Ethan Barkley Reflection – Lessons from Soddo, Ethiopia

Ethan Barkley is a College of Medicine student at MUSC. He was awarded a Center for Global Health Student & Trainee Travel Grant in early 2024 to pursue a project at Soddo Christian Hospital in Soddo, Ethiopia. View more photos of Ethan's time in Ethiopia in this Flickr photo gallery.

During the past month, I had the enormous privilege of rotating in a teaching hospital in the town of Wolaita Soddo located in southern Ethiopia. From the moment I arrived, my senses were flooded with the newness and unfamiliarity that comes with being immersed in a foreign culture. The smell of spices simmering in pots of shiro and doro wat, the sight of whole families cramming into small hospital rooms tending to their young child, and the sound of prayers being sung throughout the city’s many churches are a tidal wave of information overload. The greatest first impression I am left with, however, is the profound hospitality of the people. Every corner I turn in the hospital, my attending and I are met with formal greetings, respectful handshakes, and deep expressions of gratitude from patients on the wards. Every patient is eager to express their thanks to my āsitemarī, or teacher. I am told from the start by my hosts how important these greetings are, and each doctor I rotate with methodically shakes hands and returns each greeting with an equal measure of respect and intentionality. What I didn’t know at the time is how these formal introductions would open the door to the most important lessons I will learn from my time here.

Abel is one of the doctors I get to work with and learn from during my time on the pediatrics service. Fluent in English, he guides me through patient cases, quizzes me on common presentations, and periodically checks in to make sure I’m not getting too faint from the altitude. He also carves out time in his busy schedule to get to know me and my story over coffee and tea. He shares about his passion for medicine and the people in Ethiopia, and what a privilege it is to be a physician in the horn of Africa. His hours are long, and his pay is low, but he is one of the happiest people I’ve met here. Abel looks at his position not as one of honor and esteem, but as one to be used for the service of others who truly need his help. His caring spirit spills over while caring for patients and additionally a random visiting medical student. Through rotating with Abel and other general practitioners of the hospital, I learn about the downward mobility of the serving physician, and how those in healthcare who humble themselves are truly the greatest.

During my month in Soddo, I worked with an ongoing program that addresses rheumatic heart disease (RHD). Teddy is one of the leaders of the program, and along with the other nurses, he teaches me how to properly screen for mitral regurgitation at a local school in the countryside. Teddy is a jack of all trades at the hospital and pulls 24-hour shifts working on the RHD outreach team and doubling as an OR scrub nurse. During coffee one day he happily shares about how he recently got married, but this means that he moved almost two hours away from the hospital. He stacks his schedule to work a few long shifts a week to minimize the number of trips he must take between home and the hospital, and I wonder out loud how he manages to maintain this schedule. He responds by saying there are times in life when there is much required of us to love the people in our life. He motions around the hospital and says, “Right now this place is like a pencil sharpener, it is hard and uncomfortable, but I know I am turning into a sharper husband, nurse, and follower of Christ.” He teaches me about grit, and how times of difficulty mold us into better caregivers and people if we are up to the task.

One of the most difficult things about my global health rotation was the front frow seat to human suffering. On my first day with the pediatrics team, I see a litany of brain tumors, hydrocephalus, traditional healings gone wrong, multiple cases of measles, and many other vaccine preventable diseases. Dr. Michelle Yates is one of the lead pediatricians at the hospital, and she is no stranger to these types of cases. Having moved with her family from California in 2015, Dr. Yates has spent the better part of the last decade caring for children and their families in every setting. A family physician by training, she serves many roles at the hospital and is the founder of the RHD program I got to work with. One morning while on the wards, she is caring for a sick neonate in the NICU. The baby is stable, but not quite out of the woods and will need careful monitoring for the next few days. After meeting with the nurses about a plan, she is called away to a busy morning at the clinic where the line of expectant patients already stretches out the door. Halfway to the clinic, she stops in her tracks and pauses for a moment, then turns back toward the NICU. As I try to keep up, she says over her shoulder that the family of the sick neonate has had a history of difficult pregnancies. She decides that the family needs more than a quick status report and invites me in to sit with the mother and family as she talks through their concerns. An anxious family crowds around Michelle as she explains in fluent Amharic the baby’s precarious condition. Relief and fear create a potent mix of emotions and it is not long before the mother begins weeping. To my surprise, Dr. Yates kneels to the floor and cries with her. Being a mother herself, she can relate in a way that most doctors in this country can’t, and in that moment, I see a picture of complete care for a patient’s body, mind, and spirit. After a hug and some encouragement, we set out for the clinic once again. I am amazed at how quickly my attending composes herself and prepares for long afternoon seeing countless patients for follow-ups and screenings. In this moment, she teaches me about how even the smallest interruption in your day as a physician can mean a great deal to a patient and their family.

I’m not exactly sure what I was expecting to learn during my time at Soddo Christian Hospital. I came in with ideas and objectives and a desire to contribute something to a hospital in a lower resource setting. What I found was that the best thing I could bring to the table was the disposition of an eager student, and a willingness to learn from the providers who have been at it for years. By happenstance, our last Sunday at the hospital fell on Easter, the holiday in the Christian faith that celebrates Jesus of Nazareth’s death and resurrection. It is a reminder how self-giving love requires sacrifice but turns into renewed life for others. I feel so blessed to have seen healthcare providers walk in the same love that Jesus did, an example of self-giving and self-denying love that cares for body, mind and spirit. I won’t soon forget these lessons from Soddo, nor the example of every āsitemarī that took the time to teach me a thing or two about how to truly serve and care for the least of these.