For some time, SAO has been working closely with our contacts in Ethiopia to establish a sustainable plan for expansion of outpatient hemodialysis. Two encouraging developments that occurred during our most recent trip provide tangible signs of progress. First, after many months of work and negotiation, the Addis Ababa Health Bureau, Ethiopian Kidney Failure Dialysis Charity Organization, and St Paulus and Zewiditu Hospitals, have all accepted SAO’s proposal for structuring the program for the grounds of the Zewiditu Hospital. This proposal, largely authored by SAO volunteer Bahiru Eghziber, assigns the Ethiopian government the lead responsibility for providing equipment. Second, Dr. Zarihun (CEO of St Paulus) announced at a meeting among these essential parties and other governmental representatives that the government has committed to providing nine hemodialysis machines and a water treatment unit, both with service contracts from the manufacturers. This is huge!

I am also happy to report that the building we intend to use for the outpatient hemodialysis program at Zewiditu Hospital is steadily becoming more functional. Volunteers on our most recent trip were not only able to set up and supply the operating room in this building, but we were able to put it to use, performing some 50 surgeries, including both fistula creation and long-term dialysis catheter placements. It wasn’t easy: we fought flies in the OR and withstood heat high enough to be quite uncomfortable; in a desperate effort to help as many people as possible, we did two surgeries simultaneously in this one small operating room for an entire week. Even at that, we left scores of patients disappointed because we simply could not fit them into our overly crammed schedule. The need is overwhelming and urgent.

However, our disappointment in not being able to help everyone who desperately wanted, needed, and deserved surgery on this trip was ameliorated by our progress toward achieving one of our most important goals to date. Consistent with our belief that sustainable improvements in Ethiopian health care can only come through appropriate education and support of Ethiopian physicians, nurses, technicians, and administrators, we have treated each operation we have performed as a training opportunity. As a result (in no small part due to the persistent efforts of Dr. Swee Tan and her associates over four mission trips) we can proudly announce that Addis Ababa now has a complete team–surgeon, anesthesiologists, vascular mapping radiologist, and nurses–able to perform these procedures without direct SAO direct involvement. WOW! It has taken us over 2 years, but we are quite proud to see the results of our commitment not merely to provide healthcare but to leave in our wake sustainable improvements in healthcare. While we all acknowledge there is still major work to do, this accomplishment feels very good to us indeed.