1. Private Orthopedic service Yordanos Higher Clinic 1997-2007 Yordanos Hospital 2007-2015

2. Worku Mekonnen, MSMI-1984 AAU,Orth.,1994 FCSorth(ECSA), YHC,1997 YH, 2007

3. Real Life Experience Huge Extent of trauma and orthopedic problems in Ethiopia. Huge Extent of trauma and orthopedic problems in Ethiopia. Specialized service just started Specialized service just started Experience in the establishment of private orthopedic service, a big challenge. Experience in the establishment of private orthopedic service, a big challenge.

4. 1. The start and progress of trauma and orthopedic service was a very difficult task being a pioneer in the private sector 2. Customers’ confidence started to build slowly on the services delivered.

5. YHC Established in 1998 Established in 1998 Yordanos Higher Clinic

6. 1. Starting was tough. Reasons: Reasons: i. Limited resources: FinanceFinance Equipments, instruments, implantsEquipments, instruments, implants FacilitiesFacilities ProfessionalsProfessionals ii. Lack of experience iii. One specialist covering 24 hours a day, seven days a week, all year round

7. Building confidence iv. Winning patients minds and hearts Love your jobLove your job Serious concern for every case Serious concern for every case Trying to implement all the best of your knowledge Trying to implement all the best of your knowledge Having up-to-date information Having up-to-date information Improvising methods Improvising methods Money should not be of primary concernMoney should not be of primary concern EnduranceEndurance Self-reliance Self-reliance On spot decision making On spot decision making Confidence on tackling problems Confidence on tackling problems

8. YHC, activities YHC-opd- >60 pts/dYHC-opd- >60 pts/d upto 10 beds upto 10 beds Mostly closed manipulations, tractionsMostly closed manipulations, tractions Surgeries were also doneSurgeries were also done General Surgeons,Internists, pathologists, ENT, ophthalmologists, radiologists,General Surgeons,Internists, pathologists, ENT, ophthalmologists, radiologists, Night duties have been covered by GP’s and Orthopaedic residents*Night duties have been covered by GP’s and Orthopaedic residents*

9. Yordanos Hospital

10. YH Hospital-57 beds Over 150 permanent workers Over 25 part-time workers OPD > 100 pts, new & repeat seen every day

12. Yordanos Hospital Inauguration, 2007

13. Yordanos Hospital Role of different consultants and contacts in the growth and development of our orthopaedic service:Role of different consultants and contacts in the growth and development of our orthopaedic service: Dr. Ralph Wolf Dr. Ralph Wolf Prof.GW Prof.GW Prof. J. Hauert and Clinic Dr. Guth of Hamburg, Germany. Prof. J. Hauert and Clinic Dr. Guth of Hamburg, Germany. Prof Wolter of Hamburg Emergency Hospital Dr. Paul Baxt Dr. Paul Baxt

14. Yordanos Hospital Last 21 months Did THR’s Did THR’s Did Hemiarthroplasties Did Hemiarthroplasties Interlocking Nails Interlocking Nails Arthroscopic surgeries Arthroscopic surgeries

17. Hemiarthroplasty

18. Interlocking nails

19. Hemiarthroplasty Austin Moore Austin Moore

20. DHS, Angle Plates DHS, Angle Plates

21. Fixation of Femoral neck fractures Screws Screws

22. Covered most orthopedic problems(>50/d) Covered most orthopedic problems(>50/d)

23. RTA- Third degree Rt. Leg Injury

24. Emergency Procedures

25. After Treatment

27. Arthroscopies

28. Short Term plan Involve Experienced orthopedic surgeons Involve Experienced orthopedic surgeons Improvise diagnostic facilities Improvise diagnostic facilities Site Expansion Site Expansion

29. Short term plans(cont.) Reorganize and intensify the quality of emergency service 1.Training paramedics 2. Assigning emergency doctors 3. Arranging fully equipped Ambulances 4.Triaging on the site of scene, ABC’s on the Go

30. Expand Trauma and Ortho. Services(cont.) Closed manipulations( use C- Arm) ORIF’s(implants, such as ILN,DHS,Angle plates,Locking plates,etc. TKR’s, SR’s, scoliosis surgery, Neurosurgery

31. Expand Trauma and Ortho. services THR’s TKR Hemiarthroplasties Arthroscopies Correction of deformities of extremities: Diff. surgical procedures External Fixators Ellizarov’s apparatus Hexapods

32. Summary Important points to remember Important points to remember RTA becoming the No.1 problem in Ethiopia. Machine injuries Well organized emergency service needed. Well equipped, facilitated and staffed orthopedic center is required.