Linda Johnson’s journals from Ethiopia. See part 1 for more information.
Ethiopian Journal, June 6, 2011
I had yet another amazing night last night at dinner. We went for Italian food at a wonderful restaurant nestled in the midst
of a large art gallery. There were scads of oil paintings from prominent Ethiopian artists on the walls, in the entry,
in the outer gallery, and stacked in corners. The quality of art rivaled any small art gallery in Portland or Seattle
or LA, and was so evocative of the life and energy of this beautiful country. I fell in love with three of the paintings
and was certain I could never afford one of the paintings. I checked the price on my favorite one, and it was $4000; when I asked, I found that was $4000 birr, which translates into about $250 US dollars! And, to make things easy for shipping, they take the painting off the canvas and roll it up so you can take it home in your suitcase. I’m giving that painting serious thought and may go back and pick it up in a few days as my trip memento.
The other thing that was fascinating about last night’s dinner (besides the fine Italian
wine and great gorgonzola pasta with pepper steak) was the company. Dick, Lindsay, and I went to dinner with the
Norwegian contingent: Gro (pronounced Grew with a hard r), Janneke, a 15 year old girl from the Norwegian embassy,
Janneke’s mom Helle, and a young Ethiopian physician who is still in
training. The conversation was lively, and the love between Janneke and the young physician. She was a nurse here for 7 months earlier
this year, and fell in love with him. At the end of her volunteer period, she returned home to Norway to spend time with
her family. Her mother shared with me that the situation is very sad, because she cannot come to live here permanently, and he cannot leave the country.
I have heard that travel visas are very difficult to come by here, as many people here want to leave the country to make a better life—poverty is
huge here. The Ethiopian government is limiting visas for natives to travel outside Ethiopia out of fear that they will not return, and the country needs its best and brightest to help the economy grow and sustain itself. So, this lovely young couple are like star-crossed lovers, having a deep love for each other, and facing potentially insurmountable obstacles of distance. Shouldn’t be so.
Today was a very busy and full day. As usual, we had the 8:00 a.m. surgeon’s meeting, and we were introduced to the crackerjack
interventional radiology team from Korea that arrived on Friday night. Dr. Cho (pronounced Joe) was very tall, and
looked like he was 18. I later found out that he is actually 40. We had several cases that needed his consultation and possibly intervention, so we were excited to finally meet him. Dr. Koning tried to present his cases in the meeting, but he CT scans were not loaded into
the picture archiving system, so we had to go to the CT department to view them. Dr. Cho has a delightful sense of
humor and is a dream to work with. When we talked to him about performing a few cases, we learned that he really can’t
do them because the new angiography machine that his team donated isn’t operational yet, and won’t be until two days before he leaves. That must be incredibly frustrating for his team.
For one of the patients, or man with the gangrenous foot that has been here for nearly a week waiting for Dr. Cho’s arrival, we were hopeful that a procedure could be done that might open up his veins and minimize how much of his foot needs to be amputated. When we did rounds on this patient, he was packed up and ready to go. We asked why, and he said that he had spent all the money he had staying
in the hospital this long, and he had no more money for a procedure. We told him that the doctor we were waiting on had finally arrived and we were appealing to the hospital administrator to allow him to have the procedure for free. The patient was adamant that he
had to go home, a full day away by bus, because his family had notified him that they would not help him out with anything until he came home and had a family council. I learned that this is the custom here. When a family member is ill, the family takes care of them. This
includes donating blood, caring for daily needs, and gathering the funds to pay for the treatment and/or hospitalization, and providing any after-care that is needed. So, after much warning about his potential for further damage to his foot from injury or infection, we had to
reluctantly let him go home with a promise to return next week on Wednesday. I hope his family council is supportive of
his return to the hospital for the amputation, and is successful in raising the funds to pay for it.
Before this patient left. we learned that Dr. Cho only brought enough supplies of a certain type to allow him to perform a procedure on one person. Unfortunately, early this morning a second person came in the ER with a gangrenous foot. He is a diabetic and has already lost one leg and is wheelchair bound. It was an interesting discussion to determine which patient would benefit the most from the procedure and would get the special stint—the new patient won the contest.
After seeing a few patients in the ER, we went looking for Dr. Cho to see about his availability to do the procedure on Wednesday.
We found him in Dr. Kim’s office, along with one member of his team. Dr. Koning and I joined them and began to talk, building relationship.
Suddenly, Dr. Kim’s administrative assistant brought in four macchiatos (they are REALLY good here!) and we spent ½ an hour talking. The man sitting next to me was named B.D. and we found we have much in common. He is the CEO of a company that makes shunts of many types, including shunts for hydrocephalus. I told him about the program we were trying to start here for indigent children, and he was very
excited to talk to us more. Before the conversation was over, he had invited Dr. Koning to visit Korea for two weeks, all expenses paid, to meet with their surgeons and find out more about how hydrocephalus is treated in Korea. And he asked for more specific information about the Reach Another Foundation, so I promised to prepare some written information and provide our contact info by tomorrow. Dick and I are hopeful that his company may agree to donate shunts to our program, as other manufacturers have done.
After lunch, Dr. Koning and I met for about 90 minutes to make a list of things that need to be done in the next 10 days before he leaves. This was really good, because it forced us to be focused on the conversations, invitations, and visits we need to make to move our program plans along. And the rest of the week will be really full. I spent the rest of the afternoon developing the foundation summary for B.D., and
making further revisions to the MOU.
Tonight was a really special evening. One of the couples that are starting the autism school invited us to dinner to express their thanks to us for supporting their school, especially Lindsay. The affection she has developed with the families at the school is remarkable and palpable. They took us to The Carnivore restaurant, and I had a wonderful chicken cordon bleu. Meseret, the wife, is a beautiful and highly intelligent woman, and her husband is a general surgeon who loves to hug everyone. He is teased by Dr. Koning that when he enters the hospital door it takes him 90 minutes to go up one floor to the OR because he has to hug every person he meets along the way. Both of them are very open and warm-hearted, and we feel honored by them. During the dinner, Meseret asked me if I could come visit the school one day next week and help her to set up the bookkeeping for the school. She is a biologist and will be the school administrator, and has no idea how to keep the accounts and financial information straight. I am honored to be able to help and am already thinking about how best to help her.
I found myself thinking in the middle of dinner how unprepared I was for my visit to Ethiopia. I had all sorts of concepts
about the country, and made many assumptions about how destitute and needy they would be. Yes, they are a poverty-stricken
country, and they are eager to learn much from us. They are also a very hard-working people, and very proud. Above all else, they are warm, loving, generous, genuine, and striving for excellence. As I sat at the table listening to the conversation, I could have been in any cosmopolitan
city with good friends, enjoying a lively and stimulating conversation about meaningful topics of concern to us.
And I am in Ethiopia. Not at all what I expected, and I am absolutely captivated by the people.
Ethiopian Journal 6-7-11
Today has been quite productive in unexpected ways. Dr. Koning and I had a really informative meeting before breakfast with
Dr. Mersha, who is one of the four neurosurgeons in Ethiopia. It is mind-boggling that there are only four neurosurgeons in the entire country, serving over 90 million people. And I have met 3 of the 4. No wonder there are waiting lists for care here for children with hydrocephalus.
And, given the high number of motor vehicle accidents here, most of which have head injuries, it is astounding that these surgeons sleep at
After the usual pleasantries about how he was doing, his latest training opportunity, and other more personal topics, we turned the conversation over to our desire to help reduce the list of 2500 babies waiting for shunts. Dr. Mersha’s take on the situation was that
it wasn’t a lack of shunts that was the problem. In fact, at his primary hospital, Zewdita, they get the shunts from an enthusiastic pediatrician who, prior to receiving the shunt for surgery, requires them to provide the necessary information about the patient in order to get a free
replacement shunt. In this way, they have a continuous supply of shunts. His take on the situation is that the real problem is a lack of staffing for the OR. Other more urgent cases (trauma, aneurisms, etc.) take priority and the shunts take what is left over. At his hospital, if they can pay the RNs $100 birr per day (about $6 US dollars) they will work all day Saturday and Sunday doing extra procedures. It would require maybe four or five OR staff, plus nursing staff on the floor to follow the patient after surgery. One day in the OR would cost the equivalent
of maybe $50 and they could probably do 4 babies easily. That amounts to about $12.50 dollars per saved life. Pretty amazing. Dr. Mersha will provide a budget for us and that may be a more efficient way for us to provide care for more kids, so we’re actively thinking about this. He invited us to sit in on his surgeries tomorrow at Zewdita Hospital, so that’s where we’ll spend our morning. Quite a productive meeting.
After that, we ran over to the cafeteria quickly to inhale breakfast before our 8:00 a.m. surgeon’s meeting, which was routine. We
then made rounds on the floor, and found out that the baby who’s shunt placement surgery I observed has now developed a leak and post-operative infection and is now being treated with antibiotics. Post-op infection is a huge issue here, which is why we’re so interested in Dr. Haggos’ infection control program. Our patient with the splenectomy that almost bled out in surgery will probably go home tomorrow—it is amazing to see him smile. When we came into his room, his son was asleep in the wheelchair at the foot of the bed, and his wife was in a
chair sleeping with her head on the bed.
Families do stay with the patient overnight here, and while it must be incredibly uncomfortable for them, the comfort it gives to the patient is
immense. We could learn something from this.
Sister Jackie from the Mother Theresa Clinic for the destitute brought one of her nuns in for a follow-up visit. Sister Jackie
is an amazing woman—she radiates such light and joy and love that it almost brings me to tears each time we meet. She was very excited today about a new project she is launching. She has taught the poorest women in the city how to make gauze in big rolls. There is
a shortage of gauze in the hospitals in the country, so there is clearly a need; and, it would employ hundreds of homeless women to give themselves a means to support themselves and their families. We told her she should talk to Dr. Kim, the administrator. As we stood there chatting, Dr. Kim happened to walk by and Sister Jackie showed him the gauze and pitched him on the
project. He was very interested and said they should talk soon. Sister Jackie leaves on Thursday for a very tiny island in the Philippines to minister to the poorest there, and live among them. She feels that the Addis Ababa clinic is too big and institutional, and she wants
to be with the poorest. She said that it is difficult to convince people to come to Jesus when they see what comfort she
lives in at the Center; she wants to live in the same way the poorest live so she can more easily convert them to Christ.
With her leaving so soon, she said that she needs to find someone to head up the program to produce the gauze so they can increase their production capacity. As luck (or divine providence) would have it, I met a woman today who launches banks and is always looking for
good programs to sponsor. I told her about Sister Jackie’s program and she shared her contact information with me
and strongly encouraged me to call her for coffee. This seems to be how things work here: you make a plan and schedule, and that never
happens but what does happen is magical and powerful.
Makes me wonder who is really in charge—not really, because I do know it isn’t me!
got in touch with the country director for Rotary who was in the US on
vacation, but he told me that there was a Rotary meeting today, so I rushed
right over to the Hilton Hotel where the meeting was held. I was warmly welcomed by the Club president,
who is a physician from Yakima Washington.
The Club secretary works for an NGO that is helping Ethiopia to build
huge export industries in order to bring more money into the country. I sat next to Imam, who runs a travel agency
with her father Mohammed, who is also a Rotarian. She invited me to sit at her table, which is
where I met the woman banker. Mohammed
and the banker were talking about the fact that 65% of the Rotary International
funds were going to programs in Uganda, and how they wanted to get some of that
money in Ethiopia; when I mentioned that our club in Bend was looking for a
local club to do some joint projects with on a world-wide scale, they were very
excited to and said that next week they would introduce me to the club contact
for world service projects. The club
president is on the board of the Hamlin Fistula Ethiopia Clinic, which is doing
amazing things for women with obstetric fistulas. Dick says I should definitely visit their
clinic before I leave.
issue is huge here. I learned of it when
reading Cutting for Stone which I highly recommend. The fistula is an opening in the wall between
the vagina and the ureter which drains urine from the bladder. In Ethiopia, especially in the rural areas,
girls as young as 12 are married through arranged marriages. When those young girls become pregnant, the
birth process results in major damage to their internal tissues. The result is that they have a fistula (hole,
for you non-medical types) that drains urine constantly from their vagina,
which is unpleasant, smelly, and a major inlet for infection. These young girls are then outcast from their
families, and sometimes have to live in a lean-to outside their family home to
survive. They may develop contractures
from lack of movement, and a whole host of other problems. Obviously, if these fistulas can be repaired,
the girls have a chance to stay with their husbands and families and have a
much brighter future. I look forward to
visiting the clinic.
One of the
more interesting conversations at lunch was about the world’s picture of
Ethiopia vs. the reality. The banker
mentioned that the whole world’s picture of Ethiopia is starving people in the
desert, pictures from the 1984 famine when millions of people starved to
death. This picture of Ethiopia is
completely out of sync with modern Ethiopia, particularly in Addis Ababa. While poverty is still unbelievably high,
there is a lot of building, new industry, and economic development occurring
here. The people are enterprising, intelligent, and striving to better
themselves and the country. My table
expressed their frustration that the rest of the world doesn’t see this aspect
of the country.
Rotary, there was a major thunderstorm, which flooded many of the streets. My taxi driver of choice, Ishmael, had his
car flood out so he brought his brother to pick me up in his car. In our ride, I learned that there are 3 kinds
of marriage in Ethiopia: tribal, governmental,
and religious. If you have a religious
marriage, there is no divorce. If you
have a tribal marriage, then you may divorce but it is rare, as most of these
marriages are arranged. A governmental
or civil marriage is easy to break. I
found this very interesting.
group went out to dinner with Gro to another habesha restaurant with
traditional music and dancing. Several
of the group got up on stage with the dancers, including Dr. Koning. It was fun, and a long evening. After a full day, it feels good to turn
in. Tomorrow will be very full, with the
morning at Zewdita hospital and the afternoon at the Mother Theresa AIDS