Rick placed the stethoscope at various places on the boy's lungs, listened intently, and then looked up at me over his glasses. "Marilyn," Rick said gently, "you've just saved a life."
If I was smitten before, now I was in love.
Had Danny gone untreated, which was practically guaranteed if he stayed on the street, his condition would have become critical. What he was suffering from, tuberculosis of the spine, would have caused him to become even more misshapen and crippled, like many of Rick's patients, and he would have been in ever-increasing pain. Within two years, Rick said, Danny's spine would collapse, damaging the spinal cord and causing paralysis. Lung function would slowly decrease and an excruciating death would follow.
Rick noticed that the boy was breathing very rapidly. "It's really important that we take care of him," he said. "If you're paralyzed in Ethiopia, and you can't move, you can't beg, and if you can't beg, you can't eat."
Rick got a kick out of my correct walk-by diagnosis of Danny's problem, which I was able to do from having observed him in the clinic. "Here one week and you've become a specialist in a disease few doctors in America have ever seen!" This kind of tuberculosis—spinal spondylitis—is virtually unknown in the United States, and doctors who come to Ethiopia are at a loss to diagnose it.
Danny is one of the thousands in Ethiopia who suffer from diseases such as spinal TB or severe scoliosis. Some conditions are caused by birth defects; others, from severe malnutrition, infection, and lack of medical care. It is not rare to see these people on the street, their backs seriously distorted, some of them so crippled they can barely walk.
Ethiopia, once known as Abyssinia, is one of the world's oldest countries and a cradle of the human race, containing humanity's most ancient traces. It is rich in history and has more UNESCO world heritage sites than any other country. But in everything else, it is the poorest country in Africa but one, subject to periodic drought with all sorts of distribution problems. Medical care was hardly a priority under the famed Haile Selassie—certainly not for ordinary people—and it did not become a priority under the successive Communist government or the one after that. Today the country has fewer than three physicians for every forty-five thousand inhabitants, but most of them are not in the public health service. Just one of many discouraging medical statistics illustrates how serious the doctor shortage is: 119 out of 1,000 babies die before they are five years old. Rick says there are more Ethiopian doctors in the Washington, D.C., area than in their entire homeland. That is why the diseases Rick sees have reached almost untreatable levels by the time patients get to him.
Upon completing Danny's physical exam, Rick asked Yeshetilla, who was an old hand at navigating the medical system after caring for his brother, to take Danny for x-rays and blood tests the following day. Rick gave Yeshetilla money to buy dinner for the two of them and sent Danny back to the neighborhood where we found him. I was surprised that Rick didn't arrange for Danny to stay in a safe place right away, but he explained, "I don't feel it's right to grab a kid off the street precipitously, just like that."