October 10 -- a good day.

Hawassa, Ethiopia October 10,2011
Greetings from Hawassa. Today was a good day for Marty and El. Marty went to her first day at the Hawassa Referral Hospital and participated in rounds with attendings and medical students. Of course it did not start smoothly, as things rarely do when working in a different culture and language and place. I was not able to find the head of the Department of Medicine, who was in a meeting but who, it turns out, had waited for me as I had wandered around the hospital searching for him. Apologies and introductions made and off to rounds on patients on the medical ward.

The first patient had hiv and was in continuous seizures unresponsive to many medicines for seizures, tuberculosis, meningitis and and malaria. Very sick and would have been on the icu and probably intubated if he were at Baystate. Others less sick - much hiv, tuberculosis, pneumonia, a little bit of diabetes and heart disease. I told my colleague that I expected to learn more from the medical staff than they learned from me. No laughter or denial in response. Rounds are mostly in English, but people speak softly with thick accents and I wished I could borrow my husband's hearing aids.

Yet it was exciting - the tiny bit of medicine that I saw appeared sound and the physicians showed respect for the patients. There are limitations to testing and medicines, but not as much as in my experience 8 years ago in Eritrea, but that was a different time and a different country. Most of the practicioners are extremely young. Hawassa is something of a frontier - part of the Southern Nations, Nationalities and Peoples Region (SNNPR). Ethiopia's capital, Addis Ababa, has long had a respected medical school where doctors from around the region have trained. However, the knowledge and technology have been centralized and areas of minority peoples have been undeveloped in many ways, including medically. The recent policy of "federalization" - dispersing both resources and autonomy, has benefited areas like the SNNPR which includes the rural poor. However, it has stretched Ethiopia's fund of medical (and technical and academic) personnel to the max. The head of Internal Medicine could not have been more than 30 years old, and he was about the same age as most of his colleagues. I also rounded with a woman, which was great.

Other great news: it seems we have an apartment that is large, bright and spacious (though at the moment lacking a stove, refrigerator and hot water). It is on the Hawassa University Campus, where we have been staying for the last 5 days. It is a ways from the hospital - I would guess 4 miles, which I walked today thinking it was a whole lot shorter. But we will buy bikes and helmets (and thus become even more of an item of entertainment for Hawassans, who though themselves bike a lot, have never seen a helmet it seems.) When lazy we ride the bajajes, 3-wheeled taxis that use an engine comparable, I would guess, to a riding mower.

El will walk to work and will be teaching 2 days a week. He met with his dean today, who arranged the housing. So far his colleagues have been very kind to us, included us in a wedding yesterday with great food but, unfortunately, no dancing, since the couples (2 sisters were married in the same wedding - makes sense for those of us who know what weddings cost, and they are relatively more expensive in Ethiopia!) were Christian Evangelist. Too bad, since what we have seen of Ethiopian dancing beats anything we have seen anywhere else - lo siento, mis amigos latinos. Don't worry, friends and family, when there is a chance to dance, we will not embarrass you.

A los mismos amigos latinos, estoy apriendo Amharic ahora! Translated, I am learning Amharic now. I can say yes and no and thank you. Still haven't gotten please or the differentiation between good morning, good afternoon and good evening down, but old brains move slow.



We are healthy, happy & fascinated by all around us. We are not yet capable of downloading pictures but will overcome that disability. We love and miss you!