So another week has passed in Ethiopia and a kind of routine is starting to form. During the week the days start early at 6am when I get up and go to catch the bus into Harar campus at 7ish. I say 7ish as that’s what time it meant to go but to date it has never departed at this time. Pat, one of the other volunteers initially told us that we had to be there by 0645 to be sure of catching it, but so far the earliest it has departed is five past 7 and so our presence at the bus stop is a couple of minutes later each day. The latest the bus has left is 0730 which then makes me late for the lectures I give, but this seems to just be part and parcel of Ethiopian life. The bus itself is for staff who live on this campus and work on the other, but the drivers pick up a whole bunch of other local people on the way including most of the local high school kids who travel from Baty, the village at the University gates, to Alemaya, at the bottom of the road where the high school is. The bus tends to play badly tuned in Ethiopian music very loudly on the radio, and that combined with the crowded nature of the bus means that any hopes of a 45 minute snooze are completely dashed. At least the people on this bus don’t mind having the windows open too much. When you take a line taxi, they are really stuffy and crowded and many Ethiopian people seem to have a morbid fear of moving air thinking it carries disease or something, and so choose to swelter with the windows shut rather than risk opening a window.
Once I arrive in Harar I usually head down to the hospital which is a 15 minute walk from the bus. On Tuesdays and Thursdays the medical students currently doing paeds and obs and gyne get paediatric lectures and on Mon and Wed they get obs and gyne lectures. This week I gave the paeds lectures on growth and development. I had been pretty apprehensive about this but thanks to some great tips from Jenny one of the education volunteers, things seem to have been going pretty well so far. One student even came to say thank you for such a good lecture on Thursday which felt like a real triumph. After the lectures they head to the ward for bedside teaching for at least an hour which I find much harder. I have very much been thrown in the deep end with the teaching as most of the pathology is very different to what we see at home, and because you don’t know what you are going to see and have no time to prepare its real challenge to the clinical skills to be put on the spot and expected to teach in detail about a patient you have never seen before.
I am beginning to understand a little more of the routines for patient care. In Ethiopia the doctors in the first two years out of medical school are called GPs and there are three attached to paediatrics who seem to do the bulk of the clinical work seeing most of the patients between them on most days. One the whole they seem to be pretty good. There is still no water and no hand washing although when I arrived on Wednesday last week someone had mopped the floor! That said we went to see a patient who had been admitted with reduced conscious level and was not improving despite 3 days of treatment. When I arrived at the bedside with the consultant, one of the GP’s was teaching some students. He was talking about the importance regular recording of vital signs (obs). This patient did have an obs chart taped to the wall above her bed and in 3 days had had 3 sets of obs recorded. He quite rightly said that this wasn’t enough and banged the chart with his hand, at which point several cockroaches emerged from behind the chart and ran down the walls – lovely!
At lunch time I head back up the health campus in Harar for lunch with Susan and Pat, we try not to eat out every day as doing this quickly gets through the 80 Birr (£2.50) a day budget. Instead we buy bread and peanut butter, and fruit.
The afternoon is usually quieter, with time to prepare lectures. Sometimes I get a line taxi back to haramaya campus, other days I wait for the uni bus. If I wait for the bus I don’t get back until 6.30pm which is a pretty long day. Just time for dinner, a quick check online and bed!
PS think you should now be able to write comments on the blog – would be good to hear any thoughts!
Wow Jo it all sounds amazing. So interesting and also sounds like you're really quickly getting into work that is so important and valuable. Not sure how I would cope with such regular and serious pathology which is so different from ours and with relatively few resources to deal with it. Never mind me faffing about with my "interest in teaching" - you are really doing it! How are you finding the culture? Do you attract a lot of attention in the street for being white?
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