And Atlas Shrugged

Sadly, and down purely to my incompetence, fatigue or whatever, my last missive disappeared into the ether never to be read again, which means that much of my transient musings are lost for ever. Given that many of you will regard it as a cynical rant perhaps no big loss. As we contemplate the sad death of a 16 year old from overwhelming sepsis, and another not looking that great on the ward I am reminded of the title, if not the content of a block buster novel of the early 80’s called ‘And Atlas Shrugged’ which concerned the multi-layer goings on in high industry but also sums up the curious chaos that is Ethiopia, a combination of personal tragedies, both high and venal government ideals and underneath the real desire to change as little as possible, keep everything chaotic and in a state of flux and do your best to profit yourself from the chaos around you – so possibly more like big business than you might initially think, particularly one suspects the armament industry. The tale of our maternal death transpires to be even sadder, in a Victorian melodrama way than you would think, unbelievable in a novel. She is the third death in the family, the mother now having no living children and bringing up 2 grandchildren on her own, so it is not surprising that she has rejected the other child who is lying rather wet but well up in the obstetric ward, destined I am afraid for an orphanage, and currently with the expectation that we will provide the NAN, clean clothes etc. in the meantime. What else can one do, but what it is not is sustainable. A high quality infant, young parent very healthy etc. is however destined for institutionalisation for a year or so and then to be sent psychologically under stimulated if not damaged to some home in the western world if luck, pity it cannot go now, but that is part of the system here. Equally, those who are having trouble conceiving, which is some on the staff are not able to grasp the concept of adoption, anther tragedy of the country. I am reminded of Plato’s ‘Myth of the cave’ when he contemplates what view of the world you would have if you were tied down in a cave and spent your life looking at flickering fire light, this is I suspect how Ethiopians view the world, though the influence of T.V. is there. An interesting observation of priorities is the T.V. is the erstwhile carer of young Jabba, who has been resident here for a couple of days having been to the hospital with his chronic cough and put on I.V. penicillin, an odd choice of both route and antibiotic, so not wanting to sit around the ward given here, till I raided pharmacy and found something suitable that was oral, if a little bitter. This meant that we needed some vimto (local Ribena) and required the solution to be kept in the fridge, which our carer of course does not have so stored here. But readers what would you have spent your money on a fridge or satellite T.V – but I suppose the latter, which as in many western homes is on all the time does provide some stimulation, but the antibiotics gently warm. Happily however the cough etc. is abating and I was heartened to see how well he has been accepted into the family which I do hope will continue. So, in this land of strange contrasts will we ever get to a situation where women can find somewhere safe to deliver in a timely fashion, where tissue destruction and devitalisation will not be so great as to let overwhelming infection take over and that housing will at least be reasonable. On a happier note, both Ca. Cx. ladies have done well and one is home. The bill 2400 birr about £100 which is a little over budget but includes histology at 440 birr which we had not budgeted for but in terms of trying to make it all faintly kosher is probably a good thing, but will it help the lady herself – no of course not!
This is a week of visitors, all of whom need entertaining or explanation. A rash of senior Adventists are going round inspecting – with some transient impact I am being given discharge summaries to do. The NHS is creeping in! The management apparachnics hereabouts were very keen that impressions should be good but the local workers, when I was guiding them around were letting rip on lack of resource so we will see. These visits were a funny mixture of long prayers in Oromo, (requiring me to stand and look solemn) and trying to keep a straight face as they uncovered layers of chaos. I was particularly amused to learn that the only autoclave works because they keep a rock on the pressure relief valve to ensure that there is sufficient pressure to kill a few germs, though it may explain why the tape on the instrument wraps never has dark lines on it! These senior Adventists are an odd lot, a paediatrician come obstetrician from Canada by way of Manchester, an Internist from cape Town and a surgeon from Nairobi who was not entirely amused by my story of car jackings. I am not sure if I did not put my foot in it as I said that there were not that many wound infections, touch wood, which suggested a non Adventist spiritual world…..there was a moments uncomfortable silence, but I did gently put across my lack of spiritual commitment. What I wonder, though I doubt if their report will be shared with me, did they make of this place.
The other big invasion of course has been the arrival of 17 odd velocopedists with assorted hangers on whom I have been required to show round talk to and try (and probably failed) to be reasonably politically correct with, though there were some slightly sullen expressions about from the leaders of the pack. I understand that the journey had been a little encounter groupy. However, as we were not serving alcohol on the veranda, Green Bar B being the venue of the reception, we were able to use the paper plates to be a banner of welcome, tastefully decorated by orphan boys and strung across the hospital entrance where we greeted them with powdered orange juice, water melon (very nice) and orange quarters, like break time at school football matches. Unsuprisingly the keen volunteer who climbed the gate to help put up the sign demanded payment which as yet (I no longer carry money) he did not get. We continue to live in a donor culture and I continue to get requests for help with education (self and others) orphans (here and away), building materials ( new and as yet completed houses) and of course teeth falling out (sugar cane and no tooth brushes).
So today has been spent wheeling (sorry!) them about the facility and trying to keep them out of the way of the adventists and allowing them to take photos of smiling people with babies and perhaps putting the not so well in the back of the picture. How much I wonder is adventure (camping amongst the monkeys) but wanting all done for them (not it turns out frightfully self sufficient but I would be a bit tired and whittery if I was cycling too, and how much is collecting for some greater good. Happily my 2nd sick lady is I think turning the corner, no collection and wind! Her pulse rate is settling so hopefully all getting better. The state of Ethiopia- well that might be another story, but then ‘Atlas Shrugged’.
P.S. Big changes around the corner in ‘Adventist times’ see next instalment.