I took my 18th trip to South Sudan this week. For several months I’ve been told that while I’m in the “neighborhood,” I should stop in Ethiopia to see the work of Dr. Rick Hodes. We did, and it was not a disappointment.
Dr. Hodes is the Ethiopia medical director for the American Joint Distribution Committee, a 100-year-old organization based in New York that is the world’s leading Jewish humanitarian organization.
Dr. Hodes completed his medical education in 1982 and went straight to Ethiopia on a Fulbright Scholarship to teach medicine. He effectively never left.
We visited his Saturday clinic at the Cure International Hospital, a Christian hospital that let Dr. Hodes use its space in Addis Abba this week, where he saw 53 patients. His focus has evolved over the years from being the primary care doctor for the tens of thousands of Ethiopian Jews and assisted their evacuation to Israel, to a current focus on a diverse population including mostly Christians and Muslims. As he says, he spends his days treating diseases he had little formal training in, but he says, “Need is the mother of invention.”
Most of the patients he saw on Saturday were “crooked.” Their spines were shaped like saxophones – the etiology of these deformities ranged from infectious (TB), to congenital to idiopathic. They all shared a common smile in which the origin seemed to stem from a deep appreciation for Dr. Rick. As some struggled to breathe due to the loss of lung capacity from not being able to fully expand their lungs, their eyes sparkled with hope – especially when Dr. Hodes told them to be sure to have their passport up to date.
Dr. Hodes relies on donors to fund each one of these spinal surgical lifeboats to the tune of about $18,000 a surgery, a cost one-tenth of the procedures performed in U.S. The surgeries are performed by Dr. Ocheneba Boachie-Adjei at the FOCOS hospital in Accra, Ghana.
Currently he has 36 patients in Ghana at FOCOS, and they begin the treatment not with surgery but by beginning with ambulatory traction for months at a time. It is only then that they operate. This method has expanded spinal surgery to another level and, because of the success in Ghana, there will be great benefits in the United States as well as the rest of the world. One surgery straightened a patient who had three angles in their spine greater than 100 degrees each.
Dr. Hodes has also arranged several heart surgeries for his patients whose valve and congenital cardiac conditions are life threatening. A heart surgery can range from $1,500 to $5,000. A donor can effectively give a heart for the cost of an Apple computer. These surgeries are performed in India for a fraction of the cost of the procedure in the U.S.
After seeing 53 patients, Dr. Hodes took us to a local Catholic mission to check on more of his patients. Dr. Hodes has been working with the sisters and their patients for over 20 years. Like Dr. Hodes, this mission takes patients without considering race or religion. Dr. Hodes is an observant Jew.
Dr. Rick also provides pre- and post-operative care for these surgical patients. The patients are ultimately “healed with steel,” as surgeons say, but there’s more involved. The patient has to be selected first. Scarce resources must be allocated, and they must be cared for to afterward. His fundamental question after listening to their concerns is, “What are you doing with your life?” It is not just a clinical visit. He wants to know how his patients are doing in school, or his older patients are doing with their work lives. One young girl patient says she wants to be a doctor and he not only encourages her, he asks her if she thinks girls can be doctors. He makes sure he breaks through cultural stereotypes by encouraging girls who want to be doctors.
Part of this pre- and post-operative care requires a great deal of “mission creep,” as they say in the military. A man came in who had a post-operative infection from a facial reconstruction surgery. He was living on the street, too sick to work and pay his rent. Dr. Hodes reached into his own pocket and gave him money for a room and food for a month, a prescription for antibiotics and told him to return next Saturday. Another man came in with his child. They had been living in a small hotel waiting for an MRI. Dr. Hodes invited them to stay at his house to save them the money while they waited for pre-operative diagnostic tests.
He doesn’t put barriers between himself and his patients. He adopted his first three spine patients so they could get on his health insurance and have spine surgery in Texas. I had the opportunity to have dinner with one of his sons in New York over the holidays. When he met Hodes, he only spoke his tribal language, and now he is fluent in English and studying engineering in Boston.
Visiting his home in Addis, we met many of his patients now recovering so they can go back home to their villages. One girl, 14 years old, is the sister of a patient who had a spinal operation. She fled her husband and village to find Dr. Hodes. She is now in school in Addis.
At the end of our visit, I asked Dr. Hodes about his dreams for the future.
“My dream he said is to have a spine center here in Ethiopia, where we can evaluate, provide surgery and also train others,” he said.
I asked him what makes him get up in the morning, and he answered, “Wow, I should be grateful that today I saved lives no one else is going to save.”
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