It’s been a full week with lots of experiences and stretching. Two visiting consultants were with us for about a week working on strategic planning for the hospital. There were many good things that came out of their time here, including team-building among the Ethiopian staff. Lots of ideas and thoughts were collected and many interviews were conducted. In the end, we have a very logical game plan to approach the next five to ten years. That isn’t to say that we know what the details of the plan will be. But we have a handle on what the process will look like that will produce those details. Overall, it is an intimidating thing because of the magnitude of effort, planning and teaching that will need to take place to make it happen.

Management, especially done well, is a difficult process and I feel very out of place trying to do it. But God has put me here at this time in my life so I will proceed as best I can, trusting in His guidance and wisdom. If His strength can be seen in my weakness, I’m pleased to say I have a lot of opportunity to display His strength. Please pray for us as we try to move into a new level of quality in management and leadership.

I took Ol’ Blue for her first difficult ride this week. The chief administrator and I had to travel to Awasa this Thursday for hospital license business. It is about 200 km away and the first 70 km or so out of Soddo is a whipping. The bad news is the pavement is in really bad shape but the good news is most of it isn’t paved ;). It was educational, though, in that we discovered the suspension system in the truck needs some work. It’s always something, right?

Medically speaking, we’ve had more adventures with airways at the hospital. Dr. Asle Aarsland, an anesthesiologist, has been with us for a couple months now and I was thankful to have his help. In one day, we dealt with two children with breathing problems. The first was a five-year old boy who inhaled an unroasted coffee bean. In the operating room, Dr. Aarsland was able to pass a flexible scope into his windpipe (trachea) and see the bean stuck in the main airway going to the right lung. Since we don’t have any capacity to remove anything through our scope, we moved on to the standard technique. We hung him upside down by the ankles and proceeded to pound his chest and perform Heimlich-like maneuvers. After several episodes of this, the bean had finally moved into the main windpipe (trachea) and we were able to surgically perform a tracheotomy and pull the bean out. It’s always satisfying to drop the offending agent in a pan.

The other child has been more problematic. She is a three-year old girl who reportedly also inhaled some food. Our “Spidey-sense” was sending off warnings that something else was amiss so we went ahead with another scope. Our intuition was right and there was no obvious foreign body. However, she had very inflamed airways and puss. The inflammation also included the vocal cords and the larynx above them. My hunch is that she sucked down some scalding liquid but it’s hard to know for sure. She initially looked better with conservative therapy but started looking worse today. We repeated the scope and it looks about the same. Ultimately, the nurses were able to rig up a tent of blankets over the bed and a heater plate was used to boil water to humidify the air. A little more complicated than a humidifier, maybe, but it seemed to work because she’s resting comfortably now.

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