Where to start? Much has happened since I last was online. The internet, or at least our access to it, went down sometime Sunday. We moved to a new house on Monday and just didn't have the time or energy to get back online until today. Much thanks to the Grays for lending us their access today so we could catch up.
Saturday, Wendy and I managed to go to the open market while Becca watched the girls (they had not yet left for their weekend away). We wanted to buy some locally made souvenirs and the market is only open on Saturdays. One of the hospital staff graciously went with us as a guide, translator, and bargaining agent. Wendy bought a bunch of hand-woven baskets and I bought two traditional Ethiopian coffee pots. It was amazing to see how far the market had come along since I had last been there. Two years ago, the whole thing had burned down in a fire and all the merchants were just sitting on tarps selling their wares. Now, all the stalls have been rebuilt – I could barely recognize the place. Coffee pots have gone up in price from about 80 cents up to 95 cents, but I still splurged. I was frequently mobbed by boys in the marketplace who were intrigued by my arm-hair (they don't have much if it themselves). I was equally intrigued by their lack of an idea of personal space, but it was all friendly and I was refreshed at how little begging went on. Everyone seems anxious to strike up some sort of a conversation and try out what little English they know. Someone started to speak to me in their local dialect, but all I could say was "no habla Wolaittinia." I don't think he understood (yet he understood perfectly).
After market, Paul held his weekly Bible study with the residents. They are studying some very thick systematic theology – Paul has selected a textbook almost as thick as Schwartz. Still, Paul manages to keep the discussion quite relevant to their lives, their work, and to the gospel. We finished with a neat time of prayer for one another. The Grays then left for their weekend getaway near the lake at Awassa.
That afternoon, I took a walk back into town with the girls to our favorite local hangout, the cafe at the FantaVision hotel. They were out of soda, so the girls had hot milk with sugar and a dash of dad's espresso. I, of course, had a couple of macchiatos (now a full-fledged addiction) and we watched part of an episode of Ethiopian Idol (no joke) on the cafe television. One of the numbers was an interpretive break-dance to "We are the world." Their version of Simon is this straight-faced guy with corn rows who apparently gave the Live-Aid reset a lukewarm response. Karmyn, the Bowers' 14yo daughter, came along for the walk and served as a valuable interpreter and child entertainer. Tessa walked the whole round trip and didn't complain a bit. We tried to take a bijaj back to the hospital, but all we could find were donkeys who were already carrying too much.
Saturday evening brought a sad case of a 6 month old baby so unfortunate as to have an unintended circumcision performed by the family dog. Daniel (the senior resident) had already performed some wound care and a temporary repair, so we set him up for a more definitive repair in the morning. John and Teddy started the 8am case promptly at 9:45 and I must say, once the swelling goes down the result may actually be functional. At least the kid can pee for now.
Sunday evening we had church at the Bowers house. The missionaries on the compound get together for a low-key worship service in the evening – it seems to be a much more relaxed (sabbath-like) atmosphere in the evening since there is often still clinical work to be done in the morning. Some of the missionaries also like to go and worship in the local churches in the morning as well (frankly, you can hear most of them from the compound since the megaphone seems to have a near-sacramental place in Ethiopian worship, regardless of persuasion... Evangelical, Orthodox, Muslim, Retail...). As luck would have it, the cell phone would buzz right as the service started and I headed to the ICU to see a few consults with the residents. This evening, they included a couple of cancer patients (both of whom had already had operations for what turned out to be inoperable cancers) with bowel obstructions, a 10yo boy with a depressed skull fracture (bones pressing down onto his brain), and a boy who had fallen and been impaled by a large stick (about 1" in diameter) through his thigh and all the way up to his groin, though it miraculously appeared to have missed the major artery and vein there. We decided to manage the bowel obstructions conservatively for now, but we took the boy to the OR for a stick extraction (and hopefully NOT for a major vascular repair). All went well and he went home a couple of days later.
Monday morning started out with the normal schedule for work here @ SCH. We made rounds with the residents around 7:30 and compiled the operative list for the day. This included much burn care (the dressing changes are so painful they must be done under some degree of anesthesia), reversal of an ileostomy (on a woman who require an emergency bowel resection a few months ago), an exploratory operation on a man with a bowel obstruction and an inoperable (at least in Ethiopia) rectal cancer, elevation of a depressed skull fracture, and then consultation clinic with the residents. Paul was still away (until around noon) on his much-earned weekend getaway. Daniel, our senior resident on the general surgery service informed us that his wife was laboring, so we gave him the rest of the day off. John and I did the days cases with the interns. I must say they are very hands-on in a good way – eager to learn and getting more and more meticulous with their burn care. I think this program is going to have a bright future once these guys have a few more years under Paul's training.
The cases went well, but by the afternoon I was completely exhausted for some reason. I made it back to our new house (we moved out of the Grays' guest room and into the recently vacated orthopedist's house – Dr. Anderson will still be away until late March). I attempted to crash for an afternoon nap, but the girls wanted to play, so I spent the next few hours in a haze of "Sorry" and "Crazy Eights."
On Tuesday, Wendy left early in the morning to travel to the Omo River lowlands with Sophie to observe the work of Mary Vanderkooi (sp?), a long-time rural medical missionary investingating a potential outbreak of visceral Leishmaniasis, also known as Kala-azar. She saw a whole village of anemic people with massive spleens (even the small children) and they did a lot of blood draws to make sure this just wasn't from malaria. If it is indeed Leishmaniasis, it is almost uniformly fatal if untreated (trust me, Wendy wore LOTS of bug spray). Hopefully, Mary will be able to obtain the necessary treatment or at least appeal to an NGO with the resources to do so. You can learn more on Wendy's entry, posted previously.
OK, I'll stop for now. There's still more (I haven't mentioned Tuesday's cases or Wednesday's adventure to observe the work of the Mossy Foot program), but I'm blogged out for the moment. Bonus points (worth absolutely nothing) for those who have made it to the end :)
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