Good morning. Or is it afternoon? Who can tell from so far away.
I'm in Ethiopia. The year is 2005. Here, they use the coptic calendar. The time, is also 6 hours different. Noon is "six o'olock". They think it silly that our clock starts at lunch time. Why not when the sun comes up, at six am? Or when it goes down at six pm?
Old wisdom here. A fascinating, and rich place, historically, and culturally. And, because of the efforts of so many people at the University of Toronto, it is also a safer one.
We arrived last week, earlier than our usual teaching trips, to deliver the final year residents' certifying exams. Of course, the emergency department is impossible to resist, and jetlag couldn't keep us from it. Deep in the scrum, we found a shivering man, from days away, blood pouring from his mouth and nose, his nails paper white. He had a lab report from three days ago that showed platelets of 13, and a hemoglobin of 50. He had no blood pressure. We pulled him from the queue and, with one of the residents, found out that that day, despite the bleeding, was his lucky one. There are platelets on Friday. One day before, or after, none. We gave him what they had, and with it some blood, and today, he is alive.
There is still a ways to go before Ethiopia is an easier place for the poor and sick, but because of the emergency program here, and you all, that day is closer. Last Saturday, we celebrated the graduation of the country's first emergency physicians. They all passed their exam, and with it, into a new era of emergency medicine for Africa, and the world.
There is no question in my mind, or theirs, that this day would not have been so quickly possible without the thousands of volunteer hours donated by our committed faculty and residents. We have given our best, and it shows. We've reason to be proud of these young men and women, and to call them our colleagues.
As I said last Saturday, at a dinner to celebrate them, they are proof of what is possible, not just from dedicated teaching or access to innovative educational opportunities, but when two institutions and countries come together in a spirit of peace. What a great lesson, and what great momentum to carry them into the first days of their career.
Sincere gratitude to all of you who have made the day possible. Clare Pain for her guidance, the TAAAC-EM executive team, who work weekends and off-days to make curricula, support research endeavors, provide mentorship. The emergency medicine groups around the city, including UHN, St. MIchael's, SHSC and Mt. Sinai, who have contributed both people and funds necessary to run this program. The high level of support we have received from ED chiefs all over the GTA, current and former divisional directors, Drs Schull, Letovsky and Chopra, as well as Dept Chairs, Drs Wendy Levinson and Lynn Wilson. The busy doctors who have made time to deliver distance or sim sessions when our teams are not in the country.
We offer our deepest thanks to those committed souls who have made the month-long trip to Addis, and left behind the best of what they know. Those who, on their return, continue to develop exam questions, develop ideas through to fruition. It is you who have inspired this first generation of emergency doctors to excellence, not just by teaching the "what" of emergency medicine, but the "how", that in the pursuit of health for the sickest, distance should not matter. It was deeply humbling to tap out the list of people who follow my signature.
A partnership is only as strong as the people who form it. Our AAU colleagues, namely Dr Aklilu Azaj and Sisay Teklu, have been the main arbiters of this success. Soon, because of it, graduates will leave Addis to start programs elsewhere. The year after, even more. One day, they will take it from Ethiopia, to Sudan, Somalia, and on.
These young graduates need our continued guidance and support, the residents behind them, our teaching. But, should we do it well, less and less each year. Together, perhaps, we can live that development dream of having worked ourselves out of a job.
For those of you who want to contribute, we are still taking applications. Trips typically run, month-long, in Feb/May/Oct of each calendar year. We'll send out another call soon, and in the meantime, you can email Sara Berman for more info (firstname.lastname@example.org). We might even expand this, should it be necessary to support the satellite programs that will follow. We'll keep you apprised.
Some dates for your calendar. We will have a TAAAC-EM info session in the coming months, but you can learn more about what's happening in international emergency medicine at our bi-monthly "Global Health Emergency Medicine" meetings, the next one December 17, 5-6pm. In the meantime, should you be hungry for more about Ethiopia, there is a global health symposium and galaon Nov 8, which will include many of our Ethiopian colleagues. And, for those of you like to travel, and plan in advance, join us as Ethiopia hosts the African Federation of Emergency Medicine, in October 2014, and meet these fine people firsthand.
In the meantime, there is reason to celebrate. Those of you who spend time virtually, can find some activity here, on the residents facebook page. The rest of you, join us in welcoming these four doctors, Seblework Temesgen, Sofia Kebede, Biruk Girma, and Yenealem Tilahun into the lifelong fraternity/sorority of emergency physicians. What great additions.
James Maskalyk MD, FRCP(EM)