Thanksgiving and the Great Ethiopian Run

Thanksgiving in Ethiopia

This year marked the first time I've celebrated a major holiday away from my friends and family. Sure, I've missed the 4th of July (2 times), Flag Day, and Veteran's Day, but none of these hold the significance of Thanksgiving, my favorite holiday. I like it so much for the following reasons: (1) no presents are exchanged, (2) there is no religious significance, (3) you can eat every kind of pie and cake available and have a solid, undeniable reason to do so. But this year, I was preparing myself not for the traditional Thanksgiving feast, but for a regular Ethiopian meal. Boy, was I wrong.

CHAI has about 30 employees working in Ethiopia, and these 30 employees have quite a few friends and family. All these people were invited to the CHAI house (where I first lived when I arrived, and where I now spend all day working) for a good old American meal. At our peak, we had about 50 or so people here, which felt very comforting, as our usual Thanksgiving is a pretty large family and friends affair.

The organizers purchased 3 turkeys for a very high price, and I was losing faith in our traditional meal when I found them to be kind of larger than normal chickens. However, they were turkeylicious, trytophane filled birds, and when paired with mashed potatoes, stuffing, and all the other fixings, the meal was quite satisfying. Even more satisfying was the rare taste of my favorite autumnal treat: pumpkin pie.

Here's a photo of me and Tim, who is the director for the Health Management Initiative in Ethiopia. I am literally saying cheese at the moment this photo was taken. Unfortunately, we don't have any photos that accurately capture the festive nature of the night.

The Great Ethiopian Run

What I failed to mention about Thanksgiving was that the day started with what would be my one and only piece of training for the 10k Great Ethiopian Run that took place on Sunday - a half walk, half jog for 20 minutes. I figured that this would be sufficient training for the largest road race in all of Africa (over 25,000 participants), especially in a city that's 9,000 feet above sea level and home to many of the greatest runners of all time.

Five of us (Kate, Adam, Peter, Rich, and Fekadu) got to the race feeling good - we were almost certain one of us would win, or, at the very least, place in the top 3 of our age groups. Among us, 3 of us ran about twice a month, and 2 ran about once a week. Needless to say, we were extremely well prepared. Here's a photo of us, pre-race, and a photo of the crowd. Or at least the part of the crowd that we could see; there were green shirts as far as you could see in every direction.

Despite my lack of training, I ran the entire 10k (except in the spots where the crowd was so thick that running was virtually impossible) and finished the race in just over 1 hour. I also ran the whole time not with my coworkers, but with a group of Ethiopian kids who decided to befriend me. It was a great day, and a great Ethiopian experience.

#2 backpost: Mtwara, Tanzania

The night spent back in Addis was uneventful yet profitable. We played 2 games of poker and I won both, giving me nearly US$80 to spend in Tanzania.

Here's a map of Tanzania. You can see Dar in the center of the country all the way to the east, and then Mtwara all the way in the southeastern corner. If you make the map a little bigger, you can also see Masasi, where I spent 1 night.

So early on the morning of October 27th, we took off for Dar es Salaam. We spent a day in Dar where we ran some errands and met a few people from the CHAI Tanzania office who we quickly became friends with. We spent that night and the next with our new friends, and then on the morning of the 29th we all took off (along with about 15 other CHAI employees or CHAI partners) to Mtwara, Tanzania. As I think I've written before, Mtwara is a small city in southern Tanzania, about 20km from the Mozambique border. It was developed in the 1940s (ish) by the British to be a great center of the groundnut (peanut) industry. The British built up the town and its infrastructure before finding out that groundnuts don't grow particularly well in the Mtwara soil, so the city is kind of large, but with not much going on. It's right on the Indian Ocean though, and the views are beautiful.




The purpose of our trip to Mtwara was twofold: first, to conduct assessments of the ART clinics throughout the region, and then to use those assessments to help the sites with their annual planning and budgeting. We set out for our sites in teams of about 5 people, but somehow I ended up in a car all alone with this kind of important guy in the Tanzanian HIV world. This turned out to be lucky, because we spent the whole ride to our district (Masasi) talking about how CSHOR could work throughout Tanzania. We also gave a presentation on our work during the planning and budgeting portion of the week, and it was well received.



The outcome of this whole thing was that there's a chance that once we complete our work with all of the clinics we're engaged with in Ethiopia, we might move our base of operations to Tanzania and see if we can work there.



On our 1 day off of work, a few of us went to this tiny town about 11km from Mtwara, where there was a beautiful hotel that was formerly a fort. Adam and I decided to check out the town, and he thought it would be fun to take one of the fishing boats (a dugout canoe) out for a spin. While we tried to negotiate a price, pretty much everyone in the town gathered around to watch. Eventually, this guy agreed to have us pay about $2 to take his boat out. I don't know if you've ever been in a dugout canoe, but they are not sturdy. While the whole town watched, I got in the boat. Then when Adam started to get in, the boat flipped over, much to the delight of the local kids. This happened twice before we finally got in a boat and took off. Unfortunately, the fun wore off after about 10 minutes, and we returned the boat. It was $2 well spent, and my first time swimming in the Indian Ocean.

Since then, we've been back in Addis working in 2 clinics here. We're planning on going a few hours south the week of the 27th to a town called Hosanna, and then there's a chance we might go to China in early December, but that's very TBD.

#1 backpost: Nekemte

I realized that I haven't really been keeping up with this, and my 3 loyal readers must be really upset. I'm going to catch us up to speed on the past couple of weeks, which were marked by week #1 in Nekemte, Ethiopia, and week #2 back in Mtwara, Tanzania.

We went to Nekemte to work in their hospital's HIV clinic, where CHAI already has 2 hopital management fellows and 2 clinical mentors. There are so many people there because the hospital is a total mess, far worse than any other clinic I've been in so far. Nekemte is about 300 km west of Addis, which equalled an 8 hour drive through lush valleys and farmland. I even took a photo! The yellow is meskal, which is a popular flower in Ethiopia, used for decoration and celebration.

So we did an analysis of the hospital's clinic and made some recommendations to them for how they could continue to enroll patients in the clinic without adding more staff. We're pretty much becoming full throttle consultants, which is okay, but I think in the next phase of our work we're going to take our findings from clinics around Ethiopia and work with the Ministry of Health to make broader changes throughout the country.

A non-work related highlight of the trip to Nekemte was talking with a lot of kids in town. Although it's the biggest city in western Ethiopia, Nekemte is pretty small. It has 2 main roads that intersect, and everything is pretty much within a 5 minute walk. The first night we were in town, we noticed a sign saying that there was bingo in the center of town at a park every night, so of course the next night, we were there right at 6pm to start playing. Unfortunately, the announcer announced the numbers at lightning speed and in Amharic, so we couldn't follow too well. Fortunately, there was a big group of teenage kids who was more than willing to help us play. We didn't win, but we found out that in Ethiopia people think that bingo is an acronym which stands for Best International Numbers Game Organization.

Later that night, we were walking home from dinner when 2 kids came up to us and engaged us in the standard Ethiopia kid/white foreigner chat, which went like this:

kid: Hello! How are you?

me: I'm fine, how are you?

kid: I am fine, what is your name?
me: My name is Kate, what's your name?

kid: My name is China.

me: No it's not, what's your real name?

kid: My name is China!

kid's friend: His name IS China.

me: Why is his name China?

kid's friend: Look at his face!

[I looked. He looked like a regular looking Ethiopian kid.]

Eventually, China told us he wanted some food, and we found him endearing, so we said we would buy him something from one of the sellers on the street. We found one, and China picked up a package of cookies, then put it down and told us that he actually wanted a real meal, not just cookies. Well, you can't deny that it's a better investment, so we bought him tibs, which is basically little chunks of meat eaten with injera, and we went on our way.

The next night, we ran into China again, and Adam decided that we should buy him some pants and shoes, since he was shoeless and wearing some big sweatpants cut at the knees and tied with a rope. We ended up buying him a whole outfit of pants, a t shirt, and a jacket, then some rubber shoes. We left Nekemte feeling like we helped one kid on a very micro level and started the process of improving the hospital's system of providing ART on a more macro level.

After returning to Addis for about 10 hours, we were off again for Tanzania.

It's official: we have the cutest dog of all time

Like any proud parent, I will inundate this blog with photos of the puppy. Did I mention that our colleague Peter was so jealous of our puppy that he got one too? By the way, we gave her a name: Buna. And Peter's puppy is called Shai. What do these names mean? "Coffee" and "Tea." Still not sure if that's super cheesy or just on the line between cute and cheesy. Peter also has 2 dogs already, so here's a photo of Buna and Bobbee (he's one of the full grown dogs) and Buna and Shai. Try and tell me these puppies aren't adorable. The one downside is that I definitely have fleas.

A new addition: contest included

This past Sunday, Adam went to a volleyball game at the US Embassy. On his way home, he and some others spotted a small animal in the road. It was moving a little bit, but then just lay in the road and went to sleep. It turns out this animal was a tiny puppy, and since we'd been talking about the possibility of getting a puppy here, this seemed like the perfect opportunity. So now we have a puppy! She remains nameless, and I'm looking to others to come up with names - the best entry will win the happiness of knowing that s/he named a puppy. Some important things that might help you in the naming contest:

1. She was found on Bole (pronounced Bo-lay) Road, Addis Ababa, Ethiopia

2. She has really bad lice

3. She likes to bite fingers

Here's a photo of her adorably chewing on a bone and one of me with her, so that no one accuses me of stealing photos from the internet...

New house

Visit our website: http://www.cshor.org

The past couple weeks have been pretty dull, but we did move into a new house, so here are some photos - The outside of the house, the living room/dining room, and my bedroom:

Safari photos

Finally, some photos to prove that I went on safari!

SAFARI

Safari, in a word: Unbelievable.

Safari, in a lot of words:

My main goal for safari was to end my previous reputation as human wildlife repellent, which I achieved during a trip in Maine a few years ago. In the Maine wilderness, all I wanted to see was one moose. "Oh, we've never NOT seen a moose," Kersten and her dad said. "You'll probably see a ton." After spending hours and hours driving around searching for the elusive moose, we quit and returned to Boston. I was disappointed, but I figured the moose population was somehow massively dwindling or something. Unfortunately for me, every time they've gone since, they seem to see thousands, if not millions, of moose. So I was nervous that on safari, I would have a similar impact on the animals.

We arrived back in Dar from Mtwara on Friday, September 8th. Luckily, we arranged to borrow the car that Meg owned when she lived in Dar from its current owner, and early Saturday morning we set off towards Mikumi National Park, about 4 hours west of Dar. We got to our camp and headed out immediately for a game drive. It's amazing to me how quickly we went from amazement to boredom - whereas at first we were going nuts for every single animal we saw, after about an hour we found ourselves saying "Another zebra??" or "Oh, it's just a group of 30 impala again." That first day, we saw many, many animals including (in order of coolness) impala, zebra, giraffes, and elephants.

It seems like a lot of people really want to see lions when they go on safari. I really wanted to see elephants, and I saw a ton of them. There is really no creature more amazing looking than an elephant...they look so prehistoric and out of place, and I couldn't get enough of them. On the morning of our second day, we were driving around for a few hours, not seeing much, when we decided to pull over to a dam to look for animals. Being the start of the dry season, the best place to spot animals was at watering holes. As we pulled in, it looked like there was nothing there. When we got closer, we noticed some movement, which turned out to be a lion! How lucky we were to see one lion, when the camp manager told us that no one had seen one for a few days. Slowly, we noticed that there were more lions. And more. Each lion stood up from the grass and walked up onto a dirt mound, and by the end we were looking at a pride of 10. A few minutes later, a group of about 15 elephants came to the same watering hole, with a few baby elephants in tow. This was like hitting the jackpot; we were so lucky that I expected a flock of pegasus or unicorns to show up next.

The rest of the weekend continued to be amazing, with more incredible animals and beautiful scenery. The African savannah is a spot that everyone should get to at some point, if possible, because it is beautiful beyond words.

I just discovered that I'm having trouble adding photos to this post. This post will be much more interesting with photos, so I'll work on a solution. Stay tuned!

Tandahimba

The funny thing about this trip so far is the amount of time I’ve spent in each place relative to the total amount of time I’ve been out of the US. So far, I’ve spent 4 days in Addis Ababa, 5 days in Dar es Salaam, 3 days in Mtwara, and 1 day in Tandahimba. I’ll be in Mtwara for another 4 days, then I’m going back to Dar es Salaam for a couple days, then back to Addis. So despite the fact that I’ve been in Africa for close to 2 weeks now, I don’t really feel like I’ve gotten a good enough feel for any of the places I’ve been to comment on them with great detail or insight.

However, that doesn’t mean I won’t try, even if the final product is lacking in detail and insight. Heck, I can’t even supply those things about places I’ve lived for years! Since I’m going to spend a lot more time in Addis, I think I’ll leave the description of that city for a time when I’m more learned in the details of it. As of now, I’ve only once ventured more than 1 block from our house; my experiences have included purchasing coffee and food, and not much more.

I wrote this large paragraph which basically said the following: Latin America and Africa are, for all intents and purposes, the same. After today, I think I need to take back that statement. It actually would have been fairly simple to have never admitted I said it, but I think the similarities and dissimilarities are enough to warrant commentary. Yesterday, I thought that the people, landscape, economy, etc, were all very similar. And then I spent a day in Tandahimba.

We were told that Tandahimba means, in some kind of translation of a translation, “Demon Lion.” This is partly due to the fact that apparently there are lions in the area, and partly due to some other facts which I was unable to ascertain. Upon hearing this, I knew that Latin America and Africa are not the same. While it is somewhat common in Africa (relatively speaking) to be eaten by a lion, this is largely impossible in Latin America. I also experienced something that I’ve never even come close to experiencing in Latin America, which is this: little kids have only seen a couple of white people in their entire lives. In fact, we spent much of last evening’s dinner and this morning’s breakfast making and breaking eye contact with small Tandahimban children who would look us in the eye, scream and run away, and then repeat the process. It didn’t make me feel bad, but it did make me feel a little bit weird.

Now it’s 8:05pm and I’m working back at the CHAI Mtwara house – when you live with your coworkers, it’s kind of hard to draw a visible line between work and non-work time. We generally end up working kind of inefficiently from 9 to 9, which is kind of funny given that our group’s job is to help other people run their operations more efficiently.

ANYWAY, I’m still enjoying Africa very much – it’s been nearly 2 weeks and was most definitely expecting to have experienced some serious traveler’s health problems by now, so the lack thereof makes me feel as though I’m doing as well as I could have hoped. I’ve met some of the most genuinely nice people of all time and seen some of the most amazing things I’ve ever seen. All in all, the past 2 weeks has been the experience of a lifetime, and I’m thrilled that I get to have another 3.5 months of it.

Tanzania is pretty amazing

Hello! I knew that when I started this blog, I would be faced with initial disinterest. My friend Judy told me about 1.5 years ago that blogging was passe. If it was passe 1.5 years ago, is it super passe now, or is it retro? Food for thought. Anyway, I'm glad to hear that people are keeping up - I'll try to make things more interesting in the future!

Anyway, right now I'm in Dar es Salaam, Tanzania. We arrived on Monday and did 2 half-day trainings yesterday and today. The group we were training is called the Mkapa fellows, and they are Tanzanian clinicians who receive additional training and salary as incentive to spend 3 years in a rural district providing HIV care. It's an interesting mix of people who seem genuinely committed to caring for people who have harder access to care and those who are doing it for the financial incentives. Either way, I think the benefit of their participation will outweigh any possible concerns about their decision to participate.

We've finalized our safari plans: we're going to a place called Mikumi for the weekend of September 8th. There will be a link on this blog to more information about the park, but I have been guaranteed that it will be the best experience of my life. So stay tuned!

Tanzania: The next destination

Okay, so we arrived safely in Addis Ababa. It is a fascinating city - as one book said, it's where the ancient world meets modern Africa. Having never been to any other part of Africa, I can't really comment on its difference, but so far, I love it. We're staying in a house owned by CHAI that is luxurious and ridiculously large. We'll be here for just a few days before we head to Tanzania for about 2 weeks to give a talk to some Tanzanian doctors and then head to the southern part of the country (Mtwara) for about a week to do some resource planning with a rural clinic. After that, we're taking the weekend to go on safari! I anticipate that this will be absolutely incredible, so expect some glorious photos in a couple of weeks.

For now, I'm still aware that African geography is tough, so here's the same map as before, but with Tanzania circled. Be sure to check out the clickable interactive map of Africa in the links on the right to learn more about these countries and all the other wonders of the continent.

The great eyepatch bet of '06

As many of you know, I was recently involved in a bet. For those of you who don't, I'll give you a quick rundown of the terms. I work with 3 other people, 2 of whom are with me in Ethiopia (Meg and Adam) and 1 of whom (Elizabeth) is not, largely due to the fact that she was due to give birth this week. Being the unique group we are, Meg, Adam and I placed a bet on the sex of Elizabeth's impending child.

The bets:
Meg: baby will be a girl
Adam and Kate: baby will be a boy

The stakes:
Loser(s) has/have to wear an eyepatch on the flight to Ethiopia.

For some reason, I felt quite confident that this baby would be a boy. Many of you might know that I rarely place bets that I'm not 98% certain I'll win. This was a clear exception, because it's obvious that there's no way I could have any certainty in this bet. Nonetheless, the hands were shaken and the bet was on.

This past Saturday night, I had a get together with a number of my friends and coworkers to celebrate my impending departure. Around 9pm, we received a text message. The sender was Elizabeth, and the message said the following: 2 I patches. Girl.

As I try to be true to my word (with the one exception of when I bet Kersten that she couldn't make a basketball shot and she did and then I didn't pay up - Kersten, I'll make it up to you some day, I promise), I slapped the patch on immediately when we got seated at the gate at Logan.

In case you're wondering, the matching outfits weren't part of the bet, it just so happens that all 3 of us wore the exact same outfit for our flight. Jeans + black t shirt: the CSHOR uniform.

Prizes may be awarded to the person who can come up with the best plausible explanation for why 2 people travelling together might both be wearing eye patches on opposite eyes.

What I'm doing

I recently found out something interesting: no one knows what I'm doing in Africa. So I'm going to try to explain it in a few sentences.

We (the Consortium for Strategic HIV Operations Research, or CSHOR) are using a mathematical modelling tool to do resource planning with governments. I know what you're thinking: Huh? We work with HIV treatment programs to help them plan their resource needs, and by resources, I mean human resources, HIV drugs, and lab tests. We'll be travelling all over the region doing this, so Ethiopia is just home base.

Hope that makes sense!

Where I'm going

Let's face it. Geography is hard. So here's a map of Africa, with Ethiopia conveniently circled. Addis Ababa, the capital, and where I'll be living, is in the dead center of the country.