Life in Mota

Mota

The sun is coming up. I hear the singing from the nearby prison church. For “inexperienced ears” it might sound a bit like a muezzin calling for prayer. In front of my room I see the cows eating straw from the big heaps of teff grain. People wrapped in their white gabis are on their way to or coming from church. It is market day today. People from the countryside pass by. They are heading to the market area in Mota, bringing, animals, eggs, vegetables, herbs, coffee beans… for sale. Some have donkeys; others – mostly women - carry baskets on their backs. Some have simple horse carriages on which they transport wood or other big merchandizes. On their way home in the afternoon, they will have replaced their merchandizes by things they themselves bought.
The air is still fresh, but soon the sun will be burning hot. 2 blue birds, shiny dark blue starlings, are eating from the trash that one of my neighbors did not bother to bring to the garbage pit. One of the wild dogs that have been procreating a lot over the past year is eating the guts of the goats we slaughtered yesterday for our party.
In front of the compound the farmers start their daily routine, a woman is spinning cotton, and a group of prisoners is passing by with yellow jerry cans. Three guards walk in the front, three in the back. They are on their way to fetch water.
After a bucket shower and a coffee I go to the hospital. There are only a few mothers admitted. One woman has delivered yesterday morning at home. But her placenta would not be born spontaneously. First she went to the health centre. So they sent her to us. A journey that took her 7 hours. By then she had lost a lot of blood. I managed to manually remove the placenta – something I would never be allowed to do in the Netherlands. We where still busy for 2 hours to get her stable again. This morning she looks better. She can sit without fainting and even walk a little bit. She did not bring the baby which is still at home in her village. No female family member can nurse it, so they will give it cow milk, until the she returns home. I hope the huge blood loss (1 liter at the hospital only, we’ll never know the exact amount she lost before) will not effect her milk production too badly.
Then we have that other woman. She came in late yesterday night, when I planned to go back to the party. She had all signs of obstructed labor and I could see that her uterus was almost rupturing. Luckily, everybody came in time, she got a cesarean section and mother and baby are well now. If there would have been no surgeon here, she and the baby would most surely have died.
Next are the ultrasounds. At least they give us some reason for laughter: A 45 year old woman is sent in: According to her referral paper form the health centre she is supposed to be pregnant for 54 weeks and 4 days now. Even for the non-midwives among you: a year lasts 52 weeks and we all now more or less how many months a pregnancy does last!
It appears that this woman is just obese. This might be due to comfortable living conditions and plenty of food, with the age explaining the lack of menstruation. But she might also have an underlying thyroid problem. In the meantime we have fun thinking that some nurse or midwife really thought this lady was more than 1 year pregnant and wondering, why they could not find a fetal heartbeat.
Then comes a young woman who has had a “safe abortion” 6 months ago. “safe abortion” means that a woman can have a termination of her pregnancy under medical supervision. This is contrary to inducing abortions with herbal infusions or intravaginal herb applications which are used in the country side. Those herbs must have some effects, as we have seen women with bleeding and incredibly contracted uterus after those applications. But they can lead to complications as hemorrhage, infections… .
Anyway, she had a safe abortion and says that she now has abnormal vaginal bleeding. After assessing the bleeding and asking about frequency, amount of blood loss etc, it seems quite sure that she just has a more irregular menstrual period. She will get oral contraceptives, which hopefully also prevents her to get more unwanted pregnancies.
“Safe abortion” is only allowed under certain circumstances, such as rape, incest or a very young woman. All women know that. Only it is somehow funny, that they never recall their last menstruation or the conception (which then would be the day they got raped). One would expect a woman does remember that. But very often they cannot even tell if they are 2, 3 or 4 months pregnant. This sounds rather like “irresponsible” sexual behavior. Only that many people here, especially women, still have very little knowledge about contraceptive methods.
After the ultrasounds, we go to the chai-bet, the tea house to have a tea and chat with other medical staff.
Then it is time for the market. So get the basket and cover my shoulders with a scarf. Strange, that I get so used to it, that this happens almost automatically. I would even feel rather naked without it.
Today I want to by beetroot and onions, get a skirt back from the tailor as well as some little “hammocks” for the baby weighing scale. Our normal weighing scale does not work properly and I found one of those “hanging weighing scales” in the store. With the “hammocks” we can use that one and make sure we get correct measurements (even though I wonder why we measure the babies at all, as in most cases there is no consequence to knowing the birth weight, unless the mother is HIV +. But hopefully, at some point knowing the weight will be used e.g. for follow up of feeding).
But back to the market: I like it a lot. It is very lively. Every time I wander around marveling at the things they sell, the nicely laid out products, the old fashioned weighing scales... This time I get avocados. So I decide to also by a green pepper and make guacamole. I ask one of the pepper selling women for one pepper. She immediately puts the 1kg weight on her weighing scale. Somehow I manage to explain that I really need only one pepper. Laughter is the answer and I get my one pepper for free.
Now that all shopping is done, we go to the Wubet-hotel and have lunch. Today is no fasting day and we can have meat – we decide for Kai-wat, a spicy red sauce with a big chunk of meat in it – served with Injera, of course!
After returning to the hospital (always accompanied by children calling us, running to shake hands and more and more asking for money, pens or other things), I check at the ward again. It is very quite. So we get the volleyball and start “training” with some of the midwives and some family members of the admitted patients. Later Amanu, the anesthetist and Yalem, one technician from the X-ray department join in. I feel very clumsy, but it is getting better. My first days of joining the volleyball were very, very embarrassing.
Ethiopians like to laugh, also about the back luck, or mischieves of others. This is not seen as something “bad”. So my attempts and also Amanu’s actions are commented with plenty of laughter.
Tired from the uncommon physical exercise I get to my room at about 7. Some of my neighbors invite me to have dinner with them (that happens so often that I wonder why I keep buying food at the market which I then don’t get a chance to eat). Injera with simple wats – sauces – like potato sauce and lentils.
Later we meet with Tenaw, the new health officer, whom I introduced in the last post. He has a very interesting life story: When he was 16, his mother decided, that he should get married. Though he was allowed to make a choice himself regards which girl to marry. His wife was 13 when they got married and by time she was 15, she got her first child. Not a story that we would say allows for a carrier. But they managed. And now is has a respected work and she is studying midwifery. It is amazing what people can achieve in life. And they have two beautiful sons.
Before I go to sleep I usually pass at the ward and see if everything is calm. Melkam, one of the midwives, mostly makes traditional coffee when she is on duty. It is a nice atmosphere to sit together. Only that I end up with little sleep after the traditional 3 cups of coffee which also contain amazing amounts of sugar.
So I walk the few steps back to the house, write my blog and will still manage to sleep somehow, after such a busy day.
… This is how I spent many days here in Mota. My camera did not work these past days, so I cannot add a lot of pictures to illustrate my story. Just let your imagination take you to Ethiopia and see for yourself how it is.
A big hug for all of you and thanks for all your posts, greetings and thoughts.
PS. Sadiye, je hebt gelijk wat die jurk betreft. Nou, dat chique jurkje uit Leiden zou ik hier niet aan kunnen. Het zou te snell kapot gaan en trouwens ook veels te kort zijn. ;-)
Beste Grundmannen, ik neem aan dat jullie al bijna weer terug zijn van het skieën. Veel plezier gehad? Hopelijk geen gebroken benen en dergelijke... Sneeuw is wel leuk, maar heel erg mis ik de kou niet.
Hoi Herline, wat een leuke verrassing dat je mijn blog lest. En leuk te horen dat het met jullie goed gaat. Ja, ik vond het heel erg jammer dat ik je niet zag toen in Leiden. Maar over een jaartje zijn we weer terug in Europa, dan gaat het heus wel weer lukken!!
Hallo Dori, Georg und Nik,
Danke fuer die kurzen Facebook Grüsse. Ich hoffe es geht Nik wieder besser. Seid ganz lieb umarmt.