Thursday, January 24, 2013

Shit Happens

Builder at Motta Hospital
There are proper toilets in all the buildings at the Motta Hospital, and a shower is included in several of them but because for  many years there has been no running water all of the toilets and showers are “non functional”. In the unit that I stay in, the toilet is still connected to some sort of septic system, so I can flush it by tipping half a bucket of water in, but the shower isn’t usable. To have a shower I heat water up on the stove and use it to warm up another half bucket and tip the water over me from a small plastic jug.
In recent months  parts of the hospital  have reacquired running water to a few taps and a couple of showers : these are the Maternity Unit, and the Operating Theatre, which apart from being the place where young men get circumcisions, is almost exclusively used by the Obstetricians for caesareans. These select areas have running water only because a few months ago a guy called Brad, the husband of one of the Farenji  volunteer midwives from Australia, decided to make himself useful while here and get it all working again. I take my hat off to him: to get something done like that, which included digging out the half filled old hospital well and getting a new pump installed and connected is no mean achievement in the culture that exists here. His contribution has made a huge difference to hygiene and the  general state of cleanliness in the Maternity ward, which for years previously  used water from  a single large plastic water container that required refilling from a tap 100 yards away every morning.
The new Hole
The toilets themselves have been non-functional for all these years as well, and instead patients use a smelly rickety tin shed in the nearby field with squat toilets over a deep hole. There is no lighting to it and the path is just a worn track through the grass. The deep hole must be getting near capacity because over the last few weeks a new one has been dug and a new toilet facility is being erected over it. The new hole, 20 feet deep was dug by several men with picks shovels, a bucket on a rope and a ladder, and it took about a week. It is lined with narrow eucalypt tree branches, which have all been chopped down locally and trimmed to size with axes and adzes whose handles are appropriately shaped limbs of a tough tree. Walls, the roof and doors are all corrugated iron nailed to a frame of more tree branches set into the earth, but as yet the flooring consists entirely of more tree branches’ laid across in two layers at right angles – somehow I think concrete  will be laid on top of them to make a floor.  Its been quite an education to see this structure being literally hand made and using branches and tree trunks rather than dressed timber
New Toilet nearing completion
One wonders what sort of budget the hospital must be managing on if this is the sort of construction method employed for something as important as toilets, and there was never enough money to re-establish the water supply.  But then, I discovered the other day that there is no Electro-cardiograph machine in the hospital – this is a fundamental piece of equipment used in the investigation of all manner of cardiac diseases and would be regarded as  essential in any western hospital. An ECG machine is not an expensive item, but apparently it also is too expensive for Motta. I also learned they would not be able to afford locally trained Ethiopian Obstetricians like myself – when one was employed to cover an unexpected gap in the supply of volunteers last year, he agreed to come only if the Barbara May Foundation paid him the equivalent of more than ten times the salary of the local General Practitioners, who by Ethiopian standards are already well paid!
Brads was not the only water project in the area : when I was here a year ago I would often run into a charming guy down at the Wubet Hotel who was a manager of a huge water project for the town. It was funded from overseas to the tune of something like a million Euros. His team had been drilling for water and planning a reservoir somewhere nearby, had a couple of nice white Toyota Landcruisers, mobile phones and requirements for lots of meetings and travel in conjunction with the Project. Enquiring about how the Project was going this year, after having realised this guy was no longer around, I was told most of the wells were dry, the guy in charge had been moved on and had apparently been rorting the finances by such devices as claiming wages for fictitious employees, and the project was probably going to be abandoned as the funds were nearly all exhausted! Even the hospital water scheme wasn’t spared this sort of scam : poor Brad was asked to send a large sum of money to pay import tax on a new pump he sent from Australia after he got back, but the person asking for it had nothing to do with the hospital and simply pocketed the money and left the pump at the airport in Addis. In contrast, somehow I don’t think the poor hardworking guys building the new toilets are finding much to rort. The irony is that in poverty stricken countries where  the temptation to help yourself to seemingly limitless Farenji  money is too great for some, the crooks are usually in the ranks of the  comparatively well off – the really poor don’t have the education or the means to participate in rorts and scams, other than perhaps asking a bit more for their onions and cabbages at the markets.

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