Saying Goodbye to Addis Ababa

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Flag of Ethiopia  ,
Sunday, October 14, 2012

On Thursday we visited the only Psychiatry Hospital in all of Ethiopia named Emanuel Hospital. Dr. Zelalem set us up with one of her good friends and colleagues, Dr. Sammi. He is by far one of the nicest people we have met in Addis Ababa. He took us around to all of the departments in the hospital. We had our reservations going to there because we had heard that the patients are often mistreated by the staff and guards. We also heard that patients are often restrained by shackles and chained to walls. Our impression of this hospital however, was very positive. The entire hospital consists of dormitory buildings located on a vast green lot. Patients are mostly found sitting outside in the sun enjoying the day and each other's company. There were a lot of acutely psychotic patients at this hospital and many of them tried to grab at our clothes and hands. Most of them wanted to shake our hands. One man even wanted to give us his money. Another patient followed us around and when he made eye contact with us he proclaimed: "I love you! I love you! I love you! I love you! I love you!", over and over! We were witness to a fight between two patients, but it didn’t last long and luckily neither patient was seriously injured. We asked Sammi about the rumours that we heard about patients being abused and he stated that these rumours were true in the recent past but that new rules were in place and as a result, the patients were rarely beaten by the staff. He told us that most of the devastating mistreatment of psychotic patients occurs in the rural areas before they come to hospital. In most rural areas in Ethiopia, mental illness is largely misunderstood. When psychosis occurs, family members believe that their loved one has become possessed by the devil and will lock them in a hut or shed away from the rest of the family, in the hopes that the devil will be released. Sometimes patients are kept in these sheds for years at a time.

We have had some funny bird incidents happen over the course of our trip. The other day we were sitting out on the balcony of our place enjoying the sun. There are large vultures that often fly in the sky near there. Sometimes they like to sit up on the roof above our heads to hang out. We saw a baby vulture one particular day and for some reason our conversation topic became about the fact that neither of us really knew the exact mechanism by which birds mate. Neither of us had ever been witness to it. The conversation continued on to the topic of how ironic it was that we use the phrase “the birds and the bees” since neither of us even know birds mating techniques. Right as this conversation was happening, the vultures on the roof above started mating right in front of us! All questions were answered at that moment. Wouldn’t it be nice if life worked that way more often?

On another bird related note, Dr Zelalem took Carissa and I to the National Museum on Thursday evening. As we entered the building Carissa said “Andrea, I have to tell you something…..You have bird Sh%@ in your hair.” Somehow while we were walking from the car to the museum, a nice little bird decided to poop on my head. Unfortunately for me, the bathrooms in Ethiopia do not have soap. Luckily we always carry a heavy supply of hand sanitizer wherever we go. We used a healthy amount of hand sanitizer on my hair to tie me over until I got home.

The National Museum is a famous museum in Ethiopia. It is the evolutionary museum of Ethiopia and holds remains from all of the ancestral lines of human beings (otherwise known as homo sapiens). It also holds remains of ancestors of most of the famous African animals including Elephant, Hippopotamus, Lion, and Rhino. Although Carissa and I were both aware of the evolutionary lines of human beings, neither of us knew about the vast evolutionary divergent lines of the current animal kingdom. This was truly fascinating.

One day early in the trip, Carissa woke up with spots all over and we were both very concerned that she had bed bugs. The hotel staff ensured us that this was not the case but still replaced her mattress and cleaned out her entire room for her. They told us that it was more likely that she had fleas from the family dog. They own a german shepherd named Max and although they clean him twice per week, fleas are rampant here in Addis. Carissa and I were convinced that it could not be fleas that she had because I spent much more time around max petting him and hugging him and I didn’t have a spot on my body. Well what do you know, the day before leaving, I ended up with the exact same pattern, but much worse! We can’t say that we would have ever imagined that we would catch fleas in our lifetime! I guess life is unpredictable!

On our final day at the hospital, Carissa and I decided to go to the operating room to scrub in for some laparotomies (Abdominal surgeries). When we arrived to the OR, our friend Dr. Nuri tried to get us the gear that we would need to scrub in for surgery (caps, masks, shoes). He had a really tough time trying to find these items and after about 20 minutes of searching, he came back to the room. We asked him why there were no masks available and he stated that there were masks, but they were in a locker that the head nurse had the key to. She didn’t show up for work that day. There were also no extra keys to this particular locker. As a result of this locker being inaccessible, some of the surgeries would be postponed. This seemed really bizarre to us. Eventually we had to make due with plastic bags for our feet and cloth masks. There were no laparotomies for that day because the surgeon was not at the hospital.  The only surgeries were a couple of urology surgeries and a fistula creation (port for dialysis). We stayed for a little while and then headed back to the Emergency Room for our final moments at the hospital.

When we said our goodbyes to the Interns and Dr. Zelalem, we were all very sad. We have made friends here in Ethiopia that will last a lifetime I am sure. It is never fun to say goodbye.

In the afternoon on Friday we met up with Dr. Amanuel, an internal medicine resident who owns a medical consulting company with two of the other internal medicine residents at St. Paul’s hospital. We had been in contact with him several times during our time in Addis. He and his colleagues have created an Emergency Medicine package, which they are presenting to public venues like shopping malls and hotels. Currently in Addis Ababa, there are no Automated External Defibrillators or Basic Life Support Training (CPR) for employees in any public area. In fact hotels are currently not allowed to bring AEDs across the border to have in their hotels. There is also no emergency medical service (EMS) provided to hotel guests.  In North America, Basic Life Support training and AED insertion is a requirement by law for all public places. Amanuel’s company intends to offer these services as a package to all of the hotels in Addis Ababa and this plan is well under way. He asked us to prepare a presentation on the standard of care in North America and the importance of travel medical services for tourists traveling abroad. We joined him to give a presentation on these topics at the Beshale hotel. I think that it is inevitable that the hotels will have these services in place in the near future and we are really glad that Amanuel is taking the initiative to have the proper standard of care recognized here in Addis.

This has truly been an amazing, life changing experience. We are sad to leave but happy to return home to our loved ones.

On to a new chapter in life….

Much Love.

<3

Andrea Kokotilo and Carissa Kratchmer
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