31st December 2011

Happy New year to you all.
We are having lots of trouble posting blogs from here and I am wondering whether the Ethiopian government have put a block on blogging sites - trying to work out what the problem is but with little success. Keep reading; we will be back soon and hopefully with lots of pictures, which are currently not uploading. 

29th December 2011

Ahhhha Maisy has just laid an egg in a cardboard box on the veranda. So some semblance of normality is returning to our ever growing household. Abdi is here this morning doing his homework and so I fed him some porridge and gave him a mug of hot chocolate. I would have helped him with his homework but he’s doing Oromo and the story is all about Gorillas in Tanzania – words I am really not so familiar with. He goes to school at 12.30 so I will make him a boiled egg sandwich before he goes.

28th December 2011

I was out at a health post near Homa today and had a very busy morning seeing 18 pregnant women. Most women were fine, although very few actually knew when the baby was due and so I spent a lot of time measuring the baby’s head circumference and giving them an idea of when they were due to deliver. I guess this is helpful for them in that they can perhaps plan the delivery a bit more. Mind you, I don’t think a great deal of planning goes on here; it’s all a matter of deal with it when it happens. After I scanned one woman who was 38 weeks pregnant, she produced 20 chicken eggs and asked if I wanted to buy them. Since our chickens are refusing to lay any eggs at the moment – or they are laying them and eating them – I took the eggs and paid her 25 Birr (£1).

Back at Gimbie, I visited the various babies and found there was an addition to the ‘cheese counter’; a small and rather battered 32 week breech baby that had just been born. There weren’t any nasogastric tubes on the ward and so we had to scavenge around in the Maternity worldwide store cupboard where there was a small stock of donated tubes. It was lovely to see that the nurse looking after the baby had got her warm, wrapped in a sheet and was also happy to insert the NG tube AND knew that she should give 10% dextrose. Considering what was happening 3 months ago when we first came here, this is enormous progress. I don’t know if their experience with Jaba – ie the fact that they can see that these small babies survive if looked after properly – has helped to improve things but I like to think so.

We were just settling down for a quiet evening with a nice plate of bean stew when Roza called (the family planning nurse) on her way back from church. So we shared the bean stew, which was pretty easy actually as there’s always much more than anyone could ever want to eat. To be fair, it was quite a nice bean stew…..or maybe I’m getting used to it. The Roza asked if she could have some help writing an email to Heidi. No problem, I said. It soon became apparent that this was a much larger task than I had thought. First I had to set her up with a Gmail account and then I had to spell out all of the 16 words that she wanted to write. ‘It is not so easy?’ She pointed out after we had spent over an hour composing the very short email to Heidi. So Heidi, I hope you appreciate her efforts!

The final task for the day was to roast the coffee beans that we had painstakingly been preparing over the past 5 or 6 days. Having peeled the fleshy outer covering, they were dried in the sun for a few days. Then the next harder covering was removed (whilst watching an episode of the mentalist – it’s a very dull task), then the beans were washed and roasted ready for consumption tomorrow.

27th December 2011

It was all excitement at Homa health centre this morning. I was scanning a pregnant woman who had woken up with a bit of back pain this morning and was struggling to find the head as it was really low. All of a sudden she started pushing and the membranes ruptured with such a force that the entire examination couch and wall were soaked. We got a few men to come and take her to the delivery room and within 30 minutes delivered her baby girl. As you might imagine her mother and husband were convinced that it was my scanning her that had brought such a quick delivery and so they were very grateful for this.

I then got back to the queue of women waiting for their scans, only to find that the next woman was 40 weeks gestation, the baby was transverse (baby lying across rather than head down), it was her first baby, she was 140cm in height, and there was less than 2cm of liquor around the baby suggesting that at some point her membranes had ruptured (unbeknown to her). So I told her and her family that they needed to get to the hospital where she would need to have a caesarean section. They were reluctant and certainly unprepared to go to hospital as she had only come to the health centre for a scan as a message had gone around that I was scanning women today. Indeed, this was the first time that the woman had ever attended the health centre, having never had any antenatal advice and so I think she really didn’t understand what was happening when her membranes ruptured. Actually, I’m not sure that she understood that her baby was due to be born. After some persuasion, however, and convincing her that she really would not be able to deliver the baby at home or in the health centre, her family set out to catch the bus to Gimbie. I then telephoned Jeremy and told him to expect her in a couple of hours and returned to the queue of women.

When I returned to the hospital that afternoon, the woman I sent to Gimbie was just recovering from her caesarean section and both mother and the baby boy were doing well. So this is a very good example of how ultrasound scanning can actually change things. This woman would not have come to the health centre without the offer of a scan. She would not have been able to deliver the baby safely without a caesarean section and it is highly likely that both mother and baby would have not survived to tell the tale. What I am hoping is that the family will report this to the community – this is how word gets around here and so a positive story told by those involved is the best way to bring about change. The woman looked rather stunned by all that had happened to her – she is only 18 and really doesn’t seem very confident with her new role as mother. Her father, however, is staying with her and he is extremely grateful that she has come to Gimbie and I am pretty sure that he realises what could have happened to her. He held my hands in gratitude, repeating ‘galatouma, galatouma’ (thank you, thank you) and then smiles with relief that his daughter and grandchild are safe. I gave the baby some clothes and a blanket as the mother really didn’t have anything to wrap him up in.

26th December 2011

Jaba seems to be a bit out of sorts today – I think he has a cold; or as they say here ‘the common cold’. Not sure what the uncommon cold is. I guess he’ll be OK but the problem is that it’s survival of the fittest and so the unfit don’t have a chance.

Both Jeremy and I worked much of today – it’s not a bank holiday here and so just an ordinary Monday. The boys came round after school and so we decided to go out to the Green Bar (as opposed to Green Bar B) for a beer as we could get food for the boys there. People eat with their right hand (apart from Matti, who is left handed) and so there is always a wash basin at any restaurant – it feels odd calling these places restaurants, but I guess that is what they are.

Well, I have never seen such a mound of food be demolished in such a short space of time. They ordered 2 portions of tibs with injera and egg. Basically, an enormous pancake (injera) filled with yet more injera, lumps of beef, some kind of sauce and a boiled egg. Each package of food also came with two bones with meat on. Well, the boys were delighted with their order and after 30 seconds of praying, they tucked into their meal. Probably no more than 7 minutes later, they were smiling contentedly and washing the last mouthful down with coca cola. They actually prefer Mirinda (fake Fanta orange) but it seems that Gimbie is totally out of this drink at the moment. Must be because all the pregnant women have been drinking it (remember previous blog re all women being given Mirinda at the start of labour).

On the way back, Abdi, who kind of looks after them all (yes, aged 11), asked sheepishly whether I would possibly buy them some soap to wash their clothes. Apparently they are allowed to get water from a nearby house for clothes washing. So we bought them each a bar of soap at 10 Birr (40p) each and they were terribly grateful. Gosh, how easy it is to please a bunch of 9-11 year olds here.

25th December 2011

Merry Christmas to you all

Christmas eve

Christmas day breakfast

As you can see, we are working our way through the festive food. Fondue tonight.





24th December 2011

This morning I was a little sad sitting on the veranda, with my cup of tea, thinking about everyone getting ready for Christmas tomorrow and the excitement that this generally brings. I miss all sorts of things that we have in England, most of which are not really important and we can do without. But we certainly need our family and friends and appreciate you all being there for us. We miss you.

 I hope that you all have a wonderful day enjoying the Christmas feast and having a nice time in each other’s company. I will blog tomorrow and post some photos to show what we are doing.

Jeremy is on call today and tonight but the hospital is fairly quiet (coffee picking time?) and so we should have a peaceful night. Clara comes back from Addis today, possibly with some goodies for tomorrow’s lunch. We shall light the Christmas pudding using the gin we bought in duty free and we have bought some eggs to make custard to go with this (that’s right; our chickens still refuse to lay any more eggs). I have a feeling that the orphan boys will turn up at some point so we shall feed them something. We will also bring Jaba to the house for some ‘fun’. Oh and Makabe is coming over to make some fresh bread. So all, in all, lots going on.

Happy Christmas eve xxx

23rd December 2011

As I reached for the chicken food bowl this morning, I stopped myself just in time to realise that the black blanket covering the bowl was actually thousands of very large ants- all of whom I am sure had enormous biting capacity. I had a flash back from a scene in the Poisonwood Bible (set in the Congo), where the villagers had to run to the river to escape the killer ants that were marching through eating everything and everyone in sight. Mental note to self; put glasses on before touching anything in the kitchen.

Undeterred by the ant invasion, after breakfast I set to finishing a funding application that I am working on with Camilla. It is due in on 6^th December and we are hopeful that we may be successful. You never know though so we shall just keep our fingers crossed. The bid is to secure funding to set up further training within the communities for health extension workers and nurses to deliver antenatal care. At the end of the day, we still only see around 20-30% of women during the antenatal period. Whilst I have been scanning women in the health centres, I see women at 36 weeks pregnant and this is the first time they have ever spoken to a health care worker. So the idea of the bid is to not only provide more training but to also support the community workers (voluntary workers) to encourage women to attend the antenatal clinics.

I also had Jaba here at the house with me as I wanted to give him his weekly bath. Here’s a couple of photos of him – the first one has a slightly festive feel to it in that I covered him in a red knitted blanket – well, it was an attempt to make him Father Christmas.

This evening we entertained the five boys from the orphanage, having invited them for a showing of Harry Potter and a pizza. So we rigged up a projector and showed the film on our wall. We don’t quite have surround sound but the BOSE speakers that we brought with us are amazing and you sort of feel like you are in the cinema. I started off by giving them popcorn, cooked with the Ghee that I brought out here and some local sugar. Then they watched half of the film before they got the pizza. They then opened one advent calendar chocolate each and settled down for the rest of the film. I finished off the evening with a cup of hot chocolate each – I don’t think they have ever had this before but they drank it with great enthusiasm.

At 8pm, they wander back to the orphanage, presumably not missed by anyone. I did ask them if they were allowed to stay out and they looked at me as if I was a little mad – they said they would normally get back by 7,8,9 or whenever and that this was just fine. Mind you, since the woman who looks after the house they live in is the very same one that previously asked Camilla to take her 2 year old baby from her and look after her, I think I am inclined to believe the boys when they say it won’t matter what time they get in. I also asked them what time they were fed because I didn’t want them to be provided with food but then eat at our house. They tell me that they have bread in the morning, then injera (the wet flannel pancake thing that is eaten everywhere and tastes pretty disgusting) with some lentils for lunch and then bread in the evening. So I think I am safe to feed them evening times as a bread roll can be used the next day – or perhaps they eat it when they return. They certainly eat everything with enormous enthusiasm when they are here.

22nd December 2011

I went out to the health centre at Ganji yesterday and then today at Homa so I’m pleased to say that I am getting on with my research despite the distinct lack of a car. Yesterday, Clara kindly drove for us – she borrowed the car from Chris, an American guy who is working at the Catholic school a few miles away. The Ecuadorian nuns, Sister Susie and Sister Matti, run the school and have a rather beaten up truck. However, it is wheels as they say and have wheels, can go to Health centre. I wasn’t able to go with Maternity Worldwide as the driver, like all drivers in the region, had been called to attend a driving course and assessment, which had been extended, without any notice, to a three-day course. So off we trundled in the beaten up van, with a translator (Hunde) with us who would help if there wasn’t anyone there who could speak English. It all worked out well and I scanned 15 women and did some antenatal checks with the health officer there and also Jeremy.

Today, we were able to utilise the MW car and driver and had a thoroughly nice, peaceful day at the health centre. The nurse there, Lensa, is really helpful and always keen to learn new things. So we had a teaching session about post partum bleeding and we drew out a flow chart that showed what to do in various situations. Lensa is going to come to Christmas (Ethiopian Christmas – 7^th January) lunch with us here in Gimbie, which will be lovely.

 It’s the coffee picking season here in West Wollega at the moment and so everyone is out picking coffee beans, drying them and then selling as much as they can. The coffee prices used to be regulated by the government but this seems to have become more relaxed. However, the price is pretty consistent in Gimbie at around 90 Birr (£3.60) per Kg. They are not allowed to export the beans out of the region and there are road stops going out of all towns where they check that you haven’t got loads of coffee in the car. The idea is that whatever they can’t sell themselves, has to be sold to the government, who I think may organise exportation. Coffee is the main source of income for most people in the rural areas and so at this time (December and January) you see quite a lot of police wandering around, making sure that things remain peaceful. With all the unaccustomed income from the coffee, people can get a bit excited – lots of food, some home brewed alcohol and competition for the beans = potential trouble.

 Kume, the MW driver, got some coffee beans for us from a friend of his in Homa and so we have been peeling and drying the beans and will roast them – perhaps a treat for Christmas.

  

When I got back to the hospital, I went to do my usual visit to see Jaba and collect the old bottles for cleaning and replenish them with fresh milk. A set of twins had been born that afternoon, having been induced as one was not growing well. Two boys; one was 1.3kg and the other 1.8kg.

The bigger one was sucking well but the smaller one will need tube feeding for a couple of days. Mum will express milk for him so he should be fine. Very cute.

20th December 2011

My nice peaceful day working at home has been somewhat disturbed by the clucking of two very noisy chickens who are clearly irritated by the arrival of four boys in need of somewhere to go before school starts at 12.30. The chickens find somewhere else to sit and the boys settle themselves down on the veranda to some squash, a banana, an orange and some fruit pastels. Probably not the best diet in the world but it is sure to beat whatever they can get hold of in the orphanage. Besides, since they need some new paper exercise books, I will meet them in town after school where we can buy some more and then settle them down for a hearty spaghetti Bolognese (of some sort) at Green Bar B – this has become our latest watering hole.

Before they left for school, I measured their feet as all of them have shoes with so many holes that they can barely be called shoes. When I come back to the UK in January, I shall find them some suitable trainers or something similar. If anyone has any unwanted size 38 or 36, that are in reasonable condition, please keep them for me as I am sure that the boys will appreciate them greatly.

Now off to the post office to see if there is any mail.

19th December 2011

It has been a fairly quiet weekend, which is a bit of a relief really as I was in need of a more restful time. On Sunday, Jaba came over for the day and had another bath. This makes him the cleanest child – actually, possibly the cleanest person – in the hospital. Three of the boys from the orphanage also came to visit and so we set them up with some computer games to play and then some drawing and colouring. Abdi, the oldest boy (11) is actually a very good artist and produced a very nice drawing of a rose when I suggested that he made a card for us to send to Camilla in the UK.  They really are very nice boys and are incredibly polite and well behaved. They always share everything they have equally between themselves and help each other with whatever needs to be done. You only have to pick up a brush or a cloth and one of them will quickly take it from you to do the job for you. After their orange squash and biscuits, I try to explain the concept of advent calendars, which given they have chocolates behind each window was a source of great interest and much enjoyment.

The chickens still haven’t laid any more eggs, although they seem to have got over their little crazy spell of a few days ago. They are very friendly and come and sit on the veranda with us whenever we are out there.  However, they also managed to get into the fenced vegetable garden, where they found the tasting menu very much to their satisfaction. Not sure that our sweet corn will ever grow to produce any food.

16th December 2011

Today I took Jaba to our house for his very first bath – actually, his very first wash. The hospital doesn’t have hot water (and at times, the cold water isn’t working).

He looked rather stunned at first, but soon got the hang of it all ……and maybe enjoyed it?

He looks bigger but I haven’t weighed him as there is a big risk that there will be pressure to move him out to an orphanage if he appears to be large enough. I fear this is coming soon.

Jeremy is enjoying his time with Jaba too and quite enjoys a cuddle with him.

Although the chickens appear to have been laying eggs whilst we have been away, Maisy seems to be having a phantom pregnancy and sits on her nest most of the time. Makabe says we should buy a fertilised egg for her to hatch as this would cheer her up. Oh dear, the complexity of keeping chickens.

14th December 2011

It’s a shame that we haven’t managed to enjoy our few days in Nairobi as the weather was lovely, the hotel was really comfortable and the food was excellent – lots of fresh fruit, a complete breakfast buffet with freshly cooked eggs, and a buffet supper of many different kinds of meat and fish. Oh and a wide range of vino to wash it all down.  However, we have recovered from the ordeals of the previous days and are ready to head back to Gimbie to continue with our work. Before doing this we had to get an emergency passport, which is a relatively painless task once you know the system. And this is the point; why would you know the system? It’s not something that happens everyday – thankfully. We had to apply for the emergency passport by submitting an application form, passport photos (thank goodness that Jeremy brought a printer with him and Sue could locate our passport photos on the computer at home), a copy of the police report detailing the theft, a copy of the air tickets to the onward journey and £95.00 (each).  This is when we found ourselves in the first catch 22 situation; we couldn’t book our airline tickets until we knew how long it would take to get the emergency passport. However, they could not be sure how long it would take but thought it should be possible within 24 hours. So then we went to the Ethiopian airlines office to buy the tickets but there you meet the next catch 22 scenario; they need you to have a passport in order to book the tickets. Actually, they were satisfied with a photocopy of the passports and thankfully, we have many of these. You have to state where you are going to and the passport will only take you to this destination. So we would have to get a further emergency passport when we got to Addis in order to return back to the UK. Worryingly, you are only allowed 2 emergency passports a year – not that I am planning to be robbed again, but you never know.

When we arrived at the British High Commission the following day (today) to pick up the passports, we thankfully bumped into an incredibly helpful commissioner, William Robinson, who advised us that we should state the UK as our final destination and not Ethiopia and this would save us having to apply for a second emergency passport in Ethiopia. This was music to my ears as I was dreading trying to get a positive response form the British embassy in Addis and they had previously been very unhelpful when we needed help with the car. We have also found that they rarely answer their phones (even the emergency phone) and when they do, they always tell us that everyone is on a training day or worse still, week. So our application had to be changed to accommodate us going to the UK via a stop in Ethiopia. This also saves us a further £95.00 x 2. The only problem we had was that we didn’t have a copy of our airline tickets to the UK, but thankfully, I had them on my email system and the lovely William Robinson allowed us into his office to access my email and print them off. This kind of helpfulness is something we have not experienced at all in any official office in Ethiopia and I was so surprised that I couldn’t stop thanking him for his kindness – he probably thought I was a total nutcase. But he has saved us endless hours of waiting in the British Embassy – if they are open from now until January – and much emotional stress. So thank you William.

However, with all the changes going on, time was marching on and we needed to be at the airport by 4.30pm to catch the plane at 6.30. We left the High Commission with a further instruction to go to the immigration office about 10 minutes drive away as we had to get a visa stamped into the passport, otherwise they would not let us out of Kenya. So another immigration office, with much the same sullen looking faces and incredibly unhelpful people as found in Addis. The real blow came when we were told that we had to pay $50 each for the new visa. Being now convinced that everyone is going to rob us, we carry very little money around, not least of all, our rather needed dollars. So we now had to make the 30 minute plus journey back to the hotel to get the dollars for the visa. Stress levels increased again as it was now 1.30 and we still hadn’t checked out of the hotel or sorted out the car (our friend had only just returned form Lusaka the previous night).

When we returned to the immigration office to get the visa stamp, we were told to fill in a form each and were then directed to another woman for the stamp. Thankfully, people in the queue to see her were understanding of our need to get to the airport and so let us go to the front of the queue. We eventually entered the room of the immigration officer, where she slowly glanced up from reading her newspaper and nodded for us to sit down. She continued to read the newspaper whilst listening to my tale of stolen passports, need for visa and urgent need to catch a plane in 2 hours time. Thankfully, she seemed to accept what I had said and stamped and signed our passports without uttering a single word to us. I thanked her and we slipped out of the room before she could change her mind. No request for $50 was ever made.

At Nairobi airport, we got through immigration without a problem and had a pleasant flight to Addis. Although we were rather worried about being let into Ethiopia, this was actually pretty much hassle free. Firstly, thankfully, we had a photocopy of our yellow fever vaccination certificates (didn’t realise that we needed this but the certificates had been stolen), then we produced a photocopy of Jeremy’s residency permit, which along with his emergency passport and once they had looked him up on the computer system, they were happy to let him in. I had my residency permit and emergency passport and this was absolutely fine.

So after a night in Addis, we journeyed on the 10-hour dusty, bumpy road to Gimbie. We are now ‘home’ and feeling rather relieved to be here. Awaiting at home were some freshly baked cinnamon rolls (baked by Makabe) and two parcels form the UK, which amongst other things contained a Christmas pudding and two chocolate advent calendars. So excited to be able to have some festive goodies. Last night we sat at ‘Green Bar B’ last night eating pizza and planning a Christmas feast with Clara, who is the only expat left here.

12th December 2011

Today is a much better day and I am feeling rested and in much better spirits than the previous couple of days. We are safely tucked away in a nice hotel – if anyone comes to Nairobi (although thinking you may have been a little put off now), the Southern Sun Mayfair Hotel is a really nice place and the staff are just fabulous. They have been really supportive and helped us deal with various official things like police statements and embassies.

Although we were only going to stay here for one night, being stuck here has its advantages; masses of clean hot water, friendly people, amazing food (and lots of it), a peaceful swimming pool and a large comfortable bed without the need for a mosquito net. If I stay here too long, I won’t ever want to go back to the harshness of Ethiopia.