11th October 2011

Today I have become an Ethiopian resident and therefore, technically, I should no longer write as the 'Faranj' who goes to Gimbie. Actually, all I was asking for was an extension of my business visa but for some reason this turned into a need to request a residency permit. After many hours of queuing and yet more photocopies of various documents, plus of course, another photo (I must have given in at least 20 photos by now and so assume that I am well known across the country), I get made a resident of Ethiopia. I think this is something of an honour and am grateful for the fact that I now have equal rights to Ethiopian citizens (not quite sure what those rights consist of, but I'm pleased to have them nevertheless.

The other most exciting moment of the day is going to the police department to get clearance from them - I guess they want to check that I am not a criminal - fair enough. Here, I not only had to give another 2 photos and an approval letter with numerous important stamps on it, but I also had to provide my finger prints. So now I am registered with the Ethiopian police and presumably, I will pick up a clearance letter tomorrow.......

We are still in Addis but hope to leave for the hills on Thursday or Friday - it all rather depends on whether Jeremy gets his clearance. We are waiting for the medical panel to sit and hopefully approve him as a doctor. Once they have done this, we can process his work permit and residency permit (now, at least, we know what the process is).

Sunday 9th October 2011

Today was spent trying to familiarise ourselves with the city of Addis. However, after walking along the side of the road for a couple of hours, the smog starts to get to you and the sinuses start to throb. The pavements are sparse and deep holes, presumably there for drainage, present potential death traps. 

By midday, a St Georges beer at the local bar (above) was much needed.

Remains of Lucy in Addis National museum.

The National Museum in Addis is definitely worth a visit, not least of all because they have the remains of Lucy, who is actually called 'Dinknesh' in Ethiopia - this means 'wonderful'. She was named after Lucy in 'Lucy in the sky with diamonds'. Her remains were found in 1974 and she is believed to be 3.2 million years old.

8th October 2011

Akam Bulte; Or good morning to those who are not yet familiar with Oromo. Actually, this will be of no use to me at all at the moment as we are currently in Addis Ababa, where they speak Amharic. I am, however, trying to get back into the habit of learning a few words of Oromo a day. I think this has been triggered by the fact that I haven't a clue what anyone is talking about here.

We arrived yesterday morning to the familiar sights of Addis; congested roads, with hundreds of cars edging in from all directions- each contributing to the enormous grey cloud of smoke above us. After checking in to the Lions Den hotel, we went to register at the British Embassy, only to find that they were closed Fridays, weekends and Mondays and even then, only opened o Tuesdays from 1.30-4.

So the next thing to do was to get our work permits sorted. Having submitted various apostled, legalised and embassy approved documents already, I thought it would be a simple matter of picking up the permit. Oh, if only that were true. There are incredibly tight processes set up here that you simply have to go through if you want to get the right documentation to allow you to work. And that's exactly what we did. At the ministry of labour and social affairs, we handed in 4 copies of our work permit application form, along with copies of our visas, passports, education certificates, professional certificates, letter of job offer, NGO certificate, health certificate and 4 passport photos. This all gets carefully read and any minor errors are corrected (a missing stamp, address, phone number etc). Then these documents get handed to someone who writes a ticket out for payment, it then gets taken to another office to pay the fee of 600 Birr (£24). Then the documents get taken to another office for stamping - here 4 different stamps are made on the documents in around 20 places. Then we take these stamped documents to the filing office, where some more checks are made before finally stamping things again and leaving one set of documents with the person there and being given the other to keep so that a copy can be given to the police, the immigration office and the hospital. At the end, though, you get presented with a small green book, with various stamps on and your photo stapled in it. This is the much treasured work permit.

Being an application for a medical position, Jeremy's work permit has another stage to go through and so we took his documents to the ministry for health, where they will be considered by a panel of experts (presumably some will be doctors) on Wednesday.

The next thing on our list is to get an internet dongle (USB stick). This was achieved easily enough after visits to various shops to find one that had the type we needed but now we have to take this to the Communications Office on Monday to allow us access to the internet. Another 2 photos and passport copies and we should be there.

Thank goodness for Mosisa, the project manager for Maternity Worldwide - he spent the day with us to help with the various stages.

28th September 2011

Tomorrow is my last day at work. I've made a start at packing up the office (I have to pack everything into boxes as I don't quite know where I will be located when I return) but it seems like I have a long way to go.

I have been saying various goodbyes over the past few weeks and this has kind of brought things to the front of my mind a bit. I have also spent a few days in the ultrasound department at St Peter's trying to improve (actually, forget improve - develop) my scanning skills. I have had a great teacher there (Brenda) and she has been very patient with my inability to grasp the skill of locating the fetal position. However, I think I have finally got it and have even managed to do some reasonable scans with my new portable scanner. Yes, I managed to fundraise enough money to buy one portable scanner and so am able to start the triage project when I get there. The obstetric risk scoring system contains 3 factors that I can only obtain through scanning.

Part of me is excited about going to Gimbie and another part of me wonders exactly why I am going there. Right now, it feels a little bit like the anticipation that you have prior to a holiday (yes, I know this is no holiday). On the one hand you're really looking forward to it, but then you are not really quite sure what it will all be like. I'm sure that it'll all be fine in the end. I guess that my biggest fear remains that we will not be able to achieve very much and so will get frustrated with the systems that prevent us from doing what probably needs to be done.

18th September 2011

Last Sunday was Ethiopian New Year and it is now 2004 over there. There are also two times (8 hours apart) that people work on so I think it is possible to never be late for anything!

With just 18 days to go until 'E' day, I'd like to be able to report that we are ready and prepared for the year ahead. Alas, that is not the case and we still haven't got our work permits, business visas or car documents sorted. Its not for the want of trying though. Over the past 4 or 5 months we have become regular customers of a local notary (to notarise many documents), the Foreign Commonwealth Office (to legalise the documents) the Ethiopian Embassy in London (to stamp said documents) and DHL, who finally get to send all these documents to a PO box in Addis. The real problem is that no-one seems to know exactly what is required for a work permit or for importing a car. So we provide everything that is asked for, only to find that there are further things needed; each time this involves various trips to get them authorised by everyone. Our work permit has required; a letter form the GP saying we are healthy, a letter from the charity offering us a job, a job description and terms of reference, photocopies of our passports, copies of qualifications, and copies of a bank statement to show you have enough money to support yourself. All this has to be shown to be genuine documentation and hence notarised, legalised and stamped.

We are just about to pack the car, which will hopefully arrive after 30 days on a ship, into Djibouti. It's not clear how hard it will be to get the car through customs but so far, things do not look good - again, no-one really knows what you have to provide. The other problem is that it's not clear what you can take into the country and what you have to pay tax on. Apparently, personal items are fine, but then a friend got stopped and charged £40 to bring her laptop through. I think these 'rules' are all a bit random and rely on visitors carrying enough cash with them to get through.

7th July 2011

As the departure date gets nearer and nearer, I am beginning to wonder exactly what I am going to achieve over the year. There are many possible projects that I feel I can contribute towards but I think it's important to start my time there with a specific focus. My main interest is in improving the referral system between the community and the hospital. Whilst I was in Gimbie last February, I was struck by the realisation that many of the women having their babies in the hospital didn't need to be there, yet many of the women having their babies at home seriously needed to be in hospital. Indeed, without the hospital treatment, these women were dying or suffering with serious life-long complications such as a fistula between the uterus and bladder.
Unlike the UK, the majority of women in Ethiopia (94%) have their babies at home. For many women, this is fine and they are able to have a safe childbirth. However, when things start to go wrong, the nearest hospital or health centre can be 5 or 6 hours walk away. Transportation is virtually non-existent in the villages and so women either have to walk to hospital or they are carried on a stretcher made by the family. As you might imagine, many of these women die on this rather hazardous journey to hospital, or they arrive too late to hospital for anything to be done.
The following letter was published in a paper that describes the problems of delays in getting to hospital and even though I have read it many times, it still horrifies me to think of the suffering that many families experience every day:

Today Mary, the lady who helps us in the house came late to work. I told her off for being late and asked why. She said that one of her townswomen had died in the hospital while giving birth to a baby. This was her fifth delivery….. By the time they found a vehicle to go to hospital, by the time they struggled to get her an admission card. By the time she was admitted, by the time her file was made up, by the time the midwife was called, by the time the midwife came, by the time the husband went and bought some gloves, by the time the gloves were brought to the hospital, by the time the midwife was called, by the time the midwife came. By the time the midwife examined the woman, by the time the bleeding started, by the time the doctor was called. By the time the doctor could be found, by the time the ambulance went to find the doctor. By the time the doctor came. By the time the husband went out to buy drugs, IV set, drip and bottle of ether, by the time the husband went round to look for blood bags all round town, by the time the husband found one and by the time the husband begged the pharmacist to reduce the prices since he had already spent all his money on the swabs, dressings, drugs and fluids, by the time the haematologist was called. By the time the haematologist came and took blood from the poor tired husband, by the time the day and night nurses changed duty….. and the husband signed the consent form, the woman died. Today the husband wanted to sell the drugs and other things they never used to be able to carry the body of his wife back to their village but he could never trace the body again in the hospital.