My Reflection, Jake Hall, MD: A Resident's Experience on Ethiopian Global Health Elective

In February 2025, during my final year of orthopaedic surgery residency, I had the opportunity to participate in a Global Health elective at Soddo Christian Hospital in southern Ethiopia under the supervision of one of my attending surgeons and mentors, Dr. JC Neilson. During this rotation, I further developed my skills in complex hip arthroplasty, forged strong connections with our Ethiopian colleagues, and gained a deep appreciation for a culture that was largely unfamiliar to me beforehand.

The spirit of the rotation is best captured in a single half day toward the end of our time in Soddo. After a lunch filled with laughter and storytelling over traditional Ethiopian injera, tibs, and coffee, I headed to the OR to perform a complex primary hip replacement alongside Dr. Neilson, Dr. Temesgen (a staff surgeon at the hospital), and Ibsa (the chief orthopaedic resident at SCH and my direct peer). We were treating a 23-year-old woman with a history of tuberculosis in the hip, which had resulted in complete fusion of the joint through a rare process called ankylosis – a complication that, as I learned, can occur with untreated TB in endemic regions like southern Ethiopia.

The case was both challenging and immensely rewarding. Hip replacement can be complex even under typical circumstances, and in this patient, the previous infection had distorted the anatomy significantly. This made both the initial dissection and the implantation tedious and difficult. Good communication was essential, and we each took turns dissecting, discussing, and sharing our strategies. Despite the many technical challenges, we worked steadily, exchanging ideas and jokes along the way (both Ibsa and Temesgen, despite English not being their first language, have a remarkable command of sarcasm and deadpan humor). After three long hours, we had successfully placed a well-aligned total hip replacement, confirmed by imaging and intraoperative assessment.

Later that evening, we joined SCH residents for a few hours of pickleball, followed by a traditional Ethiopian dinner at the home of Dr. Tadesse, another attending surgeon at the hospital. Dr. Neilson and I deeply enjoyed the rich and flavorful dishes, traditionally eaten by hand, and our Ethiopian hosts ensured we experienced everything authentically. I enjoyed the food so much over my elective that I’ve since visited two Ethiopian restaurants back home in Milwaukee.

The next morning during rounds, we turned the corner of the hallway and were met by the smiling face of our 23-year-old patient, gleefully scooting down the hallway with a walker – delighted that her hip could finally move again.

Throughout the rotation, we tackled many such cases – addressing complex pathology through team-based approaches, often with multiple surgeons scrubbed in. This format dramatically enhanced my technical skill, intraoperative communication, and overall surgical judgment. By the end of the experience, I felt significantly more confident in managing complex primary and revision hip arthroplasty cases – a great foundation as I prepare to begin fellowship training in adult reconstruction next year.

Equally impactful was the opportunity to experience a new part of the world, enjoy a beautiful culture, and form meaningful friendships with my orthopaedic colleagues at Soddo Christian. While I wasn’t sure what to expect upon arrival, I left with a strong desire to return after fellowship. As my skills continue to evolve, I hope to return and contribute meaningfully to challenging arthroplasty cases at SCH, which serves as a tertiary referral center for multiple countries in the Horn of Africa. Dr. Neilson and other Milwaukee-area surgeons contribute to the Soddo team by assisting in difficult cases and supporting the education of local providers, and I would be honored to join this group in the future.

This was an exceptional educational and personal experience – an ideal capstone to residency. I am deeply grateful to the MCW Department of Orthopaedic Surgery for the opportunity to participate in this remarkable elective.