On the horn of East Africa lies Ethiopia, a country the size of Texas and home to 70 million people, whose average per capita income is 150.00 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.
At the capital city's Black Lion Hospital 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.
Laryngeal papillomas affect 4.3 per every 100,000 children in the USA.In Ethiopia, this affliction occurs at an alarmingly higher rate. Dr. Abebe Melaku, MD, director of ENT services at the hospital and one of only 10 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.
Aside from the children with papillomas, there are 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.
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. Cholesteatomas, subtotal perforations, conductive hearing loss from otosclerosis, and glomus tumors were 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. During the 13 days of surgery, 8 stapendectomies, 11 microdebridments of laryngeal papillomas, and 20 modified radical mastoidectomies were performed.
Lack of MRI as well as invasive angiography limited the staging of the glomus tumors and therefore they were not operated on. The glomus tumors presented as masses in the ear canal and were all well advanced when diagnosed.
Due to internal political issues the GEO program is currently on hold.