As the American Jewish Joint Distribution Committee’s (JDC) medical director in Ethiopia, Dr. Rick Hodes has been responsible for the medical care of tens of thousands of Ethiopian Jews for almost twenty-three years. Today, although his priority is caring for the dwindling number of immigrants to Israel, Hodes works with mostly children from all populations suffering from malaria, tuberculosis, heart disease, diseases of the spine, cancer and major deformities that defy the imagination.
“Right now, I have an eighteen-year old kid with a huge facial deformity recovering from 24-hour surgery in Munich. Another eight-year-old Moslem boy is in Nahariya undergoing reconstructive surgery after having much of his face torn apart by a hyena. A second kid, who was also attacked by a hyena, is recovering from five hours of skin grafting in Addis Ababa. Two days ago, 11 kids returned from Ghana where they underwent spinal surgery. Nine of them were in traction for months. Ten kids are still in Ghana and 16 are about to leave for Ghana for spinal surgery. I’m following nearly 1,200 spine patients, having gotten over 200 new ones this year,” says Dr. Hodes. At the end of the summary of his coming day’s work, he mentions the few thousand people that he is also caring for. And yet, when I set up a time to speak to him, he assures me that he doesn’t have anything on for the day!
Doctor to Thousands
In 1989, when Ethiopia and Israel agreed to restore the diplomatic relations that had been broken off by Ethiopia in 1973, thousands of Ethiopian Jews (aka Beta Israel) flooded to Addis Ababa. A year later, Dr. Hodes, an observant Jew from Long Island, N.Y., was hired by the JDC to be the medical director in Ethiopia and oversee their care. The original six-week contract was to morph into nearly twenty-three years…and Hodes is still counting. “Addis is a long way from Long Island, but I always saw myself as being someone who does things on the fringes,” he says.
Hodes, who holds a degree from the University of Rochester Medical School and trained in internal medicine at Johns Hopkins, has spent time working in Alaska, Albania, Bangladesh, Sudan, Rwanda, Tanzania, and Zaire. In 1985, he went to Ethiopia where he taught for two and a half years at the Addis Ababa University Faculty of Medicine on a Fulbright professorship. In his new position with the JDC, he became responsible for the health of 20,000 Ethiopian immigrants to Israel. “I’ve been the doctor for one percent of Israel before they became Israeli,” he says. But Hodes is no stranger to large numbers. “In Goma, Zaire, I was directing healthcare for 25 percent of the Kibumba refugee camp – that’s 50,000 people,” he says.
During the initial stages of his work in Addis Ababa, Hodes quickly discovered an underlying problem. “When I sat with my patients checking that they were getting the correct medical care and discussing symptoms and illness, I realized that there were a great many more tuberculosis cases than we were addressing,” says Hodes. To treat the hundreds of cases efficiently, Dr. Jack Adler, then medical director of the Bureau of Tuberculosis at the New York City Department of Health, was flown in.
A Full Jewish Heart
Free time is something that Hodes doesn’t have: he uses it to treat patients pro bono. One day at the Black Lion Hospital, Hodes met Bewoket, a twelve-year-old boy weighing 24 kilos with rheumatic heart disease who had traveled alone 300 kms from Gojjam to Addis when his family decided, after several hospitalizations, that the time had come to leave him to die. Hodes changed Bewoket’s medications, followed up on a major medical error and tracked his progress when he was discharged to Mother Teresa’s Mission, a Catholic palliative-care clinic. When Bewoket fell into a depression, Hodes moved him into his home. Then he sent him to America for heart surgery. “Bewoket is now in nursing school and I’m helping a lot of his family as well,” says Hodes.
What started out as Hodes’ personal volunteer mission developed into a JDC non-sectarian program for which Hodes is constantly raising funds. And he continues to treat mission patients weekly; often without X-rays, lab tests or MRIs, Hodes makes diagnoses and provides as much treatment as possible to these severely ill patients. Where hope still flickers, he will arrange testing and treatment at private hospitals. And often he’ll personally pay for the patients’ food and transportation. Hodes’ patients are a worthwhile investment: on a recent trip to Atlanta, he was reunited with a former patient, Mesfin, who now works as a respiratory therapist.
In 1999, Hodes opened his heart even wider. He met two abandoned orphans with tuberculosis of the spine who had ended up at the Catholic mission. One boy had a 90-degree angle in his spine, the other a 120-degree angle. After trying unsuccessfully to arrange free surgery for the boys, Hodes decided that the easiest way to get free medical help would be to adopt them. Then he adopted a third. One son recently graduated with a degree in chemistry and is now applying to pharmacy school. The second has been studying with a rabbi in Israel until the fall when he will start engineering school in Boston. With a wry sense of humor, Hodes notes, “Serial adoption is probably not the answer to spine disease in Africa.”
However, the kernel of a revolutionary idea had sprouted. Many of Hodes’ patients have severe scoliosis or kyphosis (hunchbacks) due to tuberculosis. Surgical intervention is needed to prevent further curvature, chest compression, and early death. Since each procedure costs approximately $18,000 (transportation, the surgery, and post-operation care), treatment remained the stuff that dreams are made of. Then, in 2006, the JDC launched a non-sectarian spine program steered by Hodes together with Dr. Oheneba Boachie-Adjei. Dr Boachie, based in New York, travels to Ghana with an international team several times a year where some of the most deformed children ever to be seen are helped at less than ten percent the cost of American treatment. “Two of the eleven children who returned from surgery in Ghana this July left Addis in wheelchairs and are now walking,” says Hodes. Eight-year-old Tesfau, from Mirabeti, a village 120 miles from Addis Ababa, lived in a home a 12 hour donkey ride from the main road. Injury left him paralyzed until he underwent traction and two surgeries in Ghana. Fourteen-year-old Alazar, who spent six months paralyzed, plans on becoming a heart surgeon now that he can walk—his best friend has a heart problem. To date, well over 200 children have undergone spine surgery.
Ripples in the Pool
In an address at Brandeis University this May, Hodes quoted Mother Teresa who said: “I alone cannot change the world. But I can cast a stone across the waters, to create many ripples.” Making enough ripples to start a tidal wave, Hodes is upgrading medical care in Ethiopia. With more than 70 percent of childhood deaths attributable to communicable diseases and malnutrition, Ethiopia’s healthcare resources have understandably been directed primarily to treat and prevent diseases such as malaria and diarrhea. Most Ethiopians with heart problems, cancer, and tumors never have the chance to seek help. One by one, Hodes is tackling each area and enlisting others to help. “I have no expectations of people,” Hodes confides. “So I’m not disappointed if they don’t help.” However, contact with Hodes brings out the best in people, inspiring them to give of themselves and donate to his projects. Half a smile in his voice, he renounces himself: “I’m a professional beggar.”
In the 1990’s, he introduced the Save a Child’s Heart (SACH) program in Ethiopia. This Israeli-based international humanitarian project provides pediatric cardiac care for children from developing countries, bringing them to the Wolfson Medical Center in Holon.
After treating two boys for bone cancer, Hodes helped American Mary Louise Cohen start a pediatric cancer program at the Black Lion Hospital, which is affiliated with the Addis Ababa University School of Medicine. Visiting radiation oncologist Dr. Jeff Forman from Michigan arrived in Addis with the Sherman Leadership Mission of the Detroit Jewish Federation, and after examining Feleke, an eleven-year-old suffering from Hodgkin’s lymphoma, offered to provide free radiation therapy for the boy. Feleke is now cancer-free and being adopted by his host-family in Michigan. This July, Hodes flew to the States taking a second child to the same oncologist.
As Hodes’ reputation has grown, he has become the address for some of the most horrific cases of disfigurement from facial growths. In stark contrast to a patient in a Western country, who’ll visit his doctor or dentist if he suspects something abnormal, sufferers in Ethiopia have no address to turn to. “There’s a lack of medical care and no expert to deal with these complex problems,” explains Hodes. Try to imagine a twenty-one-year old girl with a jaw tumor the size of a bowling ball, an eighteen-year-old with a tennis ball-sized tumor that diminished eyesight in one eye, clogged one nostril, and caused a chronic, foul-smelling nasal discharge. After undergoing surgery in Munich, these patients can face the world.
When he unexpectedly detected “amazingly botched heart surgery” in a child who came to him with spine disease, Hodes sent him to Denver. The child, Akewak had such an impact on the community that $250,000 was raised for Hodes’ programs. Similarly, when Hodes sent a young man with scoliosis to Vancouver, Jews, Christians and Moslems donated to his work.
Robel Haile, a college student at UC Davis Medical School, who heard Hodes’ graduation speech started Bottles for Poverty. “The program enlists undergraduates who recycle garbage to raise money to build schools in Ethiopia,” says Hodes. The JDC already has over 20 schools in rural Gondar province and several others under construction. With over a hundred girls who have graduated from university thanks to JDC scholarships, investment in education has proven itself worthwhile.
Commenting on his drive, Hodes says, “That’s the way I am. The more you give, the better you get at doing it.”
In Touch with the Divine
Crowded hospitals, lack of medicine, infinite pain: Hodes faces them daily. “You have to be able to tolerate chaos and you have to remain hopeful,” he answers when asked how he copes. Then he adds, “I draw my strength from the God of Israel. And I’m actually happier at the end of the day despite the suffering I see—I know a few people are being taken care of because I went to work,” he says.
Hodes helps to support four homes, with a variety of orphans, patients, and patients’ brothers and sisters living in them. Each of them runs on a Jewish calendar. Friday nights finds the extended family, a variety of cultures and religions, greeting Shabbat with Shalom Aleichem and If I had a Hammer, a song from the early ‘60s that calls for freedom and justice for all people regardless of race.
Hodes’ patients are themselves also a source of strength. “Ethiopians are strong people. They believe in God and see their troubles as a challenge from God,” says Hodes. Indeed, both strength of character and faith shine forth in a hyena mauling case that Hodes recently encountered. Abdulrazak, an eight-year old Moslem boy, was walking to a nearby village when a hyena attacked him. Alewi, his father, was in a nearby field. Hearing the screams, he raced towards them. When he saw the hyena eating his son’s head, he threw himself onto the animal. After five months of treatment at a hospital near the village, Hodes was contacted and reconstructive plastic surgery in Nahariya arranged. Thanking Hodes, Alewi said to him, “Doctor, fetari yekefatot—may the Creator bless you and give you back what you are doing for me – I am not able to.”
In 2007, CNN selected Dr. Hodes as finalist for one of its CNN Heroes in the Championing Children category. In 2008, the American College of Physicians awarded him the rare title of Mastership in recognition of “exceedingly stellar career accomplishments.” He is the subject of a new book, This is a Soul, by Marilyn Berger and a HBO documentary, Making the Crooked Straight. Two more documentaries, Bewoket and Zemene, are currently being produced. But you won’t hear Dr. Hodes talking about these accolades: he’s too busy changing lives – and dreaming big about opening a facility in Addis Ababa that will treat spine deformity and provide heart surgery. Care to be a partner?
Visit Dr. Rick Hodes at his website: www.rickhodes.org
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