So with my final few weeks in Ethiopia disappearing quickly I have started planning for home. My final report for VSO is complete and just requires submitting, I have finished off writing exam questions for the medical students and I am now trying to complete my "clearance" - another wonderful bit if Ethiopia bureacracy which sees me requiring a signature and purple stamp from every single university department even if I have nothing to do with them before they will write the necessary letter for me to get my exit visa. Its a long and painful process and doesn't exactly help make you feel sad about leaving.
What does make me a little sad is the mass exodus which has taken place from Haramaya University over the last few weeks and will continue over the next wee while. One by one, most of my freinds and colleagues here are leaving. Some of them - the expats and other volunteers I will likely see again in Europe (or at least there is a real chance of it if week make the effort). My Ethiopian friend though, I will probably only ever see if I return to Ethiopia. Even if we paid for their flights to visit the UK, the chances of being allowed a visa would be slim. One of the university professors here has had a paper he wrote accepted for presentation at a conference in Glasgow this summer but so far he has not been granted the visa to travel to the UK to take part. So it feels a little bit like saying good bye forever and that is pretty tough.
On top of all the preparing for home, there is still plenty of work in the hospital with regular teaching sessions and plenty of attempts to consolidate everything I have tried to do in the last year. I do worry slightly that anyone following in my footsteps will wonder what I've done all year as the changes are barely perceptible and there is still so much to do. I sometimes wonder if I had gone about it with a completely different attitude and been a little more forceful with my views and opinions whether i would have made a more of a difference. I distinctly remember some consultants of mine waving sets of patient notes around until all the loose sheets fell on the floor to make the point that you hadn't filed things properly. As a junior doctor I filed things properly fairly quickly after that to avoid scrabbling around of the floor picking up all the bits that had fallen out. I do wonder if taht kind of approach might not have made more of a difference. In the end though, some thing I accepted fairly early on, and still know is true, is that there is no way one person can fix everything here in a year. Fortunately there is meant to be another paediatrician following me next year, so hopefully she can continue to bang on about good note keeping, and hand washing and the importance of doing regular vital signs etc. At least I think that because of my year here there will be alot of nurses and midwves resuscitating babies more effectively and (with the help of all the baby hats and blankets) keeping them warm, and that alone feels worthewhile.
