October 14 -- end of an eventful week

Hawassa blog 10-14-11

Greetings from Hawassa!

Sitting in our hotel room on the Hawassa University Main Campus with the ravens, kites, vultures, maribou storks and some form of eagle flying and perching out our porch window. Smells of food from the restaurant downstairs. Clear blue sky and a pleasant 75 degrees. Elliot is asleep on the bed after struggling to get our apartment set up this morning and beginning learning Amharic phrases and numbers. After we both bought bikes in the Muslim Sector a couple of days ago, I have biked to the Referral Hospital and back this morning, about 5 miles across town each way. It is an enjoyable challenge with every fraction of a second employed in scanning for emerging bajajes, suv's and trucks (rarer), horse and mule-drawn carts, bicycles and pedestrians. The hardest to deal with are the carts -- they don't stop no matter what. The bajajes never look before pulling out. The pedestrians are far more humble than our Northampton crew -- zebra crossings are meaningless and to stay alive you bow to the more powerful. We are lucky it is a relatively small town, only about 150,000, but still growing fast and chaotic.

My hospital experience has begun to absorb my thoughts and emotions. I work on the internal medicine ward and for now trail the rounding clinicians, act as consultant when appropriate and asked for, and ask a lot of questions about procedures and resources available for the terribly sick people that are being treated. Like the pedestrians, I am humbled in the face of superior forces -- hiv, tuberculosis and malaria being the main. When someone has a headache and fever, the main concerns are malaria or tubercular or bacterial meningitis, not the flu. Huge numbers of people are hiv infected. Antiretrovirals (for treating hiv), many antibiotics, and antitubercular drugs are available and used. I have no idea about the critical piece in this if people survive the hospital phase -- do they have support to continue their medicines? Also, patients must pay for many treatments and tests -- not clear which ones. Ah, yearning for single payer.

The Referral Hospital is a teaching hospital with medical students but not residents. The last year of medical school is the internship year, and the interns are really the physician workforce for the hospital. They do not have a whole lot of backup as they admit patients and treat. My heart goes out to them -- they are young and hardworking and the staff physicians can be highly critical. I get flashbacks from my own internship year.

The patients are poor and surrounded by family who do much of the nursing care. Unlike in most American hospitals where the critically ill are elderly, in Referral, most of the adult patients are in their 20's and 30's, reflecting disease patterns and morbidity in much of Africa. They are the age of my children.

Pain and suffering hit one over the head here in this beautiful land.

Will tap El next week to talk about his teaching. Please keep us informed. We follow the Occupy work with  huge hope and support. Add the suffering of the Ethiopian poor to the library of crimes committed by the CEO's and Pentagon as you protest.

Much love to you,

Marty and El