would have just gotten the whole ‘hell week’ thing over with in college and not deal with this now. But I know that this is all part of His plan and I have a peace in that and in all that He is doing.