6th May 2012

What a week! It is never dull here that’s for sure, although at times, I really wish there were fewer events in my life. Last Wednesday brought the busiest health centre clinic so far. Around 50 pregnant women turned up to be seen, many of whom actually had considerable problems and required further interventions. Time was marching on and by 11.30, it became obvious that we would not be able to see everyone. The last 20 women to arrive were therefore told that they would have to return on Friday, which is when I would provide an extra clinic. I felt bad about this as for some of these women, this would mean another 1-2 hours walk back to the village and then the same again on Friday. But there’s not a lot that can be done in a health care system that is totally devoid of any form of appointment system. I guess, there’s little point in giving appointments as the notion of time and days of the week are really rather pointless here.

Even having split the clinic into two days, we still didn’t manage to leave until gone 4.30, meaning that we only just got back in time before it got dark. I am particularly concerned not to be driving at night here as not only is my night vision poor, but there are so many hazards on the road that make driving in the daylight a great challenge. In fact, earlier in the morning, I had to take the car off road to avoid a live (well, I assume it was live) electricity wires that had fallen across the road when the pole came down. I’m pleased to say that we managed to identify 2 very sick pre-eclamptic women, both of whom I took back to hospital with me and a further woman who had a placenta praevia, where the placenta had grown across the cervix. This is rather hazardous for the woman as delivering the baby would bring about enormous haemorrhage and almost certain death. So she is also now in the hospital, where she will get a caesarean section. There was also a woman who had previously had 4 babies, 2 of which had died on delivery and one who had a breech presentation – both of these women have been told to come to the Hospital for delivery in a few weeks time. I have been collecting data about what the women’s plans are for their delivery and so it is interesting to know that none of these women had planned to deliver in hospital and 4 of them would not have even gone to a health centre (not that unusual as 90% of women deliver at home).  So this was all good work, with positive results for all concerned.

The 2^nd clinic on Friday was also pretty hectic, not least of all because we had to break in the middle to drive to Lalissa Dibbee, a little village around 2 hours walk from the health centre, where, by the way, every woman seems to be pregnant. You may recall that a woman who delivered twins lives there and she has been having some problems with her C/section wound and, more recently, has apparently been bleeding and getting considerable pain. As Jeremy was able to come with me to the clinic, we decided it was easier to drive to the village and take her to the health post for examination. Yes, easier said that done. Having navigated our way along the rocky road, by which time Jeremy was getting agitated by the whole palaver of it all, we finally found the 12^th tree on the left by the corn field on the right and the earth mount that marked the way to her house. The two nurses with us went of in search of the family whilst we stayed with the car, which within 10 minutes was surrounded by every person in the neighbourhood.

We piled the woman, her husband, the twins, and the 2 nurses into the car and set off, now to a private clinic, as it turned out that the health post was closed. Once more, within seconds of our arrival, the entire village joined us, pushing through the clinic doors and jumping up at the ‘windows’ to see what we were doing. Try examining someone with that lot going on. Anyway, despite having considerable pain, it would seem that there was nothing seriously wrong with the woman so after giving her some diclofenic and iron tablets, we took her back to her house and then headed back to the health centre to see some more patients. On the way, however, we spotted a very pregnant, sweaty woman walking up the dirt road, heading to the health centre. Having put her and her husband in the car, examined her at the health centre and finding out that her previous 2 babies died during childbirth. As she was full term, she was advised to head to Gimbie hospital the following day.

Having given the boys pizza and a viewing of the Lion King later in the evening, I collapsed into bed, totally exhausted. Saturday morning came too quickly and I was up early to have Jaba for the day. After just 30 minutes he vomited all of his banana breakfast over the floor and my jeans, which should have been the first sign that this was not going to be a good day. On my way back from dropping Jaba off at Makabe’s house, I heard an almighty bang and the smashing of glass, followed by what sounded like hundreds of people screaming. I headed off to wards the noise with Makabe only to find that the commotion was created around the place where we park our car. You have to know at this point that our car is reversed onto a steep incline for parking. Having reached the parking spot, I looked up the hill to see that the car was now parked backwards into – and I mean ‘into’ the mortuary wall. The story goes like this;

We were meant to be going to a wedding and so Jeremy decided to take the boys along to wash the car – it was pretty dirty from all the journeys to the health centres. He asked one boy to wash the windows from the inside and another was then placed into the boot to wash this area. It seems that the boy doing the windows decided to play with the gears – which, being an automatic means the park, drive, neutral etc controls. Having found that he could move the stick, he placed it into neutral and the car proceeded at a great speed to roll back down the hill and into the mortuary wall. The trouble was, Jeremy was standing right behind the car, having just helped the other boy to get into the back of the car. He was knocked to the ground but thankfully managed to get himself in the middle of the car rather than under one of the wheels, which given the weight of it, would presumably have crushed him pretty badly.

By the time I arrived, Jeremy had managed to crawl out from under the car but looked rather confused and his head and face was covered in blood. There was also about 50 Ethiopians gathered around and many of them, including Makabe, were hysterically screaming. After much persuasion, I managed to get Jeremy to agree to go to hospital as he had a large and quite deep cut on his head and I didn’t know what other injuries he might has sustained. Having made sure that all of the boys were alive and uninjured, and phoned all the people I could think of who could be of use, I headed off to the operating department, where they were examining Jeremy and suturing up his head.

Thankfully, he’s fine; a few bruised and possibly cracked ribs, some nasty grazes and bruises in various places and a nicely sutured head wound. It wasn’t a great night for sleeping as I had some rather unpleasant thoughts about what might have happened – it could have all been a very sorry tale indeed.

The road to Lalisa Dibbee

The road to the twin's house

Remote villages

Always a crowd when the faranji and her car arrives

One of the twins - boy

The twins and parents - 8 weeks old

Jaba enjoying Robin Hood

Jaba - 6 months and teething

The car rolled into the mortuary - perhaps symbolic

Very much jinxed car

The mortuary; minus a wall

Sutured head injury