UVA Nursing in Addis Ababa, Ethiopia

July 9th:

Emily and I arrived safely to Addis on July 8th.  The flight was VERY long, and we were both tired and swollen by the end of it, and when the sun rose and we caught our first glimpse of the hilly, African landscape, we were both very excited to get off the plane.  The customs process was long, and completely disorganized, but we made it through and were relieved to find all of our bags waiting for us on the other side.  In addition to our own packs, we brought two very large suitcases full of medical supplies, toys, and books for the children at the adoption agency.  There was some question as to whether those bags would make it, but they did, and we delivered them to the Transition Home this morning!

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The driver who picked us up from the airport, Johnny, was very helpful, and his reflexes are incredible. Driving in Addis Ababa, there are no lanes, very few sidewalks, pedestrians everywhere, and I’ve seen one traffic light.  The drivers are constantly opening their windows and yelling at each other, and they have to stop on a dime to avoid hitting another van or taxi veering in from a turn.  Pedestrians walk along the roads and cross at will, and children roam through the cars when they are moving slowly to ask for money.

Once we arrived at the guest house, we had just enough time to unpack and take a short nap, and then another driver, Champ, picked us up and took us to lunch at a pizza place with two of the adopting families.  We were told later that the drivers often take families to restaurants for faranjis, better known to all of us as “white people.”  We did enjoy getting some time with the families, because they told us about the process for adopting their children.

We visited the Transition Home after lunch, got a tour, and met the kids with special needs, who we will be working with primarily.  One of the older boys decided that Emily looked particularly appealing and decided to cuddle with her while we waited for our ride back to the guest house.  She was quite pleased about it.

On July 9th, we went straight to the Transition Home and spent much of the morning with the pediatrician, Dr. Nehassie.  She led us through some assessments with the toddlers, who are all precious as can be, and we talked about some of the main health concerns in Ethiopia.  These include infectious diseases, like malaria and tuberculosis, and of course, the dreaded HIV/AIDS.  She was very open and passionate about her Christianity, which is to be expected as America World Adoption Agency is a Christian organization.  All of the children are expected to go to church and are only sent home to America with practicing Christian families.

In the late morning, we spent an hour with the children with special needs, interacting with them and feeding them lunch.  It was very challenging as the nannies who stay with them only speak Amharic, and the children have very limited mobility, so I most of what I did on this day was improvisation.  We hope to do some research to better guide our care and the education we provide the nurses and nannies.  I think we both feel like there is a lot of work to be done while we are here.

In the afternoon, we stirred ourselves out of naps and took a walk down one of the main streets in Addis.  Most of the sidewalks, if they exist at all, are crumbling, and the streets are often dirt roads.  We saw a herd of goats running down the street, and there are stray dogs running around all over the city.  There were a lot of tiny shops on each side of the road, called souks.  There were also people selling food off of grills in the middle of the sidewalk, and it smelled delicious.  Emily and I are excited to try the samosas the next time we venture out.  While we were stared at a lot, we were never harassed, which certainly made me feel more comfortable about more expeditions into the city.

July 13th:

Emily and I really enjoyed our first weekend, here in Addis.  On Saturday, we began our day with a jolt of energy from two delicious Ethiopian macchiatos, courtesy of our driver, Johnny.  He then took us to the National Museum of Ethiopia, where we saw ancient artifacts, clothing, crowns, and thrones of Ethiopian royalty.   Here is a photo of the throne used by Emperor Haile Selassie, the ruler of Ethiopia for fifty years, before the Derg took over in the 1970’s.  I don’t think it really looks all that comfortable, but then my idea of a comfortable chair is couch with a bunch of pillows and a throw blanket.  I guess I would make a terrible empress.

3Also in the museum was an exhibit of the extinct ancestors of many of Africa’s most notable animals, including crocodiles, elephants, giraffes, warthogs, and, of course, humans.  The second photo is of me and our darling great, great, great, great, great, great, great, great…great, great grandmother, Lucy.

We had a delicious lunch of papaya and avocado juice, shiro (ground chickpeas), beg tibs (sauteed lamb), and the staple of Ethiopian cuisine, injera bread. Injera bread also serves as the utensil, which makes the meals more filling.  It’s very flat, rather sticky, has a bit of a sour flavor, and it’s a strange grayish-brown color.  It doesn’t sound terribly appetizing, but you cannot get a traditional meal here without it.  When I asked Emily if she thinks Ethiopians ever get tired of eating injera, she asked, “Do you ever get tired of eating normal bread?”  Point taken.

After our lunch, we went to the Red Terror Martyrs’ Museum, which is a tribute to the half a million Ethiopians killed by the Derg, which means “committee” in English.  The Derg was a military dictatorship, led by Mengistu Mariam.  He called for his followers to participate in a genocide to rid the country of his opposition, which would later form the Ethiopian People’s Revolutionary Party.  Our guide was a victim of the Terror, and during his eight-year imprisonment, he lost many friends and was brutally tortured.  While most of the governmental officials were later sentenced to death, some have been released, because the Ethiopian automatically releases criminals after 20 years, regardless of their sentence.  Our guide told us that this part of Ethiopian history is rarely discussed or taught in schools, so it was very significant to us to become aware of his story and the events that occurred here, not too long ago.

On Sunday, July 12th, Emily and I walked south to more metropolitan area.  We spent some time at an internet cafe (because, oh right, we have SO much work to do), but most of the day was given to roaming around the Edna Mall and the Bole Medhane Alem Cathedral.  The mall is less commerce, more arcade, which was a happy surprise to us.  The top floors of the mall house Ethiopia’s only movie theater with 3 screens, so Emily and I went to see Jurassic World!  The crowd was very enthusiastic and responsive, which made the movie even more fun.  Also, the theater sells doughnuts, which are the size of cakes, and I would love American theaters to consider adding this to the concession stands.

45When we visited the cathedral, we made a friend, Mark, who is a Canadian in town for a big conference.  The three of us walked right into the post-celebrations of three weddings.  The wedding parties were dancing, singing, and clapping, but most importantly, there were men thumping away on huge drums, and I could not have been happier.  Here is a photo of the cathedral and a photo of one of the weddings, just as it erupted into the celebration parade.

We spent all of today, July 13th, at the Transition Home.  This Transition Home is one of several around the world run by America World Adoption Agency, which was founded by a married couple, who have a passion for international adoption within the global Christian community.  This home has been in existence for eight years, and there are about 40 children there right now, ranging from six months to 12 or 13 years of age.  The home houses children who are matched, but still need completed paperwork and children whose paperwork is generally complete, but have yet to match with a family.  Children in the latter category are typically older, or they have developmental disabilities, which makes it more difficult for them to get adopted.

The home is a compound of three buildings, which hold the children’s rooms, the kitchen, the physician’s examination room, and the offices of the nurses and administrators.  The buildings all look like one-story houses, and there are two playgrounds for the older kids.  The children live in different rooms, according to their age, and their primary caregivers are the nannies.  Emily and I are working mainly with the special needs kids, and the nannies have already told us that while working with them contributes great meaning to their lives, it is very challenging work.  We hope to offer some ideas about how to improve the quality of life that these kids experience.

We got a lot of good work done today, visiting with many of the children and talking with the nannies and nurses.  Emily and I have found the toddler’s room to be particularly challenging, because they are particularly hungry for affection, and they are mobile.  For us, this meant that they would literally chase us until we picked them up and showered them with cuddles and kisses.  At one point, I had four children climbing on me, including one little girl who wrapped her entire little body around my face, like a koala.

July 18th:

Happy Saturday, everyone!

Emily and I have been working very hard this week.  We’ve been putting in 7 to 8 hours a day at the Transition Home, and then writing and brainstorming our nights away.  One of our assignments is to assess the care given to the kids with special needs, who all suffer from varying levels of developmental disabilities.  We are then supposed to plan and implement some improvement in their care.  Emily and I decided to focus on feeding techniques.  We are putting together a training session with handouts that we will present to the nannies and nurses at least once this coming week.  We are also both enrolled in a pilot course to augment our cultural experience during our trip, so we’ve been working on some reflective assignments featuring this city and the people we’ve met.

Yesterday, Muslims were celebrating the end of Ramadan, so most of the city was closed.  This includes the oh-so important roads that we use to get to the Transition Home.  At one point, we hit a dead end, and when our driver asked the policeman directing traffic how we were supposed to get to the home, he replied quite frankly that we should walk there.  The Transition Home is 30 minutes away from our guest house.  There was no way we were walking.  Luckily, our driver knew a back way to the home, so we sneaked our way there successfully.  When we arrived, we were informed that all unnecessary staff members would not be coming, because it was a holiday.  None of these people are Muslim, but that didn’t seem to stop them.  Perhaps the lack of road access did.

Regardless, Emily and I took a half day, and we filled our afternoon with an exploratory walk through one corner of the city to find a Japanese restaurant.  The only building that presented itself even slightly like a Japanese restaurant (with two red lanterns and what turned out to be Chinese script over the door) was virtually abandoned on the inside.  We redirected our trip, and we managed to find a very tasty Korean restaurant for lunch.  I couldn’t tell you what it was, but Emily became quite enamored of some strange, black, nut-like things.  Then again, I don’t actually know what I’m eating most of the time, here, so I guess this lunch went right along with the theme.

Today was a day to remember.  We joined one of the adopting families for a day trip to the Muger River Valley Gorge, which we were told is like a miniature Grand Canyon.  The drive was about two hours, but we finally got out of the city, and we saw some of the green parts of Central Ethiopia, so Emily and I were thrilled.   Much of the land we traveled through was devoted to agriculture, and I must say, I’ve never seen so many adorable donkeys in my life.  I must have seen over one hundred donkeys throughout the day.

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We were accompanied by two drivers, Johnny and Champ.  Champ has particularly excellent English, and he clearly has a passion for showing off his country.  He asked Johnny to pull over so we could stretch our legs, but also so that we could get beautiful pictures of the countryside with many of the local children.  Every time we got out of the van, Ethiopian children came running from the fields to get a closer look at our strange white skin, and they shyly allowed us to take photos with them.

8A little further down the road, Champ asked Johnny to stop, turned around in the van, and asked, “Okay, who will ride horses?”  That’s right, people.  I got to ride a horse in the Ethiopian countryside.  Granted, the owner stayed with me the whole time, because this horse was apparently only tame for him, but it happened!

Just before we got to the Gorge, we took a detour into baboon territory, and we saw four different tribes of baboons.  Let me tell you, their shrieks are LOUD.  Right before we left, two of the tribes entered into a skirmish, so Champ swept us back into the van.  No monkey bites for us.

Finally, we made it to the gorge, and it really is beautiful.  I’ve never 9seen the Grand Canyon, but Emily says the description is appropriate, except that this gorge is quite green.  Champ told me later that it is only green during the rainy season, so we went at the best time of year.  During our hike at the gorge, we crossed an old bridge called the Portuguese Bridge, which is made of crushed ostrich shell and limestone, according to my guide, Dedemje.  The bridge spans a rather large waterfall, which dumps dirt-saturated water into a pool that is 15 meters deep and then onto the rocks below.  When I asked Dedemje if he ever swam in the pool, his rather extended response was to climb over to the top of the waterfall and jump into the pool.  It looked incredibly slippery and very dangerous, and he did it with ease.

On our way back from the gorge, Champ asked Johnny to make one more pit-stop.  This pit-stop needs a bit of back story.  Do you all remember that lovely, little girl who koala-bear’ed my face?  It turns out, she had a cold.  And, yes, I caught that 1cold.  Champ picked up a cold this week, as well, and I guess he decided that we both needed some relief.  He got out of the van and ran over to a tall plant growing on the side of the road.  He pulled down a couple of stalks and passed one back to me.  I gave Emily half, and he instructed us to rub it vigorously in our hands and then inhale deeply from our cupped hands.  The first inhalation was startling.  What felt like cool mint shot up into my sinuses, and Emily and I looked at each other with pleased amazement.  Champ told us that the plant is local eucalyptus, and it provided me with the most relief I’ve experienced in the last couple of days.

We are now hunkering down and preparing ourselves for our last week in Addis.  Emily and I cannot believe that we only have three more days to work in the Transition Home and to wrap up our clinical rotation.  We are very excited to move on to Uganda, but we will have a hard time saying goodbye to these kids.

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