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On the horn of East Africa lies Ethiopia, a country the size of Texas and home to 87 million people, whose average per capita income is 324 USD per annum. Of the total population, 85% live in semi nomadic rural settings, while the remainder live in cities, chief among which is Addis Ababa, the country's capital city of 5 million inhabitants.

In the capital city's Black Lion Hospital, in 2005, there languished 11 children, isolated on ward 7B because they were afflicted with laryngeal papillomas and thus unable to breath without the use of metal tracheotomy tubes. Not only were they isolated, they could not speak a word. Due to the metal tubes and the viral growths caused by the papillomas in their larynx, air was unable to pass by their vocal cords, making them speechless. The real problem was lack of resources and training to be able to handle this medical problem and allow the children the opportunity to live outside of the hospital.

Laryngeal papillomas affect 4.3 per every 100,000 children in the USA. In Ethiopia, this affliction occurs at an alarmingly higher rate. The director of ENT services at the hospital and one of only now 14 ENT in the country, dreamed of sending the 11 children at Black Lion Hospital back to their homes to live normal lives. With the aim of fulfilling his dream, GEO, in June, 2005, was awarded a travel and teaching grant to travel to Addis Ababa. The eleven children were operated on and after two days 7 of them were able to return home. The serious lack of resources including home health care and portable suction machines to care for the tracheotomies, had required them to live in the hospital, some for years, with six to a room. Meals and schooling inside the hospital were provided by the government-run hospital. This program has allowed them to return home and live with their families under normal conditions and to attend school in their communities.

Although Global ENT Outreach emphasizes the care, management, and education with respect to ear disease, we could not shrug the opportunity to help these children. Papillomas are one of many other pressing health issues in Ethiopia. The country is riddled with malnutrition, poverty, substandard housing, as well as poor sanitation and infectious diseases, all of which contribute to the myriad of illnesses seen in the country. Ear disease affects as well over 8% of the population.

Close to 12% of the population are HIV positive and 40% of the people with HIV present disorders of the Ears, Nose, and Throat. Adults frequently present with nasal obstruction secondary to adenoid enlargement and serious otitis media, tonsillitis, pharyngitis, oral Candida, leukoplaquia, esophagitis, mastoiditis, facial paralysis, parotid enlargement, Kaposi's sarcoma, and cervical masses.

Due to poverty and other substandard conditions, diseases of the ears run very high in those of the lower socio economic classes, and affects as well over 8% of the population. Cholesteatomas, subtotal perforations, conductive hearing loss from otosclerosis, and glomus tumors are the most common disorders diagnosed. Due to the lack of needed equipment and supplies, including middle ear prosthesis, there is little ear surgery being done there presently.

It was not until recently that GEO returned to Ethiopia to work with Dr. Nega Kiros in training both ENT residents and new ENT graduates the principal and skills needed in ear surgery. The program is located in Butajira, Ethiopia and serves a vital role in tracking not only doctors, but as well the clinical health care workers that are under Dr. Kiros training.

Annually, GEO goes to Ethiopia with colleagues from GEO-EU to support this program. Those that might be interested in knowing more about the program and opportunities should contact Dr. Sandoval.