Saturday, 26 February 2011

25th February 2011

Well, we're back in the UK, having had a really interesting trip to Gimbie. I had hoped to update this blog whilst there, but establishing a means of accessing the internet was more of a challenge than I thought it'd be. It's not impossible, but just needs some time to register an account - so a couple of hours queuing in a communications office in Addis should do it. This will be top of the list of things to sort out when we return in October.

Ethiopia really is a very pretty country and the people were largely very friendly, if not totally amused by the presence of faranj (foreigners). Indeed, such was the amusement of a couple of white faces appearing  in the town, that both children and adults would giggle and point at us before being bold enough to shout out 'faranj' or if that didn't invoke a reaction, 'you, you, you, faranj'. I guess that these are the few English words that they know. Below is a typical view of the interested faces that look quizzically at the faranj.

The city of Addis Ababa was largely what I expected it to be - lots of people walking about, venders selling fruit and vegetables, some pretty tatty looking bars and many, many cars tooting their horns in an attempt to get through the traffic. The pollution was a lot worse than I expected and after a couple of hours wandering along the streets, it was a relief to get back to the hotel, which was off of the main roads. What I hadn't anticipated was the extent to which Ethiopia's alleged 80 million people were packed into village after village along the road out of Addis. I thought that once we got out of the capital, there would be vast areas of empty spaces, with the odd village along the way. What I saw was thousands of people living in a variety of dwellings built along the roadside. Each time you drive through a village, you have to avoid the mass of people walking along the road going from one part of the village to another. Most villages have pavements, but they are in such poor condition that it is less hazardous to walk on the road. Below are a couple of pictures taken along the drive from Addis to Gimbie.

We had a 13 hour drive from Addis to Gimbie, which is where the hospital is located. The slightly longer journey was due to the car's clutch finally breaking, after many miles trying to keep it working by driving at less than 10 miles an hour with smoke bellowing through the gear lever housing unit. Having been towed the last part of the journey, we finally arrived at the accommodation in Gimbie hospital. The photo below is the entrance to the hospital.

For now, all I'm going to say is that the house was really very basic - but in comparison to what the majority of the villagers are living in, it probably seemed like a palace. The picture below is likely to be the house that we will live in when we stay for the year.

The hospital is also pretty basic in that there isn't much in the way of equipment and what is there is fairly old and often broken.

I was quite surprised at the level of hygiene in the hospital and at first, wondered whether I would ever be able to spend more than a few minutes amongst the stench that pours out of the Obs and gynae ward. In the end you get used to it and luckily the house had plenty of hot water - which is more than I can say for the hospital, which relies totally on cold water from the stream below.

I saw some amazing sights in the hospital during the week; on the maternity ward, the tightly packed beds, most housing a new mother and her baby (those women who lost their babies were also in the same ward) were full of smiling women, probably relieved that they and their baby had survived the process of childbirth. The majority of births occur at home, but when women are concerned about their baby or the labour looks like it is going on for too long, they often have to walk for hours to get to the hospital. By this time, for some women it is too late to save the baby but hopefully it is possible to save the mother.

The other wards also contained patients with conditions that you would just never see in the Western world; quite a few children with burns, having fallen onto the fire in the house; a child with obstructed airways, who, following an adrenaline nebuliser had a leech crawl out of his mouth (the leech came from drinking river water); a child with such bad malnutrition that I was reminded of the 1980s Ethiopian famine; and patients with a variety of unknown, but probably infectious conditions. Most people have hook worm and so there is also a very high prevalence of reflux, which is very likely caused by the hook worm.

There are lots of opportunities do contribute to health care here in Gimbie and also some clear research opportunities that may actually lead to improvements in health care. I have a few ideas now and am keen to get on with the development of a research proposal. It's not going to be easy, simply because it is difficult to follow people up once they have left the hospital. However, patients do have medical records and although they are not always complete, it does allow you to start somewhere. Below is one of the education centers in Gimbie town - I assume it is closed....

The town of Gimbie (see picture below) is much like the many other towns that we passed through on the way to Gimbie - very busy with people walking everywhere and heavy trucks carrying goods driving through.

Goats and cows also wander the streets, looking for scraps of food and skulking in the shade wherever they can.

Although I had heard that there wasn't a great deal of variety in food; I hadn't quite appreciated how little  choice there was. The only things that were readily available were; onions, potatoes, tomatoes, avocados, mangos, bananas, and oranges. It was also possible to get some kind of lentil or bean (dried), white bread, oats and some tins of tuna and sardines (from one or two places). There was, however, a very nice 'bar' called Jimi Juice, which served fantastic juices, all freshly squeezed. This is definitely going to be a regular visiting place.

So will it be possible to survive a year in Gimbie?

Undoubtedly challenging but certainly possible and hopefully, in many ways, enjoyable.

Friday, 11 February 2011

11th February 2011

OK, so now I'm seriously excited about our upcoming trip. We've now got our international driving licenses through........although we have not succeeded in our pursuits at hiring a car. It seems that you have to hire a driver as well as a car, which I guess is OK, but then you have to look after the driver for the duration, which is not so easy. I don't think that even and Ethiopian driver wold appreciate sleeping in a car for 10 days. So the next plan is to try and borrow the Maternity Worldwide car (and driver) for our trips put and about. Perhaps they have some good bicycles.

I'm off to buy some essentials for the trip - by this, I mean food. I thought that some mixed spicy beans and some half baked bread would be a good start and then I guess some cereal, long life milk, biscuits and whatever else I can fit into the case. It says on the Ethiopian airlines website that we can have 2 x 23kg bags each, which is pretty good for cattle class. So I'm thinking of taking one bag for clothes and the other for food!

Monday, 7 February 2011

7th February 2011

The next hurdle in our preparations is communication. In order to get the most out of our time in ethiopia, we really need to be able to speak the language. Aahhh, but which one do we choose? The villagers living in the area of Oromo speak Oromifa and the majority of hospital workers speak Amharic. I think that many of the nurses and doctors also speak some English, although I'm not sure how fluently. There are around 77 different languages spoken in Ethiopia, so I guess we're lucky to have to choose between just two. Ideally, we should speak both Oromifa and Amharic but let's not get too carried away.

On the basis that we want to ideally communicate with the 'locals', we've decided to learn Oromifa. This may sound easy enough but we have been confronted with the fact that there appears to be very little written Oromifa around. Many hours of trawling on the net made me conclude that a visit to the School of African Studies is necessary. It may also be possible to pick up a dictionary from the area when we have our brief visit soon. So far, I've learnt around 100 words but have no idea how to string them together.

Thursday, 3 February 2011

3rd February 2011

In less than 2 weeks, we will be landing in Addis Ababa to spend 10 days in and around the area of Gimbie.  We have had our vaccinations already as we needed some of them for a recent visit to Botswana and Namibia and so we thought we may as well get the extra ones needed for Ethiopia - Rabies, Yellow Fever and meningitis. We're not sure how high the malaria risk is as Gimbie is around 2000 meters high and so presumably not such a popular place for mosquitoes. Mind you, we have bought a mosquito net for the bed and also stocked up on Malarone for our brief visit.........just in case. I haven't a clue what you do for a whole year as it seems a bit problematic to take anti-malaria drugs for 12 months (not least of all because of the cost - they are around £2 a tablet).

We're wondering what the weather will be like. I had always thought that Ethiopia was very hot - I guess I still have the images of the 1980's Ethiopian famine in my mind, where television cameras illustrated the desperate dehydration and starvation of hundreds of thousands of families living in what appeared to be total desert land. In fact, it seems from what I have read, that Ethiopia is quite a lush country, and although the land is pretty rugged in many areas, there is plenty of green shrubbery and forestry around. During the rainy months (July and August), I think they get around 6 inches of rain a day.  The temperature over the next few weeks is supposed to be around 24C and so we'll have to take our sun screen as well as mosi spray.