Linda Johnson’s journals from Ethiopia. See part 1 for more information.
Ethiopian Journal 6-11-11
I haven’t written in a few days—have been coming down with an intestinal thing and have just been exhausted. Will try to capture
the highlights of the past few days.
On Friday morning, Dick and I went to Black Lion Hospital, the public teaching hospital for aspiring doctors. We attended the
neurosurgical conference, where one of the residents gave a presentation on the sympathetic and parasympathetic nervous systems. The presentation was pretty dry, but factual. After the lecture, Dr. Barnerjee, and Indian physician who has spent most of his practice in the US,
began asking the students questions to provide meaning and context for the information just presented. They were naturally struggling to respond, getting some of the questions right, but not the full picture. With his encouragement and delightful stories, he was able to translate normal human responses into the two nervous systems. One of the systems can be controlled, and the other cannot. The example he gave was that, if they were in surgery and the patient began major bleeding and the surgeon got anxious or frightened, the heart rate picked up and they felt like they needed to pee—this is the uncontrollable response. The controllable response is to focus and not give in to panic, the weak knees, the intense desire to run away, and to choose to focus on the anatomy and actions that the physician needs to do to save the patient’s life. Dr. Barnerjee was such a delight in so many ways, being vulnerable so that he could create a wonderful teaching moment.
The class took a break for coffee mid-morning, and Dr. B spoke to me directly in the break room. He was passionately telling me that he tells his students that they need to pick up a baby that will die because treatment is not possible, and they need to feel that mother’s grief and helplessness and find therein their heart and compassion. This is not weakness—in fact, he said that when a physician can find his compassion, then the patient has two doctors, not one. As he spoke, we both felt the tears well up as we recognized a deep truth and connection, that part of us that knows suffering and it is not fearful—our response is compassion, not avoidance. It reminded me of the
overwhelming desire I had to pick up babies at the AIDS clinic, or that young baby who would not survive the operation from a few days ago. Although I know we are all connected (in an abstract, esoteric sense) I am always breathless and emotional when I experience
that connection with others. And to find it in a public hospital in Addis Ababa was a reminder that the connection transcends human and geographical borders.
My roommate left on Thursday night. It has been a wonderful experience for me, watching Lindsay’s journey, her competence and struggles,
and to admire how quickly she wove herself into the hearts of the families she worked with. The apartment feels kind of empty now. We went to the grand opening of her school last night, and it was a delightful event, with an attendance of people from a Portugese NGO, an American expat that I’ll meet with next week, and about 30 people in all. I took some pictures and will have to show them to Lindsay so she can see the fruit of her labors.
It is raining outside now—very hard. For the past few days, it has rained hard in the afternoon (with thunder and spectacular lightening) for about an hour, enough to flood the streets and get everyone soaked. And then it stops and clears off for the evening. This week starts the
rainy season, and everything is greening up.
Yesterday, Elizabeth (the shy undergraduate) went on a road trip to Debralebela with Jonneke and her mother. They are staying
at the Norwegian embassy residential house, as Jonneke had taken care of the ambassador’s daughter when she had some health problems in February. We had the luxury of a van and private driver for the day, and got to see the countryside. There were several trucks turned over on their sides on the twisty mountain roads where their drivers had lost control on the curves. The speculation is that they were high on
chat, an amphetamine-like substance that is openly sold here. The vendors gather up the chat in the fields, and sell the leaves and branches in a big bunch. Chat is a major export for Ethiopia, mostly to other African and arab countries. There are no studies on whether it produces gum or lip cancers (it is chewed and wadded up in the cheek) but the damage from a life-long use perspective mirrors the drug problems in our country.
At Debralebela we saw the Portugese bridge, built over 400 years ago, which spans a riverbed and waterfall (which is dry for another week or two). We were led down to some ledges by our guides, and got some spectacular photos. The best part of the trip for me was the transition from the vibrant metropolis of Addis, up over the mountains where the stick-carrier women were walking, and out into luscious, verdant farm land with cattle goats, sheep, and people populating the roads along with speeding vehicles like ours. The homes also transitioned from corregated metal shacks in the poorest part of Addis to metal containers being used as homes to round, thatched-roof homes sequestered into compounds and villages surrounded by tall hedges of some kind of growing green crop. As it was Saturday, every town we drove
through was about 5 or 6 blocks long, maybe 3 or 4 blocks deep, and the highway was crowded with everyone from town, their wares for sale, and whatever animals were for sale or used to carry goods. The Ethiopian landscape, north of Addis, is strikingly beautiful.
I decided that driving in Ethiopia is a young man’s sport, because it requires lightening-quick reflexes, skittish and unpredictable animals, people who may try to run in front of you, and massive traffic. In Addis, a town of about 30 million, there are just a handful of traffic lights. The major streets intersect at big multi-lane roundabouts, with double lanes of cars and trucks coming from all directions, moving quickly, and trying to out-maneuver each other. It is not for the faint of heart, and I understand now why motor vehicle accidents are such a high cause of death and injury here. Drivers who are old or slow don’t stay alive very long, I suspect.
Today is intentionally very slow. Dick and I had plans to do breakfast at the Sheraton Hotel where I could safely access an ATM,
but my incubating GI disturbance came to its fulminating peak last night from about 1:30 a.m. to 4:30 p.m. I have been able to keep down dry toast, and some rice and fruit for lunch, laced with heavy doses of tea. I think a nap is in order.
Ethiopian Journal 6-14-11
It has been a couple of days now since I last sat down to write. I am still a little queasy
in the stomach department, so food doesn’t sound very good, especially spicy
Korean food. I’m managing to find other food alternatives, but still feeling queasy.
The past few days have been very eventful. Yesterday (Monday) was supposed to be Dick’s last day here, so there was a flurry of
completions to be done, which marked several accomplishments for us. At the early morning surgeon’s meeting, we
got budget numbers from Dr. Haggos that completely changed our proposal to pay for hydrocephalus shunt surgeries at Zewditu and MCM hospitals. After rushing back to crunch the new numbers and refine the MOU, we were able to sit down with Dr. Kim after lunch. The meeting went very well, and he was positive about our approach and our intention to do both long-term and short-term efforts to prevent and treat this condition. He agreed to review our proposal and agreement in detail and to get back to us.
On Sunday I met Kee Park, an energetic and passionate young (50) Korean American neurosurgeon who has managed to retire early and spends all of his time flying around the world to do humanitarian work. He comes to Ethiopia often. He is bright, intelligent, committed, insanely funny, and extremely thoughtful. We enjoyed dinner together with Dick and several of the young neurosurgery residents at the German Biergarten. It was delightful to be sitting with the next generation of neurosurgeons in Ethiopia, who will expand the number from 4 to 8, and will result in many lives being saved. They are so serious about their work, and yet love to laugh. They are simple human beings, and yet they are filled with greatness. With them, hope begins to reside, and lasting change can begin. I recognize at a profound
level what a difference just a few committed and passionate people can make to millions, and I am filled with awe.
In the many hallway conversations that we have going from point A to B, I am finding growing support and excitement from several people who want me to return to help them with incredible projects: developing a public health outreach campaign to get women of child-bearing age to take folic acid to prevent neural tube defects; to create a trauma care system in the country so that victims of injuries can be resuscitated in the field and transported to the closest hospital for care; to consult with the burn foundation to help expand their outreach efforts; to
staff mobile outreach clinics for women and children—the list goes on. Several have contacts with the Ministry of Health and have offered letters of support to bring me here through the Peace Corps. I am honored and humbled, and excited about the possibility of committing two years on huge projects that will make a significant difference.
Last night was Dick’s going away dinner, as he prepared to jet off to Frankfurt to meet up with his wife Patricia for some further world-wide travel. Dr. Don Pearson and his lovely wife Barbara opened their apartment to about 12 of us, and Dick prepared a delicious chicken
dish with rice. There was only one Ethiopian physician there—the rest were ex-pats from Korea, the US, and Norway. The conversation was varied—who knew what about the constantly changing requirements for visas and resident cards, what new programs was the hospital planning, which spa in town was the best, who had been where, challenges with broken equipment and troubles with customs, comments about the lovely artwork in the apartment, and other pleasantries. Always the talk comes around to why you’re here and when do you leave. Dr. Park mentioned that he just arrived on Saturday, and had planned to stay for several weeks, but he’s leaving early to
go to Libya as the UN has requested additional trauma surgeons to serve in the rebel stronghold. His courage is admirable, and he is making sure that arrangements are in place when he arrives so he can be safely transported to the hospital from the airport. The group is awed by his heart and willingness to serve.
Just before dinner, Dick found out that his flight to Frankfurt was cancelled due to a volcanic eruption in Eritrea, just north of here. The ash plume was expected to cover Addis Ababa today, and that’s why Hillary Clinton’s plane had to leave a day early. Dick’s flight was cancelled
tonight also, so he has spent most of the afternoon trying to figure out a way to get to Rome to meet his wife who arrived there today. The eruption appears to be slowing down, but it’s difficult to tell when the skies will be clear enough to fly between here and Frankfurt. Apparently, Ethiopia Air has flight agreements with Saudi Arabia and can fly to the east from Addis and skip the cloud, but Luftansa can’t fly over Saudi Arabia. It will cost him a new plane ticket, but he is anxious to see Patricia so it is worth it—and very sweet to see.
Yesterday I contacted Sister Maryela at the Mother Theresa AIDS Orphanage to follow up on the gauze project so we could get some product samples for testing, and to establish a fair market price. Sister Maryela informed me that they had talked about the project and figured out that the women could make more money by producing brightly colored scarves for sale, so they are scrapping the gauze project.
I was initially disappointed, but in reflection realized that sometimes a project is just not meant to be, and I need to let that go. For a hundred trial balloons, maybe 10 or 12 make it—I believe the others keep going up and hang out until the time is right, or burst to become seed clouds for new ideas. I think they made the right choice for themselves.
Today was another full day. The Rotary meeting was fun, lively, and we felt very welcome. I have made several excellent contacts for our home club to connect with for projects here in Ethiopia. This morning, I mailed off the MOU for the hydrocephalus to Drs. Haggos, Mersha, and Park for their final review.
Dick and I did rounds on his last surgery patient, a guy who came into the ER with multiple stab wounds in his chest and abdomen. Dick called me late Sunday night when he operated to see if I wanted to observe, but in my ill state I decided to pass. Dick did not expect the man to live, as his condition was critical when he arrived, no palpable blood pressure, pulse not palpable, ashen color, and profuse bleeding into his abdomen. There was no blood available for transfusion because he was type AB negative, and his hemoglobin was down to 5 (extremely low). When I saw Dick at breakfast the next morning, he had operated successfully and pulled the patient through. We saw the patient this morning and he was out of ICU, up and walking, and is going to live. I wonder how many lives are saved here, by doctors who come to visit, that would have been lost if the doctors and nurses had never listened to their hearts longing to come here. Again I am struck by the power of
compassion—I really think that our passion is God’s whisper to us, the doorway that spirit wants to enter to manifest good things here on earth.
In our morning rounds we visited the hydrocephalus baby that I saw surgery on my first day here. That baby is still here, and has
had some complications that have been corrected. Because of the multiple surgeries, the baby is not getting enough nutrition from the mother’s breast milk to heal properly, and needs some formula. We were informed that the baby was being transferred to the public hospital Black Lion because MCM doesn’t have infant formula. Dick and I were amazed, and offered to go to Black Lion in a cab to get the formula
for the baby. Apparently, infant formula is not available in Ethiopia—even that is a revelation to me. The staff pediatrician was consulted, and he knew where some formula was at the hospital and directed that it be used for this baby. The transfer was avoided. Sometimes the solutions are so simple, yet people who are accustomed to lack of resources just assume that there are none. And if you assume it’s not available, and aren’t accustomed to achieving solutions by creating a ruckus, you are likely to just accept what is and not try to change it. I wonder—what am I accepting, or what are we as a country accepting, that really could be different if we just tried? How many things am I resigned to? I’ll have to mull this one over for awhile, and recognize that at many levels I am no different from the people here who just accept the lack.
This afternoon Dick and I went to Black Lion hospital to meet with the head of the Pediatric Services section of the medical school.
She was a delightful woman, and she agreed to work with us to provide free shunts to the babies we serve, and she said she should be involved as a signer on our MOU. This provides another twist to the approval process, but we believe it is workable. She was very enthusiastic about our program, and she also referred us to her equipment guru to repair some donated equipment at MCM. Taking the time to make the
personal visit was invaluable.
Most of the afternoon was spent trying to get Dick new flight arrangements to Rome, which was successful. The ash cloud did not
descend into Addis, and it is a clear moonlit night—a rare commodity this time of year. Five of us went to the Top View Restaurant, with a spectacular view of the city at night. Temeskin, our driver, has a bad clutch so we had to make a running start at the hill, dodging traffic, people and dogs to get to the top before we stalled, but we made it.
Tomorrow promises to be another full day, so I’ll call it a night.