independent

Tuesday 25 September 2018

THIS IS A MEDICAL DEVICE

Retired surgeon Dr Fintan Shannon spends six weeks each year in a clinic in the Ethiopian capital, Addis Ababa - where the health service is so ill-equipped that using a Black & Decker drill on bone injuries is actually seen as a sign of progress. He spok

How Sligo surgeon Fintan Shannon has to take 'the DIY approach' for six weeks each year T HE NEXT TIME you feel the need to complain about our 'deplorable' health service, consider this parable: An impoverished man is told in hospital that the only thing which will save the life of his 13 years old son is the amputation of his cancerous leg. He is given €500 to buy medicine while he decides whether to allow the operation proceed. His dilemma: go back to the hospital and agree to the amputation, or abscond with the €500 to feed the rest of his starving family, knowing his sick child will die.

It is but one of the heartbreaking episodes encountered by retired orthopaedic surgeon, Fintan Shannon, over nine years of voluntary work in the Black Lion Hospital in the Ethiopian capital, Addis Ababa. The achingly sad story encapsulates the almost unimaginably difficult conditions which exist in the hospital, and the heroic efforts of the 72 years old Sligo medic to somehow improve the situation.

Mr. Shannon spends six weeks every year at his own expense working in the challenging environment of a hospital deprived of even the most basic medical equipment and facilities, where armed guards patrol the grounds and wards and seriously ill patients are often turfed back on the streets without proper treatment.

He brands the tragic story quoted above as the 'chemotherapy or cattle' dilemma -- a father literally having to choose between treatment for his terminally ill child or buying cattle to help the rest of his family. And that's only half the story. To get to the hospital in the first place, the father and son had to make a mammoth 700 kilometer trip over ten days, including two days on a bus rattling over dirt-track roads and two days being stretchered across desert wilderness.

"When we told the father we would have to amputate his son's cancerous leg in order to save his life he said he didn't want this. They said it would be a loss of dignity if the boy had to go home with one leg. He said he wanted to go home and talk it over with his wife and family and that he would come back. We gave him some money, the equivalent of €500, to help with transport and medication, but a nurse told me he would not be back, that he would use the money to buy cattle. We never saw him again. There is no doubt that young boy died soon after, maybe even during the difficult return trip home. I don't believe the father was a conman. He genuinely made the choice to help the surviving members of his family, knowing it would cost the life of his young son," Mr. Shannon recalls.

Another illustration of the pathetic lack of facilities and equipment: Up until recently, surgeons at the hospital used manual drills to drill through bones for the insertion of pins. Things have improved -Mr. Shannon brings over electric Black & Decker drills, the type we use for our DIY chores. With sterilised towels wrapped around the blades, they do the job.

"The sterilised drills used in Irish hospitals cost about €4,000. I picked up the Black and Decker drills for about €40 each. The thought of using such equipment in Ireland would be greeted with horror; in Ethioipia it's actually progress," he reports.

Our throw-away items such as crutches or Plaster of Paris are scarce and valuable commodities in the Black Lion Hospital.

"I once came across a man lying on a trolley in a corridor with an open leg wound, who had been there for days. I enquired about the reason for this and was told his family wouldn't co-operate. On investigation, I disovered what they meant was that the family couldn't afford to pay the €10 for the plaster. On another occasion, I went to buy some sets of crutches, only to find it was a massive bureacratic exercise, with trips to and from the hospital office and the local store looking for the necessary paperwork. I was so worn out in the end that I probably needed the crutches more than the patients," he reports.

After 25 years working as an orthopaedic surgeon in Sligo General Hospital, Mr. Shannon would have been well entitled to indulge in the 'pipe and slippers' model of well-earned retirement in 2003. Instead, he responded to an appeal in a medical journal and headed to Ethiopia for the first time. He's travelled there for his annual six week sojourn ever since, in recent years being accompanied by nurses from the Sligo hospital's orthopaedic and oncology units, all of whom travel entirely at their own expense. His selfless devotion to the cause has inspired a team of helpers and supporters. Over the years, a stagggering total of €100,000 has been donated in a wide-ranging series of local fund-raisers, every single cent of which has been put to good use on the ground in Ethiopia.

"The money goes straight from our hands into the hands of Ethiopians, be they starving beggars on the streets or patients in the hospital who just can't afford to pay for things such as x-rays, scans, crutches or plaster. Anyone who donates to our fund-raisers can be assured that every cent goes directly to the people who benefit from it. There is no such thing as overheads, as we all pay our own expenses," Mr. Shannon points out.

Despite what he describes as the grim conditions and the chaotic need for improvements in medical services, Mr. Shannon finds the impoverished people to be remarkably dignified.

"They live in dreadful poverty and yet they are a very gracious, refined people. They are so appreciative of any care, just that you care at all means so much to them," he says.

Hospital staff, meanwhile, find it increasingly difficult to cope with the incessant demand for overstretched services. Not nearly as well trained as their Western counterparts, they have a great appetite for learning and improvement.

"They probably need organisation more than anything else. I have noticed over the years how the doctors and nurses seem to be gaining more confidence in their own ability, but they are simply snowed under with work, and they need to be better organised in order to cope. I try to pass on as many tricks of the trade as I can while l'm there, and just hope they can learn from that and cope that bit better when I'm gone," he says.

While he thankfully notices little improvements each year he goes there, Mr. Shannon still encounters feelings of utter frustration at how difficult it can be to provide even the most basic treatment.

"Even small things, like getting a set of crutches for somebody, can be a nightmare. People lose limbs or die simply because they don't come to hospital in time. The amount of deformities or neglected injuries that become infected and beyond repair is quite shocking," he adds.

Notwithstanding that sense of understandable frustration, the indomitable Mr. Shannon has no intention of putting his feet up just yet.

"As long as the Lord spares me, I'll continue to go each year. I get a lot of fulfillment out of it. There's a good feeling about being of some use, even if it's only a drop in the ocean," he explains.

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