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.

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