Monday, February 1, 2010

SV 13-14 Closing Up and Logistical Notes

Site Visit Day 13-14 (Saturday-Sunday) -- Magical Saturday finish to January 16-31 EHN/LeAlem site visit. Several morning patients, including aged pastoral woman requiring two levels of translation -- from Oromifa to Amharic, from Amharic to English. A beneficiary mother and child, both receiving treatment. Met Alemayehu's 84 year-old father, Dinku, who lives 185 Km north of Addis (he still herds a few cows). A grateful patient whose daughter I know in Washington sent several gifts -- goat skin sandals, an ethnic shirt, and a copy of the Quoran. Most amazing and generous, social worker Almaz threw a party at her compound in north Addis. We had extraordinary foods, a traditional coffee ceremony (bean roasting on eucalyptus fire, then grinding and brewing), followed by an exhilarating dance party with about ten children -- LeAlem family members and friends -- going wild. Also, many fine gifts from Alemayehu and colleagues. I reciprocated with a lot of gifts I'd brought from DC. I was overwhelmed, nonetheless.

The town is partly shut-down due to the African Union summit. The zone between the Hilton, Sheraton and Africa Center (ECA) is chock-a-block with machine gun wielding security personnel. Cars are not allowed to pass and much traffic is at a standstill.

Sunday, I got up early and packed. Great breakfast at "Parisienne Cafe." Later, Alemayehu and I drove to the top of Entoto mountain, at 10,000', site of King Menelik II's palace before his wife Queen Taitu led him to establish the present capital 2,000' lower, Addis Ababa (new flower). After our hike and tour of the old palace and 700 year-old church and sepulchre nearby, we lunched and returned to Allemayehu's house to spend a comfortable afternoon with his wife Wolansa and son Joshua. Of course, I was sated by more great food, coffee, bread and honey. At the aiport at 7:30 PM for 10:15 PM departure. Scheduled arrival Monday morning.

Logistical Notes

On the logistical front, many things about the trip went well. I'm a bit compulsive when taking big trips -- they're once-in-a-lifetime experiences and one missing part could be pretty disruptive, particularly on the technical front (e.g., forgetting a camera battery charger.) Also I carry a lot of technical stuff -- cameras, lenses, and computers, -- and this trip had unusual heathcare issues, such as visiting HIV/AIDS patients.

Not to be too exhaustive, but here are a few tips that made a difference for me.
  • Expect communication failures In Africa, where English is usually a weak second language to native tongues, communications get jumbled and folks you are speaking to often say "Yes. Yes." when they don't understand. This trip, for example, when I checked-into my hotel I asked to extend my reservation to January 31. The clerk said "Yes" but he heard "21" and, as a result, I had a guy knocking on my door asking me to leave way too early. Luckily, I carried copies of my confirmation letter from the hotel and battled to stay longer ... then downshifted to a cheap guest house when I could extend my stay no more.
  • Bring lots of documents Related to the above, I brought lots of documents, full copies of my vaccination records, business visa letter, print outs of Google maps for the Addis area, lists of phone numbers for contacts, country maps, the mix. It is very hard to get good printed information once on the ground. For Ethiopia, the best guidebooks I found I bought on Amazon in the US.
  • Know the US Embassy 24x7 phone number When I got bad sick, this was invalauble. The emergency number -- embassy "Post One" -- connected me with a medic who talked me through symptoms and course of treatment. Really helpful in an unfamiliar place, when faced with a complex problem.
  • Photographically, be excruciatingly clean Addis and probably most north African countries are dust bins. Two minutes out of the hotel and you have a thin layer of dust on your clothes and camera. So, try to keep everything sealed-up. Don't pull your camera from the bag until you need to take a picture, bring a couple canisters of compressed air to clean-up at night. I used a damp washcloth every night to wipe down the exterior surface of gear bags. I never changed a camera lens except in my hotel room, after I'd taken a shower or bath. (The bump in humidity keeps the dust down.) Also, I kept lots of back-ups on multiple media: on computer copies, external USB back-up, CF cards (never re-used cards while on travel), internet photo site, burned CDs/DVDs ... as noted, this type thing is a once-in-a-lifetime deal, and I don't want to chance data loss.
  • Clothing I'd traveled in Ethiopia, Egypt and similar places before, so I had a pretty good idea of what to expect, including visiting slums and interacting with sick people. I pretty consistenly wore an L.L. Bean safari jacket, sort of like a canvas sport coat with extra pockets. It was a good barrier against the dust; I'd shake it off at the end of the day -- $59 at post-Christmas sale (I wish I had brought two!). I generally wore light, long sleeve shirts, including the "Buzz Off" anti-insect variety. Seemed to work well. For pants I'm a devotee of Columbia khaki trousers with a zipper pocket inside the right-hand pocket. Put my wallet and stuff I didn't want pick-pocketed there. $49 on sale at REI; I think I own six pairs, traveled with four. I wore trail sneakers and cushy socks most of the time. I brought a sport coat and ties for fancy meetings.
  • Healthcare and personal protection For health protection I always carry blue EMT gloves (even when home) in case I need to get involved with someone else's body fluids. I took my EMT kit when visiting slums. I avoid letting children touch my face, and I brought six bottles of Purell alcohol gel cleanser to sterilize my hands quite often. I made a mistake picking-up one child with Typhus, but I scrubbed down afterwards. I put on SPF 30 sunscreen before heading out each day. Addis is above 8,000' so I drank lots of water -- and I only drank bottled water, not tap. I had an episode of food poisoning; Alemayehu speculates it was some uncooked cheese. I'm uncertain. I had many vaccinations, a few more than usual due to my healthcare work -- Typhoid, Yellow Fever, Hepatitis A/B, Rabies, Diphtheria, Pertussis, Tetanus (DPT), H1N1, Meningococcus -- and I brought Ciprofloxacin, Malarone for malaria (didn't take it), various pediatric and adult analagesics, Lomotil, Pepto Bismal and such. One thing the embassy medic suggested was carrying packs of moist baby wipes; I didn't, but I carried TP in my bag.
  • Drivers You probably don't want to drive in Addis -- it's a very complicated place without good maps and most drivers negotiate every intersection, rather than paying attention to signals. Pedestrians (and goats, cows, sheep, donkeys ...) walk randomly on the road and, by law, they have the right-of-way. Ethiopia liability laws are heavily weighted against drivers. I had drivers from LeAlem, took a few taxis or often walked to get around.
  • Lodgings I did very well with lodgings, at both ends of the spectrum. At $100 US per night, the Jupiter International Hotel (Kazanches) proved ideal. A short walk from LeAlem, clean, good restaurant, free breakfast and -- key for me -- free Wifi. This compares to the Hilton, about a kilometer distant, at about $200 discount rate (no free Internet), and the closer Intercontinental, also about $200. Pictured below is the Jupiter lobby/bar, where I spent time watching soccer, lunching, listening to jazz, and working on my laptop. At the other end of the spectrum, at $25/night, was La Source Guest House, in the Meskal Flower district. It was cheap but very clean and safe, endearing native art work on display. (I had to stay there when my Jupiter reservation lapsed).

All in all, a great trip, enjoyable, and, I think, good for people I care deeply about.

LeAlem 2010 Picture Library
EHN Blogs

Post -- Home safe in Arlington Monday morning 11:00 AM. Good flight. Time for hot bath, laundry, dog walk ... back to my real job tomorrow!

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