FEB-C-2

THE LONG DAY BEGINS AT CHECK OUT FROM ADDIS

BEFORE FIVE AM AND CONTINUES IN THREE JUMPS TO GONDAR

TO A FORMAL VISITING PROFESSORSHIP,

MEETINGS WITH THE DEAN AND THE CHAIRMAN OF SURGERY AND A SERIES OF LECTURES AND ROUNDS WITH THE NEW GONDAR COLLEGE OF MEDICAL SCIENCES, AND EARLY EVENING IN THE HOTEL GOHA OVERLOOKING THE GONDAR VALLEY

February 16, 2004

It was three AM when I woke up, and a good thing for that as well, since there was no alarm clock and no answer when I had tried to call the desk for a wake up call. I put a few of my things together, including stuffing the carry-on bag into the duffel bag, with a lot of empty capacity now that I had given the two packs of still-carried surgical and medical supplies to Rick Hodes last night to be distributed through the Mother Teresa Clinic and Gondar as appropriate. It is a good thing I had jettisoned the two bags, since I found I was overweight with what I still have left, since the 20 Kg limit is all I would be entitled to carry, and the books and journals I had carried for Gondar are half of the that total.

I went down to the lobby, where the door was locked and the doorman was wrapped up in a blanket next to the door. He awakened when I put the two bags down and tried to check out from the Hotel Ethiopia, a government hotel, and staffed and serviced with about the alacrity one would expect from a sinecure job. I asked to call Air Ethiopia to get the bus to pick me up. I had no voucher, since the three students who had left at midnight had the voucher for the bus they did not take since they wound up going back to the airport with Rick Hodes carrying them in his four door pickup truck. I then asked if we could call a taxi. The door man would do that and did so at a slow motion speed that looked comical, pausing as if to say, “Now, I know there is something I must be about doing right now, let’s see now, what was that again? Ah, yes, taxi…” Meanwhile I saw the only movement outside the locked door on the street was an occasional empty taxi whizzing by on the empty streets. I thought I should try to get the door open and just flag one down. “”Oh, no! You must not get a road taxi! It is dangerous at this hour!” said the door man over the course of five minutes getting this explanation out in a painful retarded speech pattern. “We will get a yellow taxi.” So, he resumed trying to call a taxi, not beginning where he had left off, but starting all over again, giving up the five minutes he had used up dialing the first several phone numbers.

I paced and looked outside in the pre-dawn darkness. I saw a line of heads moving silently through the dark on the far side of a wall that shielded their bodies from my view. It was a remarkable pantomime, since there was no sound and they were regularly spaced along the road, looking like a belt fed series of metal ducks in a shooting gallery making the turn and coming back for more. I then saw a few rifle barrels and a series of uniforms when they go to the end. Only later did I learn from my taxi driver that I was across the street from the Ministry of Defense, and the morning drill is putting out a deployment of enough troops to show a display of force that might discourage anyone from attempting a mass rally of their own. I watched as the conveyor belt of soldiers made the circuit again and again, figuring that at least what was doing by standing still for an hour was made to look much more worth while in the early waiting period before my departure scheduled a half hour earlier than we actually left.

We drove through empty streets and the huge Moscow style plaza for review of such massive troop displays as were the vogue in May Day celebrations. That fashion may have even worn down now for the Russians in the post-Soviet era, but at least the capitol here at Addis is well equipped if they want to put on the equivalent of the Washington DC “Million Man March” or “Promise Keepers” or protestors of the world amalgamated. I got to the big beautiful and empty Bole International Airport (named after the region with no one I asked familiar with what, if anything, “Bole” meant) and I got a porter to push my bags through the security check and X-Ray at the door. The only thing I was hand carrying besides my ticket and passport was the translucent plastic bag in which I had stored all my film both unexposed and that which is already wrapped in the mailers with the labeling for the dozen rolls of film I had shot in Somaliland. It is early in the morning, and there is a young woman and a bored young man at the table for a hand search of such items. Well, what else do we have to do?

So, the young woman opened each of the glued shut film mailers to take out each exposed roll of film from the foil wrappers and the film box in which it is enclosed with the tag identifying it. “They are all the same,” I said. “How do I know that?” she said. “Because I just told you.” With great deliberation she ripped open the GWU film mailers on the next several packages and found out, sure enough, each was the same—except for the identifying tags which she had now scrambled, the purpose for my putting them all together in this fashion of organization. Having done all this, and with all the film isolated for hand checked search so as not to have it exposed to the X-Ray, she put it back into the clear translucent bag, and without further ceremony, took it over to the X-Ray scanner and dumped it on the conveyor belt.

There is no rationale in any of the security required maneuvers I have detected in this or other countries, except to delay and to check on the reaction of the passengers for signs of unusual behavior, like screaming out why are they doing this. I had my carabineers taken from me as a major threat to international security in Charles De Gaulle Paris last year for the express reason that the guards wanted to split up my new high tech carabineers. I had the batteries removed from each camera and laptop in Bagdogra because the guards there had a second market in used batteries. And, I went through this drill here at Addis Ababa since there was nothing else happening and the bored woman wanted to delay and talk with a westerner on entry into the airport since there would be nothing else to make here shift do anything but drag slowly along. And, who knows if there may not be a certain dreamy fog-like quality added to the pictures when they eventually do get processed in the new mailers which will have to be made up, since they are torn open to allow the film to fall out anyway?

It was surprisingly cool in the pre-dawn, as I sat and waited for my flight. Almost everyone except me was wearing heavy coats and stocking caps if they were not wearing the nomadic blankets wrapped around them with the head covers pulled down over their faces. I shivered and tried to listen to the Amharic announcements about which flight destinations were being called for. For domestic flights they do not make announcements in English under the assumption that you are already inside Ethiopia and are going to be going to somewhere else inside it, so you must know what it is that they are saying. Complicating this is the fact that my flight is not really a flight to Gondar, but, as I learned later, it is actually a flight to Axum, the prehistoric capital of a Nile Valley civilization of millennia ago, and its first stop is not Gondar either, but in the ancient Christian church city of Leilebela. So, I had to keep asking and finally got inont the queue of those heading downstairs to board the plane, and only on the ramp did I get confirmation that I would be getting off at the next stop.

IN FLIGHT WITH ETHIOPIAN AIR

OVER THE FORBIDDING HIGHLANDS

OF THE NILE RIVER WATERSHED

I looked out over the long view from the airplane window at a forbidding landscape of a highland plateau deeply burrowed with canyons and crested buttes below. In the furrowed landscape I saw the banded buttes with steep cliffs of rack face looking like the backdrop for a spaghetti western movie. Far below would be a small trickle of river in this the dry season at this point on the globe, This is also the hottest time of the year when it is also driest. Even so, looking around me at the other passengers, I might carried the only warm clothing I had brought—the George Washington University Sweat Shirt and the fleece vest, which may have to be my re-entry costume back into DC winter. We approached our first stop and set down on a high butte flattened out at the top and running to a cliff face for a “carrier takeoff” after we had swapped out the passengers stopping here and picked up a few new ones for the next bounce in this Fokker 50. The city of Lifebelt is renowned for its ancient Christian Orthodox church, and is on the tourist route for this unusual vertical rectangle dug into the ground with colorful murals and paintings and an assortment of Byzantine icons. But, not for me, this tourist experience, since I am on a working safari here and will have to waiter for another visit to get up into the magnificent Simeian Mountains to climb and trek and to chase the Simeian fox and the ibex resident there.

We took off again for a half hour bounce to Gondar. When we landed it was pleasantly sunny and dry with a warm gentle breeze. I was no longer underdressed for the weather, although I soon would be underdressed for the formality of meeting the higher management of the newly created Gondar University. I looked lost and forlorn, I presume, since a driver named Ismail picked me up and asked if I needed a ride. I had told him I would need to b e going to Gondar University, and he took me there and dropped me off saying he would return for me after he had dropped off his other passengers, presumably his paying customers.

We drove along the steep roads to go up the face of some steep hillsides to Gondar. Along the way, I noted a very colorful pastiche opf pedestrians twirling umbrellas or carrying large loads of sacks on their heads. And everywhere were rather perky ambitious donkeys, small, carrying a large sack of something bulky on their backs, and trotting independently uphill through our traffic e route. The people were more colorfully than their livestock, with a variety of styles present, from young women in tight pants to older folk in flowing robes and leaning on knobbed sticks. A whole series of men were like walking haystacks carrying large bundles of grass on their heads that made all but their legs disappear beneath. It was such an intriguing shot, that I tried to snap it as it was spread out before me in the camera’s range of a tableaux a busy unaffected Africana middle urban life. When I pushed the button there was a time delay before it could go off, and then nothing ever happened. This is my chief complaint with Digital photography, the built-in delay factor which obliterates all candid shots and requires posed portraits. And here I have in hand a simple camera but it is for reasons of its simplicity that I intend to use it. I would expect it to be reliable and instant, but this camera refused to snap the spur of the moment shots, and put as much delay into the film cameras as the digital cameras that I had abjured for the reasons I had just now experienced. So, I did not get that shot or several others.

Just then we came around a curve in the uphill drive, and ahead I could see a group of clergy dressed in colorful garb and carrying multitiered religious umbrellas. Behind them stood a large number of women in identical white homespun robes looking toward the priests who were waving censors at the shape of a cloth covered coffin, resting on saw horses at the road side. This was the end of this colorful saga of life on the move on an Ethiopian roadway, in which one of its passengers was no longer quite so vital as most of those I had seen already, and was being carried down the road to a burial service in a churchyard. I hope the camera did not fail to take the picture as I had ordered it to do so, but a camera with a mind of its own is not my favorite tool.

Camera glitches aside, I decided already that I liked the vitality of this hillside Gondar terrain and climate, with the coldest that it gets being about ten degrees C and the warmest being right about now. It looks quite a lot like the Thika Highlands of Kenya, and through the middle of this is a parade of very vital and scurrying Ethiopians in various characteristic shapes—with white robes and headdresses, carrying umbrellas and following prancing small donkeys. Some carry umbrellas as protection for the sun, but big black umbrellas seem also to be thermal collectors. At the roadside are knots of people clustered around small piles of fruits or vegetables to be selling those to the passers by. It is like the scene of the contented Africans in the Out of Africa song scene.

ARRIVE AT Deans’ Office AT

GCMS—GONDAR COLLEGE OF MEDCIAL SCIENCES

I was dropped at the Office of the Dean and sat in the secretary’s spot as Iskaendaer, the competent secretary, went in and out, making calls to alert Mensur Osman the professor and chair of surgery as well as the Dean of my arrival. I waited and soon met the Dean. He and I had a very quiet talk which he announced was for him a very important meeting with lots of potential of good collaboration. He is a physiologist, and has major emphases on teaching the underclass of medical student. The Gondar College was founded fifty years ago this year as a public health nurse training program. They then started a medical school which graduated, among others, Mensur Osman who then served two years as a GP in this hospital before going to the AAU (Addis Ababa University) to learn surgery from a Swede Professor Johnson who has been in Ethiopia for thirty years. He came over from the OT where he had been operating and looks even younger than the Dean. Together they have set goals for the next phase of the specialty development within the formerly GCMS (Gondor College of Medical Sciences) and soon to be Gondar University. AT fifty years old it is the oldest college of medicine in Ethiopia with one more, younger, having started last year of the seven there are now in operation by the Ministry of Education among the 70 million Ethiopians.

THE HOTEL GOHA,

ON THE CREST OF THE HILL OVER GONDAR

I was driven up the hill from the Dean’s Office by a driver in a white Mercedes van. I was registered in at the Hotel Doha, the place to be in Gondar. I quickly unpacked the bags, noted the total collapse of the organized talk on Antibiotics and surgery in infections, and stopped long enough at my room overlooking the valley to note to objectives GOND = 12* 37.16 N; and 37* 28, 06 E.—So, now you know where you are! The altitude is 2500 meters, and the normal pO2 is 70 torr (mm Hg).

I snatched up several lectures in the form of the slides to support such a talk and found that the ring had come off the carrousel which made the whole of the slides on surgical infection fall into the suitcase in a total shambles that I could not sort out again without several hours to individually correct them. So the afternoon lecture on the subject of surgical infection and its management and prevention is going to have to be rescheduled, and I should begin with the topic of Surgery in the Developing World.

I gave the lecture during my low point in my circadian rhythm, but I tried to shake that and respond to the questions and the interests of the medical students, 12 interns, six residents of the first group to have just started and the dozen GPs I will meet individually on the ward rounds.

The lecture was intensive, and I tried to stir up a good deal of interaction and discussion. The students were very attentive and grateful, but very reticent and shy about responding, so that the interactive part I had to coax from them. They seemed really to enjoy it and did stay extra long. I exhausted myself in the process, and began to feel some sort of illness coming on. For that reason I was happy to be going back to the Hotel Goha, where I thought I should have a quiet dinner alone and simply go to bed to start recharging the batteries for the following day when I would repeat the whole process again. I did so, and could hardly stay awake long enough to eat, but sat down as a fellow in a Williams College tee shirt came into the room and asked if he might join me,

Leo Murray is a graduate of Williams College and came from Boston originally, having gone to Hong Kong to teach English for a year, and has subsequently lived there for most of his life of 61 years. He married a Hong Kong woman each for the first time, only six years ago, but he has continued his penchant for hiking in various interesting places on earth, among them 23 trips to Nepal. He had especially enjoyed Mongolia and will be going back there, but one of his friends highly recommended to him the highlands of Ethiopia and that brought him up here to the Simeian Mountains where he had been trekking for the last several days. He had seen the Simeian fox and the Walia Ibex, endemic species up in these mountains. He was carrying a digital camera and a carryon bag as his only luggage and he had plans for many more of the good things in life as his knee had given out and needed operation about five years ago, and he is grateful for the continuing use of it. He and I swapped stories and eventually pictures which I shared from my laptop in the Power Point program. He will look up my web page, buy Out of Assa, and come down to join me for breakfast in the morning before taking off later the next day to make his way back to Hong Kong.

And, tomorrow is a still bigger and better day!

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