The Dutch Oven

Once again this is my second attempt to publish this post. The first attempt was a waste of two hours on the Ethiopian internet. Let's seeif I can remember what I was trying to write about...
On Sunday I went to lunch at the home of Diny, a Dutch nurse who lives and works in Addis. She was the woman I contacted to get the go-ahead for my trip from the sisters at the compound. Every few weeks she has these gatherings for volunteers but the occasion this time was the upcoming departure of one of her friends and a fellow Mother Teresa-er. The crowd was an eclectic mix, to say the least. There was one truly free red-blooded American (guess who), three Canadians, a Brit, two Ghanaians, one Nigerian, three Koreans, a German, three Dutch, and three Ethiopians. We ate Korean noodles, kim chee, some kind of Dutch meatballs, lentils, rice, green beans, some kind of apple pie with banana custard, fruit, yogurt, and cake. The food was delicious and the conversation draining. It reminded me of the scene in Hung where Rick's pimp goes to her mother's house and runs into all of her highly educated international friends. My end of the backyard was dominated by the conversation between the Ghanaians and a young Canadian woman, Jenna, regarding the plight of... anyone in the world with a plight... American economy, Ghanaian off-shore oil drilling, Ethiopian street children, etc. etc. All important issues, I'm sure, but none of them got a rise out of me like the way Jenna kept prefacing all of her good samaritan opinions with "I think." "I think people really need to reprioritize if we are to help the street children in Addis" or something. If that even qualifies as an opinion, as opposed to fact, saying "I think" only serves to claim some sort of propriety over that opinion, or perhaps suggest that maybe other people present don't think the same thing. Wow... you think that... I wish I could think that. I think if you talk like that you're likely to get Blah Blah Blogged about. I suppose that's how conversations between strangers always progress... some sort of obvious statement received by raised eyebrows and a nod and an acknowledgment of the idea in different words, and repeat. What a waste of time. I also talked to a man who works for the International Livestock Research Institute (the company that owns the highly secure property that Diny lives on) and lives on what I understand to be the Canadian San Juan Islands. He taught me that everyone who talks about the inefficiencies of eating beef are uneducated liars. Despite my cynicism, I enjoyed the company and the soiree as a whole, and this week I've had lunch or coffee with Jenna's English boyfriend, Damien, three times (the pleasant parts just aren't as fun to read or write about).

COMPOUND UPDATE

Seeing as how the compound is essentially for people on their death beds I've been wondering how frequently residents pass away. Today I learned that this morning three or four of them died. Apparently a high percentage of patient deaths are from malaria, contracted in rural areas before arrival at the clinic. Also today I followed around the other Abebe, a "nurse's assistant" (titles here don't necessarily reflect any formal training) who dresses wounds for bed-ridden patients. His job stinks. Like death. Many of his patients suffer from cancers of some kind and almost all have bed sores. One man with a catheter has bed sores from his waist to his ankles and needs his dressings changed every day. I admire Abebe's dedication to his job and I will hopefully assist him regularly from here on out. In the dispensary there has been a wave of patients with problems that require dropping trou... Three in a row yesterday and two today after having none in my first week. The most painful of them was clearly the rectal absess, which made the man wail and cry just from climbing onto the bed. I'll spare you the details of the more disgusting ones. Another patient I won't forget anytime soon is the woman whose right breast had been (intentionally) burned by a fire to the point of melting her nipple clean off. Tuesday was my second outpatient dressing day and was busier than the first. Most of the patients we had seen before, which is good, but clearly don't/can't do much to take care of their wounds between visits. I was relying on emotional reward for the sake of my endurance here, but there really isn't much when you scrub and wrap hard, open flesh from knee to ankle of a man who can't feel what you're doing. The wounds are obviously just symptoms of much bigger problems faced by the poor here and rarely show improvement. Unfortunately the alternative is a patient who can feel his wounds but won't receive painkillers or antibiotics. I would like to say I'm having a good time here, but"fun" is an inaccurate description. It has already been one of my more interesting experiences, though, and I'm sure will be invaluable in the future. Volunteers have come and gone, 80% of them Spanish and all of them significantly older than me. Consequently, I am doing a lot of reading.

A CALL TO ARMS

This is directed to the (large) portion of my readership who have steady jobs and are financially comfortable. I have been spending more time with Dr. Rick who, probably because I am American, has started to take me under his wing. He does some amazing work here and is famous for it in Addis. Sadly, many patients come after other doctors have turned them away, often times because they have some incurable and fatal condition. However, Rick's program has been able to send many spine and cardiac patients abroad for life-saving surgery. People leave for Ghana or India with S-shaped spines and $1000 later return straight as an arrow (fashioned by an amateur whittler, but an arrow nonetheless). Without surgery, the spines deformed by scoliosis or tuberculosis become worse and gradually reduce lung capacity, a fatal process. Rick's biggest fault seems to be his inexperience with fundraising... or maybe it's just the impossibility of sending all 300 spine patients abroad. He arranges these procedures, which would cost 20 times as much in theUS, whenever possible but relies on small, private donations. If you feel like passing on the newest generation MacBook and keeping your old, outdated, 2008 model instead, you can save the life of a stranger by donating to Dr. Rick's cause at https://jdc.org/donation/donate.aspx . The entire donation will go to Rick, so be sure to add a note withyour donation including the name "Dr. Rick Hodes." You can watch avideo interview with Rick at www.cbc.ca/sunday/2009/05/051709_6.html . If you can't donate or don't feel comfortable doing so, please consider passing the information on to your affluent colleagues (City of Bellevue).

A BERG'S EYE VIEW, THE RETURN

- Ethiopian men of all ages love to hold hands or link arms. ClearlyR-71 passed here.
- There are enormous holes all over the sidewalk, big enough for me to hide unconscious in after falling in one after the sun goes down.
- There are no street lights.
- People urinate without discretion in the street, but typically aim for the aforementioned holes.
- Regardless of severity of illness, sick people invariable walk around with a blanket or hood on their heads, flanked by two friends or family members who act as crutches. It's really an excellent idea. I know not to walk up to and stick my tongue in the mouth of any such person like I do with the healthy people here. I don't want to catch a cold.
- If you show an Ethiopian person a picture of him or herself, the response will not be "me," but rather the person's name.
- Masses of goats and cattle are regularly herded through the streets.
- The days are hot but the nights are cold... nothing three flea infested US Military-issue wool blankets can't take care of.
- I came to Africa and didn't bring sunscreen. I suppose that's more of a mistake than an observation...
- They don't have contact lenses in Ethiopia... thus no contact solution... thus only glasses for eight weeks... thus constantly being mistaken for a doctor... thus being asked questions I can't answer.
- For a few days I thought Ethiopians kept gasping at what I was saying, as if shocked, until I learned that the Amharic equivalent of"uh-huh" is an audible inhalation.
- Orange soda is orange soda no matter where you go. And it is delicious.
- There was a guy on my plane who lives at the compound. He was sent to the US by Dr. Rick for some sort of facial surgery.
- The minibuses all have Nike stickers... I think it makes them go faster.

- Internet here is totally reliable, until you click "publish post" onyour blog.

Back in Black...

... well, surrounded by it anyway. I am here, safe, and tired. My first attempt at posting was thwarted by a blackout but the internet was too slow and my face was too close to the screen to try again when power returned. The flight over was exhausting, mostly because I purposely stayed awake so that I could fall asleep at a normal bedtime here in Ethiopia (but the lap dog yapping away like Joan Rivers didn't hurt either)... unfortunately that method doesn't keep you from waking up at an obscenely eary hour, so I'm still callibrating that part.

I spent my first night at Taitu Hotel, the oldest hotel in Ethiopia. The accomodations were fine and the room was cheap, and now I am a part of African history. The next morning after waking up at 3am, sleeping sporadically until 6:30, I took a Taxi to "the compound," the name given to the enormous, walled Missionaries of Charity property. Apparently the nun in charge of volunteers is gone for a month and the rest are too busy running around to care much about their own work, so I was ushered around by some Canadian woman named Jerry who introduced me to some other volunteers and showed me the quarters I'm now staying in. The space is pretty nice but has been crowded with both the male and female volunteers due to some redecorating of the women's room. Most are leaving tonight for another city, though, so I'll be able to pick a bed that doesn't touch the dining room table. There are three volunteers from Spain, two young and one older; a 42-year old marble worker from Italy; a physiotherapist couple from Poland; a vet student from France; and a med-school applicant from Canada. All but the older Spanish woman, the Italian, and I will be gone after tonight.

On Friday morning after dumping my crud in the volunteer house I headed over to the wound dressing dispensory where I worked with Claudio, the Italian, and two local workers, Abebe and Araya. I watched them change the dressings of a couple patients and then jumped in for my first. Really most of the wounds are pretty disgusting... one noteworthy patient had a foot full of pus but couldn't stand the pain long enough to drain it all. Generally the mornings are busy and the afternoons slow, so from 8:30-noon we have a steady stream of patients and at 3 or 3:30 after the long lunch break we mostly prep for the next day. The real excitement comes on Tuesdays and Saturdays when a doctor takes over the wound dressing wound and we take a supply cart outside to treat outpatients coming in from the street. Needless to say, there were a lot of infections.

When there was no more wait, I tracked down Dr. Rick, an American cancer specialist working at the compound. For about four hours I shadowed him as he consulted patients. Because of the multitude of medical problems people present with, over the years he has chosen to limit himself to patients with heart, spine, or cancer problems. A good percentage of the patients had severe scoliosis or tuberculosis of the spine. One woman had an undiagnosed muscular deterioration condition that her nurses said hit her suddenly a couple years ago. There was nothing Dr. Rick could do for her, but instructed the translator to tell her to wait a month and come back anyway... easier than watching her find out she's doomed, I suppose. There was also a baby girl with bladder extrophy, meaning her bladder is on the outside of her body. Apparently she is also lacking a uterus, so it's possible there is still some ambiguity in regards to her gender. It's cool, though, she can still grow up to be a famous sprinter.

Dr. Rick is an interesting guy. He's a Jew from Long Island who lives full time in Addis and has adopted several local children. He is clearly brilliant, but might relish in the way people treat him like House... to be determined. He showed us a clip on his computer of his Today Show debut and a picture of a kid with a crooked back standing with Natalie Portman, who is apparently a friend of Rick's. His most interesting visit of the day was actually not medically related. It was the long-lost brother of one of Rick's adopted sons. Apparently Rick's son left his village for Addis ten years ago, and two years ago the younger brother also left the village for greener pastures. Rick's son spotted him randomly from a car shortly after and recognized him, talked to him, but for some reason didn't tell Rick about the encounter. Rick's son is now in college in the US, but some sort of communication between the brothers is being arranged and it sounded like the younger one will be able to move in with one of Rick's friends in Addis.

I haven't seen any of the city yet because I've been so tired, but I'll check it out this coming week. We are close to Addis Abeba University and the National Museum, and walking distance from the Piazza. There is potential for a lot of free time with nobody looking over your shoulder to enforce the already lax volunteer schedule. Everyone seems to speak English, so I might not learn as much Amharic as I had hoped, but it makes things a lot easier. Today I'm going to have lunch with the Dutch nurse, Diny, who Joe contacted for me to set this whole thing up. If there is time afterward I'll walk to the Piazza to see what all the fuss is about. Anyway that's it for now... blogs should improve as I get more sleep. Hope everyone is doing well.