22nd November

I have been out to the health centre and health posts in Nole over the last couple of days to work more on my risk screening project. I am seeing about 30 women each day and managing to get them seen by the midwife for an antenatal check and then I take some risk assessments and scan them. I have been documenting the information and will need to work out a mechanism for following up the women to see what actually happened during their labour. At the moment, around 20% of the women have risk factors that would suggest that they should deliver their baby in a hospital. They have been advised to do this but it will be very interesting to see whether they actually take this advice, and if they don’t whether they run into trouble if they deliver at home.

It’s quite amusing going right out to the health posts because these places are really quite remote and many people there have never seen a faranj before. So they are fascinated to see 2 or 3 white faces arriving at their village in a car – another rare sight. Indeed, when at Nole health post, we found around 200 children (age 5-16) clinging to the health post fence trying to get a glimpse of us. I guess that in a world where you don’t have any television or radio and due to a lack of electricity, you have to go to bed when it gets dark, a few faranjis make a pleasant change to the usual routine of the day.

The health post is a very small building, often containing two rooms but without running water or electricity. The idea is that these places are nearer to people out in the villages, with most people being able to reach one within a 1-2 hour walk. They provide vaccinations for children and some health advice for various sections of the population, including pregnant women but they are not allowed to dispense drugs and are not staffed by trained clinical staff. On the whole, the health extension workers work out of the health posts – these are people who have had one year of training on 12 different aspects of healthy living. So it tends to be a health education role. So it was rather odd to find piles of out of date drugs stashed in the store cupboard. Most were drugs for TB treatment but there were also iron and folic acid tablets, which would have been of more help to the tired pregnant woman than the bottle of Mirinda that she was advised by the Ethiopian midwife to drink. Mirinda (fake orange Fanta) seems to be something that all women drink once they go into labour. Sick women also seem to be given the same drink, even though they are barely well enough to drink water let alone fizzy orange.

Also in the store cupboard, which by the way was covered in dust and had much evidence of rodents, there was a box of about 30 digital thermometers, all still in their boxes. I really don’t know what they were doing there, other than gathering dust, but it’s crazy as there is just one thermometer for the entire female ward in Gimbie. I assume that the drugs, and the thermometers had been donated by some charitable organisation – indeed, there were also some out of date United Nations rehydration sachets there. I suspect that all across Africa there are examples of donated goods being given to people who are not in a position to use them. I’m sure it is difficult for the donors to ensure that that things get to the right places but when you actually see these things and know that you could really have used them to benefit those in need, it leaves you feeling quite exasperated.

I still have mixed views about the impact of the various aid programmes on Africa. It’s certainly a complex picture, and Ethiopia, having been a recipient for so many years, is paying in some way for the World’s input into their survival. Looking at places like Gimbie, where there has been considerable assistance over the years, you notice a changed culture in the people. The faranjis sit there like beacons signifying potential monetary assistance.  The Ethiopians, with their ‘dog eat dog’ approach to being the recipient of the faranji’s money will appear to befriend the faranj, but within the first of second meeting (there is always more than one meeting) they will have revealed a desperate story about their starving family, each of whom needs assistance with an operation, schooling, food, clothes, medication and so on. What to make of it all?

Oh well, I go back to my risk assessments and I ignore the 12 inch lizard/reptile thing that it hanging on the curtain above my head……