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!