CIO Unplugged 5/1/13

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

It’s Not About the Rock: The Remote Village that Turned our Lives Upside Down
(Part 2 of 2)

While the majority of us climbed Kili, five of our team — including my wife and daughter — went to the village and succeeded in making introductions, finalizing plans, and educating. The village elders opened the schools, and the advance team covered critical subjects on the basics: nutrition, health, and universal precautions.

By the time the rest of us arrived, clinic construction was still a few days behind. We would open without water or electricity.

June 22, opening day. Seventeen of 20 senators plus the former Tanzanian Prime Minister attended the incredible ribbon-cutting celebration. Doug and Martha represented our team, and with the Prime Minister, blessed the clinic. Villagers dressed in a vast array of colors, surrounded their new clinic, singing in Maa. This put most of our team in tears; I hid mine behind a camera lens. We were all humbled and a little shocked by the fanfare and how much this meant to the Maasai and their country. Media from all over Tanzania rolled cameras and a major party wrapped up opening day.

Talitha Marx

The following morning, we opened for business. Winjie and Liz had us well organized. We had a doc and medical assistant for each of the four treatment rooms plus another working in the lobby. The triage unit included two assistants and two translators. They started the medical records, took vitals, and prioritized patients. Two women manning the supply room / pharmacy / break room dispensed meds and supplies. The rest of us rotated between crowd control and entertaining all the kids. We played lots of soccer and taught them football and Frisbee.

Our first patient was a young mother who had not felt her baby move in 36 hours. “Oh great,” I heard myself saying. “What if our first two patients die?” What would be the risk to the clinic longevity? Would the villagers turn hostile? Had we lured all these people here to die? Even if the village accepted the deaths, it would cast a dour vibe over our clinic. What an ominous beginning. I prayed, but, as much as I hate to admit it, I was more negative than positive.

While I was getting uptight, the team swung into action. One of our docs happened to be an OB/GYN. Liz also went into our “birthing suite.” She held the mother’s hand and assisted her OB/GYN husband with the delivery.

Outside, it seemed the entire village had gathered as news spread quickly (without FaceBook). Crowds pressed in and my thoughts grew darker as we held the line. I could hear the rest of the team behind me going in and out of the room, but no baby. Someone shouted for one of the other docs, who by coincidence happened to be a neonatologist. When he entered the room, I figured the baby had been born. Unbeknownst to me, our CEO, his wife, and some of our ladies met inside the pharmacy room, held hands, and prayed.

Silence fueled my anxiety. The eager crowd grew antsy. Some had traveled many miles to receive treatment and this incident held things up.

Resuscitation attempts were underway. Lacking requisite equipment, improvisation came into play. A plastic baggie turned into an ambu bag; a shoelace became a clamp. Ten minutes passed. The baby took a breath on her own. The precious infant pinked up, and then … the cry that loosed hope. Those in the birthing room heaved deep sighs and shed tears. That one cry carried a message to all the villagers and (as we found out later) reached the Serengeti, a four-hour drive away.

Open Arms Clinic is a good place!

Baby Elizabeth at birth, with neonatologist Darryl Miao, MD

Isina suffered a second-degree tear. The only suture available was a 5-0 chromic suture, and no needle driver. The OB/GYN found makeshift suture scissors and sewed up the tear. All this time, Liz had been consoling Isina, acting as her birthing coach. She had built a bond with this first-time mother. Toward the end, Isina asked her name, and she replied, “Elizabeth Ransom.” While the physicians are working, Isina announced, “I am naming my baby Elizabeth.” 

Everyone in the room broke out in tears. Nine months prior, Elizabeth Ransom had been the doctor who originally suggested we set up a clinic. Coincidence?

Talitha Marx at TEDxKids

We learned many things in June 2011. A few universal leadership gems include:

THR CEO Doug Hawthorne and UNTHSC  CEO Scott Ransom, MD

• Leaders serve. We saw this over and over again, but perhaps nowhere as poignantly as when we caught the Texas Health CEO and UNTHSC CEO kneeling and wiping up urine from an exam room floor. This was not posed.
• Want what you have because you may not have what you want. We had sparse equipment and facilities. But compared to the locals, we were blessed. Had we focused on what we did not have, our time would have been miserable and full of complaint. Rather we learned to accept the circumstances and did what we could. That is where joy came.
• Influence knows no boundaries. My then 17-year-old daughter Talitha was the bridge between the villagers and our team. From the mouth of babes. Don’t ever tell me title or experience matters. This video above tells the story from her perspective via TEDxKids.
• Innovation. Our clinical improvisation saved lives and healed wounds. Always think outside of the box. When the right tools don’t exist, make them.
• Rewards beyond the vision. We came prepared for any opportunity. While Open Arms Clinic was our mission focus, the team was ready for anything. When the elders realized we could teach the village about universal precautions and nutrition, school was called back in session.

Baby Elizabeth at age 20 months, two months ago

The Open Arms Clinic continues to serve the village today. An African physician and nurse run the operation. Residents from UTSW will begin rotations there in 2014. The government continues to honor its commitment of service. Several from our team continue to offer in-kind support.

We took care of 350-plus patients and witnessed various other miracles that week. We went to climb a mountain, but found our trip wasn’t about Kilimanjaro. While we impacted a village of 10,000 in a remote part of the world, that village turned our own world upside down. We came back changed, transformed, as the villagers were. We grew as leaders. As friends. As individuals. We found ourselves. We deepened our faith. Our lives will never be the same. It’s not about the rock.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.