Letter from Mr Nishikawa to the team

While working in Ethiopia Mr Nishikawa sent this letter back to the team about his experience. As raw insight into the experiences there we wanted to share it with you.

Dear Tara and Michelle,

It has been a gruelling week. I have been bitten mercilessly by bed bugs and had the usual tummy troubles, but nothing too bad.

We are on the road side of the hotel. In the morning the glorious sight of the new church being built in the distance greets my eyes and the busy street and stream of Ethiopian life bustles below. I see rivers of shabby greys and blacks interspersed spots of brilliant colour as people and cars move inexorably somewhere I cannot fathom.

This strange foreign land gives way to the surreal strains of Frere Jacques. I notice a primary school I had not seen before in front of the hotel. Neat western school uniforms worn by little Ethiopian children running around the play ground before school roll call. They look like the produce of the elite. Then it’s breakfast. I eat what seems safe but the Russian Roulette of gastroenteritis is a constant threat.

I leave for my walk to the Korean Hospital to work. The dust, traffic, dying dogs and beggars mix with the wonderful energy of shops and fruit stalls already open. Then there is work to do. Brand new theatres are a joy, coupled with the same old filthy toilets and dingy changing rooms. I suppose there are echoes of the NHS.

Less than 48 hours ago we carried out a ten-hour operation to reconstruct a new lower jaw that had been ripped off a five year old boy by a hyena. He had survived this attack that had occurred several weeks ago, and finally we were here so the surgery could take place.

A free fibula flap combined with his leg skin was transplanted to his face. The bone fixed to a pre-engineered titanium plate that had been constructed in the UK with computer controlled laser technology. This had been brilliantly planned by Kelvin back in the UK. Together, aided by a team of skilled anaesthetists, the auto-transplant worked. The operation was like a battle. Sometimes the dark forces of trauma seemed to be winning but eventually these were overcome. We had some problems with the micro-surgery. We needed vein grafts as the pedicle was not long enough. There was much scarring from the previous trauma but eventually I managed to find some vessels and the flap came alive. Late into the night on ICU I will never forget the look of the child’s parents and their tearful relief. Never had the hum of the Doppler probe that indicated that the vessels were flowing sounded so sweet. This was the first time we believe such surgery has been carried out in Ethiopia. Truly the developed world met the undeveloped that night.

Walking back to our shabby hotel after the surgery I passed by sleeping beggars on the dusty rough pavements. Some were children. I felt a cacophony of emotions: fear, sadness, relief and a privilege that I was not ever fated to be among them.

Now in Adama for a couple of nights I can rest and reflect. Will be back in Birmingham next Friday. Keep well.
Best wishes, Hiroshi