The Dark Side of the Moon

Are the forces of darkness gathering, if you are able to read this we have beaten the system! The problem is that we are having difficulty accessing the blog site. Karen is convinced that the Ethiopian thought police/bureau of state security has read the politically incorrect thoughts of Winston Wright and has thus pulled both blog sites and taken away our voice. If this is the case and we have circumvented it – read on. Ethiopians do not do criticism, which is possibly why they do not respond to any form of training and that sustainability is but a hollow slogan. As the famous philosopher ‘Pangloss’ would say ‘All is for the best in the best of all possible worlds’ and that must be the way of things in this strangely beautiful, over bureaucratised grubby and chaotic country. Karen and I have major discussions about the need never to offend, the politically correct view of never being forthright about what you believe as it will prevent progress as compared to mine which is speak and be damned if that is what you think. As Voltaire famously said (but in French)’ I strongly disagree with what you say but I will defend to the death your right to say it,’ so with two quotes from the same philosopher I have to defend my position to say in this blog, or elsewhere what I think, at the risk of casing offence, or even as has been locally suggested, cause all blogging sites in this country to be unreadable as the thoughts and stories emanating from them cause offence to the censors or leaders of the country. So is it better to tippy-toe around the manifest problems or to face them head on and say what you think. One allows you to co-exist in a cosy if false harmony, the politically correct and I would say soft centred view and the other is robust if sometimes uncomfortable debate – the problem to me is that no one these days really feels able to say what they really think.

The land here is rolling hills of teff the wheat that makes that sour dough the staple of the food, the trees that cover the coffee plants the main source of income (other than NGO and faranji tax) and with the vast population, rusty corrugated iron roofs that somehow blend into the landscape and from which pour forth small and snotty children if you ever stop with the familiar refrain ‘Faranj, you, you, you give me money (I have stopped carrying any and pull my pockets out to show that they are empty) to the amazement of the young. Meanwhile at home, the only place that Masie will now lay eggs is the basket of baby clothes on the floor, happily so far without skid marks. The noise she makes prior to this is enough to allow the practice to continue – anything for a quiet life.

Meanwhile, back at the ranch we are providers of NAN milk for the neonates of West Wollega as they survive the cold and wet. Wet is inevitable as there are no nappies and unless you are fit and well with enough material to dry the odd bottom that is the fate that awaits you. If you are ill by virtue of say being unconscious or confused having arrived fitting and on your own your baby is at the mercy of local forces and dressing is dependent on availability of clothes, now of course with the added advantage of chicken down duvets!

As ever I never have the head camera in the right place as a woman turns up having travelled many kilometres - the locals say about 4 hours, septic, with a ruptured uterus, the result of an undiagnosed brow presentation in a gravida 5 (aged 25 so if she dies that is 4 orphans) and strangely not too much in the way of blood loss. If I had pictures I would have shown you, assuming they would let it on to U tube, but with the current difficulties of getting this stuff on to the blog who knows. The cervix (in 2 pieces) and the lower segment are a soggy smelly friable mess, so as she wants (as they say in these parts) a BTL (sterilisation to you and me) I do a hysterectomy – very carefully with everything double clamped and particular care around the vagina as two ureters would be in the words of Oscar Wilde be careless. She comes from a different tribe up country and is clearly short of money as when I went to see her next day I was confronted with a request for money to pay for Tramadol, which they could not afford, the antibiotics presumably having exhausted their financial reserve. The charity for which we are here have pulled the ‘safe birth fund’ as of the beginning of the year, on the understanding that treatment is free in the government hospital (though it is not clear if this includes drugs) so the future is I fear even more uncertain for those travelling long distances in the hope of staying alive while giving birth. Those of you who know about third world (sorry politically correctly ‘developing world’) care will know about the 3 delay model. Commendably, here the third delay, that of getting treatment on arrival is virtually non- existent here as resuscitation is brisk, crystalloid and antibiotics and anaesthesia swift with no questions asked, no nonsense about CEPOD lines and fighting for space. The tough and antibiotic naïve seem to survive. Have also managed to find a better suction for the ventouse, so hopefully this will help my on-going struggle too.

In the meantime our second radical hysterectomy went home praising the Lord (not I note her surgeons) on day 4 without immediate mishap – I do hope she does well in the future.

Please feel free to comment then I know you have read this.

Hopefully to be continued……