3/1/09

During my time here in Ethiopia I have had many experiences with folks
who aren’t quit 100% normal in the head. The first one that comes to
my mind is a man called we all affectionately called “Naked Man”.
Naked Man can without fail be seen pacing the street above the new
nursing school. Naked Man isn’t actually completely naked. He actually
wears a flap that hangs over his frontal apparatus. The only problem
is that the flap is very rarely in the right place so that makes
things a bit interesting. Rumor has it the he used to work for the
hospital before he went crazy and that he speaks great English. And
despite what you say to him he never more than grunts at you though
when you walk by.

A couple weeks ago I was in the examination room used for the HIV
tests waiting for Chu-Chu (the nurse there) to finish a couple of
patients. I was sitting behind the desk in the room when a man came in
and promptly told me that he needed to leave because his friends had
brought him to the hospital to kill him. The strange part about this
was that he spoke really great English and was also very nicely
dressed. I tried to assure him that we would not try and kill him and
that hospitals are actually used to make people better. He would have
none of it though and would absolutely not let Chu-Chu draw blood from
him. After talking with him for some length of time I realized that he
could not be persuaded and he realized that his friends had brought
him here to kill him for sure.

A while later I heard a disturbance out in the waiting area, and when
I poked my head out of my office I saw that the man’s friends were
trying to persuade him to go to the ER, because our psychologist was
there. He would have none of it. I then noticed that one of his
friends reaching into his pocket and watched as he pulled out a rope.
As soon as the crazy man noticed me, he started to yell at me to help
him because he again said his friends were going to give him an
injection that would kill him. As he was being tied, mayhem broke
loose in the waiting area. Children who where slightly traumatized by
what was going on started crying so there mothers were dragging them
out. And men jumped up to help control the fighting crazy man.

Eventually the fighting man was dragged/carried into the ER where he
did indeed get an injection that calmed him down. When I walked back
into the waiting room, everyone looked absolutely petrified. I told
Birhani, the head nurse, to tell the people that the man was crazy and
that he was now okay, and not dead.

On another occasion a very old lady was being very fussy and would not
let Fletcher and I take her blood pressure. Birhani came into help us
and immediately started laughing. We asked here what the lady was
saying. Birhani said that she could not repeat some of the words
because they were not nice, but one thing she did repeat that the lady
said was this, “Don’t let the ferrangie doctors touch me, they will
kill me!” The funny thing was that Birhani later told us that this
woman was the aunt of Naked Man.

I’m thankful that I haven’t yet gone crazy. And with only two weeks
left here in Ethiopia, that’s truly something I can thank God for.

2/27/09

 I’m now not only a surgeon but a dentist. So maybe not quite a
dentist or a surgeon but I have pulled 6 teeth, okay so maybe four
were baby teeth. I think of it this way though, if baby teeth are
teeth than kids aren’t humans. My new experiences as a dentist became
possible because a medical missionary team has just been here from
Oregon.

This team was headed by Dr. Erling Oksenholt, the man who originally
got Fletcher Justin and me interested in Gimbie and played a huge part
in us coming here. Our house was transformed the day before he came
into a cafeteria to feed the 13 ferrangies and many other visitors who
would join our every meal. It was nuts! Each of the 10 days they were
here I was absolutely exhausted when my head finally hit the pillow.

The team included a dentist, two doctors, an eye specialist, a
physical therapist, a nurse, a journalist, and others who acted as
medical assistants. Most days this team would head out to one of the
clinics to receive and care for huge crowds of people that had come to
see the “ferrangie” doctors. The biggest hit was always the eye
specialist Dr. Harris. Many people have a lot of trouble with there
eyes here due to both the sunlight and the dust.

I switched off with Fletch going to these clinics. One day I worked
with Dr. Raj Bamon. I started out being his assistant and helping him.
 After a couple of hours though, the translator was talking to me and
not the doctor and I was diagnosing problems, prescribing medicines
and ordering lab tests. While I was doing this Dr. Raj was usually
busy taking pictures out the window or reading. It was great! At the
other clinic I went to I assisted the dentist Dr. Ray Lunt. After I
watched a couple of patients get their teeth pulled. A little boy came
in and Dr. Lunt informed me that this was my patient! Oh boy, I though
to myself, it just has to be a kid who will probably cry and I am
supposed to pull not one but four of his teeth. That just sounds
great. It ended up going well though, well at least all four teeth did
eventually come out and the poor kid didn’t cry to hard  as I was
yanking viciously at his teeth. I saw one other patient that day also,
this second one I received a little professional assistance but I did
eventually get two of his teeth also.

Life is almost back to normal now. One of the best things is that the
group left all of their extra food. I can’t tell tell how good it is
to have cheese, Heinz ketchup and cold cereal. Wow! It’s a taste of
home I tell ya. But I was jerked back to reality when one of the first
patients I saw back at the OPD was a 10 year old girl who had been
raped, and was coming to get medical attention. Well only two more
weeks of this, and that is another thing that doesn’t quite seem like
reality.

2/13/09

In the past few weeks I've gotten the chance to observe many
surgeries. Jacob, our new roommate has been helping us with triage and
because it does not take three people to work there we take turns
doing other jobs or things. This includes watching surgeries and
shadowing the doctors. The experience has been absolutely great to
far.

There are a couple of surgeries that I have seen that have really
amazed me. The first was that of young man who came in with a
distended stomach. Because this hospital does not have the proper
imaging equipment the doctors were not sure exactly what the problem
was, but the figured it was a blockage in the bowel. It turned out
they were wrong and the surgeons, Dr. Kahlid and Dr. Johnson, were in
for a very big surprise. They did a midline incision and his insides
practically popped out of him. His whole digestive tract was filled to
bursting with air. The worst part of it seemed to be his colon and so
it was decided that it should be removed. Two and a half hours later a
four foot section of his 5 inch in diameter colon was removed. Wow was
that ever amazing to watch. Even Dr. Johnson had never seen anything
like it.

There also have been some other interesting operations. One was a boy
who had a perforation in his bowel from a tree that fell on him.
Another was a lady who had a liter of pus drained from a sore on her
back. Recently I also saw the the most disgusting operation I've seen
so far. A young lady came in with a absolutely horrendous infection in
her lower leg. They brought her into surgery to see if they would need
to amputate it. The smell was enough to make you vomit and that
combined with the sound of the steel instruments scraping away the
dead skin and pus from the bone put me to the point were I had to step
out of the room to catch some fresh air. Luckily there was some life
still in her leg so for now no amputation is needed.

This last week I also got my first chance to be a real surgeon. Well
not quite but for me it seemed that way.  A young man came in and he
had all the signs of appendicitis, but he did not have the money to
pay for the operation. When I found out about this I decided that I
could use some money I had gotten from the states for charity to help
the boy out. If not he might have been sent home, and appendicitis can
easily kill you if left for too long. So off to the operation room we
went, I went along to try and get some pictures to send back to the
donor. It was late afternoon and so there was no one to assist Dr.
Johnson in surgery. An assistant is not necessarily needed for and
appendectomy but Dr. Johnson asked me if I would like to help. Of
course I jumped at the chance.

Dr Johnson showed me how to wash and get all sterile and in my gown
and drapes and soon I was standing over the patient. It was amazing!
Just to be so close to what was going on. I proceeded to help by
mopping up blood with gauze, cutting sutures, holding the skin apart
with retractors and so on. It was the highlight of my time here so
far. The only complaint I had about it was the fact that my nose
itched terribly and I couldn't itch it! The young man has now been
discharged so I know now that I didn't do anything wrong too, which is
good news.

I now only have about one and a half months left here, and I'm very
much looking forward to more time in the OR. By for now.

nk

Greetings

These last 5 days have not been so great for me here in Gimbie. I've
been sick. It started out on Friday morning and hasn't let up since.
Being bed ridden around here is not the most fun thing in the world
let me tell you. I hope to be well very soon but we'll see. I was told
that there is a common cold going around Gimbie, and working in the
OPD and being exposed to all the sick people in the town doesn't help
my chances of staying free of sickness during my time here. I did get
checked for malaria just to make sure that's not what I had.. My
results came out negative, so that was a blessing.

Two times during my sickness I was visited by some of the neighborhood
ladies. The first time was from Galeta's mom, who knelt down by my bed
and prayed for me in Oromo. Although I could not understand, it felt
good to know that this woman cared so much about me.

The second visit came from Eseye, Mulu, and Dinke, the three ladies
who work in our guest house. This was a bit different. They just kind
of stood there, looked at me, and said some things in English and a
lot more to each other in Oromo. This was a bit awkward…me lying in my
bed sick, and them peering down at me. But they where trying to be
nice. Right?

In my last blog I believe I wrote about our clinic trips that were
planned for this week. Those were all postponed due to the fact that
the medicine has not yet arrived from Addis Ababa. I'll be sure and
keep you updated though. 

nk

January 10

Hello All,

We are now back in Ethiopia after a wonderful trip to Zanzibar. Our
time there was absolutely great. We had a great time swimming,
relaxing and soaking up the sun.
All good things must come to an end though. It did feel a little bit
like coming home when we came back to Ethiopia. Fletcher and I have
gone back to our daily work at the OPD and Justin spent last week
tying up some loose ends. His time is done here and he left on
Thursday for Europe.  No sooner had he left that we got a new
roommate. In fact the day after he left Jacob showed up. Jacob is a 21
year old from Denmark who just got accepted to med-school but is
taking six months before he starts to travel around Africa. He will be
staying with us for a month, volunteering at the hospital before he
leaves for southern Africa.

The big event of the week was Ethiopian Christmas, which is January 7.
On Christmas Eve we came back from eating out for lunch to find that
an oxen had been killed in our front yard. I was severely disappointed
to find that I had missed the actual execution of the animal, but I
sure did get my fare share of watching it being cut up. The butcher,
who was apparently a professional, was armed with three weapons: a
sickle,   like the kind for cutting grass, a normal looking knife, and
an axe. It seemed to me he was doing quite a fantastic job breaking
the ribs with the axe into nice sections of meat. I've always known
that cows have four stomachs, but I had no idea that they where as big
as the are. Wow! Maybe the most disgusting thing of the whole ordeal
was the some of the kids that were watching got a hold of one of the
oxen's testicals. What better thing to do with a testical than try and
blow it up like a balloon….Some people's kids.

On Christmas day Justin, Fletcher and I where invited over to two
houses to eat. For lunch we were invited to our cook Dinke's house,
and for dinner to the home of the caretaker for our guesthouse, named
Eseye. We knew that we were going to be absolutely stuffed, but it
turned out to be even worse than expected. We showed up to vast array
of food at Dinke's tiny house, and knew that we were done for. You
see, it is considered an insult if you do not eat a lot, and I mean a
lot, of food when you are invited over to someone's house. After the
first full plate of food, Dinke kept telling us "nyatu nyatu" which
means "eat, eat". We did all manage to get a second serving of food
onto our plates, and finish them. This wasn't without sheer will and
determination though. WE WERE STUFFED, but, Dinke seemed satisfied
with how much we'd eaten. Finally we waddled out the door. Thank
goodness, 1 down 1 to go.

After lying down to try and sleep off our food most of the afternoon,
we started to devise a plan for house number two. Fletch came up with
what seemed like a fool proof plan. It was to slow play. In other
words to eat really slowly for the first 20 or so minutes, that way
when Eseye would ask us to take second, we could show her that we
still had food on our plates. After this we would eat more quickly to
finish our first plate of food, then maybe get less for second. We
hoped that this would at least throw her off.

From the minute we sat down our plan was foiled. Eseye apparently
decided that it would be good if she served us, instead of us serving
ourselves. Not Good. So we sat there as our plates grew and grew until
they were heaped with food. Luckily the food was again delicious which
made the task of eating it all a bit easier. The only problem was that
it seemed that every time I took a bite Eseye would plop another
spoonful of food on my plate and say "nyatu." Feeling very sick, I
finally took the last bite of food and shoved down my throat. Nope I
wasn't done. Eseye again got up and plopped food on my plate. This
continued on for sometime until finally I had won. Thank goodness.
Needless to say I wasn't hungry for about 1 full day and also felt
quite sick.

Oh the adventures of living in Africa. Sorry there are no pics but the
internet is too slow right now.

nk

December

These last couple days here in Gimbie have been absolutely great. It's
not that much has happened it's just that I really do enjoy it here.
In the OPD lately I've taken it upon myself to lighten up the mood a
little bit. So when I call people's names I occasionally use an
announcers voice and call them like they're on the Price in Right.
Even though 95 percent on them don't know what I'm saying after I say
their name. All of the people seem so get a pretty big kick out of it.

The other day the staff got their turn to have a good laugh at my
expense. About mid-morning I was getting really thirsty so I decided I
would run up to my house and get some water to drink. When I returned,
the thermometer I use was nowhere to be found. I went around to all
the other examination rooms to ask the doctors and nurses if they had
seen it. None on them had. This really puzzled me because I couldn't
figure out who would have taken it. Finally, I gave up and returned to
my work. About a half an hour later the x-ray tech came into my room
holding the thermometer and sporting a huge grin on his face. The
nurse from the next room over, Burhane, also came in and she could not
stop laughing for all she was worth. Birara, the x-ray tech who has
become one of my favorite people to see around the hospital because of
his great personality, then went on to explain that I had left the
thermometer in someone's armpit. Apparently, the man had tried to tell
me that he still had thermometer, but to no avail. ( in my defense
generally when I tell the people to go back and sit down, they all try
to say many things to me, so I generally just say "yes, yes" and send
them on there way). So anyway this poor man had carried the
thermometer back into the waiting room, then to the docor who sent him
the get an x-ray. There when Birara was getting him all set to go the
thermometer dropped to the ground. Boy was that ever the funny story
of the day.

Another story is that we caught a thief…on camera. To make a good
story short, we had been noticing that we where would occasionally
lose money when we left it on our dressers. So one day to check and
make sure, I left a small some of money out, and sure enough, that
afternoon half of it was gone. So the next day we again put out some
bait but this time Fletch set up his camera in a top secret location.
Sure enough, we caught a "tief" (Ethiopian can't pronounce the "th"
sound). It was our cleaner, Negusay. After taking her to the police
station and showing the film, because she would not admit to it even
though we showed her the video, we released her of her duties. I do
feel a little bit bad about it, because she not is jobless with a
baby, but what else could we do? Oh yeah, and the police men thought
the video was the greatest thing ever created. I don't know if it's
possible but I'll try and get the video up on this blog.

In other news, Justin's father, Brad, is now here in Gimbie. It's has
really been great having him around. Also pray for Fletch, he's been
sick for a couple of days with a throat and ear infection. I am happy
to say that I have not caught that bug… yet, it's been tough though
because a lot of American candy is in our house presently. Now, the
three of us are just counting the days till we leave for our Christmas
holiday. We are going to the island of Zanzibar for Christmas. Man can
I hardly wait. I've never had Christmas away from the northwest, but
Christmas on the beach with two of my best friends also doesn't sound
half bad. Bye for now.

Nk

December

If I had to choose a memory that I think will stick with me the best
for the rest of my life, I would have to say that it would be what
happened to me this last clinic trip. The plan was for me to meet the
hospital Land Cruiser on it's way back to Addis and meet up with
Justin and his dad, Fletcher, and some others and head out to the
Greenlake Clinic. On this trip we were to do the inventory and payroll
for the clinic. After a very antagozing trip on the Ethiopian public
transportation system, if it could even be called a system, I arrived
in Bako, the halfway point between Addis Ababa and Gimbie. That's
where the fun began.

Paul, the hospital administrator, decided that he would also like to
go out and have a look at the clinic. So we drove the first leg of our
journey, to a town called Kada, no problem. There, generally everyone
gets out and puts there stuff on pack mules for the 12k hike in. But,
it hadn't rained for a month and the natives said the road was again
passable, as it is not in the rainy season, so we decided to give it a
shot. Another factor was that we had arrived too late to make the walk
in before dark.

The road to drive on is about 5k longer than the donkey trail, so we
knew we had a lot of four-wheeling to do. It started out extremely
rough, but doable. So we continued. After about a half hour had passed
we noticed some dark rain clouds coming our way. Not good. By the time
we had reached a large meadow, where the road was now just grass, it
started to rain. So here was the problem, most of the "road" was made
out of the typical Ethiopian top soil, clay. As you probably know when
clay becomes extremely slippery when wet. Kind of like snow and ice in
fact. I think I also neglected to mention that our land cruiser was
packed full with nine people, and three of them had all there bags
from the airport, seeing has they had just arrived in Ethiopia. Two of
them, Jen and Heather, were PA students from Union College, who had
come to do there tropical region rotation for two weeks. They had come
straight from the airport and this was their first look at Africa. The
other was Justin's father, who also had just arrived.

To continue my story, because the Land Cruiser was so full five of us
where half the time running, half the time standing on the back bumper
and holding on to the roof rack. This was to lighten the load when the
going got extra rough. We continued on, getting more and more soaked
by the second, but we where still driving, that was the good part. The
road went through many small creek beds, and at most of them everyone
would also have to get out so as to lighten the load even more.

After about thirty minutes of this kind of driving two things
changed. One the road got considerably smoother, and the rain had now
soaked in to about an inch of earth so we started sliding. It soon
became that at every small incline we would have to push, and at every
decline, we would just slide, it didn't really matter what way the
wheels where turned. We finally, got to one hill where it looked like
we weren't going to make it. We had tried three or four times, but to
no avail. Paul, who was doing an absolutely amazing job, decided to
give it one more try. I followed him to the bottom of the hill, and
checked out the situation then was off. We had decided that the car
could maybe gain a little bit more speed if one set of tires was on
the grass on the edge of trail. When the land cruiser finally came off
the grass to dirt embankment, I watched in awe as it stayed on three
wheels for a good solid second. Needless, to say it did make it to the
top of the hill and so our journey continued. Not for long though.

Soon we found ourselves in another predicament, a long sloping hill
that went down into a creek bed where it took a sharp right turn and
went up the other side. The problem was that the hill was slightly
tilted, and in the direction of the tilt there was a deep rut. If
this rut was follwed into the creek, the car would head directly into
a 6ft water fall. Not good. Because of the slippage it seemed
impossible to keep the car our of the rut. After many attempts, we
still hadn't made it.

Finally Paul was able to take the jeep to the far side of the road the
swing back across just before the creek. From there he was committed
though and had to try and make it all the way across. No luck, the
jeep hit some kind of rock or rut and slide into the creek sideways.
No the Jeep was in the middle of the creek, parallel with it's
direction of travel. By now it was pretty much dark, and still
raining. We tried everything we could to get push, pull, or whatever
to get this thing out, but to no avail. The trouble was that there was
no room to back up, because we would back right over the waterfall.
After, we were all out of ideas, and now even more soaked because of
sloshing around in the sometimes knee deep creek water, we gave up and
decided that we would walk the rest of the way.

The guard that was with us told us that it was about a fifteen minute
walk to the clinic. What he did not tell us is that that is in good
conditions. But, after everyone had what they needed for the night we
set out. It was an interesting walk. Our shoes couldn't help but
picking up what seemed like pounds of mud with each step. I walked
with Gadisa, who had lost one of his sandals to the mud, and now
walked barefoot. He also had a newly split toenail. Not fun. To make
matters just a little bit worse one of the PA student had an asthma
attack, probably mostly due to the fact that we where at around
8,000ft. Finally we arrived at the clinic and settled in for a nice
and wet nights sleep.

The next morning we did our work and also go the Land Cruiser out. We
though we might have to enlist the help of many donkeys but it ended
up being that about 20 Ethiopian and a couple of shovels did the
trick. And praise God we did make it back out that day, and shoot, I'm
even still alive to tell about it.

nk

December

The internet has always been bad here in Ethiopia, but this past month
has been exceptionally terrible. Due to the fact that in early
December someone chopped through the phone cable, and now, that all of
Ethiopia is having internet problems, it's been awhile. In any case, I
hope you enjoy these blogs.

This week was again filled with both fun and action. For instance, I
got to help deliver a baby. Fletcher, Justin, and I have all become
decent friends with the amazingly upbeat Danish midwife named Belinda.
I really didn't do all that much, but believe me I was right there in
the thick of it all. I even got to cut the umbilical chord. Thanks to
God the baby was a healthy one. Here, at least one in ten does not
survive.

Tuesday was the start of another adventure, a three day clinic trip.
There where six of us that went on the trip. The plan was two spend
two days at the Guliso clinic doing both patient care and maintenance,
then the third day traveling to two other clinics and doing their
payroll and inventory.

The clinic head had done his job of advertising in Guliso and there
where about 160 patients signed up to see the doctor we had brought
along. There were also many who needed to have teeth extracted. That
is where I spent most of my time. I worked with the Ethiopian dental
nurse that we had also brought from the hospital named Siguy. It was
great, but also at times very disgusting. After each patient I
severely wanted to go back and brush my teeth again. Virtually every
patient had rotting teeth. When Siguy would check them with his probe,
pieces of tooth would always come out on the end of it.

Really the only thing that I didn't like about the whole dental
experience was when small children would come in. They hate needles.
Like really really hate them. So I would have to help hold the poor
kids down. Not fun.

On the second day, a young girl about the age of fourteen came in.
After a short examination it was decided that like many others she
would need and extraction. When Siguy told her this, she said she had
no money to pay for it. Being in a charitable mood I decided to pay
for the extraction for her. No big deal, it was about $2 US. They
funny thing was that then all of the sudden the next patient also did
not have money. I quickly realized what was going on and told Siguy
that I was not going to pay for this extraction also. After Siguy had
relayed this message, it was found that this second patient did indeed
have enough money to pay for the extraction she needed. Weird huh??

The food situation was a very lacking on this trip. But we survived I
guess. For lunch the first day we had three day only cold chiro (kinda
like a bean dip) and enjera. We vowed never to go back to that
restaurant again, you can be sure of that. From then on our diet
consisted of almost exclusively bread, bananas, and Ethiopian cookies,
which are hardly cookies at all, more like sweet crackers. No worries
though, I survived, and am even still healthy enough to write about
it.

Nk