Today after morning rounds we set out for the MCM (Korean) hospital to teach residents, hands on, how to do a balloon compression procedure/operation for trigeminal neuralgia. We are to treat three of the patients I saw last week. These are private patients who are paying substantially to the hospital for the procedure, as compared to patients at the Black Lion who are treated free.
I describe to the residents (14 of them) how to do the procedure, and demonstrate the equipment. I then perform the procedure on the first patient, which went flawlessly.
For the second case, Abenezer, one of the fourth year residents who has helped me interview all of the patients, is anxious to try it. We immediately identify a problem. Whereas I am ambidextrous and easily perform the procedure standing on either side of the patient, Abenezer is right handed and this patient’s pain is on the left side creating substantial awkwardness, as his (left index) finger must be inside the patient’s mouth (the procedure is carried out under general anesthesia) as he inserts a needle through the cheek and through a tiny hole (foramen ovale) in the base of the skull with his right hand. He had some difficulty, but with some help from me the procedure was successfully executed.
The third patient was a little easier for another of the residents, Azarius. They were all thrilled to learn this new skill and tripping over each other to hopefully have their turn to try next week.
In the afternoon I went to visit my friend, Akeza Teame, at his new outpatient facility, The American Medical Center, that opened to great acclaim and publicity two months ago. It is a sight to see in this (trying to emerge) third world country. It must be at least 40,000 sq ft and probably more. It is spiffy clean, very attractive, furnished beautifully and equipped to hand all of the outpatient medical and pediatric needs of a wealthy Ethiopian population. The charge for a medical visit is 300 birr (about $16.50). Charge for a comprehensive annual physical with a 10-15 page printout of all results and numerous other amenities is $300. This clinic is definitely the leading edge of medical care in Ethiopia. He is hoping to halt the exodus of wealthy Ethiopians to India and the middle east for their medical care.
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| Akeza's American Medical Center |
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| Interior courtyard of American Medical Center |
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| Teaching procedure for trigeminal neuralgia |
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