Medical Mission in Ethiopia: Month 6

March 16, 2015 Kristen A. Austin

January 27, 2015

We are now in Zanzibar, Tanzania.  This is our first week-long family vacation since venturing to Ethiopia.  It is a tropical paradise. 

February 1, 2015

True vacation style, I didn’t even crack my laptop while on vacation.  Now we are in the airport at Dar es  Salaam, waiting to fly back to Addis Ababa.  It is hot.  Really hot.  Josh, Sonja and I are hovering under one of several air conditioning units propped up throughout the terminal.  Mark is under another one, talking on his cell phone to his sister, Mary, using the rest of his Tanzanian cell phone minutes.  It is so humid we can see the cool air condensing as it pours out of the air conditioner.  Most Mzungos are red faced with drips of perspiration curling at their hairlines.  The Swahili look more comfortable.  I don’t know if it’s a façade or habitude.  Ah well, soon we will be back in the altitude and cooler weather.  Sea level in Africa is hot.  Fortunately, there is the sea, being sea level.  The Indian Ocean winds blow with such force that I felt there should be small craft warning flags flapping on the beaches.  Instead, kite surfers whip up and down the water surface.  Local fishermen raise their sails from sea-worthy wooden canoes to glide over the coral reefs.  White sand, white like powdered sugar white, blows across the poolside deck.  Yes, we have been in paradise. 

I cannot recall our family taking this kind of vacation before, but we seemed to adapt rather quickly.  Sonja must have averaged 5-6 hours of swimming time every day, Josh a close second, although he spent more time in the ocean.  Sonja and Josh were introduced to body surfing.  I recalled being taught to body surf at my grandparents’ in Massachusetts, and it brought back fond memories of Gloucester and Cape Ann. 

We had nine fabulous days of sun, white beaches, seafood, kind and hospitable service.  One day the pool-man arranged a snorkeling trip in a traditional sailing trimarang.  These are the long wooden canoes with two small canoes attached for ballast, one on either side.  The mast was a large branch placed near the bow of the boat, the boom was raised with the sail hanging below.  The captain and his crew person pushed us toward to the snorkeling area with long poles, occasionally using paddles.  Luckily another boat with an outboard motor came by and gave us a tow.  The snorkeling was beautiful, viewing coral reefs and colorful fish.  The sail back was my highlight.  Our young captain allowed me to take the helm and we sailed.  Oh, how I love sailing.  I haven’t smiled a smile that wide and truly happy in a long time.

Another day we went to a spice farm and learned about the many spices grown on Zanzibar.  At one point it produced 75% of the world’s cloves.  We ate fresh fruits, coconuts felled from a coconut tree by a coconut tree climber, sniffed and tasted cardamom, cinnamon, vanilla, pepper, cloves, nutmeg, jack fruit, red and yellow bananas, pineapples, “lipstick” plants, lemongrass, ginger, saffron, star fruit, watermelon, papaya, mango, and passion fruit.  Maybe more, I just can’t remember!  The kids enjoyed this trip very much and wrote about it in their journals. 

Our favorite excursion was a trip to swim with wild dolphins.  This was an early rising day, we left the hotel around 6:30am, drove about 45 minutes, were all fitted with snorkeling gear, then hopped on a skiff at the beach.  We pushed off and our captain zipped us out to sea.  Soon we found a pod of dolphins, our captain cut the motor and yelled, “Jump! Jump! Jump!”  After we recovered from our initial surprise at this command we jumped into the middle of the dolphins.  Sometimes the dolphins would surface and then dive deep as soon as we entered the water, but sometimes we would swim alongside them for a minute or two.  I was close enough, I could have touched them, but I didn’t.  I just looked in their eyes and marveled.  There was one baby who we saw suckling from its mother.  Josh was geeked that he saw one poop.  Boys.

The week rounded out with a trip to a local island to see some ancient tortoises and a tour of the city.  The oldest one there was 191 years old.   We visited these old tortoises before seeing the old slave trading grounds in the city.  It was sobering to think that these tortoises were alive during the slave trading times.  The Anglican cathedral is built on the slave trading grounds.  There is a round marble stone at the alter where the whipping post tree grew.  A gift shop and hostel is built over the slave holds.  I get nauseated just thinking about the small dungeon room where 75 women and 45 men would be kept, with three small holes at one end, the only ventilation.  Peeing and pooping and trying to live in one cramped area.  Zanzibar traded slaves from central and east Africa.  The British, Portuguese, and Sultan Oman were involved in most of the trading.  I read an email from a wonderful African-American friend at home who has recently visited Ghana, and took strength knowing what her ancestors had survived.  The positive aspect I tried to focus on was that our Anglican church had a major role in ending slavery in Zanzibar.  It is too daunting to only remember our horrific acts without also thinking of all those who work for positive change, who believe that we can love one another.

February 11, 2015

Now we are back in Ethiopia.  It is 4:00 in the morning.  I am in Addis.  Yesterday I started the process to extend our 6-month visas.  Apparently the immigration office is a pilot project and is the best governmental office, because you can finish a process in about one week.  Last year we saw the Seattle Opera “The Consulate” and I thought I was living out this opera.  OMG.

On the positive side, I was met at the airport by Mr. Fekade, a very kind man.  He is a pharmacist from University of Gondar and moved to Addis three months ago to assist with procuring pharmaceuticals for U of Gondar hospital.  This position has put him in the position to learn and know the customs and immigration system very well.  I did not realize we would need additional passport photos of the kids, so our first stop was a photo store where some very adept photographers took a couple Zanzibar photos and used photoshop to edit out the backgrounds, give Sonja some hair to complete a close up cropped photo and generally make a couple of passport photos.  This was all fine. 

Then we went to the government immigration office.  It had closed for a couple hours for lunch.  I went back when it opened and entered the opera.  The part the Seattle opera did not capture in the performance was the literal madness that can consume someone going through this process.  First I waited in one line to get the application forms, then I waited in another line to make photocopies of our current visas and passports, then I waited in another line to see the visa officials.  These visa officials did not feel comfortable approving our visas, so sent us to room number 12, where I again waited.  Eventually my turn came and I went through the large doors into this capacious office where the man in a suit sat behind a huge wooden desk.  He didn’t even look at me, just reached for my papers and our passports and chastised me because they were not organized the way he wanted them.  I explained we  were here for a year, had a 6 month visa for our first 6 months and would like another 6 month visa, told him what we did, we had contracts, showed him the signed and stamped letter from the University, after which he wrote down something in Amharic on the paper and dismissed me.  Again, without even looking at me, just telling me to go to room 95.  This is a large compound.  Where is room 95?  Eventually I found it, in another building, up the stairs.  Another huge office.   Waiting with the secretary.  Eventually let in to see the director of Immigration.  Again, told my story.  But he has guidelines and we only received approval for a 3 month extension.    He then sent me to room 77.  This was with the masses of people, many foreigners, many Ethiopians who were back to visit their homeland, in a mass of people who don’t have the concept of waiting in line.  We just push our way until able to get inside the door.  Then there was a line of chairs.  We sat down in this line of chairs, and as one person moved forward we all stood up and moved one chair closer.  Eventually I reached the front of the line and the person who was to help me, only to find out that the scrawl that the director in room 95 had written on the bottom of the University of Gondar request letter needed to be copied for Mark’s, Sonja’s and Josh’s visas as well.  SO then, I was sent back to the photocopy room from the start of this whole process.  After making photocopies of this paper I went back to room 77.   This man stapled the forms and our passport photos together and told me to go to room 76 and then room 78.  Room 76 was very confused for a while, but eventually took Mark’s and the kids’ passports with their visa application forms and tossed them in a wire basket.  I hope to God that we get those passports back.  I was then sent to wait in line for room 78 to pay $120 per visa. This line was 50-75 people long and did not move for 45 minutes.  I gave up and called Mr. Fekade to come and get me.  It was 5pm.

Mr. Fekade has graciously offered to complete this process for me.  Thank God.  Mr. Fekade is one of those angels, because I CANNOT DO THIS!   He explained that the immigration office is the best government office, because there is actually someone behind those doors of all the rooms.  Other offices will have you wait and wait, only to eventually be told that the person you need to talk to is in a meeting or even out of the country. 

Fortunately I did not come to Addis only to renew our visas.  I believe divine intervention has occurred, because the three days I am here are also the three days that my parents are here.  I surprised them by walking into the beautiful bed and breakfast where they had booked reservations.  Dad was sitting in the garden, reading.  Mom was by her room window, writing in her journal.  They were so surprised.  I didn’t see my Mom’s initial facial reaction, because I didn’t see her, but I heard her!  She yelled out, “Kristen?!?!?!?!?!!”  My dad looked up and did that half smile, half smirk that he does, and rolled his eyes, then got up and gave me a great big bear hug.  They look great.  They are happy.  They are healthy.  It is wonderful to see them.  I wish I had been in a better mood and could have been more positive when I initially saw them.  I was still brummin’ about the whole visa thing.  It’s almost as if seeing them made my mood worse, because I was reminded of how life CAN be.  Conversation is good for soul, though, and I am so glad that this worked out to see my parents.

The other piece that has fallen into place is that I will go to the Ethiopian National Conference on Cervical Cancer Screening in Addis tomorrow.  I will be joining the two public health directors from University of Gondar to discuss what we are doing at Gondar and to find out what other institutions are doing in other parts of the country. 

It is 5:00 am now.  I should try to get a little more rest before the conference.

March 15, 2015

It has been a month since I last wrote.  Life has been busy.  A bit of a whirlwind as they say.  To summarize:  Mom and Dad visited Ethiopia for almost 2 weeks.  This was good timing, because Mark went back to Seattle 3 days after they arrived and they could help a bit with single parenting.  Mom and Dad then went to Zanzibar, Tanzania and later we all (Mark, Mom and Dad, the kids and I) met up in Nairobi, Kenya to venture on an 8 day safari.  During Mom and Dad’s stay in Ethiopia we spent one weekend up in the Simien Mountains and another weekend visiting the rock hewn churches in Lalibela.  Josh (and several other children at school) had a nasty upper respiratory infection that coincided with some significant air pollution during a rather hot and windless couple of weeks.  He is fine now.  Work was busy for me during the last month as well.  As mentioned in my last entry, I went to a Cervical Cancer Screening launch for Ethiopia with the public health directors from University of Gondar where I had the amazing opportunity to talk with people from WHO, The Bush Institute – Pink Ribbon Red Ribbon, the CDC, the Ethiopian government Ministry of Health, USAID.  Most of these people were Public Health folks with many interesting stories.   They had enthusiasm, energy, motivation.  Just the injection needed 6 months into our venture.  Back in Gondar I also had 4 hours of formal lectures to give the medical students, 6 surgeries scheduled for patients with HSIL, cervical carcinoma insitu or invasive carcinoma (these were done with a visiting gyn-oncologist from Germany), and the continuing Monday/Wednesday/Friday schedules of 2-hour impromptu informal lectures in small groups of 20 medical students.  We met another American family living in Gondar with two girls, ages 6 and 8.  Sonja has been very happy to have friends she can truly communicate and play with.  I have enjoyed time chatting with Laura, the mom, as well.  Sonja and her two new friends go to art class twice a week with a kind and gentle 24 year old artist in town.  And finally, our Simien Mountains guide was shocked that we did not have a helper to cook, clean and do laundry (practically everyone has a helper here, interns and residents, teachers, bajaj drivers, everyone).  So, after our guide got us back to Gondar, he found us someone.  Her name is Worke and she is wonderful.  The apartment has never been so clean.  I think we can make it for the next few months. 

That is the summary.  Of course I could write for hours about all of these things.  Now that Mark is back, Mom and Dad have left, the kids are back in school and I don’t have any imminent conferences I think we will get back in a routine, including time to document these experiences.  Routine may not last for long, however.  It has been getting more and more difficult for foreigners to obtain visa extensions.  Today I heard of a couple of social workers who had been working for an NGO in town but were denied their visa extensions and had to leave.  Liz, the most recent ex-pat anesthesiologist from the Leicester-Gondar link, has had her passport in the immigration office for 3 weeks now, trying to get a visa extension.  On hindsight, we were fortunate to have obtained the three month extension.  We are not sure what is going to happen with our next application.  It is possible that we may be leaving this country in May.   Our original plans were to leave in mid-July.  Who knows.  Who knows.

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