Hakim

Ethiopian-Trained Orthopedic Surgeon Performs Successful Pelvic Reconstruction in the Management of a Rare Case of Complex Gunshot-Induced Pelvic Fracture in Puntland, Somalia Open reduction and internal fixation (ORIF) of multi-fragment displaced iliac wing fractures with extension to the acetabular wall has been widely described in the management of high-energy pelvic trauma. It has also been utilized in patients with pelvic ring disruptions presenting with pain, deformity, or functional impairment. However, only a limited number of cases have been reported in which complex pelvic fractures from gunshot injuries were managed successfully using open reduction and internal fixation in resource-limited settings. At Arafat International Hospital in Puntland, Somalia, we successfully performed open reduction and internal fixation of a multi-fragment displaced right iliac wing fracture with extension to the anterolateral acetabular wall and an extraperitoneal bullet tract injury. This achievement represents a significant milestone in expanding access to advanced orthopedic trauma care and the management of complex pelvic fractures in this resource-limited region. It offers new hope to patients who previously had few or no treatment options. Case Presentation A 32-year-old man presented to our center on August 29, 2026, after sustaining a gunshot injury to the right pelvis. Immediately following the injury, he developed severe right-sided pelvic pain and was unable to bear weight on the affected limb. On arrival, the patient was in severe pain but hemodynamically stable. His vital signs were as follows: pulse rate 92 beats/min, blood pressure 110/70 mmHg, respiratory rate 20 breaths/min, and oxygen saturation 96% on room air. Physical examination revealed a 1×1 cm entry wound at the right upper lateral abdomen and a 4×3 cm exit wound at the right gluteal region, with an extraperitoneal bullet tract. There was marked tenderness over the right iliac crest and anterior acetabular region, with visible swelling and ecchymosis. Neurological examination demonstrated intact motor power in both lower extremities (5/5). Sensory examination was intact except for mild numbness over the anterior thigh. Distal pulses were palpable and equal bilaterally. Anal tone was normal, and the bulbocavernosus reflex was present. Computed tomography (CT) of the abdominopelvic region demonstrated a comminuted right iliac crest fracture extending to the anterior acetabular wall with an intact articular surface. The bullet tract was extraperitoneal with no evidence of visceral injury. There was no evidence of vascular injury on CT angiography. Initial Management During the first 18 days following admission, management focused on conservative wound care and hemodynamic stabilization. The patient received intravenous antibiotics, analgesia, and deep vein thrombosis (DVT) prophylaxis. Serial wound debridement and dressing changes were performed to prevent infection and promote healing. The patient remained hemodynamically stable throughout this period, and his wound showed progressive signs of granulation and healing. Surgical Management On the 18th day after trauma, the surgical team led by Dr. Sahal Ahmed Mohamud, Consultant Orthopedic and Trauma Surgeon at Arafat International Hospital, performed open reduction and internal fixation (ORIF) of the multi-fragment displaced right iliac wing fracture with extension to the anterolateral acetabular wall through an anterior approach. Excellent reduction of the fracture was achieved using a 3.5 mm reconstruction plate, 3.5 mm cortical screws, and cerclage wire. The procedure was performed under fluoroscopic guidance to ensure accurate reduction and hardware placement. The articular surface was confirmed to be intact intraoperatively, and no intra-articular hardware was placed. The procedure lasted 3.5 hours. The patient tolerated the procedure well without intraoperative complications. Discussion In injuries characterized by multi-fragment displaced iliac wing fractures with extension to the acetabular wall, open reduction and internal fixation through an anterior approach is considered the standard of care to restore pelvic ring stability and prevent long-term functional impairment. However, in resource-limited settings, the availability of specialized orthopedic trauma surgeons, fluoroscopic imaging, and appropriate hardware remains a significant challenge. Conservative management of such fractures may lead to malunion, nonunion, chronic pain, and significant functional disability. In this case, the decision to proceed with ORIF was made after careful consideration of the patient's hemodynamic stability, the absence of visceral or vascular injury, and the presence of an intact articular surface. The anterior approach allowed direct visualization of the fracture fragments and facilitated anatomical reduction without the need for a posterior approach, which carries additional morbidity. The use of a 3.5 mm reconstruction plate, cortical screws, and cerclage wire provided robust fixation and allowed for early mobilization. Fluoroscopic guidance ensured accurate reduction and hardware placement, minimizing the risk of intra-articular penetration. This case demonstrates that complex pelvic fracture fixation can be safely performed in carefully selected patients, even within a resource-limited setting, when appropriate surgical expertise and equipment are available. Conclusion This successful case demonstrates that complex pelvic reconstruction using open reduction and internal fixation can be safely performed in carefully selected patients, even within a resource-limited setting. The procedure provided excellent fracture reduction, stable fixation, and early mobilization while avoiding the additional morbidity associated with conservative management or delayed surgery. This landmark achievement marks the beginning of yet another chapter in the advancement of orthopedic trauma care in Puntland, Somalia. Our sincere appreciation goes to the anesthesia team, operating room staff, intensive care team, and all healthcare professionals at Arafat International Hospital, whose dedication, professionalism, and teamwork made this milestone possible. Dr. Sahal Ahmed Mohamud Consultant Orthopedic and Trauma Surgeon at Arafat International Hospital, Puntland, Somalia #PelvicFracture #OrthopedicSurgery #TraumaCare #ArafatInternationalHospital #Puntland #Somalia #MedicalMilestone #OrthopedicTrauma #SurgicalExcellence #HealthcareAdvancement @HakimEthio

“ዶክተር፣ ለረጅም ጊዜ የራስ ምታት አለብኝ። ከጊዜ በኋላ ወደ ካንሰር እንዳይቀየር እፈራለሁ…” ‎❌ የተሳሳተ ግንዛቤ ‎ ‎“ለረጅም ጊዜ የቆየ ራስ ምታት በጊዜ ሂደት ወደ የአንጎል እጢ ወይም ወደ ሌላ ከባድ በሽታ ሊቀየር ይችላል።” ‎✅ እውነታ ‎ ‎ራስ ምታት ሁሉ አንድ ዓይነት አይደለም። እንደ ማይግሬን (Migraine) እና (Tension-type headache) ያሉ የራስ ምታቶች ለረጅም ጊዜ ሊኖሩ እና በየጊዜው ሊደጋገሙ ይችላሉ። ‎ ‎እነዚህ Primary headache ናቸው። ማለትም ራስ ምታቱ ራሱ ችግሩ ነው፤ እንደ የአንጎል እጢ፣ ኢንፌክሽን ወይም የደም መፍሰስ ያለ ሌላ በሽታ የፈጠረው ምልክት አይደለም። ‎ ‎ስለዚህ ለረጅም ጊዜ የራስ ምታት መኖሩ ብቻ ወደ ካንሰር እየተቀየረ ነው ማለት አይደለም። ‎ ‎ለምሳሌ ማይግሬን ያለው ሰው ማይግሬኑ በየጊዜው ስለሚመለስ የአንጎል እጢ እየተፈጠረበት ነው ማለት አይቻልም። የሁለቱ በሽታዎች ምክንያትና ባህሪ የተለያየ ነው። ‎ ‎ነገር ግን ይህ ማለት አዲስ የሚመጣ ወይም ባህሪው የተቀየረ ራስ ምታትን ችላ ማለት አለብን ማለት አይደለም። ‎ ‎⚠️ ለምሳሌ፣ ከዚህ በፊት ካለው የተለየ አዲስ ራስ ምታት ከጀመረ፣ በድንገት እጅግ ከበረታ፣ በቀን በቀን እየባሰ ከመጣ፣ የማየት ወይም የንግግር ችግር፣ የሰውነት መስነፍ፣ ትኩሳት ወይም የማጅራት ህመም ጋር ከተያያዘ ግን ሌላ ምክንያት መኖሩን ማጣራት ያስፈልጋል። ‎ ‎👉 በአጭሩ፦ ‎ራስ ምታት ለረጅም ጊዜ መኖሩ ብቻ ወደ ካንሰር አይቀየርም። ነገር ግን አዲስ ራስ ምታት ከመጣ ወይም የቆየው ራስ ምታት ባህሪውን ከቀየረ ምክንያቱን እንደገና መመርመር ያስፈልጋል። ‎ ‎#MythVsFact #Headache #Migraine #PrimaryHeadache #PatientEducation #Neurology #InternalMedicine References 1. American Headache Society. Red Flags in Headache—What if it isn’t Migraine? � 2. Kurth T, et al. Headache, migraine and risk of brain tumors in women: prospective cohort study. Cephalalgia. 2015. � 3. PubMed 4. American Headache Society. Overview of Migraine Diagnosis. � Dr. Ermias Nigusie Balcha: MD Internist SPHMMC @HakimEthio

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Strengthening Minimally Invasive Surgery at St. Paul’s Hospital Millennium Medical College (SPHMMC) St. Paul’s Hospital Millennium Medical College (SPHMMC), in collaboration with MIS Africa and HOLA Academy, has successfully conducted a collaborative surgical initiative aimed at advancing minimally invasive surgical services and strengthening local surgical capacity. The initiative featured the participation of international expert Dr. Khaleel Abdulkader A.P., Consultant Laparoscopic Surgeon, specializing in proctology, endovenous laser ablation (EVLA), and podiatry. During the collaboration, several advanced minimally invasive surgical procedures were performed, including: 🔹 Laser proctology: Laser hemorrhoidectomy and laser lateral internal sphincterotomy (LIS), representing a first-of-its-kind initiative in Ethiopia. 🔹 Endovenous laser ablation (EVLA): A minimally invasive treatment for varicose veins. 🔹 Laparoscopic hernia repair: Transabdominal preperitoneal (TAPP) repair. Beyond the procedures performed, this initiative represents an important milestone in advancing modern surgical care at SPHMMC. It provides a valuable platform for knowledge exchange, hands-on learning, and professional collaboration, while laying the foundation for continued training, sustainable capacity building, and future international partnerships. Acknowledgment and Appreciation We would like to express our sincere appreciation to: Dr. Efeson Thomas MD, ECSA Founder and CEO of MIS Africa and an expert in colorectal  and Minimal access GK surgery, for his leadership and commitment to advancing minimally invasive surgery. Mr. Biroj Battakkandy, Founder of HOLLA Academy and the HOLLA Group of Companies, for his valuable contribution to this collaboration. Dr. Khaleel Abdulkader A.P., for sharing his expertise and contributing to this important surgical initiative. Dr. Helina Amare and Dr. Biniam Addis, General Surgeons and former MIS trainee, for their participation and contributions to the initiative. We extend our gratitude to all the teams and partners whose dedication and collaboration made this initiative possible. Together, we look forward to building a stronger foundation for minimally invasive surgery in Ethiopia through continued training, innovation, and international collaboration. #SPHMMC #MISAfrica #HOLA Academy #MinimallyInvasiveSurgery  #CapacityBuilding #InternationalCollaboration Prwpared by Dr. Biniam Addis, Assistant  Professor Surgery  SPHMMC. @HakimEthio

Dr. Seid Mohammed's research project on bone-marrow derived cell therapy for cartilage restoration has been selected for the ISAKOS Excellence in Authorship Program 2026–2027. @HakimEthio

Dr. Hale Teka has received Mekelle University's 2026 Community Service Excellence Award. @HakimEthio

"የስኳር በሽታ ይድናል?" "የስኳር በሽታ ይድናል ወይ?" የሚል በተደጋጋሚ የሚስተዋል ጥያቄ፣ እልባት ይሰጣል ብዬ የማስበውን ላጋራችሁ። የስኳር በሽታ ሊድንም ላይድንም ይችላል። እንዴት? እስከመጨረሻው ብታነቡት በትህትና እጠይቃለሁ። አንድ ሰው በስኳር በሽታ እንዲጠቃ የሚያደርጉ ምክንያቶች 2 ናቸው። አንደኛው ምክንያት ጤናማ ያልሆነ አኗኗር (ይህም ጤናማ ያልሆነ አመጋገብን መከተል፣ አካላዊ እንቅስቃሴ አለማድረግ፣ ውፍረት፣ ወዘተ) ሲሆን፣ ሁለተኛው ደግሞ በዘር የሚተላለፍ የስኳር በሽታ ተጋላጭነት ነው። የነዚህ 2 አጋላጭ ሁኔታዎች በሁሉም የስኳር ታማሚዎች ላይ እኩል ሚና የላቸው። አንዳንድ ታማሚዎች ጤናማ ያልሆነ አኗኗራቸው ስኳር በሽታ እንዲይዛቸው ዋነኛው ምክንያት ይሆናል። ይህ ማለት ግን በቤተሰብ የሚተላለፍ አጋላጭ ሁኔታ ሚናው አነስተኛ ቢሆን እንጂ ሙሉ በሙሉ የለም ማለት አይደለም። ይህ እጋላጭ ሁኔታ ባይኖርማ፣ ውፍረት ያላቸው ሁሉም የስኳር በሽታ ተጠቂ ይሆኑ ነበር። ነገር ግን ከፍተኛ ውፍረት ካላቸው 3 ሰዎች ውስጥ ስኳር በሽታ የሚከሰትበት አንድ ሰው ነው። ልብ ማለት ያለብን ይህን ያነሳሁበት ምክንያት፣ ጤናማ ካልሆነ አኗኗር ውጪ ሌላ አጋላጭ ሁኔታ፣ ማለትም በቤተሰብ የሚተላለፍ አጋላጭነት እንዳለ ለማስረገጥ ነው እንጂ፣ ጤናማ ያልሆነ አኗኗር ለስኳር በሽታ አጋላጭ እንደሆነ መረሳት የለበትም። ይህን ሁኔታ የሚያጠናክርልን ሌላ ማሳያ፣ አንዳንድ ስኳር ያላቸው ታማሚዎች ክብደታቸው ኖርማል ሆኖም (አንዳንዶቹም ከኖርማል ክብደት በታች ሆኖውም)፣ አመጋገባቸውም ተቆጣጥረው፣ አካላዊ እንቅስቃሴም እያደረጉም፣ የስኳር ታማሚ ሆነው መድሃኒት የሚያስፈልጋቸው አሉ። የእነዚህ ታማሚዎች ስኳር በሽታ እንዲከሰትባቸው አስተዋፅኦ ያደረገው በቤተሰብ የሚተላለፍ አጋላጭ ሁኔታ ምክንያት እንጂ፣ ጤናማ ባልሆነ አኗኗር እንዳልሆነ ግልፅ ነው። ይህን መረዳት የሚያስፈልገው ፣ የስኳር በሽታ ህክምናን በተመለከተ የምናስቀምጠው ግብ ምን መሆን እንዳለበት በግልፅ እንድናውቅ ይረዳናል። የህክምናው ግብ መሆን ያለበት እንደሚከተለው ነው። በዋናነት ጤናማ አኗኗር ባለመከተል ስኳር የተከሰተባቸው ታማሚዎች፣ አኗኗራቸውን በማስተካከል (ጤናማ አመጋገብን በመከተል፣ ክብደታቸውን በመቀነስ፣አካላዊ እንቅስቃሴ በማድረግ) የስኳር በሽታው የሚስተካከልበት ሁኔታ አለ። እነዚህ ታማሚዎች ከላይ እንደጠቀስኩት፣ ስኳር በሽታ እንዲከሰትባቸው ያደረገው ዋናው ምክንያት ጤናማ ያልሆነ አኗኗር ስለሆነ ነው። በሌላ በኩል፣ ጤናማ አኗኗር እየተከተሉም የስኳር በሽታ የተከሰተባቸው፣ የስኳር በሽታውን ለማከም መድሃኒት መውሰድ ግድ ይሆንባቸዋል። እነዚህ ታማሚዎች፣ የስኳር በሽታው እንዲከሰትባቸው ያደረገው ዋናው ምክንያት በቤተሰብ የሚተላለፍ አጋላጭነት ስላላቸው ነው። የስኳር በሽታ ሙሉ በሙሉ ይድናል ብሎ በመናገር፣ ስኳር በሽታ ያላቸውን ታማሚዎች ለመዳን ያላቸውን ፍላጎትና ጉጉት የማማለል ተግባር፣ ኢ-ሳይንሳዊና ኢ-ሞራላዊ እንደሆነ መታወቅ አለበት። ሁሉም የስኳር ታማሚዎች የበሽታቸው ሁኔታ አንድ አንዳልሆነና፣ ለአንዱ ታማሚ የሚሰራው ህክምና ለሌላው ላይሰራ እንደሚችል መገንዘብ ያስፈልጋል። የስኳር ታማሚዎችን ትክክለኛ መረጃ ሳይሰጡ፣ ከላይ የጠቀስኳቸውን ሁኔታዎችን ሆን ብሎ የመተው ተግባር፣ የህክምና አገልግሎት በመስጠት ስም የmarketing ወይም ደንበኛን የመሳብ ስራ እንደሆነ መታወቅ አለበት። Dr. Mohamed Abdulkadir: Internist, Cardiologist @HakimEthio

Based on previous experiences, ERMP Registration is expected to be between November and December 2026. Prepare Early with NEUS! What do we have in general at www.neusmedical.com ? 1️⃣ Q Banks National QBanks ✅ ERMP 2019 - 2025 ✅ Medical COC 2023 - 2026 ✅ Medical Exit exam 2024 - 2026 ✅ NGAT/GAT 2020 - 2026 International Q Banks ✅ UWorld USMLE step 1, 2025 ✅ UWorld USMLE step 2 CK, 2025 ✅ Amboss USMLE step 1, 2025 ✅ Amboss USMLE step 2 CK, 2025 ✅ Mehlman USMLE Step 1, 2026 ✅ NBME  Comprehensive Clinical Science for USMLE step 1 (upto form 33) ✅ NBME Comprehensive Clinical Science for USMLE Step 2 CK ( Upto form 16) ✅ NBME - CMS ( Clinical Master Series) To be added Soon ✅ Mehlman USMLE  Step 2 CK ✅ USMLE-Rx – Step 1 ✅ USMLE-Rx – Step 2 CK ✅ PassMedicine USMLE Step 1 ✅ UWorld USMLE Step 1 2026 ✅ UWorld USMLE Step2 CK 2026 ✅ GulfMedicalExams (DHA, DOH, MOH, SMLE, .....) 2️⃣ Lecture Videos 3️⃣ Reading Materials (Book store) 4️⃣ Updated Clinical Guidelines 5️⃣ Updated International Reference Books 6️⃣ Recent Published Medical articles 7️⃣ Many more We have the superwebapp having all in one 🌐 Subscribe here: www.neusmedical.com 📱 Follow us: @Nitsbinteam | @NEUSofficial | @NEUSscholarships 📞 For Support Regarding NEUS: DM t.me/NEUSguide or call 0909111188 Nitsbin (ንጽቢን) =  Book of medicine in Ge'eze Language Medicine is not only a science, But also an art Dr. Mulualem Gashaw Internal Medicine Resident, AAU Founder and CEO of NEUS (Nitsbin PLC) @HakimEthio

Bridging Two Worlds: From Digital Connection to Real-World Impact Over the past nearly five years, I have learned that meaningful change often requires us to work across two different but deeply connected worlds: the physical world, where geography, borders, regulations, resources, and institutions shape what we can do, and the digital world, where ideas, knowledge, and professional relationships can cross borders almost instantly. While the physical world often creates limitations through distance, regulations, bureaucracy, and resource constraints, the digital world provides an unprecedented opportunity to connect people, institutions, expertise, and ideas across geographical boundaries. In the physical world, moving people, equipment, technology, and resources across borders can be challenging. Visas, customs procedures, regulatory requirements, financial limitations, institutional processes, and geographical distance can significantly slow international collaboration, particularly in resource-limited settings. In contrast, the digital world allows knowledge and ideas to travel rapidly through professional networks, academic platforms, medical communities, social media, and other communication channels. A local challenge can therefore become visible to an international community, creating opportunities to connect with people who share similar professional interests, values, and commitment to solving important problems. For me, digital engagement has never been simply about maintaining an online presence. It has been about purposeful networking and identifying people, who share a commitment to improving healthcare, strengthening professional skills, transferring technology, and creating opportunities for communities that need those most. Digital world need strong penetration skill to reach people who share your idea, passion and understand your vision. To expand your idea and reach to your target audience it really needs your commitment, sustainability and consistence. Through this complex process, relationships have developed with surgeons, professors, universities, non-governmental organizations, volunteers, and other professionals from different parts of the world. These connections have gradually developed into practical forms of collaboration, including professional advice, training, equipment support, technology transfer, visiting expert programs, research collaboration, and opportunities for professional development. However, digital connections alone cannot create sustainable impact. The real value comes from transforming digital relationships into action in the physical world. The development of laparoscopic surgery and surgical capacity at Madda Walabu University Goba Referral Hospital over nearly five years is one example of this process. What began in a resource-constrained environment gradually developed through local commitment, international networking, training, technology transfer, equipment support, visiting experts, and collaboration with partners from different countries. These efforts have helped translate global knowledge and professional relationships into practical healthcare services and capacity development for the local community. The journey has not been easy. It has involved complex procedures, institutional requirements, regulatory challenges, logistical difficulties, different interests, limited resources, and many unexpected obstacles. There have been difficult and uncomfortable moments, but having a clear vision, remaining persistent, building relationships, and continuing to work despite challenges have helped transform an idea into practical impact. This experience has reinforced my belief that a clear vision combined with meaningful collaboration can create opportunities even in highly challenging environments. I strongly believe that the digital world can serve as a bridge to the physical world. Digital connectivity can open doors to knowledge, expertise, partnerships, technology, and resources, but sustainable community impact requires bringing these opportunities to the ground through training, technology transfer, institutional collaboration, research, and improved healthcare services. The ultimate purpose of digital networking should therefore not be visibility alone, but the creation of meaningful relationships that lead to measurable and sustainable impact. I sincerely thank everyone who has supported this journey—those who have read, liked, shared, reposted, discussed, encouraged, and supported these ideas. I especially appreciate those who went beyond online engagement and were willing to work with us through difficult and unfamiliar circumstances to create real impact on the ground for communities in need. Every connection, conversation, and collaboration has contributed to building a growing community committed to knowledge exchange, capacity development, and equitable access to training, skills, and technology. I would also like to express my sincere appreciation to Madda Walabu University and  Goba Referral Hospital for real support.. I am also grateful to Ethiopia for opening the door to the digital world and allowing ideas, professional relationships, knowledge, and opportunities from around the world to connect with local needs and priorities. This nearly five-year journey has taught me that building sustainable impact takes time, vision, patience, persistence, collaboration, and the courage to continue even when the path is complex. This journey is not the end, but a foundation for what comes next. By continuing to connect the digital world with the physical world, we can transform relationships into collaboration, collaboration into action, and action into sustainable community impact. What begins as an idea can become a connection, a connection can become collaboration, collaboration can become action, and action can ultimately create meaningful change for communities in need. Dr. Kebebe bekele Associate professor of general surgery in MWU Country director of Skill Bridge initiative President of Rotary club of Goba CPD Committee member of surgical society Kebebeb21@gmail.com @HakimEthio

Bridging Two Worlds: From Digital Connection to Real-World Impact Over the past nearly five years, I have learned that meaningful change often requires us to work across two different but deeply connected worlds: the physical world, where geography, borders, regulations, resources, and institutions shape what we can do, and the digital world, where ideas, knowledge, and professional relationships can cross borders almost instantly. While the physical world often creates limitations through distance, regulations, bureaucracy, and resource constraints, the digital world provides an unprecedented opportunity to connect people, institutions, expertise, and ideas across geographical boundaries. In the physical world, moving people, equipment, technology, and resources across borders can be challenging. Visas, customs procedures, regulatory requirements, financial limitations, institutional processes, and geographical distance can significantly slow international collaboration, particularly in resource-limited settings. In contrast, the digital world allows knowledge and ideas to travel rapidly through professional networks, academic platforms, medical communities, social media, and other communication channels. A local challenge can therefore become visible to an international community, creating opportunities to connect with people who share similar professional interests, values, and commitment to solving important problems. For me, digital engagement has never been simply about maintaining an online presence. It has been about purposeful networking and identifying people, who share a commitment to improving healthcare, strengthening professional skills, transferring technology, and creating opportunities for communities that need those most. Digital world need strong penetration skill to reach people who share your idea, passion and understand your vision. To expand your idea and reach to your target audience it really needs your commitment, sustainability and consistence. Through this complex process, relationships have developed with surgeons, professors, universities, non-governmental organizations, volunteers, and other professionals from different parts of the world. These connections have gradually developed into practical forms of collaboration, including professional advice, training, equipment support, technology transfer, visiting expert programs, research collaboration, and opportunities for professional development. However, digital connections alone cannot create sustainable impact. The real value comes from transforming digital relationships into action in the physical world. The development of laparoscopic surgery and surgical capacity at Madda Walabu University Goba Referral Hospital over nearly five years is one example of this process. What began in a resource-constrained environment gradually developed through local commitment, international networking, training, technology transfer, equipment support, visiting experts, and collaboration with partners from different countries. These efforts have helped translate global knowledge and professional relationships into practical healthcare services and capacity development for the local community. The journey has not been easy. It has involved complex procedures, institutional requirements, regulatory challenges, logistical difficulties, different interests, limited resources, and many unexpected obstacles. There have been difficult and uncomfortable moments, but having a clear vision, remaining persistent, building relationships, and continuing to work despite challenges have helped transform an idea into practical impact. This experience has reinforced my belief that a clear vision combined with meaningful collaboration can create opportunities even in highly challenging environments. I strongly believe that the digital world can serve as a bridge to the physical world. Digital connectivity can open doors to knowledge, expertise, partnerships, technology, and resources, but sustainable community impact requires bringing these opportunities to the ground through training, technology transfer, institutional collaboration, research, and improved healthcare services. The ultimate purpose of digital networking should therefore not be visibility alone, but the creation of meaningful relationships that lead to measurable and sustainable impact. I sincerely thank everyone who has supported this journey—those who have read, liked, shared, reposted, discussed, encouraged, and supported these ideas. I especially appreciate those who went beyond online engagement and were willing to work with us through difficult and unfamiliar circumstances to create real impact on the ground for communities in need. Every connection, conversation, and collaboration has contributed to building a growing community committed to knowledge exchange, capacity development, and equitable access to training, skills, and technology. I would also like to express my sincere appreciation to Madda Walabu University and Goba Referral Hospital for real support.. I am also grateful to Ethiopia for opening the door to the digital world and allowing ideas, professional relationships, knowledge, and opportunities from around the world to connect with local needs and priorities. This nearly five-year journey has taught me that building sustainable impact takes time, vision, patience, persistence, collaboration, and the courage to continue even when the path is complex. This journey is not the end, but a foundation for what comes next. By continuing to connect the digital world with the physical world, we can transform relationships into collaboration, collaboration into action, and action into sustainable community impact. What begins as an idea can become a connection, a connection can become collaboration, collaboration can become action, and action can ultimately create meaningful change for communities in need. Dr. Kebebe bekele Associate professor of general surgery in MWU Country director of Skill Bridge initiative President of Rotary club of Goba CPD Committee member of surgical society Kebebeb21@gmail.com @HakimEthio

What’s New in UpToDate 2026 — Version 4? Explore the latest updates to UpToDate guidelines, featuring new and revised recommendations designed to support you at every stage of your medical journey. 📚🩺 🔐 In our group(4450 members), you can obtain UpToDate 2026 V4.4 account registration. https://t.me/+Of2TGtpBRQ0xNTg0 Additionally, we offer preparation resources for: · USMLE exams — AMBOSS and UWorld 🌍 · National exams — EXIT, EPHPL, ERMP, and NGAT 🎓 Keep learning. Enjoy UpToDate. ✨ Click the link to join! 🔗 https://t.me/+Of2TGtpBRQ0xNTg0 Contact us Telegram: @MDatHewan Phone No:  +251703649896 Hewan Abebe

Is the system being guided by established guidelines or by individuals? Most health facilities administered under district authorities are under the influence of poor governance at the district level. There is no need for much explanation to justify this; the recurring issues we see, such as the denial or withholding of professionals’ benefits and shortages of medicines, reagents, and other supplies, are strong evidence of the problem. A hospital or health center should be managed according to established policies, guidelines, and regulations; not according to the interests or preferences of a particular Woreda administration its executive officials. Guidelines are developed to guide the activities that are actually carried out on the ground; they are not meant to be placed on a shelf merely for formality. Given the problems we are seeing, even when there is no actual budget shortage, health facilities under Woreda administration continue to face difficulties because of problems with allocating the available resources. Instead of directing resources toward services that benefit the wider community on the ground, there are concerns that resources are sometimes diverted toward areas that are more convenient for those controlling them. If there are guidelines and regulations, how can there not be accountability? For example: 1. Medicine procurement: There is a mismatch between the amount of money reportedly allocated for medicine procurement and the amount that actually reaches the health facilities. As a result, our people are facing significant difficulties in accessing the medicines they need. 2. Denial or withholding of health care providers’ benefits: When providers’ benefits are withheld, there seems to be no one who takes action until the issue reaches the media, facilities are forced to close, or professionals can no longer tolerate the situation and leave their jobs. Who gave district authorities unlimited power to act this way? And why is it that when a hospital CEO comes in and tries to enforce these issues and protect the institution, they are sometimes subjected to political pressure, undermined, or removed from their position? Of course, there are also districts that deserve recognition. There are districts that prioritize and promptly pay professionals’ overtime compensation, as though they had brought the money directly from their own tax revenue. Fikadu Thomas (HO, MPH) @HakimEthio

Dr. Kaleab Habtemichael Gebreselassie has been selected by the American College of Surgeons (ACS) as one of the three global surgeons to receive the 2026 ACS National Surgical Quality Improvement Program (ACS-NSQIP) International Award. @HakimEthio

📢 Call for Abstract On October 10, 2026, World Mental Health Day will be celebrated nationally at Eka Kotebe Hospital in collaboration with the Ethiopian Ministry of Health. You are invited to submit your abstract.