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 8^th, I leave for the airport in Addis Ababa.

At 6:30 pm on March 9^th, 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 9^th – my diurnal rhythm got here on March 17^th.

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 program. Met 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.

The Surprise Birthday Party

Well, it is all over now. I am actually seventy - and while I don’t usually feel that a birthday changes the way i feel - this time there is a warm glow from my tippy toes to my scalp, my heart is bursting with gratefulness and pride. I am so grateful to all the friends and relatives that took the time to join us and my daughters, friends and partner who planned it - I am so proud to be honoured by such a bunch of accomplished, talented, beautiful people.

The fact that this was pulled off without my foreknowledge is pretty surprising too. The fact that Bill was in on it blows me away; I never suspected because he doesn't like surprise parties! (The get together should’ve been as much for his birthday as mine - and perhaps it was and he doesn't know it. Gotta love that guy.)

It was so totally orchestrated. We walked into the gallery - I was still a little annoyed at Bill and Shauna’s nonchalance at getting there because, after all, the gallery closed at 5:00 pm and he went shopping at 3:30 and she insisted that we had time for tea and showed no sign of moving. I was anxious because Mac and Beth Hone's retrospective was one of the reasons that we had come to the city. Eventually I had walked over to the grocery store to “get things moving”. 

The first thing that I saw after coming through the door was Beth all dressed fancy - I thought maybe the group with which she was allegedly rehearsing  in the afternoon had needed photos. A couple of acquaintances were wandering the gallery which was not surprising because I would expect to know people who wanted to see Mac and Beth's work. I did think it odd that there was a bar set up at one end and a table with nibbles on it - but brushed that off as "galleries have the right to do what they want". Beth wouldn't let me hang up my own coat - but then people started appearing - from behind corners and behind dividers, Regina friends, Saskatoon friends, everywhere friends! Allison, Ken, Catherine from Regina Friends. There was Rob and Phil and Karen from Saskatoon! Bernadette and Glen from Daystar! Janice and Marge from up our way! Jim, Will and Brenna, Avery and Ethan appeared. And more.... What is this? I had to scrinch my eyes closed to take it all in.

I was over the top! Someone had to force me to look because I didn’t think that I had room to go when Ev, Don, Betty, Kelly and Denise showed up! 

My head was swirling. I'd spoken with some of these people recently - even invited Marge to join us for dinner and she had excused herself for a meditative retreat. Invited my family ages ago but they were all busy or seemed to be. Nobody really lied - Denise simply told me that Marika was competing in Winnipeg and I assumed that she was going to be there. Betty and I had conversed but a lot of it was about sister Heather's lucky cardioversion for which we were grateful. (Although Shauna might have lied when she implied that she was getting on a plane to go to Regina on Friday evening when she was already in Regina!)

The setting was lovely - a far cry from the little restaurant in which I was expecting to meet Jim and Jan for a cosy family supper. Amongst pictures and pottery of artists that we knew and had known, gracious hosts at the Slate Gallery, chairs were gathered and a slide show presented using archived pics from our collection. Very well done even if they couldn’t ask the one person who might have known the dates! (I have a few corrections.) Letters were read - thanks to all who took the time to write - I had no idea how many addresses Beth ripped out of my computer!

Beth also arranged for a yoga class the next morning in the basement of the Unitarian Centre - Will held up the testosterone side for you guys - followed by a very nervous me doing a talk at the service that morning. (Very nervous because I hadn’t had a moment to review what i was going to say and I had family in the audience - how is that for pressure!)

Leisurely lunch/brunch at the La Bodega. We saw Betty, Kelly, Don and Denise off at the airport - in spite of the lack of security they all boarded, Don didn’t even check their luggage! They would land at Shoal Lake to leave Denise and hopefully arrive home before dark.

That was such a lovely celebration and a roast that I won't need a funeral!

Dale

From Hiroshima to Fukushima to You

This is the title of a book that is about to be published.

In writing this book, I didn’t want to come across as a know-it-all because I’m not.  I consider myself an expert in rural family medicine – I’m a jack/jill of all trades and master of some.

As I was growing up, I was always encouraged to “look things up” in our tiny behind-the-living room door set of shelves that was our library – it had a very fat short green dictionary that seemed to have almost every word that I looked up, a small encyclopedia set bought from Reader’s Digest on a book a month deal, and several atlases.

For some time I felt that there should be a book that linked the uses and abuses of ionizing radiation; I kept hoping that someone would write it.  It certainly sounded like a good project for Physicians for Global Survival. However, if PGS were going to write it, we needed assistance from someone who could “look things up”. Florian came to the Physicians for Global Survival’s office as part of a Master’s student community placement at a time that I needed help with some research.  He quickly produced material to satisfy the small project that I was working on and together we hatched up the idea of doing a sort of “ionizing radiation for dummies” book.

This became a scholarly thesis as he and I watched the framework evolve.  Florian did not have a scientific background; he was completing his Masters thesis in International Studies. What started as a student placement continued as the work grew. We were able to offer him a better salary than minimum wages at Canadian Tire. Flo fit into the PGS office; he drank tea, rode the bus and joined conversations. The framework of the book is entirely Flo’s with consultation. He was also the perfect skeptic – we didn’t argue but we did have lively discussions about topics or ways to present material that only served to improve the project. Flo was initially engaged as a research assistant but so much of the book was written by him that it is fully coauthored. I think that it is safe to say that he and I learned far more about this topic than we ever expected – in fact, I don’t think that we knew how much information was available about the field of ionizing radiation. We realized that we couldn’t write the “ionizing radiation for dummies” book – at least not before writing a book that explained the topic for ourselves!

What we discovered in our work was that we can not speak of the topic without defining it, its history, its science, how is it measured, what it does, how harmful is it, what can we do with it, its abuses, politics around its use and more.  We found that we were writing a history book, a social studies and political science book and a science and health care text.

Neither Flo nor I could have done this without the other.