Ciao to Addis

Our last day in Addis.  Heading back from ADD to YYZ via Rome.  I had thought of making some sort of list to compare things I will miss in Ethiopia and things I have missed about Canada.  I then changed my mind and thought it doesn't make make sense or do any good to compare.  I think what makes you remember a place or an experience is the people you meet and the
friends  you make.  So, I'll leave you with some photos of some of the people who have been part of our lives during this year in Addis.  We'll miss everyone!

Not For Vegetarians.

We were recently invited to the wedding of one of our residents.   It was a lovely affair with a beautiful bride, energizing music and good fun all around.

After the ceremony we headed to the wedding lunch; and what a huge spread it was.  In a country where most people fast (no meat or dairy) at least twice a week, I have been surprised with how much meat gets served when you are invited out.    This wedding was no exception.

Tere Siga Vendor near our house

Raw meat is part of the Ethiopian cuisine.   There are raw meat vendors on almost every corner.   It comes in various forms like kitfo and kurt or tere siga.  Kitfo is raw or very rare minced beef that has been marinated in various spices.   Tere siga comes straight off the animal (usually a cow) in alarmingly large chunks and is dipped into spices.

Tere Sega station at the wedding

It is thought that kitfo and kurt started as a necessity for Ethiopian soldiers.  During various wars, Ethiopian soldiers would hide in the mountains and need  “quick to prepare meals” that could be made without using big fires.  The smoke from the fires and the smell of cooking food could point enemies towards the secret location of the soldiers, so the “food that doesn’t require cooking” option was a good one.

I guess after the wars were done, soldiers brought these new recipes home.  I think the reason kitfo and kurt have become so popular is because the soldiers’ wives and girlfriends were so pleased with the “no cooking required” portion of these recipes.

I was lacking in courage the day of the wedding and probably appeared to be a ferengi wimp but couldn’t bring myself to sample any tere siga---maybe next time.

Of course raw meat is not limited to Ethiopian cuisine; there are recipes in Korean, Japanese, French, Italian, Lebanese… cuisines.

Should you decide to broaden your repertoire of recipes, here is a link to LA’s top 10 raw beef recipes: http://blogs.laweekly.com/squidink/2011/08/raw_beef_dishes_los_angeles.php

A single story, some hippos and a running race.

Before coming to Ethiopia, we took part in “pre-departure training” with CUSO.  As part of this, we were shown a video of Chimamanda Adichie, the acclaimed Nigerian novelist, talking about the danger of a single story.   The talk was given at a TED conference in July 2009.   She describes the problems that come about if we limit ourselves to a single story or image of a country or people.

A few quotes from her “The single story creates stereotypes, and the problem with stereotypes is not that they are untrue, but that they are incomplete. They make one story become the only story.” …….“I recently spoke at a university where a student told me it was such a shame that Nigerian men were physical abusers like the father character in my novel. I told him that I had recently read a novel called American Psycho, and that it was a shame that young Americans were serial murderers.”

A long pre amble to say that I hope I haven’t left you with a single story of Ethiopia.  When I look through my postings, I see there is a lot about poverty, lack of water, poor health for women….  These things are a big part of Ethiopia, but not the only part.

Here is another story of Ethiopia; posh hotels, tennis, golf, swimming pools..... 

Relaxing in our room

View from our room

This weekend a few of us headed down to Hawassa which is about 5 hours south of Addis by road.  Our very good friends loaned us one of their vehicles and we drove down in convey.  We were going to Hawassa to take part in a running race, but were really there to relax at the Haile resort

The Haile resort is a posh hotel that is partly owned by Olympic champion Halie Gebreselassie.  Haile is considered one of the greatest distance runners in history.  He has won two Olympic gold medals for 10,000m, four world championships, still holds the masters world record for the marathon and the list goes on.

He also has a very nice hotel.  We had a most relaxing weekend.  Drinks by the pool, hippo watching in the lake the hotel overlooks, golf for the kids and yes a running race .

The highlight; a photo op with Haile Gebreselassie.

You can watch Chimamanda Adichie at the TED conference at: http://www.ted.com/talks/chimamanda_adichie_the_danger_of_a_single_story.html

Sleepless Nights and an Easter Rooster

I think Mike has posted something similar on blipfoto, but this rooster is driving us nuts so I feel the need to post as well (apologies for the re run).

Orthodox Ethiopian Easter is this Sunday.  During the lead up to Easter, Orthodox followers fast (no meat, eggs or dairy) for 55 days.   The fast is then broken with a meat laden dinner.  Doro wat (a kind of chicken stew) is the traditional food for Easter.

A rooster that is destined to become Easter dinner has been roaming around our tiny cement compound for the last few days.  Not sure he knows what’s in store for him.

We are really wishing that Easter would come sooner, as the cockerel has been causing some extremely disrupted sleep.  It doesn’t appear that roosters crow only in the morning.  They seem to crow all night long with a blatant disregard for those of us who like to catch some shut eye at night.

Today Mr. Rooster had the gall to come into the house and have a little relax on our sofa.  Mike had forgotten his computer this morning, zipped back into the house and, there the rooster was, standing on our sofa, making himself at home.  

We’re heading out of town for the Easter long weekend, so unfortunately will miss the rooster feast.   But we’re hoping for some better sleeps when we get home.

Happy Easter!

Entoto Beth Artisans

I under packed in terms of clothes for our Ethiopian adventure.  As a result I can be seen on most working days, wearing the same black top and cardigan with the occasional variation in trousers.

I’ve taken to adding some accessories, and covering up my frayed wardrobe with a lab coat.

Luckily, I have discovered the Entoto Beth Artisans.  A very interesting  social cooperative.   They work in partnership with a local NGO and have trained marginalized HIV positive woman to become skilled jewelry makers.  They also provide basic health care and a daycare program (very proactive—for women to be able to work and have their children cared for close by).

     A quote from their pamphlet “An Ethiopian business dedicated to restoring the  HIV/AIDS affected community on Mt. Entoto by providing fair-wage employment.”

A sample of their wares

Discarded bullet casings and scrap metal from past armed conflicts in Ethiopia are used to make the beads.  Local farmers craft most of the beads.

It is surprising to me that discarded ammunition can be turned into such beautiful things.

It is now no problem to wear the same black shirt everyday—just put on a lab coat and wear something from Entoto Beth Artisans.

You can visit them on facebook:  Entoto Beth Artisans.

Work?

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So, I was reading through some blog posts the other day.  By the look of my blog you would think we weren’t doing any work here.  I thought I should make an attempt to set the record straight re this.  Here is a mini post about our work.

Teaching Session at Arada HC

Our program started in February with 5 residents.  We are now up to 8 residents, with our 8^th resident joining today.  We’re hoping this means that residents are hearing good things about our program.   Initially our resident demographics were a bit gender skewed, with 4 men and 1 woman.  We are now on even footing in terms of gender with 4 men and 4 women.   This is good because gender equity gets a lot of press at VSO (and obviously good for a whole host of other reasons).

Coffee with the Health Officers at Arada HC

Our little health centre, the Arada HC, seems to be blossoming.

With more residents to organize and teach, work is getting busier.  This is all, of course happening, two months before we leave (sigh).

Here are a few photos of some actual work.

A few of our residents

ALSO (Obstetrics) teaching with Ann from WI

Living the High Life

A very short post.  It seems the closer we are to leaving Addis, the busier we are becoming, hence the short post.

Mancala game/candle holder

Here’s a little story.  We had a few days where we were either without power or without water in the house.  Our mancala game turned into a very useful candle holder.

Happily, yesterday our household had both electricity and a functioning shower.  Sunil came down to breakfast and said “whoa, we are living the high life....we have power AND water today”.

Homework by candle light

So, a little lesson on how quickly opinions can change on what living the high life means.

A 23 year old Toyota Corolla

Last month we rented a car.  After 6 months without a vehicle, we finally broke down (we are not the salt of the earth people we were hoping to be).  It is now much easier to get the kids back and forth to various activities and social events and of course easier for us to get to work and be back home in good time. 

 

Our landlord found us a vehicle and we are now the lucky renters of a 1990 red Toyota Corolla.  A very popular car.  According to Wikipedia over 39 million Corollas have been sold as of 2012.

There are many elderly cars roaming the streets of Addis, mostly because the import taxes on new cars are huge. 

Here is some information from the Ethiopian Customs and Duty Tariff site.  A motor car is liable to five different taxes.   An example:  A vehicle with a cylinder capacity greater than 3000 cc is subject to the following taxes:

Duty Rate: 35%
Excise Tax: 100%
VAT: 15%
Sur Tax: 10%
Withholding tax: 3%


This gives a grand total of 163% tax to the assigned value of a car. As well, one is unable to import “old” cars into Ethiopia.  As a result, old cars currently residing in Ethiopia, retain their value quite well.

Mike is the driver of the red Corolla and has an Ethiopian drivers license, valid from 2005-2007 (Ethiopian Calendar).  He is doing an excellent job negotiating the tricky and unpredictable Addis traffic.  The kids and I are the passengers and are doing an excellent job of trying not to be backseat drivers.

The Yellow Jerry Can

A common site around here is a yellow jerry can.  In many countries in Africa women and children use this 20 litre jerry can to collect, transport and store their water.   

The jerry cans initially held cooking oil or (more alarmingly) diesel fuel.  They are cleaned and then used to transport water.

Apparently this is a big improvement from the old clay water vessels as jerry cans are lighter, more durable and easy to carry on the head.  The phrase “easy to carry on the head” may be a matter of opinion as I would be hard pressed to lift a full jerry can let alone get it up to my head.

According to the WHO, living within 1 km of a safe water source and having access to 20 litres of water per day (per person) is deemed sufficient for adequate drinking and personal hygiene.  As Canadians, we would have a tough go of it on 20 litres of water per day.

                                                               Here is a little number quiz:

-Number of kilometers walked by the average African women in search of water per day:  6

-Number of kilos of a 20L jerry can weighs when filled with water: 20

-Number of people living more than 1 km from a safe water source:  1.1 billion

-WHO estimate of annual deaths from water-borne diseases due to unsafe water: 3.3 million

-Number of litres of water used per day by the average Rwandan: 5

 -Number of litres of water used per day to irrigate the world’s golf courses: 9.5 billion!

 -Hours spent in one day by women and children on collecting water for domestic use: 200 million

 -Environment Canada stats of how many litres of water individuals use in an average day:

                                                                     Americans: 575

     Canadians: 335         

     Europeans: 200

     Asia: 95

     Sub-Saharan Africans: 10-20

I think I will start taking shorter showers.

YELLEM!

Yellem is an Amharic word.  It’s a handy little word to know.  The rough translation is “none”,  “there is no…” ,“we don’t have any..”

There is a lot of yellem in Addis.  Here are a few examples:

1.  There is a cute little pizza stall/restaurant close to our house called Yoni’s.  Yoni’s has two things on the menu; pizzas and sodas.  Yesterday Yoni’s pizza house had “yellem” pizza .

2. One fine day at work, I needed something copied.  Surprisingly it is a bit of a production to do this; one has to obtain permission by getting various forms stamped with an official blue stamp.  After completing the numerous procedures in a not too timely fashion, I arrived at the photocopy station with my blue stamped papers.  I was then told there was “yellem” power, so “yellem” photocopying.

3.  The last time we were at the Mekele airport there was “yellem” to everything on the menu.

4. Luckily, in our neighbourhood we don’t often have “yellem” power or water (only occasionally).    However, when this happens we seem to have “yellem” working flashlights and “yellem” matches in the house.

5.  There is generally a lot of “yellem” in our little grocery store.

At any rate, the list goes on.  Initially, all this yellem caused some slight angst, but we have become used to it.  We now hardly bat an eyelash when we can’t order anything from a menu.

Our friend Brian says we need to get signs printed for various establishments that say: “YES, WE HAVE YELLEM”.  I think that would be a good idea.

Yellem photos for this post :).

Tej

Ethiopia is Africa’s largest producer of honey.  Honey has always had a special place in Ethiopian culture.  When the Queen of Sheba went on her little northern trek to visit King Solomon, it is thought that she brought Ethiopian honey as part of her gift package.

As in most cultures, home brew of some sort makes it way into the local cuisine.  Tej is Ethiopia’s home brew.  It is a honey wine that is brewed and drunk exclusively in Ethiopia and Eritrea.

Berele

I really wish I liked it more.  It has a lovely yellow/orange colour and is served in a berele, which is a container that looks like a funky chemistry beaker.   All in all it looks like something that should be thoroughly enjoyed.  Unfortunately it tastes (as you might expect) like sweet fermented honey.

Usually when we are out, if I am having some difficulty managing eating or drinking something, Mike will come to my rescue and finish up my eat or drink.  Not so with Tej.

Our landlady brews Tej, so we have a steady supply.   Some photos of our last meal at their place, complete with a large glass of poured Tej.

The Launch

Haven’t blogged in a while; we have actually been busy working (shocking as that may seem)…..,

And so our program launched.  The first ever family medicine residents in Ethiopia began on Feb.  4^th, 2013.

A little bit of background: The idea of family medicine or “specialist” generalist has been percolating in Ethiopia for many years.  After many years of work from both Ethiopian and U of T faculty, family medicine has arrived in Ethiopia.  It has been well shown that countries with a strong primary care health system have better health outcomes, so we hope that will be true in Ethiopia.

The program is led by our Ethiopian colleague, Dr. Dawit.  It is a collaboration with Addis Ababa University, U of T and University of Wisconsin.   Mike and I are the outliers from NOSM.  We had a big crew from all these places the help with the inauguration.  The U of T gang did a terrific course on the foundations of FM.

Our five residents with Dawit (very left)

We have five amazing residents from varied backgrounds.  These brave souls will have the job of shaping family medicine in Ethiopia.

Their stories of why they chose medicine as a career are both inspiring and heartbreaking but keep us human.  A few examples: “ I wanted to be a doctor because when I was in 8^th grade I saw my sister die in childbirth”……” I chose medicine because when I was small, my father, who was a tailor, came home and just died…..I wanted to know how this could happen”.

The whole gang

I sometimes wonder how much of an impact 5 family doctors will have in a country of almost 90 million people, but I suppose you have to start somewhere.  This is the start.