Otolaryngology – Head and Neck Surgery resident to improve global surgery care in Ethiopia

Photo of Dr. Joshua Wiedermann in the operating room wearing a green mask.

By Max Martin, MA'19

In Addis Ababa, Ethiopia, an 11-year-old girl lived her entire life hiding behind a scarf. A form of curable cancer had caused a gigantic mass to grow on her face, leaving her disfigured. So, she chose to hide, waiting for what she assumed would be death.

But Dr. Joshua Wiedermann had different plans.

The otolaryngologist found the young girl while visiting the capital city. He convinced her family to bring her to a hospital in Mekelle, Ethiopia, where he was working as an otolaryngology surgeon and teaching residents.

He performed a procedure – one unknown to the surgeons there – and removed the tumour.

“It’s an example of how no one would tackle this surgery in Ethiopia because they haven’t even seen this procedure before, but it is entirely reproducible there,” Dr. Wiedermann explained.

Now, Schulich Medicine & Dentistry residents are learning from Dr. Wiedermann’s experiences, and one resident will travel to Ethiopia alongside him in the new year for a global surgery rotation.

Dr. Wiedermann is currently a Fellow at Schulich Medicine & Dentistry and working at London Health Sciences Centre on a locum in paediatric otolaryngology. He had been in Ethiopia since June 2018, creating a sustainable residency program at Mekelle University’s hospital.

“It was by far the most meaningful experience I’ve ever done in my entire life,” said Dr. Wiedermann.

“It was by far the most meaningful experience I’ve ever done in my entire life.” Dr. Joshua Wiedermann

When he arrived in London in October, he shared his experiences with Dr. Kevin Fung, Chair/Chief, Department of Otolaryngology, who was quick to see the opportunity for a global surgery rotation when Dr. Wiedermann returns to Ethiopia in January.

Dr. Hannah Ernst, PGY3, will be the learner that takes part in this educational opportunity. For the Medicine Class of 2017 graduate, the trip will provide a valuable experience that will enhance her education and support her global surgery career goals.

“I’m hoping to see interesting pathology, continue to learn surgical techniques and see both through the lens of an under-resourced area,” said Dr. Ernst. “A unique and valuable component of this experience that I’m also looking forward to is simply seeing what it looks like, on the ground, to partner with international institutions in an effort to build up training and health care infrastructure. What resources, leadership and collaboration are needed? That’s something that I hope to incorporate into my future career, and this will provide me with real world insights from a successful undertaking.”

She also says understanding different cultural practices will be an eye-opening experience.

“Your head is very personal area of the body and culture plays an important role in what kind of surgery you might offer,” Dr. Ernst explained. “You may not be able to offer the same surgery that we have here, so what do alternatives look like? What are some ethical implications? Are there gaps of care that we can bridge? That’s something I have limited exposure to right now.”

She’ll also join Dr. Wiedermann in performing additional reconstructive surgery on the young girl from Addis Ababa.

However, the learning will be a two-way street, with Dr. Ernst teaching junior residents at the hospital.

“Hannah might be younger than some of the practitioners there, but she will have more surgical experience than most of the people in Ethiopia,” explained Dr. Wiedermann, adding that the surgical residents in Ethiopia are extremely smart and skilled, but simply don’t have access to the same medical education that is available in Western countries.

His long-term goal is to create a self-sustaining education program in Ethiopia that includes other departments to ultimately raise the overall quality of care at the hospital.

“It’s my duty as a physician, if I have the means and the willpower to spread this knowledge to areas that are most in need, I see this as a quintessential aspect of being a physician,” Dr. Wiedermann said.

Dr. Wiedermann spoke about his experience in Ethiopia with all of the School's otolaryngology residents during the department’s Grand Rounds lecture series.

For Dr. Ernst, the talk only made her more excited for the rotation abroad. She became interested in pursuing global surgery after the release of The Lancet Commission on Global Surgery in 2015. The landmark report characterized the global surgical needs crisis and showed more than five billion people around the world don’t have access to safe, affordable surgical and anaesthesia care.

“If you can do something, you should do something about it,” Dr. Ernst said. “We have such a gift of education and opportunity here in Canada, it’s almost a crime to not share that with other parts of the world – they are so hardworking, enthusiastic and eager but just lack the same opportunities we do. What an exciting thing to be able cultivate global partners and together, create a better future for patients everywhere.”

She’s actively involved in advancing global surgery knowledge at Schulich Medicine & Dentistry, founding the Global Surgery and Perioperative Care Journal Club, an interdepartmental club with the Department of Surgery, Anaesthesia and Perioperative Medicine, and Obstetrics and Gynaecology. During meetings, staff and trainees of all levels discuss ongoing international initiatives at Western University, and relevant global surgery literature.

The upcoming global surgery rotation in Ethiopia is the perfect opportunity for Dr. Ernst, as she continues to work toward her global surgery goals while helping those most in need.

“Honestly, I just want to change the world. I want to marry all my passions of surgery and helping marginalized populations. There’s so much to be done and it’s the most exciting thing to be a part of what’s going on globally to address these needs,” she said.