The sun has yet to rise. The air is thin and chilled. The cocks are crowing confident of impending light. Worn sandals, multiple layers of tattered clothes, and few personal possessions will accompany the journey ahead. Over the past 10 days, word of American doctors has spread, and the people of Yetebon have traveled up to 30 kilometers on foot over uneven and ill-defined roads comprised of volcanic rock and dust, hopeful to be evaluated though uncertain they will be.
Feet. The most common mode of transportation. The supportive and protective foot wear we know and are accustomed to in the States is far from the reality of the used and ill-fitting shoes worn by nearly every patient we’ve seen. Access to shoes is limited to slip-on gel shoes, plastic boots and thin canvas slippers with little-to-no sole attached, that can be purchased at the local market. Despite shoe gear shortcomings, people with ailing feet have little option but to walk great distances for hopeful treatment of their aches and pains.
That’s where we step in. Team Podiatry. Just as patients are unknowing of what treatment might lie ahead, we truly have no insight into what may present to our clinic. At times we were challenged by the unpredictable nature of our day and the barriers to seemingly straight forward conservative treatments. For example, not everyone has access to ice which can be helpful in reducing pain and rehabbing minor injuries. One patient could not pursue surgery because he could not afford the crutches needed for his recovery. Another patient had painful varicose veins. On exam, these were mild in presentation, and would be amenable to compression stockings, however, these are not available locally or even in nearby towns. Many patients did not know what pumice stones or nail files are, because these things aren’t found in this region. Given these obstacles, we worry many patients may struggle to follow recommendations given. Thankfully, we were able to help many people, and even saw one patient as a 1 year followup from surgery last year, who was very happy to see us again and reported positive results from her prior surgery.
Often times, a clinic appointment was punctuated by a podiatric surgical patient ready and waiting in the OR; unexpected surgical consults with Dr. Fekadu; and injured patients in the emergency room. While we have treated many foot and ankle related concerns, we have also had patients present with ailments such as poor renal function, dermatologic abnormalities, domestic abuse, cervical spine injuries and sexual dysfunction. Within the list of nonpodiatric conditions that presented to our clinic, we identified a large number of patients who would benefit from orthopaedic care. Conditions including low back pain, knee arthritis, extremity deformities and neurological conditions such as cubital and carpal tunnel syndrome were common findings. Dr. Fekadu has great interest in working alongside an orthopaedist and even has a multitude of orthopaedic instruments on hand. We hope in the future, an orthopaedic team will join Global Partners in Ethiopia.
Even this morning, during our last day in Ethiopia, we saw many patients who may require surgery. We are anxiously awaiting the arrival of Team Two, in order to handoff these new patients as they get started. While it will be hard to join the “readers” of the blog instead of continuing to be “writers”, we are confident Team Two will continue to provide excellent care to the people of Yetebon.
Team Podiatry: Devin & Stephanie