I speak about failure quite a bit in this forum. My last three posts were dedicated to unique aspects of failing. I see failure as essential to growth, for what we learn after committing mistakes writes textbooks.
However, the failure that I have now experienced in Addis Ababa, the capital of Ethiopia is one that has no learning points. This is a catastrophic failure of Ethio-American bureaucracy. Following months of incredibly hard work, research, fund-raising and endless paperwork, it regrets me to say that ALL FOUR residents have been denied the opportunity to present their research at our most prestigious ENT meeting in Austin, Texas in May. The denial came from the red-inked stained fingers of agents in the United States Embassy in Ethiopia. They were denied a simple two-week US tourist Visa.
Although I know all the details of what occurred, I still can’t understand how 4 ambitious, hardworking, extremely intelligent, patriotic, selfless Ethiopian physicians were denied the opportunity to participate in the educational experience of a lifetime.
Before I even arrived in Ethiopia, it was my hard-fast mission to get some of the residents to a meeting in the US. Seeing the leaders in our field and learning from them would be an educational experience of a lifetime. But, going to the meeting wasn’t enough for me, I wanted them to present their research there. An amazing opportunity for me when I was a medical student and resident, but the possibility for one of our Ethiopian residents would be unheard of.
The 3rd year residents (year 2 at the time) and I submitted research abstracts to one of the most prestigious meetings in otolaryngology. Amazingly, 3 of the subjects were selected for poster presentations at the meeting. We worked tirelessly to complete our proposals. Meanwhile, I contacted everyone I could to get the word out that we were coming. I arranged tours of the hospital in which I trained for the residents. We would even hold an academic conference so they could see how it was done at my training institution. At the same time, I arranged a fundraising campaign to get all of them to America. A ridiculously expensive proposition. I estimated it would take around $19,000. And because of all the wonderful people in our lives, many generous people donated >$16,000.
At the same time, the residents began to apply for their VISA to come to the states. Contrary to most countries with a US passport, the US embassy in Ethiopia needs to grant a visitor’s VISA to the US BEFORE a ticket can be purchased. In order to do this, the residents needed to fill out a 30-page application and apply for an in-person interview in the capital.
I didn’t think much of the process. Here we had some of the most ambitious, loyal, intelligent physicians applying to go to the US for a conference to only make their practice back in Ethiopia better. I even obtained official invitation letters from the conference and our institution (Mekelle University). Clearly explaining that they will be in the US for a week for this conference.
Paperwork in hand, 2 of the residents ventured down together about two weeks ago. ~4,000 Birr flight round trip ($142). 4,200 Birr application fee ($150). After waiting in line for an hour, they walked up to see the US embassy agent. Less than 30 seconds later, WITHOUT looking at all the official paperwork we had secured to explain the reason for their travel, they were DENIED. No reason was given.
Furious, I called and emailed the embassy. No one answered my calls, but I eventually received a generic e-mail telling me that all details considered for the VISA will be reviewed by the agent at the time of the interview. Bullshit. We already know that’s not true.
Another resident went down the next week. ~$300 later, DENIED. Again no reason. He attempted to explain the rationale, but it went on deaf ears.
I called everyone I knew that had some power in Ethiopia. Even former US embassy employees. The response I got from all of them was the same. It’s a lost cause. If they want to deny, they will. Every time.
So finally, we set up interviews for 3 of them at the same time after RE-PAYING all of the application fees and I decided to join them. My goal was to speak with the US embassy agent to vouch for these wonderful residents and make myself personally responsible for their return.
I was met at the entrance to the US embassy by an overworked guard. I was not allowed entry into MY OWN EMBASSY unless I had an appoint to obtain a VISA to the US. After explaining that I would never need a VISA to my own country, that this is my own embassy and that entrance to this embassy is my right as a citizen of the US, I was still denied.
After my persistence, they even had the audacity to LIE to my face. Telling me they would let the residents in, speak to the agent and the agent would let me in. I shouldn’t have agreed, I knew it was a bullshit lie.
Less than 10mins later, all three exited with the heads tilted towards the ugly cement floor. They had all been denied. They even told me that while they were explaining to the agent and handing her the paperwork, she just stood up and walked away. Indifferent to their aspirations and rational.
I have never been prouder of anything in my life as I am for these residents. I was so excited to show them off to the US otolaryngology community and to expose them to amazing academia. The fact that what kept them from doing so wasn’t a lack of hard work, research or even money, but that they became victims of meaningless bureaucracy. The process has left me speechless.
It appears to be a two-sided issue. From the Ethiopia point of view, losing these residents to the US permanently would be a huge setback for the future of otolaryngology. They would have to prove that they would return to Ethiopia. But how the hell can you do that? The other side of the coin is that the US, especially today’s administration, is strict on immigration. So there’s pressure from both sides on these agents to let none pass.
In fact (based only on observation and conversation) probably less than 1% get granted a travel VISA to the US. When you start to sit down and do the math, you begin to see why this is sustained.
At least 400 people line up every day for VISA appointments in the embassy. That’s an underestimate probably but never mind that. Remembering that each application pays 4200 Birr ($150) that means on a daily basis, the US embassy collects 1,680,000 Birr ($60,000). Saying they only do this 5 days a week minus big holidays, they are making 436,000,000 Birr ($15,600,000). That’s absolutely insane.
Finally writing that out makes me even angrier. How could these amazing residents be cheated out of an opportunity of a lifetime by greedy, xenophobic American politics?
The only good thing to come of this is that Yilkal WAS able to obtain his VISA. They decided that since he has a wife and child that he probably would not leave them behind in Ethiopia. They still didn’t look at his official documents that we had provided. Although it will be great to show Yilkal around and network with him at the conference, I am still devastated by the fact that the residents were robbed of their opportunity to do the same.
As for all the amazing people around the world that donated for this cause, I will be sending them an e-mail explaining what happened and offer a full refund. Because what they donated to is only partially happening. If you are one of these amazing people, thank you so much for being there for us and I’m so sorry it didn’t work out.
I will be searching for good otolaryngology meetings outside of the US to submit research to in the future. If anyone has any suggestions, I’m all ears.
If anyone will be at COSM next week, I’d love to meet up! Email me at firstname.lastname@example.org