Crisis Management:

How one ECU professor is working to alleviate the health care crisis in his native land.

Eneriko Omoding’s thyroid gland was swollen into a goiter the size of a large gourd. It protruded uncomfortably from the base of his neck, and extended internally into his chest. He could no longer sleep on his back at night for fear that its weight would suffocate him while he slept. He could not swallow without great difficulty. A farmer, he could no longer work in his fields and provide for his wife and four children. He had been told that the goiter was likely to continue to grow, and he knew that without help he would eventually be unable to eat. Then he would slowly waste away until he died.

It is hard to accept that a thyroid goiter can essentially amount to a death sentence in some areas of the world. Most thyroid goiters are caused by iodine deficiency, and they are practically nonexistent in places where table salt is supplemented with iodine. When goiters do develop, they can be treated and cured. But in Omoding’s home of rural Uganda, the complete lack of health care allows seemingly benign medical conditions to become life-threatening.

Like many sub-Saharan African nations, Uganda toils in poverty and most of its citizens suffer under the burden of poor health. Malnutrition, contaminated water, and tropical diseases—especially malaria—are devastating. In Kadami village, where Omoding lives, there is simply no health care of any kind.

Dr. Sylvester Odeke, assistant professor of endocrinology at the Brody School of Medicine at East Carolina University, is a native of Kadami. He returns home once a year to visit family and friends, and while he is there he does what he can to help. On one such trip, Omoding came to him for help.

People began lining up before dawn to see the visiting ECU doctors in 2006.

It was immediately apparent to Odeke that Omoding needed surgery to remove the goiter, and that the tissue should also be analyzed for cancer. And in Kadami, to get that, he’d need a miracle.

The people of Kadami are in the midst of a health care crisis. The existing medical facilities are distant and poorly supplied. One

is a dilapidated missionary clinic located 16 miles from Kadami. The other is a government clinic that is twice as far away, and so old that it was originally built as a leprosy hospital by Dutch colonists. The predominant mode of transportation in Kadami is by foot or by bicycle, and at those distances, the clinics are simply too far.

For pregnant women, there are no antenatal services and no hygienic birthing facilities available. The mortality rates for infants and children in the region are high. More than one in 10 infants die at birth, and fewer than 80 percent of children live to see their fifth birthday.

When Odeke was a young man, he promised himself that someday he would do something to help his people.

“When I finished medical school, there was this burden in my heart,” said Odeke. “Looking at the need in the area—the poverty, the distance that people have to travel to [receive care], the significantly high mortality rates of women who give birth in the village under very unsanitary conditions, the very high mortality rate among young children—I knew I needed to get a health facility there.”

He knew that what his village needed was a hospital. Not just another small clinic, but a real, modern hospital that could become the primary care facility for more than 100,000 people in the region. A hospital could offer care to the sick and injured, but it could also administer public health solutions through immunization programs and other preventative services that currently do not exist.

Odeke’s vision of what he wanted to do was clear, and his passion to do it was strong, but he had no idea how to begin. He never told anyone of his desire to build a hospital. A devout Christian, he simply prayed that somehow he would find a way to make it happen. In 2002, he received the answer he was waiting for.