Reunited in Gondar!

I arrived in Gondar on Saturday and was reunited with Gelane who has been living here for the last year.  Her cousin was graduating from nursing school at the University of Gondar and so her cousin's parents, sister, uncle, neighbor, etc were visiting from Addis for the occasion.  They immediately welcomed me into the festivities!  First we went to extended family's house in Gondar for graduation lunch.  "Fasting" is very common in Ethiopia especially among Ethiopian Orthodox Christians when praying for a certain outcome.  I was initially confused when seeing "fasting foods" or "Beyanatu" on menus in restaurants, but quickly learned that "fasting" means no meal until midday and then when eating - no meat or diary products.  Perfect for my vegetarianism, because Beyanatu is on most menus in Ethiopian restaurants and is an easy way to explain I don't eat meat.  So we had a delicious lunch with Beyanatu for those fasting and meat for the others....

We then went up to Goha Hotel on the mountain overlooking Gondar (the pic at start of blog is from there) for pictures and tea.  Like Lalibella and Aksum it rains here most afternoons and when it rains it is pretty cold but during the mornings it is usually pretty warm and sunny.  So the Ethiopian tourism commission likes to use the slogan "13 months of sunshine" since Ethiopia follows the Julian Calendar there are 13 months - though i am not sure that slogan works when over half of the day during this season it is overcast and rainy.....Also it is actually 2004 here!  And time is different with sunrise (or our 6 am) being 1 am and then the time going from there.  Most official tourism things (like flights, store openings, etc) use the Western dates and times but it is still a bit confusing in places like the hospital where sometimes both systems are used.

Interesting spellings are very common

On Sunday we walked around town, going to the market for some Ethiopian scarves, rather than live chickens which were also for sale....

We also went to a traditional Ethiopian restaurant for dinner where several traditional dances were performed. Here is a video of the traditional Gondar dance....

On Monday I went to see Gelane in action at the hospital.  She taught medical students on the malnutrition ward.  Several of the patients were very severely malnourished - one was 2 years old but was the size, weight, and developmental age of a 6 month old.  Medical care is not free here.  For malnourished patients formula, plumpy nut nutritional supplements and some other care is provided but when diagnostic tests (blood tests, chest xrays etc) have to be done the patients' families have to pay first.  The prices are quite low, but for poor families with nothing, even the slightest fee can be too much.  There is some free care for very poor families, but they have to provide documentation from their  village leaders of the fact that they are destitute and if they are traveling a far distance to come to the hospital this can often be quite hard to get.  Often the resident doctors who are very poorly compensated (3500 Birr or about $200 USD a month) end up paying for tests out of their own pockets!

Today I went to the tourist attractions in Gondar.  The castle compound is the main attraction.  The first castle (above) was built by Fasildas  when he was Emperor of Gondar from 1632-1667.  It apparently took ten years to build.  The subsequent kings built other castles on the compound because they each wanted to have their own.  There was also a house for lions which were kept on the compound, steam baths and a "music hall".  I then went to Debre Birhan Selassie church which is famous for the incredible paintings inside.  There are more than 100 angels on the ceiling and they were painted 300+ years ago and have not been retouched but remain very vibrant for the most part.  Some more photos....

A place of mystery - Aksum

I flew from Lalibella to Aksum, a 30 min flight where I could choose my own seat and the boarding pass looked like this

No worries they had a hard core metal detector, all (checked and carry-on) bags went through a scanner, and I had a serious pat down from the female security officer. 

Aksum is a town with a lot of mystery.  The Ark of the Covenant is said to be here (my guide told me God had said for it to be brought to Ethiopia because he knew that Israel would be too unsafe).  It is housed in this building

It is guarded by a monk.  The monk never leaves the building’s grounds and is the only one to see the Ark of the Covenant.  I asked what happens when he dies and I was told that when he is about to die he tells those who supply him with food etc the name and where to find the next monk to stay with the Ark.  Only he has not left the area for numerous years (the current one is 50+ years) so he does not really know any other people and hence his choice is actually from God.  The are other stories on how the guard is picked – including that all the monks sit and select one.  Regardless once selected that person is the only one to see the Ark and never leaves until he dies.  Fascinating!

There are two churches on the complex with the Ark, one is the “old church” of St. Mary of Zion women are not allowed in here “because it is a monastery.”  I asked what would happen if a woman went in and was told that it would bring very bad luck to that woman – “she might walk in and then completely lose her eyesight!” Yikes, I didn’t want to tempt it so took the picture above from over the wall (the last point where women are allowed).  The new church of St. Mary of Zion was built by Hallie Selassie in the 1960s and doesn’t exactly fit in with the surrounds…..

The town is also said to have been home to the Queen of Sheba.  This was apparently her palace....

Aksum is also known for its stelae, which are incredible.  They were apparently built as tombstones and range in size from 1 meter to 33 meter (though that one is broken on the ground) some are quite plain will others super intricate.  A true engineering feat considering that the quarry where the stone comes from is 4 km away and granite is super hard.  Each one is a single piece of granite and it remains unclear how they were transported and carved and raised hundreds of years ago. 

People are incredibly friendly here which is nice, but makes it hard to go anywhere without being asked for something: "ferenji (which means foreigner or white person) money?", "Ferenji, candy?", "ferenji, pencil?", etc, offered a guide, asked if I want my shoes cleaned, etc. 

In Lalibela a typical conversation with a school age child went like this:

Child: Hello

Me: Hi

Child: Welcome

Me: Ames a ganalu (thank you in Amharic)

Child: Where are you from?

Me: America

Child (with huge smile): OH, Obama we love him!

Me: me too

Child: You live in Washington, DC?

Me: no, New Jersey

And then they would tell me about their football team, which needed uniforms (showing me a crumpled piece of paper requesting money).  Or about how it was their sister’s birthday and could I give them a shirt to give her, etc. 

After having this conversation numerous times I decided to change it up a bit and said I was from South Africa

“Oh Pretoria?”

No, Cape Town

“Oh Mr. Mandela, great man!”

Clearly education of world capitals and famous “good” leaders is working in Ethiopia (interestingly there was no mention of Bush or Zuma…..) 

All over Ethiopia, students graduated from University yesterday.  So on Thursday and Friday they dressed in their graduation gowns and walked around the town taking pictures.  As I passed a group of them I said "congratulations."  We had a short conversation about what each of them had studied and then they requested that I take pictures with them.  I agreed, figuring it was the least I could do after spending all this time taking pictures of their town and its inhabitants.  I thought we would take one group shot but then they each wanted a private one. After they took many with their cameras, I had them take one with mine.

There are also ping pong tables and foosball tables all over town, on the side of the road.  These guys asked me to play with them as I passed by.  Unfortunately I only got a pic of them playing.

Lastly, anyone who has ever seen me eat Oreos knows that I really only like the cream filling and often only eat that part, or at least scrap the filling off and save it for last.  This monkey was a pet of the cafe in one of the local parks, I had some "biscuits" with cream filling which I had bought as a snack and my guide suggested that we give the money a few.  The monkey gladly took them and proceeded to lick the cream filling off and leave the cookie part to the side!  

Where have I been? Where I am going?

Last Sunset over Camps Bay

I realize it has been WAY too long since I have updated this blog, so probably no one is reading it anymore ;)  The "why" is multi-factorial.  For one, there is facebook which makes it easy to just post a quick update and some photos and not feel like I have to write a whole story, but I realize not everyone is on FB.  Secondly, I have been having a rough couple of months from a work prospective and I like to keep the blog relatively positive so haven't felt like there is so much to write.  Lastly, I have decided to move back to the United States (for now ;) and planning that transition has been consuming a lot of time.

One of my last trainings at the "African Cave Lodge" in NW province South Africa, it is really cave like. 

We taught the nurses and lay counsellors to calculate the adherence of patients taking ARV medications

We also taught them a color coding system useful for patients who cannot read and write to make drawing up medications easier

After spending the last year doing mentoring and training of local nurses, doctors, and lay counsellors on pediatric HIV, I have realized how much I miss clinical work.  I do enjoy teaching and training, but I need more of a balance.  I miss having patients.  I also feel that while "capacity building" should be the gold standard of global health work, building true capacity is quite hard when many of the barriers are secondary to mismanagement of resources, lack of infrastructure, and shortage of health care workers.  It is also really hard to show that all this training and mentoring is making a difference.  Ask me about this next year and I may be able to give you a different perspective ;)  Regardless I have decided to return to St. Christopher's Hospital for Children in Philadelphia (where I did my residency) and work as a general pediatrician.  That patient population served by St. Chris is quite diverse and I am excited to serve those patients again and to be able to put my Spanish (which is now quite rusty) to good use.

Before going back to the US, I decided to take advantage of the fact that I was already in Africa.  For the next month, I will be traveling around and attempting to see more of this incredibly diverse continent.  I started in Ethiopia.  After a day in Addis Ababa, I traveled to Lalibela which is known for its rock hewn churches.  In the 12th and 13th century King Lalibela wanted to create a "new Jerusalem" in Ethiopia and apparently instructed workers on the construction of 11 churches.  The churches were carved from the rock with hammer and chisel - an incredible feat.  In the Ethiopian orthodox tradition, coming to Lalibela is just as holy as going to Jerusalem and during holy days thousands flock to the town to pray. All of the churches are incredibly crafted especially when you consider the tools that they would have had at their disposal.  Of course pictures are worth a thousand words so here are 50 or so of them....



Tomorrow I head to Axum for 2 days and then Saturday on to Gondar where I get to see Gelane for a few days (unfortunately my work permit ended and I had to leave South Africa during her already planned trip to the US) but we still get 5 days to see each other. Then I will fly to Tanzania where I hopefully get to see Tecla (my anatomy lab partner from first year of medical school!) and then Zanzibar for a weekend.  Finally I am joining a Nomad Adventure tour which will be an overland trip from Dar to Victoria Falls - 11 days of camping across Tanzania, Malawi, Zambia, and Zimbabwe.  Finally on 28 July I will fly back to the US and begin my transition back into life "that side."

A Tribute

At my medical school graduation

My grandmother passed away 2 weeks ago.  She had just turned 88.  She lived a long and mostly happy life, but had not really been physically able for the last few years and was very sick for the last few months, so it was her time.  A few months ago she had a major stroke which prevented her from saying more than "Hi" and causing her to become very frustrated that she could not express herself.  Despite knowing that it was for the best, losing someone you love is never easy.  Being 7,800 miles away did not make it any easier. She was incredibly proud of her 3 sons, and their partners, and her 4 grandchildren.   She loved to brag to her friends, and anyone else who would listen, about what her children and grandchildren were up to. She was an avid reader of this blog, when she was able and later liked to have it read to her by my father and look at the pictures.  So I thought it only fitting to have a small tribute to her here. 

Sonia Scherzer (Sunny as she was called by everyone, Grandma to me, and Grandma Beady as she was aptly named by Daniel (and later Sarah) - for her love of beaded necklaces) was a wonderful grandmother.

Trying on the cap and gown with her four grandchildren

Though she was clear that she would have preferred for everyone to live and work in Queens so she could see them everyday, she was also proud that her offspring were globetrotters (some of us more than others).  She herself loved to travel and lamented the fact that she was not able to visit me in Africa – one of the few continents she had never been. 

I can only speak for the last 31 years of her 88-year life, but I feel so lucky to have gotten to know her so well.  I think all would agree that Grandma was a very opinionated, strong willed person who could be very demanding at times, but she was also an incredibly honest, loving, and kindhearted person.  She could, and would, talk to anyone and everyone, and random strangers always felt comfortable telling her everything.   I remember several times when I met her in NY City after she had taken the bus in from Queens and she would tell me the life story of the person who had sat next to her on the bus ride in.  Inevitably they would have shared their problems with her and she would have provided suggestions to them.  She would go on elder hostel trips and easily make new friends.  On our trip to Israel together, when I was 13, I remember how easily she became good friends with the other grandparents.  Though she was at times sad that she was one of the few single grandparents on the trip, she never let that stop her.  For most of her life she had a very active social life of bridge games, dinners out, movie nights and scrabble.  Social work was definitely her calling, and though she was officially retired in my lifetime, she continued to provide “counseling” and advice to her friends and also to random strangers.  

She was an avid reader and loved to recommend books for me to read and get recommendations from me, we shared a love of Jodi Picoult books.  She was a big tennis fan as well and could watch the tennis channel for hours on end, though at the end of her life she was not always sure who was playing, it didn't matter to her.  I will always have fond memories of playing tennis with her in Florida and upstate NY.  Even though I was never particularly good at tennis, she never gave up on me and was happy to play and give pointers.  She had a supreme patience for board games and was happy playing hours upon hours of Monopoly or other such games with her grandchildren. 

We also shared a birthday month and it was often jointly celebrated during Thanksgiving.

She was also an avid knitter and needle pointer.  She, and my mother, taught me to knit and needle point when I was 8 and she passed her love of knitting to me for sure.  She always wanted to know what I was knitting and in the last few years was excited to share her comments over Skype.  She did not get to see my last few knitting projects, when I have branched out into toys....

Over the last 10 years she was so lucky to be expertly carried for by Maxine, and in the last 2 years Charlene and Dimples as well.  Though she was certainly not an easy patient, and not always the best at showing her gratitude, she did appreciate the loving care she received from them and I know she was very thankful that their care (and the devotion of her sons to her wishes) enabled her to stay in her home rather than having to be in the hospital – a place she hated more than any other!  The devotion of her sons to caring, visiting (even coordinating schedules to make sure that someone was there at least once a week – and usually more frequently), and making sure that her wishes were carried out was a true tribute to her and a great example for me and the rest of her grandchildren. 

At Aaron's college graduation

She will continue to live on in all of our memories and actions.  For me she will be ever present in my love for knitting, my inability to have dry eyes at special occasions (happy or sad), my strong-willed sprit, my love for travel, and my pride in and commitment to my family.  Grandma you will be missed, but most definitely not forgotten.  We all love you.

A Race!

I used to say I would never run.  I also said I would never wake up early to exercise!  Well all that changed last year.  After walking the 10 km race at the Soweto Marathon, I saw an announcement for the Gaborone Marathon at which there was also a 10 km race (but only a run).  Long story short, I was talked into training to run it.  I realized that anyone can run if you run slow enough (my run is definitely more of a jog ;) I also realized that in Botswana the only time when it was cool enough to run outdoors in the summer was just after the sun rose (before it had time to heat up the day).  So crazily I began to get up early to train.  Things were going well until a few weeks before the marathon when it was canceled!  Of course, this was after I had already paid my 50 pula (around $8) and I was told that there would be no refunds - just an entry into next year's race.  Anyway it was sad and I decided I would have to try again.  Upon moving to Cape Town, I began running again, this time at more normal hours (after work) as it is not as hot here!  I decided to RUN the 10 km race in the Soweto Marathon.  This year on November 6th I did just that!  I had one goal - to run the entire thing (not to walk any parts of the race).  Despite several large hills, I managed to achieve my goal and to run the 10 km in 1 hr and 10 min which I was happy with (you might remember that I walked it in 1 hr and 35 min, so I really don't run much faster than I walk, but still ;)  

My friends Jacquie and Shikata drove down from Botswana to meet up with me and run the race as well.  We made a nice weekend out of it.  We stayed in the same B+B in Soweto as we did last year.  We went to the Apartheid Museum and though I had been once almost 2 years ago, I still managed to learn a ton.  We also went to Nelson Mandela's house in Soweto.  Of course, he did not actually live there very long before being sent to Robbin Island but Winnie Mandela and his children lived there while he was in prison.  Unfortunately it was burned at one point so there is only one original table (it had been leant to someone else and they got it back afterwards).  The house has a random collection of various citations and awards that the Mandelas have received over the years.  Including "the key" to the city of Newark!  There is also the tree in the backyard under which all of the Mandela's children and grandchildren's umbilical cords have been buried.  Jacquie and Shikata dropped me off in Pretoria for a week of working that side, before heading back to Botswana.  So we stopped at the Union Buildings as well.  The Union Buildings were designed by Sir Herbert Baker in 1910 and were the site of many marches and protests over the years.  Today it houses the offices of the Presidency and Presidents (including Nelson Mandela, of course) are inaugurated at the Union Buildings.

This is Jacaranda season.  Pretoria is known for it's Jacarandas, in fact it is called Jacaranda City because there are so many lining all the streets that the whole city looks purple during this time of year. It is quite pretty. 

The race was followed by a week in the Northwest Province.  In addition, to our regular visits to the clinics, Carolin (one of the South to South nurses) and I conducted a two day training for nurses in the Province.  We were supposed to have 11 people, but due to staff shortages we ended up with only 6.  It was unbearably hot (40C/104F) and the room we were in had no fan or anything!  It was a challenge for the participants to stay awake, however we did manage to get them to do some group work on cases to stay awake.  It is really incredible the conditions under which nurses here work and a true testament to their commitment to their patients!

Here is a slideshow of the week's events:

Bo-Kaap

 Believe it or not, there is Groupon South Africa!  When I saw a coupon for a cooking tour on there, I knew it was meant to be.  Who doesn't want to learn how to make Cape Malay Curry, Chili Bites, Samosas, and Roti?  So on Saturday I headed to Bo-Kaap, a 15 min walk from my house. The neighborhood is full of colorful houses and home to much of the Cape Malay population in Cape Town.  The Cape Malay community are descendants of slaves brought over from Indonesia, Malaysia, other parts of Asia, and the Middle East by the Dutch East India Company in the 16th and 17th centuries. Cape Malay is actually not a correct term as many are not from Malaysia, but they were all clumped together by the Dutch.  Many practice Islam and the Bo-Kaap area has many mosques today (though they were originally not allowed to practice their own religion, they were able to maintain it). 

We (a group of 16 South Africans and me) were met by Zainie at the Bo-Kaap museum (which has a small exhibit on the history of the area).  She gave us a brief orientation to the area and some of the history and then took us to the famous Atlas spice shop which has supplied the community with the essential spices for years.  She pointed out some the essentials and then we walked to her house a few blocks away.  Walking down the street we were greeted by the aroma of delicious smelling curry and knew we were headed in the right direction (she had already spent the morning preparing chicken curry since the group was so big).

We started by making Rotis.  Basically flour, water and oil but then after they have "risen" a bit you roll them out in a special way, spread butter on them, roll them back up, freeze them so the butter sets, roll them out again and then fry them!  Quite a process, but it results in buttery goodness.  While the rotis were rising we start on the chicken curry, but she instructed me, and the other vegetarian, on how to make a butternut squash, carrot, lentil curry that was delicous!  Then we made our own samosas, quite fun to fold.  And chili bites as appetizers.  After 2.5 hours of cooking we sat down to a spectacular meal.  At the end we each got a recipie book and a starter package of spices to go home and try for ourselves!  Looking forward to attempting it one day soon ;)

Here is a slideshow of photos (have to go to the actual blog for the slideshow as always ;)
The first few pictures are of a movie set next to my house.  No photos were allowed when they were actually shooting, but they stopped filming on Friday. On Saturday morning as I made way to Bo-Kaap, I noticed that the set was still there.  So if you every see The Great Britian Story you might recognize something from these photos and will know that it was filmed next door to my apartment complex ;)

Hikes

20 years ago if you asked me to go on a hike, I complained, had to be bribed with M+Ms, and "hated" it! I am also NOT a morning person.  So many would be surprised to learn that I agreed to wake up at 6 am last Sunday for a hike! My how things change, as I now love hiking ;) But really, who could refuse a hike with views like this one?

When people think of Cape Town, they often think of Table Mountain, but Table Mountain is actually one mountain in a whole mountain range and there are tons of awesome hikes.  One of the participants, Allan, who attended the training that I conducted last week, asked me if I wanted to join him and a few of his friends for a hike.  I would have preferred to start a bit later in the day, but people here like to get up early.  We drove to Noordhoek, a suburb of Cape Town and ended up hiking for 4 hours.  It was a beautiful day and we were joined by two gorgeous and super well behaved dogs.  We went along the trail at Silvermine and ended up in Elephant's Eye cave (which is where the picture above was taken).  From there you can look out on the Southern Suburbs of Cape Town.  Interestingly it is a great view of Pollsmoor Prison (an infamous high security prison in South Africa) which is situated right next to an extremely posh golf course community!  How is that for interesting zoning?

Here is a slideshow of the day:


The previous Sunday I also went hiking.  This time up Table Mountain.  I have been up Table Mountain a few times, but always on the cable car.  It was probably not the best idea to try to hike it the day after fasting for Yom Kippur when it was 90+ degrees out, but I made it.  I went with Bev (who I met at a Rosh Hashanah dinner) and her friend Jon.  It was nice that I got to attend services this year for Rosh Hashanah and Yom Kippur, though it did make me miss B'nai Keshet and it's fabulous co-presidents even more ;) We went up the most direct route which is basically straight up and it is in the sun the whole way.  It was a rough hike and next time I will make sure to drink water and eat the day before ;) But it was worth the sense of accomplishment at the end!

Here are some photos from that day: