Wednesday, July 16, 2025
Fares Medium Clinic
Day 3 of (W)HOLE's Ethiopian Immersion 2025
The best way to start your day is with coffee. But not the brown water that is "coffee" in the US. It must be Ethiopian coffee, from the birthplace of coffee. I had the privilege of starting every day with this beautiful nectar, direct from God. And most afternoons, we had coffee as well. You could say I was very spoiled while on this immersion adventure.
After breakfast we went for a tour of Fares Medium Clinic. This was Lynne's first time seeing it in person. Even though I have seen it many times before, there is always something new to view. The front has an updated sign along with some new greenery.
The clinic has experienced a multitude of phases. When Kevin and I were getting to know the Zebene family this entire space was their home. They rented out a back section to another family. The front housed their family (of then) six. When Dr. Hiwot and Zebene opened the clinic they used half of the space for their family and the other half to treat patients. Eventually the clinic became so prominant in the Bole area, they sold their one vehicle in order to purchase land for a home. The entirty of this space was then dedicated to Fares Medium Clinic. Each time I see it they've rearranged or updated various spaces. In addition, there are some big dreams to come. Be patient, more on that in a later post.
Through the doors of the entrace you'll find the waiting/reception room. They have comfortable couches, a desk for the receptionist, healthcare information posted, and a space for making coffee. You can guess which spot I sit when I'm in this space! (As close as I can be to the making of coffee.) Through a doorway on the left is a long open air hallway. The doctor's office and exam room is behind the wooden door shone in the picture below.
Both Dr. Hiwot and Dr. Hannah share this office, which is also an exam room. The doctor's desk sits to one side with multiple chairs accommodating a couple of family members in addition to the patient. To the right in this picture is the ultrasound machine that was donated to the clinic through the generosity of Redeemer Lutheran Church Family in Columbia, along with other supporters.
The clinic has seen significant use with this machine. In Ethiopia, most clinics of this size do not offer ultrasounds. Pregnant patients receive higher quality prenatal care. In addition, the doctors have the opportunity to treat patients with other issues that an ultrasound can reveal.
The lab is equipped with microscopes, a hematology machine, centrifuges, and many other items that I don't know the names. The two lab techs take shifts and run tests immediately as the doctors order them. The hematology machine was brought over in 2021. Two new centrifuges came with us this year. The hope is to be able to take a urinalysis machine with our immersion trip in July 2026.
The emergency room, used for immediate needs such as IV fluids and monitoring, is in the back of the clinic at the end of the long, open-air hallway. While our immersion team was around the clinic, a woman came in presenting with dehydration. Two family members had brought her over an hour and a half to this clinic, specifically. She had previously lived close to Fares Medium Clinic in the Bole Area of Addis Ababa. Since moving, she still sees Dr. Hiwot for her healthcare needs. The caring, compassionate, holistic care that both doctors provide means that much to their patients.
Next to the emergency room is the nurses' station. There is a partial wall between these rooms for nurses to monitor the patients. In this room, Nurse Lemlem (pictured below) and the other nurses have space to administer injections, check a patient's vital signs, and provide other nursing care.
Continuing through rooms that are still in the back of the clinic building, we have the small procedure room. Circumcisions, stitches, and other minor medical procedures happen in this space. There are three procedure tables, a privacy curtain, a supply cabinet, an instrument cart, and plenty of light in this room.
This outdoor hallway connects all of the rooms together. It is not covered by a roof at this time. Even though it is the rainy season, drainage is not a problem. Seating in this area provides a place for patients to wait while lab tests are performed. In the picture below is a view of the hallway from the back of this clinic, looking toward the front. The iron gate you see ahead is another door that leads to the street running in front of the building.
The view in the picture below shows the doors to the procedure room, behind Bill. Behind Lynne is the entrance to the nursing station. Next to Bill is their washing machine. Scrubs, bedding, and other washables are hung to dry. In the far left of the picture is a partial view of the incinerator. They dispose of various hazardous materials themselves.
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Moving toward the front of the clinic is the sanitizing room. The back table holds a bucket of bleach, water, and another sanitizing liquid. A pressure cooker-style machine sits on the table on the left. This primary method of sterilization will soon need to be replaced. What the picture doesn't show is the hole in the ceiling. A round hole... about the size of the pressure cooker lid. This might be taking the non-profit's name, (W)HOLE in the Roof, a bit too far!
Toward the front of the compound, there is a men's and women's toilet along with a shared sink. Yes, both restrooms have a squat toilet. If you're not familiar, YouTube can help you out, or ask me in person. I can't bring myself to type out those directions here. The door on the right side of the picture leads to the street in front of the clinic.
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After the tour of Fares Medium Clinic, Dr. Hannah took some time explaining how they keep patient records. Three different ways ensure that the patient's medical needs are recorded. Below, Dr. Hannah and I are looking over the registration book. They use this to record the clinic activities of the day. Each patient is signed in with their basic information, a diagnosis, and a treatment plan.
Fares Clinic also keeps files sorted alphabetically with more detailed information about the patients they see, the diagnoses, and the treatments they provide. And hey, there happens to be a fabulous picture of the founders of (W)HOLE in the Roof and the founders of Fares Medium Clinic! Amanda Burke, Zebene Shewakana, Kevin Burke, and Dr. Hiwot Zeleke (2021)
The third way that the clinic keeps records is through a charting application on their laptop. In the US, it is reasonable to keep all records with technology. However, in Ethiopia, the electricity is not always reliable. During the immersion team's time there, the clinic lost power for a solid day and a half. In order to continue treating as many patients as possible, the medical records must be kept on hard copy as well.
This is the view down the side street of the clinic. Children play ball, mothers walk up to reach the little shop up ahead, and worship songs echo from the church next door. This clinic is a central fixture in this particular community. Just sit on the porch for a bit. You'll see it in each person who walks by.
If you've read this far down... thank you! So much information!
Connect with Fares Medium Clinic through Facebook
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