Tuesday, January 1, 2013

The last Day of 2012

Deep fried crispy packet with a few lentils inside: "Sambusa"

About now I think its next year in Sydney, but in Motta the hot sun has been shining brightly and its December 22nd 2005.This is what happened.
For breakfast I had my first cup of coffee and the last of yesterdays bread roll with two small bananas, then after tidying up the room and the dishes went across to the Hospital at 8.30. at which time every day we do a round of all the patients. Sometimes there are surprises waiting for me – things that have happened overnight – but as I got there this morning, the midwives were struggling to deliver a baby with a vacuum device – I watched for a couple of minutes – it wasn’t coming so I delivered it with forceps, and we started the round a bit late. Today we sent Emaway to Bahar Dar for some blood –  her family had wanted to put her in the back of a bus and take her there yesterday but I wouldn’t let them, but today she is just well enough to travel. Her Haemoglobin concentration is 31g/L – normal for an adult woman is over 120, mine is probably 140, in Australia we usually give blood if its much under 70 and I don’t know if I ever saw someone there with such a low Haemoglobin. As I said before these women seem to be indestructible. .. We also sent Laku home with a catheter in place after confirming she does indeed have a fistula. We have spoken to the Fistula Hospital Service that operates out of Bahar Dar, a service that was started there by Andrew Browning, who then set up the Barbara May Foundation which is how I came to be here - they will see Laku after she has fully recovered from her caesarean. We also sent home the woman who had the caesarean straight after Emaways hysterectomy, reminding her that she must come to the hospital early in the next pregnancy so we can accurately plan a caesarean rather than wait for labour to start as we did this time. There was a bit of paperwork to do and then I bought my daily bread- 3 bread rolls for 10 cents each and the sambusa (pictured above) for 12 cents, and went to sit in the sun at my flat, read my Kindle and have a cup of tea.
Sooner or later I get called back for an Ultrasound scan – the first one today was for a woman who was said to have been treated for a molar pregnancy a couple of months ago but had returned with bleeding and her pregnancy test was still positive. There hadn’t ever been any actual tissue diagnosis – it is never available here - and the usual monitoring of this bizarre placental abnormality in which there isn’t usually a baby just placental tissue – involves blood tests that aren’t available here either. So we just have to make a clinical judgement, and on this occasion, because my ultrasound scan showed a persisting abnormality, I decided the best option for her would be a simple hysterectomy, which is in fact the treatment that was usual about 50 years ago in the west before chemotherapy. We explained all this to her and she left saying she will  discuss it with her family and return in a few days if they decide to go ahead with the operation. This is quite a common response to this sort of advice – usually they return but not always…
The other scans were ordinary pregnancy check ups, and when these were done I walked back along a newly forming path, a short cut across a recently harvested field of Teff, for my lunch, another bread roll, this time with tomatoes and slices of the beetroot I boiled yesterday, and another coffee. On my Kindle I am reading “Eureka: the Unfinished Revolution” by Peter Fitzsimons at the moment. It’s the story of a rebellion by Gold Miners –“Diggers” - in Victoria around 1855. I am not half way through yet but the story seems to be one that polarises Australians, some saying the rebellion was an honourable movement whose aims were democratic and libertarian, others that it was a mob of lawbreakers who needed to be brought into line. This happened just before the era of the Kelly Gang in another part of Victoria, and Ive just finished an “actual” book and a Kindle book on that subject, another one which divides Australians into Pro and Anti factions, which I found fascinating as well.
Typical dusty and rutted back street of Motta near the hospital

So I sat in the sun reading till called back for some more scans at about 2.30 and after that walked into town. It was a lovley calm sunny afternoon and a pleasant walk, but one gets a bit tired of being yelled at by every kid on the street “Hi” “Give Money” “Birr”” What is your name” ”What is the time” and I try to limit the number of traditional hand shakes I get from small filthy kids with snott running out of their noses!  Ive been here a month and was heading for the bank -  I’m obviously living it up, having spent almost $150 so far! They seem to have dispensed with that crazy counterfeit note detector they used on my US Bills last year, so the transaction was pretty quick. I crossed the road and got my haircut – I had been warned the price had gone up from 4Birr it cost a year ago – but 10 Birr was a shock – 60 cents! But they do a good job – one thing that surprised me was having my ears stuffed with cotton wool to stop hair going in! As usual a large crowd of kids stood round outside watching me getting this done, while beyond them standing almost motionless in the middle of the street was a sad old white horse, ribs visible and a sunken back, the tired old pony stood there as people and donkeys and even a couple of trucks passed on either side of him.
I walked home after getting some essential supplies – lollies, biscuits, a card to top up my internet useage-  and watched some news on BBC World Middle East – Syria, the Fiscal Cliff, Hilary Clntons clot – the usual stuff - then cooked my evening meal – rice with carrots onions tomatoes and cabbage.  And after posting this I shall hop into bed as it gets cold at night, and read a bit more about the rebellion.

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