Saturday, 3 March 2012

1st March 2012

I’ve had an exhausting week. Sunday saw the arrival of the 17 bike riders, who despite a few illness along the way, all managed to arrive in Gimbie in one piece in time to go to the reception that we had arranged in Green Bar B.

Monday I went to a health post in Ganji, where I saw 32 pregnant women for a risk assessment and Tuesday I went to Homa health centre, where I saw 49 women for risk assessment. Homa has a set of weighing scales where I always weigh myself and was a little concerned to see I am now just 52Kg so now I am treating myself to regular rations of chocolate.

So why are things in the clinics getting so busy all of a sudden? Well, I think that word of the risk assessment clinics has reached women living out in the more remote areas. The women that are now coming for antenatal care live in many different villages, often far away from the health centre. This is, of course, excellent news as these are the very women that we need to reach, as they have often never seen a health professional throughout their pregnancy. Interestingly, they tend to have had more children than women who live nearer to the health centres, with some women having 8 or 9 children and now onto their 10th. Thankfully, there aren’t too many of them. In fact, when I first came here I was quite surprised at how much women were planning their families as many chose to have just 2 or 3 children, despite the fact that it is not unusual for one or more to die before the age of 5 years.

The little boy that I mentioned last week – the one that was abandoned by the family when the baby’s 15 year old mother died – is still in the hospital, although we have prompted the hospital to start the process of getting him to the orphanage, where he will hopefully be adopted by a loving American couple. He is certainly better off in the orphanage at the moment as he is currently being deprived of adequate supplies of milk. Yes, the same problem arises again; the nurses don’t think about sorting out the nutritional needs for the baby but instead they give a large shrug and mutter ‘no milk’ when asked why the baby hasn’t been fed. The frustration of it all is deeper than you can imagine. The trouble is it is so difficult to understand why people don’t have the motivation or inclination to resolve problems. There is a clear problem; a baby needs milk and doesn’t have any family to buy the milk. It turns out that the hospital will provide the milk BUT for some curious reason they need to be informed of the situation. Now you might think this is obvious but here, this is far from obvious to many people. So the baby doesn’t get the milk until some faranj buys it. However, now that we have managed to work out what the hospital policy is – something you might think the nurses would already know – we can make sure that they inform the admin staff when a baby needs some milk. Do I believe that they will do this next time? What do you think? Am I becoming just a little cynical?

Wednesday I went to an incredibly remote place called the Green Lake clinic to look at the facilities there and help with an assessment of these. The clinic is set in the middle of a large flat plain (unusual for Ethiopia) with the nearest town being 3 ½ hours walk away. The clinic doesn’t have any running water or electricity, although this was something that the people I went with were looking to resolve. Being so remote, there is little food available and so we ate injera and lentils for each meal. I drew the line on the sieved bean soup for breakfast though, deciding that 3 cups of tea would be just fine – I brought my own teabags. At night, we made a camp-fire and since we were still hungry, we were very grateful for the bag of Bombay mix that I had brought along.

Typically untidy clinical area at the health centre

An unsuccessful health education message

My bed for the night

The faranjis arrive at Green Lake

Having heard that there were fanjis in ‘town’ there was a queue of people to see the ‘doctor’ the next morning. Well, as it turns out, there aren’t any doctors here but instead an Ethiopian nurse who has been here for 18 years and is probably a little jaded and now a fresh out of school nurse who has virtually no experience in symptom recognition and diagnosis. So, although I also don’t have the skills of a General Practitioner, I thought it would be helpful for me to work with them. It was certainly an interesting experience, although not reassuring to see a young man complaining of headaches, neck stiffness and a dry cough being diagnosed as having pneumonia. He wasn’t examined in any way, let alone having his chest listened to. I couldn’t help but intervene – even I would raise an eye at headache and neck stiffness – and decided to use the clinic as a teaching/learning experience. I was relieved to see 3 pregnant women as this, at least, is something I now know quite a bit about.

I returned from the clinic on Thursday evening totally shattered. I woke in the night, however, feeling something crawling in my hair – it felt like a mouse or something like that but we couldn’t find any evidence of it. So now I am wondering whether I imagined it – perhaps I am becoming psychologically disturbed by the bugs and the fact that we seem to have at least 2 resident rodents. Jeremy placed a piece of orange matchmaker chocolate on two traps that Makabe bought but these don’t seem to work as the chocolate went and the trap didn’t go off. Actually, I was quite pleased about this as I didn’t fancy coming down to a dead creature in the morning. Mind you, I also don’t fancy it being in the bed either. Anyway, as part of my ‘therapy’ I am collecting a photographic portfolio of the bugs and animals that live in the house. I will post it on the blog when complete.

Last night, we were settling down for a nice bowl of baked pumpkin, potato and tomato, made hugely better by the grated mature chedder sprinkled on the top (good idea to bring the waxed chedders from Christmas Sue), when I thought a nice glass of chilled white wine would set the whole meal off to a treat. I was a little concerned to find that the wine had disappeared form the fridge, and even more alarmed when it occurred to me that Makabe must have done something with it – the thought running through my mind was ‘perhaps she thought it was water and has used it to make up Jaba’s milk’. Makabe uses the water that we boil and filter in the house for Jaba’s feeds and so it isn’t beyond the realms of possibilities that she could have taken the wine, cleverly decanted into a water bottle so it could be chilled, by mistake. Once she came round from her sleepy state (it was only 9.30pm but people go to bed early here), we managed to sort out that she had thought it was tap water that she had chilled when she had a headache and she didn’t want us to drink it as it hadn’t been boiled so she tipped it down the sink. Now this may seem trivial to those of you who have easy access to supplies of wine but we have to buy ours from Addis and we are running very low! Oh well, another enforced health improvement comes our way.

 A game of Bingo on the veranda

Connect four championship

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