Happy Christmas!!

Happy Christmas to you all!  Helen did a fantastic job of decorating our flat, which has now been nicknamed the 'grotto' and feels very festive.

Looking festive - the back of the bookcase makes a great fireplace!

Our Christmas celebrations got off to a great start on Saturday evening when Helen and I held a Christmas party, complete with a buffet, mulled wine and facepaints...



The fruits of our labour (with sparkle effect!)

Daisy wasn't sure about being a Christmas pudding... 

...but the boys enjoyed being big cats! 

We spent yesterday evening at Susie's flat and very much enjoyed a mince pie and (another!) glass of mulled wine whilst we opened our 'Secret Santa' presents.  Susie is cooking Christmas lunch today - we have managed to find a pork shoulder joint and a very small chicken to roast...  I've put together a quiz for later, and Helen and I have everything we need for the 'chocolate game'.  It will be a different Christmas but I am sure it will be full of fun and festive cheer!

I hope that you all have a very happy Christmas - I'll be in touch soon with more news from Ethiopia.






Christmas is coming...

In many ways it doesn’t feel like December but Helen is compensating for the general absence of Christmas by making sure we have plenty of festive cheer in the flat.  Our bookcase has been turned around so that we can create a fireplace (!) and Helen has been busy making snowflakes and paperchains, photographs to follow...

Daisy, one of the VSO volunteers based in Dire Dawa, visited last weekend so we went on a tour of Harar’s old walled city.  Binyam, our guide, was very informative and expertly led us through some of the many narrow cobbled alleyways.  Around 30,000 people live in the 1 square kilometre walled city which contains over 80 mosques.  We visited the home of the 19^th Century French poet, Rimbaud, as well as a traditional Harari house and a very peaceful Catholic church which sits on the same site as a school and orphanage.  I bought some of Harar’s famous coffee from the city’s small factory and have been enjoying it this week with milk from one of the farms on campus.



Showa Gate, one of the six entrances to the old walled city

Inside the walled city

 

Donkeys bring wood to the city



Local butcher...



View over the surrounding countryside

Another of the gates to the walled city


It was ‘Nations and Nationalities Day’ last Sunday so many of the university students dressed in traditional costume and took part in a parade on campus to celebrate the nine different regions of Ethiopia.  Later in the day Helen and I went for a walk with Gary, one of the other volunteers, through the eucalyptus forest on the edge of the vast university campus.

Students in traditional Harari costume take part in the nations and Nationalities parade



Sunday afternoon stroll with Helen

Life at the hospital continues to be busy.  I have now presented the findings of my short audit on the temperature of newborn babies, as well as the data I collected about admissions to the neonatal unit during October.  Keeping babies warm is a very simple but effective way of improving neonatal outcomes and an area of practice that I’m really keen to improve during my time here.  My audit showed that 49% of babies on the neonatal ward had a low body temperature.  I have now developed a guideline for temperature control in neonates which has been translated into Amharic, and I am encouraging staff to promote the use Kangaroo Mother Care (skin to skin contact of mother and baby) to keep babies warm.  I think the doctors were surprised by how high the neonatal mortality (28%) and self-discharge rates (44%) were during October.  The importance of regular monitoring of babies and effective communication with families (including managing expectations – the same all over the world!) cannot be overestimated.   I introduced a new observation and fluids/feeding chart to the neonatal unit last week and hope that this will help to improve monitoring of the babies.  I have also worked with one of the doctors to develop a prescription chart (currently medication orders are written in the medical notes and there is no documentation of drug administration) which we plan to introduce this week.

I have been really encouraged by the presence of the new medical interns on the ward and am sure that they will make a big difference to the quality of care given throughout the hospital.  I delivered a session on emergency paediatrics as part of their induction programme and included revision of the neonatal resuscitation that they were taught by Jo, the previous volunteer paediatrician.  I hope to run a similar session for the medical interns working on the maternity ward to try to improve the care that newborn babies receive.  I now spend two afternoons each week working with the interns in the paediatric admissions area so that I can share my skills in acute assessment and management, including the role of effective leadership and teamwork.  I also continue to enjoy my regular bedside teaching sessions with the 4^th year medical students.

I will be in touch again with more news and photographs, including progress with the Christmas decorations! 

A goat and a hyena

The weeks now seem to be flying by.  It’s just over two months since I left the UK and I am certainly becoming more used to my surroundings.  Every now and again, however, I am reminded that I am a long way from home.  The day that I saw a goat wandering around the children’s ward and the morning that a hyena stared from the roadside as we left the university campus served as such reminders!

Life at the hospital is busy and I am becoming more involved with the various activities of the paediatric team.  The fourth year medical student exams were held last week so I spent two days examining the students on ‘long cases’ (students take a history, perform a physical examination and then report their findings and management plan) and another day examining the respiratory station of the OSCE (Objective Structured Clinical Examination).  The OSCE consisted of a circuit of eleven stations, some involving clinical contact and some requiring the students to answer questions related to photographs.  I was asked to develop two questions on developmental milestones and newborn classification.  Forty four students are attached to the ward at any one time and watching them each spend six minutes examining a child’s chest felt like a bit of a marathon!

The first intake of medical students graduated from Haramaya University last month and started work as interns today.  Thirteen of them will be attached to the paediatric department for ten weeks.  I have worked with the paediatric doctors to develop an intern induction programme and suggested that it would be good for them to each have a clinical mentor.  I attended a meeting about the proposed roles and responsibilities of the interns at the medical school last week which was very interesting.  Professional accountability and continuous professional development have very different profiles here and at present there are no postgraduate examinations.  The medicolegal system is very much in its infancy but I am sure that things will be very different when the new doctors approach the end of their careers. 

My clinical contact continues to be mainly focussed on the neonatal unit.  I have been delivering weekly training sessions to the neonatal nurses but at times feel very frustrated by the lack of basic care.  I reviewed the log of all admissions to the neonatal unit during October and identified a mortality rate of 28%.  A further 44% of babies leave the hospital without medical agreement and I know that many of them will not survive.  At times things do go well though and it was lovely to see a preterm baby whose Mum brought her back to the ward for a ‘check up’ last week – she looked really well and was gaining weight which was great.

A happy Mum returns to the Neonatal Unit with her thriving preterm baby

I have been struck by the number of babies with congenital abnormalities here – many women do not have any antenatal care and few have antenatal ultrasounds scans.  I have seen three babies with no anal opening (fatal if not operated on), two with severe spina bifida (one who was born at home and didn’t come to hospital until he was three weeks old) and two with encephalocoeles (herniation of brain tissue through a defect in the skull) – more than I have seen in over six years of paediatric practice in the UK.

Helen and I continue to enjoy our Amharic lessons, and I helped at Saturday Club again last week.  I enjoyed pottering around Harar at the weekend – the market was really lively on Saturday afternoon and I managed to fill the fridge with quite a range of vegetables.  Green beans, lettuce and cucumber have become quite exciting!  I also located the alcohol shop so was able to enjoy a gin (with lemonade...) at an Ethiopian friend’s party on Saturday night.

I think I will have a busy week introducing the new medical students to paediatrics and delivering some of the induction programme to the interns.  Susie (VSO midwife) and I plan to visit the other government hospital in Harar tomorrow afternoon to arrange some refresher neonatal resuscitation training for the staff there.  I will be in touch again soon with more news.

City Break

I’ve had another busy couple of weeks and very much enjoyed a trip to Addis Ababa for the Ethiopian Pediatric Society Annual Conference.

I feel that I am beginning to make small changes at the hospital and that there is a definite willingness from the staff to work together.  The first training session with the two neonatal nurses went well.  We worked together to design a ‘Welcome to the Neonatal Unit’ poster which included photographs of the nurses and some ‘ground rules’ about infection control for staff and visitors.  I wrote the wording in English and one of the students translated it into Amharic, the national language.  The nurses very much appreciated having their own copies of the photos and seemed very pleased with the plastic bottles for alcohol rub – these were tied to the cots in no time!

Progress with infection control: bucket of water and soap for handwashing...

... and cotside alcohol rub

I am really pleased that a midwife with neonatal training has started working on the Neonatal Unit and that a neonatal nurse who has been on long term leave has also returned.  It was great that all four of the neonatal nurses were able to attend my second training session about intravenous fluids.  We’ll practise the various calculations again this week and I’ve printed some supportive material to put on an education board.  I’ve now delivered the last of the eight neonatal lectures for the 4^th medical students and have continued to do bedside teaching sessions with them.  It is the final week of their paediatric block this week and I’ll help with their clinical exams next week.

I travelled to Addis Ababa last Wednesday for the Ethiopian Pediatric Society Annual Conference and returned to Haramaya on Saturday evening.  It was my first trip back to Addis since arriving and I was quite surprised by how struck I was by all the Caucasian faces at the airport.  The clean flushing toilets (complete with toilet paper) were also quite a novelty!  The conference was held at the Sheraton Hotel which is beautiful.  The opulence felt a long way from my work environment and made me feel a little uneasy.  However, it was really good to understand how paediatrics is being led at a national level and I felt very encouraged by what I saw.  For me, the most inspiring speaker was Dr Dube, a paediatrician from Blantyre, Malawi, who worked with her colleagues to develop a triage system for their incredibly busy paediatric emergency department.  Previously patients had been seen on a ‘first-come, first-served’ basis rather than according to clinical need.  Introduction of this system had a significant impact on mortality rates and it has now been implemented across Malawi.  The team have developed a three day ‘Emergency Triage Assessment and Treatment’ (ETAT) training programme for health workers which is being rolled out across sub-Saharan Africa.   Dr Dube will deliver ETAT training to paediatricians in Ethiopia this week and hopes that they will disseminate their learning to colleagues across the country.  Dr Dube ended by saying that ‘insanity is doing things the same way and expecting to see different results’ - wise words which are very relevant to my work here.

 

It was really lovely to catch up with several other VSO volunteers in Addis.  In addition to the Addis-based volunteers, I saw some education volunteers who were attending another conference and met three new arrivals (two of whom I knew from a training course in the UK).  I certainly ate (and drank!) far more than I would usually but it was hard not to make the most of the beautiful lunches at the Sheraton and vast choice of restaurants in Addis in the evenings.

Life here on the university campus continues to be good and it was nice that the flat felt like home when I returned on Saturday.  Helen (my flatmate) and I helped at ‘Saturday Club’ at the school on campus last weekend.  The Club was started by a previous VSO volunteer and aims to teach school-aged children life skills and improve their English.  We had a Halloween theme - Helen expertly painted the children’s faces whilst I organised some Halloween-themed games.  Several of the children showed me around the school afterwards – I understand that it is very well-resourced compared to many others but class sizes are still large and access to books seemed limited.  Helen and I have also started twice weekly Amharic lessons with one of the English lecturers at the university.  It would be great to be able to have basic conversations with staff and patients at the hospital, and a little Amharic would probably help secure better prices when negotiating with taxi drivers and in the market! 

It is strange to think that the nights are becoming longer in the UK and that you’ll be celebrating Bonfire Night tonight – can’t say I’m missing the colder weather, the blue skies and warm days here are great!  I’ll be in touch again soon with more news and photographs.

Power cuts and water shortages

The past couple of weeks have passed much more quickly than the last, perhaps a sign that I am settling into a routine and feeling more familiar with my new environment. 

The students began to arrive on the main campus for the new academic year two weeks ago – the university arranges transport to bring them here from cities across Ethiopia so no weepy parents in sight!  The arrival of the students coincided with the onset of long power cuts (and consequently no internet access), significant water shortages and the absence of mobile phone reception.  Helen and I are very lucky to be living in an apartment block with ‘people of high position’ so seem to have had more electricity than most.  We have still spent a few evenings with the flat lit by candlelight and had several cold bucket washes in the mornings, sadly a situation that is the norm for millions of people across the world.  Water has also been a big problem – we are now familiar with the locations of the standpipes on campus and my headtorch has been very useful!  Much of eastern Ethiopia has been affected, possibly due to a problem with a dam which took longer to repair than anticipated.

Young boy looks on as the students arrive for the new academic year

Things are going well at the hospital.  The medical student final exams were held the week before last and I was asked to examine on one of the days.  It was interesting to observe the process and certainly brought back memories of my own clinical exams.  Each student had a ‘long case’, ‘short case’ and viva so I was able to see a range of children, some with pathology I have only read about in textbooks.  Several patients had severe malnutrition which is really sad to see.  I was pleased that a couple of the viva topics were subjects I knew something about – neonatal jaundice and diabetes care are stronger areas than the management of a child with smear-positive tuberculosis! 

At times things have been very frustrating and I have found the significant staff shortages particularly challenging.  However I feel that I have begun to establish positive relationships with both nursing and medical staff, and that some small things are slowly starting to change.  I have worked with the nurses to rearrange the furniture in the neonatal unit and am pleased that the phototherapy unit has been taken to be repaired.  The appearance of the Ward Sister with a brand new bucket labelled ‘neonatal unit’, together with a new bar of soap, was a definite step in the right direction.  I have collected and washed several small drinks bottles which I hope to fill with alcohol rub and tie to each cot so that it is easier for staff to clean their hands between babies.  The neonatal nursing staff highlighted ‘training’ as something that would help to improve patient care so I will start weekly sessions with them tomorrow. 

I have found working with the fourth year medical students particularly rewarding - it is great to have such an enthusiastic and motivated audience.  I started delivering bedside sessions and lectures last week, and both seem to have gone well so far.  Bedside teaching is fairly challenging with 22 students in each group (a lot to fit around one cot!) so I decided to split the groups into two, with half the time spent on clinical examination and half preparing a poster presentation.  The students are generally taught in a very traditional way and are given a fairly tough time in handover and ward round settings – they told me that they have never been asked to prepare posters before and that they have enjoyed the interactive nature of my lectures. 

I spent last weekend with four other VSO volunteers in Dire Dawa, Ethiopia’s second largest city.  The city is about an hour away by line taxi and lies several hundred metres below Harar so is much hotter.  We spent Saturday afternoon at one of the hotel pools – great to relax and enjoy a swim.  We had an excellent Indian curry at the hotel in the evening and met some other expats in the garden afterwards.  I really enjoyed a (cold) shower the following morning, so good to feel properly clean!  It was fun to visit one of the markets – known as ‘Taiwan’ because of the number of electrical goods available to buy.  I bought a scarf which I have used to tie back the curtain in my bedroom.  I wandered down to Bate, the village at the university gate, last Sunday evening to buy some vegetables and enjoyed a beautiful sunset as I walked back.

 

Women sell vegetables in Bate

Photogenic girls in Bate

Beautiful African sunset

This weekend has been spent relaxing in the sunshine on the main university campus.  I finished reading ‘The Secret Life of Bees’ by Sue Monk Kidd yesterday – I would certainly recommend it if anyone is looking for a good read.  One of the other volunteers had a party last night which was fun.  It is really interesting to chat to local university staff and makes me feel very privileged that I grew up in such an affluent and free society.  I went for a run this morning and ventured off campus for the first time – I saw some camels carrying heavy loads and was joined by a little boy for a few metres. 

I’m looking forward to the coming week and will be in touch again soon, internet-permitting!

Hungry hyenas

I met Helen and some  of the other volunteers in the old walled city of Harar after work last Friday evening.  After dinner we went to watch the ritual of ‘men feeding hyenas’, a slightly strange experience which I decided wasn’t for me!  Some of the others fed the hyenas meat skewered on a stick, and one or two people went as far as putting the stick in their mouth... 

Helen looks slightly apprehensive...

...whilst Daisy plays it cool

We explored our local town of Alamaya on Saturday which has a large market and a small supermarket.  I felt a bit of an idiot when I walked into the supermarket and asked for a basket, not terribly culturally sensitive!  We found some hooks in the market which Brian, one of the visiting volunteers (and over 6 feet tall...), used to help Helen and I put up our mosquito nets.  We had a housewarming party last Saturday evening which was good fun – we managed to feed ten people pasta with roasted vegetables, bought some wine in a bar in Alamaya and some beer on campus, and were treated to some Ethiopian music and dancing later in the evening.  Last Sunday was unusually wet so we played Bananagrams and Boggle rather than getting soaked outside.  The wet weather quickly disappeared though and the days since have been warm and sunny.  It is great to be woken each morning by sunlight flooding into my bedroom and for the temperature to have reached mid-high 20s by lunchtime.

The reality of the role that I have taken on has begun to hit me this week.  Senior university staff are keen that I work to improve neonatal care at the hospital so I have spent much of the past week on the Neonatal Unit.  There is currently a ten cot 'intensive' nursery, a room for less dependent babies and their mothers, and a room designated for Kangaroo Mother Care that is not used at present.  I am well aware of the statistics surrounding child mortality in the developing world but actually seeing babies die every day due to a lack of appropriate care and equipment is really hard.  Just three nurses provide 24 hour cover for the Neonatal Unit, and only three junior doctors work a rota to deliver 24 hour care to the whole paediatric department.  It is therefore perhaps unsurprising that the babies have only one set of observations each day and that documentation is minimal. 
 

The workstation and assessment area on the Neonatal Unit

The 'intensive' neonatal nursery

I am sure that relatively simple interventions, particularly those to prevent hypothermia, could make a big difference to neonatal mortality rates.  I know that Jo, the previous VSO paediatrician, worked really hard to try to prevent the babies getting cold and that many people in the UK sent her knitted baby hats.  I have discovered where these hats are stored and have been doing my best to encourage staff to use them.  I have also been able to talk to two of the neonatal nurses about what they feel they do well and what could be improved.  Following a discussion about infection control, one of the highlights of my week was watching a nurse find a bucket of water and some soap, and proudly show me how I could now wash my hands!  I just need to encourage everyone else to do the same....  I have put together a report containing my observations and ideas for the development of neonatal care which I hope to be able to discuss with paediatric and university staff soon. 

I also attended a 'follow up' clinic for children with chronic conditions such as diabetes, epilepsy and chronic liver disease.  There is limited availability of drugs for these conditions but the medication that the children receive is dictated by what the family can afford.  For the medics and nurses reading this, none of the families could afford short-acting insulin and the diabetic children had random blood glucoses between 15 and >30 mmol/L.  I have also been asked to review some interesting ward patients - with very limited investigations, the doctors are very good at piecing together the medical history and eliciting clinical signs to arrive at a likely diagnosis.  I have attended two ‘management sessions’ where medical students present recent paediatric cases and discuss the scientific background afterwards.  I have been impressed by the quality of their presentations and learnt a lot about malaria, not something I saw very frequently in Bristol...  I have agreed to deliver the neonatal topics in the medical student lecture programme and will begin this in a couple of weeks. 

I have found the days at the work tiring – I leave the main university campus at 7am and return just before 7pm, by which time it is dark.  I have enjoyed having some time to relax this weekend and to further explore the local area.  Helen and I took a ‘line taxi’ into Harar yesterday – the journey was quite an experience with 22 people, plus a baby, crammed into a minibus with 12 seats.  The two ‘ferengi’ (white people) seemed to be quite a talking point!  Many people on the bus were chewing ‘chat’, the leaves of a flowering shrub, for its stimulant properties.  The area around Harar is particularly renowned for chat growing and its trade certainly seems to be big business. 

'Chat' trade in Harar

Women sell nuts on the street in Harar

We had a wander through the market in Harar and found some aubergines and ginger which will add a little variety to our diet this week!  We then went for a walk around the perimeter of the walled city and back through the narrow, winding streets.   Unfortunately I missed the guided tour of the old city last Friday but will hopefully be able to do a tour soon, perhaps when we next have visitors.  I went for a run around the fields of the university campus when we got back from Harar.  Haramaya University has its roots in agriculture and the campus is very green with several farms.  Helen and I are meeting two of the other volunteers for breakfast on campus this morning, and plan to go for a walk later - we'll pack a picnic lunch, the Kindles and my frisbee!

Harar market

Laden donkeys on the street in the old walled city

The coming week will no doubt bring its challenges but hopefully some rewards too.  I’ll be in touch again soon with more news.

Goodbye Addis Ababa, Hello Haramaya University

It's been a busy week!  The last few days of our in-country training in Addis Ababa were good fun, and included a pub quiz and a cultural evening (great band and very talented dancers), as well as more language tuition and information about our various placements.

Ethiopian coffee ceremony at the cultural evening

Ethiopian traditional dancers

We had a health sector workshop last Thursday which was led by current volunteers and included a session from an Addis-based Neonatologist about developing neonatal care in Ethiopia.  The statistics surrounding maternal and newborn health here are striking – a woman has a 1 in 67 lifetime risk of dying during pregnancy and childbirth, and 40% of child deaths occur in the first month of life.  Two current VSO volunteers told us about their incredible work in developing a neonatal unit in the south of the country – they started with an empty room and are hoping to open the unit in a couple of weeks.  We also heard from a representative from the Ministry of Health who acknowledged that working in the health sector can be very frustrating.  Supplies of drugs and equipment are often available but in a warehouse rather than in the hospital where you need them. 


After our language tuition last Saturday morning (getting to grips with conjugating regular and irregular verbs...) we went into Addis to shop for equipment for our new accommodation.  As our flat is well equipped, I took the advice of a current volunteer and bought some dried milk and custard powder - apparently good comfort food and difficult to get hold of outside Addis.  Each volunteer received a box of supplies from VSO which includes an electric stove, kerosene stove, water filter, blankets and mosquito net.  There was a demonstration of how to cook on a kerosene stove which included a tasting session afterwards.  A typical Ethiopian meal includes injera (a type of flat ‘bread’ with a crumpet-like texture) that is served with vegetables and various stews.  Lentils and chickpeas are popular, and beef seems to be the most commonly found meat.  After the shopping, some of us went to a German Beer Garden, certainly a hangout for expats and wealthy Ethiopians but it was great to eat some European food!

 

Results of the cookery class - injera at the front of the picture

Demonstration of how to put together a water filter

I left Addis Ababa early on Tuesday morning.  I flew to Dire Dawa with Susie, a lovely volunteer midwife who has been working at Haramaya University for 12 months.  We were collected from the airport and drove for about an hour to Haramaya University main campus where all five of the VSO volunteers live.  We shared the road with other vehicles, pedestrians, goats, cattle and camels!  The scenery was beautiful and the sense of space was great after a couple of weeks in Addis.  The main university campus is very green and well equipped with a couple of small shops, a staff lounge, swimming pool, a bank and a post office (hoping to open a postbox on Monday...).  Helen and I are sharing a large three bedroom apartment which is really quite plush in many ways – fridge/freezer, internet access and a better television than mine in the UK (some would say not difficult!).  In other ways it is very basic – we have one tap that works and gives us water for about two hours each day.  I am perfecting the art of washing using a bucket and a jug!  Everyone has been very friendly and we are really lucky to have three current volunteers to show us the ropes.  They have introduced us to some of their Ethiopian friends and they have met several other expatriates at the university during their time here. 


My new bedroom

 

 

 

The lounge

 

Helen sits at our rather grand dining table

 

The kitchen

 

The bathroom

The tap on the right is the one that works!

View from the front balcony...

...and from the balcony at the back

I visited the health campus and hospital in Harar with Susie yesterday.  There is a bus that leaves the main campus at 7am each morning and returns from Harar at around 5.45pm.  The journey takes about 45 minutes.  The lecture rooms and clinical skills areas are located on the health campus where I will share an office with Susie.  The hospital is about a 10 minute walk from there.  Unfortunately I was unable to meet any of the doctors yesterday as today is Meskel (Ethiopian Orthodox Christian festival – ‘the finding of the true cross’) so many people weren’t around.  Susie did give me a brief tour of the hospital and the paediatric department.  Things are very basic and there is no running water.  There was just one baby on the neonatal unit but I am sure that Jo, the previous volunteer paediatrician, would be really pleased to see that he was having regular observations.  There were only nurses and medical students on the ward but hopefully I’ll meet the doctors tomorrow and have a more formal introduction to the department.  I plan to spend the first couple of weeks meeting people and getting to know how things work.  I think a good approach will be to view every challenge as an opportunity!

   

Two of the other VSO volunteers (who we met at our in-country training) are visiting this weekend.  I hope to meet everyone in Harar tomorrow evening and watch the local ritual of men feeding hyenas.  We plan to visit the old walled city on Saturday, apparently fascinating with 368 alleyways within one square kilometre. 
 
I will be in touch again soon with more news and photographs.

Tena yistillign!

It is now a week since I arrived in Addis Ababa for ‘in-country training’ before beginning my placement in the east of Ethiopia.  The 35 new VSO volunteers come from seven countries (UK, Canada, Ireland, Netherlands, Sweden, the Philippines, Kenya and Uganda) and will mainly be working in education, health and engineering environments.  Our in-country training is being co-ordinated by three current volunteers, one of whom has been in Ethiopia for five years which is surely a good sign!  We have had daily language tuition as well as sessions on the cultural, political, economic and developmental context in Ethiopia.  There has been plenty of advice about the practicalities of life as a volunteer and the trainers have worked really hard to set us up with mobile phones and internet access.



The Ethiopian Red Cross Training Institute, location of the 'in-country training'

Back to school for Amharic lessons

Last Friday we had our first trip into the city.  This took the form a scavenger hunt with small teams each being given a list of tasks to perform.  Our first task was to take a ‘line taxi’ (overcrowded public minibus, similar to a Kenyan matatu) to a nearby shopping centre.  All went well until we asked for the bill – I thought I’d grasped numbers in Amharic but none of us had a clue what was being said!  Other tasks included buying half a kilo of bananas, buying a newspaper (surprisingly difficult – ended up asking in a bank and being given a paper from July 2011...) and making a call from a public telephone box (not to be recommended...).  A huge thunderstorm and power cut gave us a realistic introduction to life in Ethiopia.  There have been several short power cuts since and internet access is certainly intermittent.  Afterwards we all met in a bar near the VSO Programme Office where I enjoyed my first Ethiopian gin and tonic (about 30p and very drinkable!).  We then spent the evening at an Ethiopian restaurant and cultural show which was very touristy but fun. 





A very wet Addis Ababa



Making our first gin and tonics...



...and enjoying them

We were invited to a reception at the British Embassy on Tuesday evening which was very enjoyable.  The Embassy sits in beautiful grounds that contrast starkly with the fumes and chaos  outside.  We were made to feel very welcome and valued by the Ambassador, and it was great to meet representatives from other organisations such as the British Council.  The red wine and canapés were also much appreciated!

Dressed up for the reception at the British Embassy

 

Yesterday was my best day so far.  We were able to arrange a visit to the Black Lion Hospital (the largest teaching/referral hospital in Ethiopia) through Phillip, an American Neonatal Nurse Practitioner who is also staying here at the Ethiopian Red Cross Training Institute.  He is in Ethiopia for four weeks and working as part of a longstanding relationship between the Vermont-Oxford network (an international network of neonatal units which seeks to improve neonatal care across the globe) and the Black Lion Hospital.  Although the neonatal unit was crowded and cockroach-infested, it was really inspiring to see how much Phillip and his team have achieved through being consistent and by thinking laterally.   We were introduced to a very dynamic and capable paediatrician who is keen for us to visit the Black Lion again and happy to be a source of advice.  Afterwards I learnt that I will definitely living on the Haramaya University campus with Helen, another new volunteer who will be working on Continuous Professional Development for teachers.

Electric stoves heat the Neonatal Unit - important not to trip over them!



The mother of a premature baby keeps him warm in the 'Kangaroo Mother Care' room

Construction of the new Radiology Department at the Black Lion Hospital

Today we have a health sector workshop which will introduce the structure of healthcare in Ethiopia and give us the opportunity to meet current health volunteers.  One of the doctors from my hospital will come to Addis tomorrow so I can meet him together with VSO Programme Office staff - I was pleased to hear that the staff at the hospital are expecting me and are looking forward to my arrival next week!