A Travellerspoint blog

By this Author: gunny64

Reflection time

semi-overcast 18 °C

It is quite surreal now sitting at home with my Ethiopian coffee thinking back over my last 4 weeks in Ethiopia. It's hard to believe that just one month ago, Jenny made that dash to Canberra for my visa. I am so grateful that it all worked out and I had the opportunity to experience one of the most amazing chapters of my life. Before I left, I questioned my motive for doing this trip and worried it was simply a 'bucket list' experience that needed to be 'ticked off'. I'm pleased to report that this is not the case. Not once did I think I had made the wrong decision or feel like scuttling back home. Sure, there were times I found it stressful (I really hate cold showers and doing a Caesarean in the dark!), but the good far outweighed the bad.

20160730_093853.jpg

20160730_092954.jpg

I was warned about the reverse culture shock on returning home but I wasn't quite prepared for the emotion I felt when I simply popped down to May Street Larder for my skinny flat white with 2 sugars. Sitting waiting for my coffee and watching the excesses of our Western culture was overwhelming (not to mention the $4.80 I had to pay for my coffee!). 48 hours earlier, I had been in one of the poorest countries in the world where life is a struggle and the basic things we take for granted are not available. We have all seen it in places like Bali but, having been totally immersed in Ethiopia for a month, I found it so much more difficult to bear. I'm sure this raw feeling with dissipate as I settle back into my old life.

I've said this before, but I still feel somewhat embarrassed by all the attention received from my family and friends. I have given a mere 4 weeks out of my comfortable life; while others like Andrew Browning, Marjolein and Katie spend months, years, or their entire lifetime helping those less fortunate in many places around the world. However, I also now realize that even my tiny contribution is part of the big picture. Without short term volunteers, the system is not sustainable. I am proud to have contributed to this important issue of global women's health.

I was lucky! Barhirdar is a safe place to work. There are no conflicts, endemic diseases or natural disasters. The hospital is well established with trained and effective staff. It is supplied with all the basic but necessary equipment and there is access to help if required. The women, although very poor, mostly have the knowledge and ability to reach the hospital and thereby prevent the worst outcomes. I have now heard many stories of areas in remote Ethiopia or countries such as Sierra Leone where this is not the case; where women still die regularly during childbirth and often lose their babies. I'm so glad that my first encounter with volunteer work was in Barhirdar. I feel it is a stepping stone for future work.

I want to pay tribute to Marjolein. I tried to talk to her about her major and inspiring contribution to maternal health in Africa. She fobbed me off. 'It is my job, it is what I am trained to do', she responded. She seems tough and practical but I see through her! She loves the women she helps, she is proud of the local staff she trains, she works for almost no money and that she earns is given away 'because they need it more'. As a single , white woman, she has worked in the most desolate and harsh areas of Africa with minimal support. In 8 weeks she is moving to Sierra Leone to work for a year in the post-Ebola chaos. She will see things that we cannot even start to imagine. It is very humbling to know someone like this.

418DD3B4027B671CC7CD2A8C8AA8C9A2.jpg

DSC00866.jpg

There have been a few questions come up that need answering:

1. Ethiopia is considered a Christian (mostly Ethiopian Orthodox) country however there are many Muslims (I am told overall 30-40%). In the Bahirdar area, around 80% of the women are Christian. There appears to be no tension between the religions and no distinction was ever made in the hospital. Occasionally I noticed a name like 'Fatima Mohamed', but otherwise I would have no idea and it didn't matter. Everyone was treated the same and there were no issues with me being male

2. I saw no FGM (female genital mutilation, female circumcision). It is a regional cultural issue and almost nonexistent in the Barhirdar area. Marjolein worked in the remote Afar region of northern Ethiopia and FGM there is almost 100%

3. Marjolein is officially a Tropical Medicine Specialist. However this name is a little misleading. There is a specific international training program in The Netherlands designed to produce career aid doctors - I guess you could call them 'professional volunteers'. The training involves obstetrics, surgery and paediatrics with a view to preparing these specialists to work in remote areas and deal with anything. Prior to doing this course, Marjolein had actually done 4 years of surgical training which has been a great help to her. So, although not actually an obstetrician, she was more capable than myself and most of my Australian colleagues at managing obstetric disasters.

4. Now that I am safely back in Australia, I can report that my lack of social media for a week was due to a 'blackout' from the Ethiopian government. They own all media outlets and the one telephone/internet company; thereby having the ability to block anything they wish. The official unofficial story was that there was a leak of a university exam paper so the government blocked all social media (Facebook, Twitter, WhatsAp, etc) so that this information wasn't dispersed. The unofficial unofficial story was that there was an outbreak of political violence in a nearby town which the government didn't want spread around. Who knows the truth! The university students were NOT happy about this censorship (and got around it anyway, like me, with a VPN!!) triggering demonstrations and probably making it worse for the government in the end!

5. Yes! I will return - either to Barhirdar or somewhere else. I'm not finished.........

These are links to the organization I worked with:

Maternity Africa

Barbara May Foundation

If anybody wants to read more about some of these inspiring people:

Hamlin.jpgValerie.jpg

So that's the end of my blog. See you next time!

Posted by gunny64 22:55 Archived in Australia Comments (4)

Goodbye Barhirdar

storm 16 °C

Yesterday was St Gabriel's Day. There is some complicated system in the hospital where each 'suburb' of Barhirdar is assigned a Saint and the nurse or midwife living in that particular suburb hosts the celebration lunch for their Saint. It was Amaled the theatre nurse who had the privilege this time. Luckily it was a quiet day as, at exactly midday, almost every staff member piled into the ambulance for the journey to Amaled's house. Somehow we managed to fit in 17 people! It was a short but thrilling trip with everyone chatting away excitedly.

20160726_122338.jpg

20160726_121204.jpg

On arrival we were ushered into the house, washed our hands and lined up for an enormous plate of amazing Ethiopian food. I am now very comfortable eating without utensils although I'm still not as efficient or neat as the locals. Everyone was offered homemade beer. Now I'm not a beer drinker at the best of times but......this was one of the worst things I have ever tasted! Fortunately many locals also don't like it so it was acceptable to not finish.

20160726_124428.jpg

90_20160726_124756.jpg

90_20160726_122718.jpg

Seconds were offered then we were all ushered out to wash our hands and hop back into the ambulance. It was all over in about 1/2 hour! As we left, many more people were arriving. It is the custom that whenever such a celebration occurs, all the neighbours are automatically invited and anyone else who happens to pass by is encouraged to 'drop in' (including the poor and homeless). I am blown away by the generosity of these beautiful people.

This afternoon the staff put on a goodbye gathering for me at the hospital. For some reason I don't understand, it was a 'tea' ceremony rather than a 'coffee' ceremony. The process started with a prayer then I had to cut this massive cake while they clapped. The Administrator made a speech to thank me for my work and then I had to reply. This was very difficult and Marjolein had warned me that it is not polite to show emotions. I struggled but managed to say a few words without falling apart. I think I might have promised to return!

20160726_165356.jpg20160726_170745.jpg20160726_171957.jpg20160726_172020.jpg20160726_172040.jpg

It was then time to eat again. Part of the ceremony involves eating popcorn! I would love to know the origin of this - no one has been able to explain. You may recall I brought several huge bags of lollies with me for the trip. I actually (surprisingly) didn't eat them all so took the remainder to the ceremony. The staff had clearly never seen or tasted anything like this but loved them. At one point, one of the midwives was looking quizzically at a jelly snake. She was trying to work out what it was and then someone obviously suggested it might be a penis. Suddenly the place erupted with raucous laughter - everyone got their own snake and there were a lot of rather suggestive movements going on to fits of hysterics. And then they discovered the jelly babies.......they must really think we Australians are odd!

20160726_170614.jpg

I had a quiet evening, packing and drinking a glass of wine with Marjolein. She had to go into work for a short time and returned with this gorgeous note for me:

20160726_210717.jpg

How could I resist? I went into the hospital to visit them one last time. They were SO excited, gave me huge hugs and thanked me for coming. One of the patient's husbands took a photo of us.

20160726_204947.jpg
20160726_205000.jpg

My last night was interrupted by the most spectacular Ethiopian thunderstorm. I seriously don't know how some of the houses survive! On waking this morning, I was without power but 15 minutes before I was due to leave, it suddenly appeared and I quickly had a (hot!) shower. I even managed to have a final coffee....

270_20160727_070646.jpg

Solomon picked me up in the ambulance and off we sped to the airport. It was a fascinating time to be on the road - so many people and animals (and the occasional car).

90_20160727_075001.jpg

Goodbye Barhirdar..............

270_20160727_092454.jpg

OK, so maybe there needs to be one more post!

Posted by gunny64 04:05 Archived in Ethiopia Comments (1)

My last working day


View Ethiopia on gunny64's travel map.

I have been looking at some statistics! In 2015, Ethiopia had a maternal mortality rate of 353/100 000. This compared to our rate in Australia of 6/100 000. Horrifyingly, Sierra Leone (where Marjolein is going next) had a MMR of 1360/100 000! The neonatal mortality rate (death of a baby up to 28 days of life) in Ethiopia was 27.7/1000 compared to 2.2/1000 in Australia. This is scary stuff and highlights the incredible disparity in safe childbirth that still exists around the world.

I've also looked at some statistics from our hospital in Barhirdar. Firstly, and most importantly, there have been NO maternal deaths for over 3 years. This is an amazing feat and a tribute to the quality of care provided by all the staff. They deliver between 150-210 babies per month and the caesarean rate hovers around 10%. Last month they had 210 births, one stillborn baby, no neonatal deaths and a CS rate of 8%. This month is likely to be very similar. What an incredible achievement!

90_20160719_084930.jpg

I have seen so many women over these last 4 weeks with terrible obstetric histories. Many have lost one or more babies, most have given birth at home under difficult circumstances, and several have no living children. The fact that they have booked into the hospital to deliver this time around has dramatically improved the odds of them having a live and healthy baby. What a wonderful gift to these women to have access to safe childbirth.

90_20160719_085830.jpg

Yesterday was my last working day here in Barhirdar. Mostly it was quiet but I was called early this morning to see a woman who had been labouring all night with her 1st baby. The midwife was unsure of the position. In fact, it was a brow presentation! This particular position of the baby's head is always incompatible with a vaginal birth and I therefore performed a Caesarean. While waiting to start, I was reflecting on the reason I am here. Even 5 years ago, this woman would probably have continued to labour for days, delivered a dead baby and then likely ended up with a fistula (or died herself). It is wonderful to know that I have truly made a difference!

90_20160726_082904.jpg
90_20160726_090806.jpg

I finally managed to visit the market. The housekeeper, Meron, let me tag along with her. OMG! I have never seen so much chaos (or mud). I have been to many markets around the world but this was a new level. It was frantic and exciting. The sounds and smells and sights were overwhelming. Having to also navigate the slippery, muddy pathways added to the thrill. I came away exhausted but exhilarated (and totally covered in mud!). I have no idea how Meron does this several times a week and remains perfectly clean!

90_20160725_095302.jpg
20160725_100705.jpg
20160725_095855.jpg
90_20160725_095101.jpg

Today was my last in Barhirdar and it was full of joy. It will be with great sadness that I write my last blog post tomorrow during the long journey home.......

Posted by gunny64 09:05 Comments (6)

Hippo Hunting (Part 2)


View Ethiopia on gunny64's travel map.

Yesterday I did the Grand Tour! I was picked up at 7am by one of Marjolein's Ethiopian friends and off we went on a boat into massive Lake Tana. Tigistu knew exactly where to go and there they were - 2 majestic hippos wallowing in the shallow water. They played hide and seek with us but I eventually managed to catch one on camera ( you'll have to believe me).

Screenshot..0725-191031.png

Having ticked that off my list we proceeded to visit several monasteries and museums scattered on islands on the lake. The first and most impressive monastery was built in the 1300s, is still mostly in its original state and remains fully functional. It is filled with beautiful original paintings which have been amazingly preserved given the harshness of the environment.

20160724_091303.jpg

Tigistu is a tour guide and full of information about everything Ethiopian. He also knows a lot about the Ethiopian Orthodox religion and chatted away knowledgeably to all the priests and monks. I am very thankful that I went to Sunday school as a child which allowed me to generally keep up with the conversation and also appreciate the art.

90_20160724_100704.jpg

We had one particularly memorable encounter. A priest had told us a long but interesting biblical story about an Ethiopian saint. He spoke no English so the tale was translated to me by Tigistu. At the end of the discussion, the priest asked where I come from. He clearly had no concept of Australia soTigistu decided that he might know about kangaroos. A hilarious scenario ensued where Tigistu and I tried to explain via miming. You can imagine!
Tigistu even grabbed the priests flowing robe and tried to fashion a pouch to explain about the joey. The poor guy was so confused. Then I had the brilliant idea of googling for pictures on my phone. The priest was absolutely fascinated and wanted to flick through all the images; asking many questions. He then rushed off and brought back his own smartphone (obviously without internet) and took photos of my phone images. It was so cute!

20160725_192412.jpg
Screenshot..0725-191738.png

Another exciting part was walking through the islands' rainforests. They were so peaceful and we saw many beautiful birds and monkeys. There were thousands of wild coffee trees which weren't flowering and I would have walked right past them without knowing if Tigistu hadn't told me. Interestingly, Eucalyptus trees have been imported from Australia and they are scattered around everywhere in this part of Ethiopia.

270_20160724_093751.jpg

We ended the day with dinner but when Marjolein and I got home, we encountered a new problem! The lock on our compound broke and we were locked inside. We managed to find some tools and tried attacking the problem from inside but had to admit defeat and call the hospital for help. One of the midwives and an orderly came to our rescue. They thought it was hilarious and spent the first few minutes in fits of laughter. Eventually we managed to break the lock but then had to work out a mechanism to keep the gate closed if Marjolein got called into work. Of course this was all done in the pitch black night under the light of our phones. Another interesting experience in Ethiopia!

Posted by gunny64 09:33 Comments (1)

A beautiful story


View Ethiopia on gunny64's travel map.

My phone is back! Solomon the ambulance driver took it to his mate who owns an electronic shop. It got a new battery and some 'rewiring' and seems to now be back to normal. An Ethiopian miracle! As you can imagine, I have quickly backed up all the photos onto my laptop and will ensure I use a surge protector whenever I recharge the phone. I've missed out on a few days of photos including my emotional visit to the fistula hospital, but I may be able to get some copies from Garry the builder.

Another day, another inspiring person. Katie is a South African midwife. She works with Andrew and is based in Tanzania but comes regularly to Barhirdar where she provides tuition and support to the local midwives. She is here this weekend to do a workshop.

Katie arrived yesterday like a whirlwind! Her hotel room wasn't ready so she came straight to the hospital, introduced herself to me, hugged the midwives and launched herself into teaching mode. She wandered around the ward, talking to and touching the women like an old friend. She admired their babies and helped them breastfeed. Along the way, she interacted with each midwife; asking questions and discussing management. They clearly respected and appreciated her instruction. Last evening (over a gin and tonic), we sat and talked about the challenges faced by both local and volunteer midwives dealing with childbirth in developing countries. Another inspiring person devoting her life to the women of Africa!

I have a beautiful story to tell which sums up so much about this amazing place and the people it serves.........

Felgu is a 35 year old woman. She had her previous 7 babies at home in the country but the last one was stillborn so she decided this time to have the baby at our hospital in Barhirdar. She made the trip into town twice during the pregnancy with her husband. Her 2nd visit at 36 weeks was fortuitous as she was found to have severe preeclampsia with a BP of 200/120. It took some time to convince her to stay for medication, and then even more time to talk her into an induction. However, all turned out well and she had a healthy 2.4kg baby girl.

After delivery, Felgu needed to remain in hospital for a few days. It soon went around the ward that she and her husband had no support network in town. Each patient then asked their family to bring in a little extra food. It wasn't long before the couple were inundated with food; probably more than they had seen in the last few months! Funnily enough, she spent these few days just eating and sleeping - clearly storing up energy to face coping with her 7 kids at home! Her devoted husband remained with her all the time; sleeping on the hard floor beside her bed.

Today we talked about discharge. Her BP was stable on medication but I suggested she return in a few days for a check. There was lengthy discussion between the couple and the midwives. It turns out that they live far out in the country - a bus journey followed by a 'very long' walk. I questioned how she would be able to walk so far so soon after the birth and was told about the 'traditional ambulance service'. Apparently her husband and other members of their village will carry her and the baby home; either on their backs or on a stretcher. I then suggested maybe she didn't really need to return for a checkup - but her husband was insistent that this was 'no problem'. His wife and baby had been so well looked after that he wanted to follow my instructions to ensure their ongoing health.

I was hesitant to ask for a photo but Felgu was happy to oblige and even encouraged her husband to join in.

20160723_091328.jpg
90_20160723_091302.jpg

In fact, the woman in the next bed was somewhat put out that she wasn't asked and insisted I take a photo of her too!

90_20160723_091345.jpg

Posted by gunny64 05:34 Comments (0)

(Entries 1 - 5 of 23) Page [1] 2 3 4 5 »