Thankful

I expect at this time (4 am your time Saturday) everyone is sleeping off residual turkey coma and recovering from Black Friday shopping.  My Thanksgiving was, naturally, a little different this year.  I started the day like any other weekday here- having my breakfast at the hotel and the heading to Black Lion for morning report.  After morning meeting and before my 10 am appointment with the students for bedside rounds, I ran down to the corner where I had seen some pretty flowers I thought I would take to my friend's family who was having me for dinner for substitute Thanksgiving.  (I was subsequently informed by him that bring flowers to the family would imply that we were getting married-- vetoed.)  I then got a call from a resident at another hospital that would be transferring a patient to the Hamlin Fistula Hospital, and would I like to come with?

I had been dying, dying to go to the Fistula Hospital so I jumped at the chance.  The Hamlin Fistula Hospital, famous throughout Africa and among maternal/global health types like myself, also made famous by the stunning documentary A Walk to Beautiful (watch it streaming on Netflix!), is a hospital dedicated to the surgical repair and social rehabilitation of women who have suffered obstetric fistula from obstructed labor.  Ethiopia has a very high prevalence of obstetric fistula, which basically results from a woman being in labor at home for days with the baby unable to fit through the birth canal in places where obstetric services and cesarean section are not accessible.  After days of labor, the tissues between the bladder, vagina, and bowel start to decompose, forming permanent holes between vagina and bladder and/or the vagina and the bowel, resulting in constant leakage of urine and stool from the vagina.  In this scenario, the babies usually die.  Women lose their fertility and their dignity.  In most places, they are cast off from their husbands and from the community because of the uncontrollable leakage of waste.  Anyway, the Hamlin Fistula Hospital, founded by two British physicians, is completely dedicated to surgical repair of these injuries, and then rehabilitating the women by giving them skills to bring in their own income and giving them self esteem.  Our poor patient who was being transported did not have an obstetric fistula, but needed advanced urologic treatment after an extremely complicated hysterectomy the day before that left her with one transected ureter (which had been identified and repaired intraoperatively) and was subsequently found to have ligation of the other ureter and failure of the contralateral repair.  She also lost 2 liters of blood.  Gynecology nightmare.

Now that I have made a short story long, I got to see the famous hospital although not for long and not in any great detail.  What I did do was peak inside the wards where about 40 women in hospital beds were side by side in a bright, white, pristine room (this in contrast to the dirty and dark Black Lion and Gandhi hospitals).  As I sat in the courtyard full of flowers, curious patients walked up to me, looked me in the eye, and some of them extended their hands to me and said "salamno" to say hi.  (I can only imagine that most of these women come from remote areas, and even though Hamlin is famous, they have not seen all that many faranjis.  I can also imagine that they all have spent some amount of time in shame from their conditions, and to make eye contact with me, and for me to make eye contact with them and speak was no trivial matter.)  It was a brief, beautiful experience.

Thankful.

Not long after that, I set off in a minibus with one of the chief residents who pitied my lack of Thanksgiving to have a late lunch with his family.  It took us about an hour to arrive at the last city within Addis Ababa (which is not only the capital city but also the name of the surrounding region or province).  He grew up with 5 brothers and one sister in a small house with a courtyard filled with chickens in various life stages.  The house was small, with bunk beds in the room with the refrigerator, which may or may not have also been the actual kitchen. Everyone, in typical Ethiopian fashion, was quick to demand that I eat! eat! eat! and drink! drink! drink! everything in front of me.  My plate was never empty-- as soon as there was any open space, mother or sister would come over and fill it up with something else.  As soon as my beer was half empty, another was opened and put in front of me ("drink! why aren't you drinking??" they said). I certainly ate as much as I would have at a Thanksgiving dinner. Mother spent 30 or 45 minutes roasting coffee beans in a pan, grinding the coffee, and brewing it in the jebena (traditional coffee pot) on the living room floor.  Little brother (18) and little sister (13) shyly practiced their English and translated for their parents (who wanted to know what my and my parents' religion are, what did I think about Obama, and all kinds of other interesting and socially controversial things).   There were so many photogenic moments, but obviously it felt wrong thinking of taking pictures of someone's family as if they are a tourist attraction, so I have nothing to show.  At the end of the evening my resident friend gave his parents and his little brother a few hundred birr as well as some to pass on to his aunt who live nearby.  A resident's monthly salary here is numerically equivalent to my salary in the US, except that $1 USD= 20 Ethiopian birr.  That is to say, I make 20 times more than they do, and I don't even think of giving money to my little brothers.  Humbling.

Thankful to share a family holiday with another family, who made me extra thankful for what I have.  I truly feel like the Ethiopians' hard work ethic and open hearts have encouraged me to be a better person.

Now that night has fallen on Saturday after I spent the majority of the day in the hotel making questionable efforts at writing the concept paper for the Ministry of Health, I am left with two full days in Addis.  This morning I did venture out to sample this breakfast phenomenon called dulet.  I had been kind of avoiding it actually, since it is one of those staples of any developing world diet that combines the leftover organ meats of things together-- in this case, definitely lamb stomach, and other lamb and beef bits, possible kidneys and liver.  I'll try anything, but I wouldn't go out of my way for offal.  It is sauteed with butter and heavily seasoned with the local spices, and is eaten with the omnipresent injera, the fermented/sour bread product that is both foodstuff and the utensil/vehicle for the food.  The small place we went was full of people coming in for their Saturday morning dulet (some accompanied by beer at 9 am- I KNOW WHAT YOU'RE THINKING, NOT ME).

It was super delicious.  My mouth is watering just thinking about it.

Alas this Saturday night I am staying in and will probably have some leftover pizza, and rest up for some real work and the remainder of Addis sight-seeing tomorrow.  See you soon!