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In which John discusses his visit to the Yekatit 12 hospital's NICU in Addis Ababa, Ethiopia, and the extraordinary neonatologist there, Dr. Mulualem Gessesse, who has saved the lives of thousands of children.

Kangaroo Mother Care is made possible at Yekatit 12 in part by Save the Children: http://savethechildren.org

The Gates Foundation, which does so much important work around the world including Ethiopia: http://www.gatesfoundation.org/
John: Good morning Hank, it's Tuesday. I landed in Addis Ababa after a thirty hour journey, met up with Bridget from the Gates Foundation, and drove into the city where I got some desperately needed and delicious Ethiopian coffee, shopped for a bit at a local market to get Henry this Ethiopia soccer jersey, and then went to visit Yekatit 12 Hospital. 

Hank, Ethiopia is one of the poorest countries in the world. Most people live without electricity or running water, most fields are tilled by animal-drawn wooden plows, and the shortage of basic services can be overwhelming.

For example, the smallest hospital in my hometown of Indianapolis has eight neonatologists. In Ethiopia, a nation of ninety million people, there are seven. One of the first was Doctor Mulualem Gessesse.

So, to get to the Yekatit 12 neonatal intensive care unit, you walk on plywood over standing water that smells of sewage. And then, up the stairs to the NICU.

Doctor Gessesse and her nurses have to be very inventive. For instance, they use the oxygen tanks, that you see here, combined with tubing and water to create a kind of C-Pap machine that keeps premature babies' lungs inflated. They don't have respirators or real C-Pap machines, which Doctor Gessesse cites as among her many critical needs. 

But still, she's been very successful. In the past few years, her ward has gone from treating a couple hundred babies per year to more than two thousand. 

This little girl had to stay in the dark while being treated.

Dr Gessesse: We suspect tetanus because she has spasms.

I asked Doctor Gessesse several times about her choice of specialty.

Dr Gessesse: So that we continue 24 hours.

John: [speaking to Dr. Gessesse] So why do you choose to do this then?

Eventually she answered me.

Dr. Gessesse: My concern is for the Ethiopian newborns. 

John: Hank, twenty years ago, more than fifteen percent of children who were born in Ethiopia died before the age of five.
Today, it's less than seven percent. Child mortality is falling faster in Ethiopia than in the world overall, and it's much lower than it is in far richer countries.

How has this happened? Well, I'm obviously no expert, but one, Ethiopia is serious about health, and two, organizations like the Gates foundation and Save the Children are helping Ethiopians execute an Ethiopian health strategy rather than trying to impose a strategy upon them.

Like, take Kangaroo Mother Care. When preterm babies are well enough, they live in the hospital for weeks or months with their moms, getting constant skin-to-skin contact. The babies and moms are together in the hospital 24/7, and studies have shown that this leads to better brain development, lower infection rates, and better weight gain.

It's cheap, it works, and when you make a small investment in these babies' lives now, they have a far better chance of growing up to have healthy and productive adulthoods.

But Dr. Gessesse also told me stories of failed outreach, as when a dozen C-Paps arrived from a charity, all of them adult-sized, and  none of them of use to her. We have to listen to each other.

Hank, I've found humans to be extraordinarily generous within their social networks, like think of how quickly we support friends and colleagues in need. But lack of access to like, Tumblr and YouTube makes most people living in absolute poverty totally voiceless in our online world, and inevitably we begin to imagine their problems as others, as things that don't happen to us.

If OUR kids were dying of malaria and diarrhea, if dozens of OUR babies were dying for every one that gets access to a jerry-rigged C-Pap machine, we wouldn't stand for it! But the thing is, these ARE our kids. OUR world is also VERY LITERALLY their world.

Oh, and I did get to hang out with Bill Gates who is brilliant, and I overcame my tremendous fear of heights to fly in a helicopter with him, and I will talk about all that stuff in the coming weeks. But for now let us just pause to be grateful to Dr. Gessesse, who has quietly and unassumingly saved the lives of thousands of babies. Our babies.

As she told me, I have many children.  Only two biological, but many children. Hank, I'll see you on Friday.