Friday, 21 March 2014

Jet Lag

On Ethiopia and jet lag

Still trying to get a grasp on the essence of Ethiopia – the sense that things will get better, the optimism. Not everyone wants to move to Canada! Amongst Ethiopians is an almost palpable sense that “things are getting better”.  My young friend, Zacharias, said that he had no desire to move somewhere else because he thought that he would find some of the same problems elsewhere. “I have a good regular job and things in Ethiopia keep improving, why leave?”

Milta, Abebech’s 15 year old daughter, said that she wanted to become an astronomer – her mother didn’t think that she’d get a job, but she said that her mother doesn’t know about the future.  Clearly she thinks that it will be improving. 

This optimism is difficult to capture, amongst the beggars along the streets, the skinny women with their equally skinny babies, the crippled and deformed, the elderly with canes – there are not enough birr to go around.

Then there is Saturday night in the hotel lobby – the sex-trade workers and the drunken white men, the noise at the bar and the quiet disapproval of the local staff.

At 10:30 pm on March 8th, I leave for the airport in Addis Ababa.
At 6:30 pm on March 9th, I arrive in the Regina Airport (and drive two more hours).

Jet lag – what is it? My brain was a mass of spaghetti – the connections were there but somewhat faulty. When we visited Elizabeth, Erin and Shayna, I was sometimes not able to connect my thoughts to my tongue – like intoxication but with a spooky clarity in my brain that is not present in drunkenness.

For the next two days, I alternated between wakefulness, exercises, brainless speediness with pingponging thoughts, overall buzziness in the body and sleep. The “buzziness” could not be relieved by bathing but would temporarily disappear after sleep. I could unpack my suitcase but not sort the papers; I could collect the bills but not complete the expense sheet. I couldn’t seem to sort out the day of the week.

The distracting unpleasant physical sensation seemed to have disappeared by Wednesday and that morning, my digestive tract seemed to have adjusted to the time zones – this meant that I was really home!

It actually did take a week before my mornings and sleep times returned to normal. My body arrived home on the evening of March 9th – my diurnal rhythm got here on March 17th.

Tuesday, 18 March 2014

My Ethiopia

Arriving after two “red-eye” flights, the line up for exchanging $US20 for a visa was expected; the absence of my luggage was not. Just as I was giving up hope in the disorganized chaos, a complete stranger brought my bag to me. A brief ride to the hotel, a quick check-in and an all-day sleep - horizontally.

Meet the others – David Zakus, Susan Jacoby, Vince Salyers – in the evening for a meal at the Beer Garden Inn next door to the Harmony, home of the "Blondies". Weather – a lovely 25 – 28 during the day and a 16 to 20 at night.

Tuesday: Getting acquainted with the teachers and their roles. Watching them work with the participants – instructor midwives who are increasing their skills as instructors.

That night, I woke at midnight with a burning forehead followed by chills. I did not have a thermometer but I am quite convinced that I had a fever – the “fever dreams” were also present. I alternately threw my covers off and pulled them back, sweat and drank copious amounts of water, finally awakening at 6:30 am. Although I felt like a wet dishcloth and just as stinky, I went for breakfast and spent the day, Wednesday, at the workshop site: I was given a tour of St Paul’s Hospital by a person who called himself a “nurse practitioner”. I had a cough and a mild headache all day so if there is an outbreak of the flu at the hospital, I would be blamed.

Thursday:  We attended the Ethiopian Public Health Association conference – held in the architecturally imposing African Union buildings. We had lunch off site, coffee in a little coffee shop and went back to our hotel.

On Friday, much as I would have liked to keep up the pace, my greatest need was to sleep which I did all day.

On Saturday morning, we heard David do a presentation and in the afternoon, we did a round of the “Mercado” arguably the largest market in Africa. 

Sunday we booked the day with Fikeray and he brought his family to go to the volcano resort. I needed my cane for the hills – flustered by the rush to the car and too many things to carry, I left my iphone on one of the terraces.

Monday: Toured two urban clinics that refer to SPH. Sat at the back of the classroom. Ate with the participants.

There are always people walking on the road – there are no sidewalks. A steady stream of workers and shoppers, tradespeople and hawkers winds out of the slums and suburbs and into the city centre in the morning and back again in the evening.

Tuesday: To Fiche with Enoch Pambour, research assistant to the project, and Josee (?) who is vaguely associated with the project. Enoch and I decide to take the hotel that he can afford. It doesn’t have any running water – each room gets a pail a day for washing and flushing. Bed - clean, frayed sheets, extremely firm mattress. There is a restaurant across the road for breakfast, lunch and dinner and there’s a bar scene associated with the hotel. Fiche - 120 km or so North of Addis Ababa - is very cool at night – it’s an elevated desert. Wearing a t-shirt, undershirt, manteau and two pair of pants, I'm chilled to the bone.

Wednesday: One of the most miserable nights that I have spent anywhere – it was cold, the bed was hard, I didn’t have a light in my room, and at 4:00 am, the diesel truck parked under my window started spewing smelly stuff at me. I started coughing the next morning.

Thursday:  And coughed and coughed and coughed. Through travels in bajaj’s, visiting the hospital and the health clinics and the zonal health office for the area under Enoch’s research interest.

The upside of electricity is obvious - lights, plug-in chargers, elevators however, the upside of having no electricity is no endless music blaring, especially over the three competing sound systems that I can hear from my room (thanks for the invention of ear plugs, I could sleep). T-V advertising in the restaurant/pub: Mercedes cars, gorgeous clothes, education and careers – seems that you can have all those glamorous things if you have an IUD!

Friday – Reviewed some of the data that we had about the hospital by returning  and meeting with the CEO and the Medical Director. Fikraye arrived at about 2:00 pm and drove back to Addis Ababa for a meeting, inexplicably held in the Hilton beer garden (was it to get us over any thoughts that we were being royally treated at the Harmony?). The second set of teachers has arrived to continue the course while Vince and Susan leave – Debbie Duran-Snell and Heather McLellan, Roger Turnell and Khalid Aziz.

Saturday – Visit the home of Abebech, Asfah’s sister. Got taken by the taxi driver who, when I told him that I was paying too much, offered to re-negotiate the fare. I declined saying that “a deal was a deal”. My friend’s family doesn't speak English - how awkward but there is one English speaking (high-school) daughter.

I went to a movie upon return – “Endless Love”. It is only 5 Birr for a big bag of popcorn; admission is 60 Birr – about $0.75 for the evening.

Sunday – Went to the closest church, a cathedral, and sat in the chanting, incense-waving service amidst hundreds, maybe over a thousand people.

Monday – I can't seem to tear my enjeera (bread) with only my right hand. Hand washing is extremely perfunctory but everyone at the table does it. Ethiopians make sure that “ferengi” wash their hands.

Tuesday – Sit down newborn mortality rounds in the hospital with Roger, two cases being presented by pediatric residents in the first year of their programMet with Dr. Lia, Vice Provost, with Drs Turnell, Aziz and where we discussed the future of SPH as a referral centre – where would women stay, how to increase capacity to receive and refer-back patients,

Wednesday – Met John Guilfoyle at his hotel a mere ten minutes away. Walked – it was a delightful stroll through back streets and past walled and gated yards. John is involved in a fascinating SOGC project teaching a version of ALARM-I to health care administrators!
Started having stomach cramps at midnight, explosive watery diarrhea started about an hour later and continued until 5:00 am.

Thursday – Fikerye identified the culprit; the rewarmed lunch that we’d had the previous day. Of course, this was the one day during which I was teaching “Community Assessment”. The students did role plays, debriefed, received feedback and used the scenarios to both analyze the resources available to them and develop new ways to use them.

Friday – Dr. Lia was extremely generous with her time in the morning and frank in discussions. In the afternoon, we went to the CPAR offices, returning to the Harmony by public taxi. David chaired a debriefing session in the hotel lobby.

Saturday – Zacharias, nephew of Asfah and of Abebech, took me shopping at the little basement “mall” at the end of our street. With him by my side, I was able to fend off some of the frenetic behavior.  

Everything packs and I am ready for the trip home. At the airport, there is great gathering of security staff over a brass cross that I bought at the market for Bill. The guy who sold it declared that it was an “antique” but his price was inconsistent with antique prices. The security guys did all sorts of tests on it before they let me take it. I was certainly glad to be early at the airport.