We have finally arrived home from
Gondar and our excursions in the Simien Mountains! It was a wonderful trip on
the whole but one ripe with misadventures and entertainment. A good week for
highs, lows, and challenges if you will.
We
started the trip sipping macchiatos in the Addis domestic airport waiting to go
through security to board our flight. As we were sleepily gazing around the
lobby, a fellow traveler called for a doctor. Since we had a third year medicine
resident, Sara, with us, we volunteered to check it out. The girls stayed
behind while Ira, Steven, Chris, and Sara went to check on the situation
developing in the men’s bathroom. Sure that someone had a syncopal episode or
was suffering from a habesha GI virus we weren’t too concerned. Once we saw
Steven’s face as he returned from the restroom, we knew it was more serious. We
followed him in and there lying on the floor, was a large German man, covered
in his own urine, ashen, unresponsive and pulseless. Immediately we started
helping with chest compressions. At this point, the men had already cracked his
sternum and broken most of his ribs in their efforts so we were spared the gut
twisting sound of a man’s ribs breaking in efforts to save his life. Sandy,
Ira, Chris, Steven, and I all took turns doing CPR as Sara lead and coached us
on our depth and speed. We continued to check femoral pulses and continued to
find no response. All the while, Ira continued to beg airport employees to call
some sort of emergency response team and Karen tried desperately to find and
contact anyone who knew the man lying on the floor. We are told again and again
that the emergency response was coming although no one really seemed to care
that a man was dying in the bathroom. Men continued to amble along in and out
of the restroom, using the facilities, and walking out after staring at us for
a bit. 25 minutes later, as we were all sweating and tiring from pumping this
man’s chest, a nurse shows up with a green bag containing medical equipment.
Let
me take a break for a moment and describe what this would look like in America.
A man collapses to the floor due to a massive heart attack in the bathroom.
Immediately someone notifies airport staff and an emergency response team is
called. Around the corner, someone grabs an AED (a defibrillator), begins CPR
and attempts to shock the man into a life sustaining rhythm. Within minutes, an
emergency response unit is there ready to continue resuscitation and transport
the man to the nearest hospital. While the prognosis is probably not great,
there is a chance that the man may survive. Now back to our story.
The
nurse who showed up ruffled through the kit she had dragged with her, took out
a blood pressure cuff and stethoscope and attempted to take the man’s blood
pressure. At this moment, the only reason this man was perfusing his brain and
the rest of his body wass due to our compressions. Thus his only measurable
blood pressure is a direct result of our efforts. However, she doesn’t
understand this as I tried to explain it to her and she continued to get in the
way of us doing compressions to check his pressure. Exasperated, I ripped the
blood pressure cuff out of her hands and threw it on the other side of the
room, so that Sandy could continue CPR. Searching through the bag, we finally
found some epinephrine that was in glass bottles that snap off at the top. I
tried to open the bottles in order to push the drug through the peripheral IV
access that Sara was working on, but the bottle was so old, it literally
disintegrated in my hand the second I tried to open it. The second bottle did
the same. The remaining items in the kit included some gauze and tape. At this
point we realized that there was nothing else we could do for this man. We felt
horrible walking away, but with no additional medical response, we were too
limited to do anything else. Almost 40 minutes into the ordeal, a man shows up
wearing an orange construction vest with a wheelchair. Hello “emergency
response.” We were assured that an ambulance was waiting for this man right
outside, but not a single one of us believed it. We helped lift this poor man’s
body into the wheelchair and they rolled him through the airport with absolute
no sense of shame or urgency and out the door he went. No one in the terminal
lobby even gave them a second look.
It
was 7:00am and 1 hour into our trip.
Even
though I am beginning my fourth year of medical school, I have never seen a
code. I have never done CPR on an actually person, and I have only seen someone
actively die once or twice, but here I was on the floor of an Ethiopian
bathroom, covered in a man’s urine, desperately trying to do anything,
immensely limited by my lack of experience and our lack of medical support. I
still see his face sometimes—his ashen skin, blue glazed eyes, mouth bloodied.
His lungs had continued to breathe for him despite his lack of cardiac
activity. I think the thing that made it that much harder, was the amazing
indifference demonstrated by everyone else in the airport. A man lost his life,
alone, in the least dignified way possible, and no one cared. Only one women,
whose job it was to perform a traditional coffee ceremony, wet her eyes with
tears. It was something I will never forget.
Remarkably,
we made our flight to Gondar and our trip was ripe with talk of what we all had
just experienced. As we landed, we were picked up by our guides who would drive
us to Debark to start our trek through the mountains. The drive was over two
hours and as we neared our destination, it began to rain. Not mild feathered
rain, mind you, but all consuming rain. However, due to the massive changes in
altitude we would be experiencing, our guide, Tesfy, decided we needed to hike
into camp to acclimate. Luckily the hike in was only two hours, but it was
spent sliding in mud, huddled in rain jackets, and eyes glued to the ground as
we carefully navigated every step. Our view was obscured with a misty fog so
heavy that we could barely see those in front of us. As we finally pulled into
camp, soaked from head to toe, we were relieved to see that our camp was
already set up and waiting for us was warm, salty popcorn and thermoses of tea
and coffee set up on a long table covered in a gold table cloth. A fire was
built and we busied ourselves drying our clothes as the rain continued to pour
down outside. Our spirits slowly lifted as we regained feeling in our fingers
and toes and as we filled ourselves with warm tea. The rest of our guides were
busily chopping to the side of the hut and soon the tent was filled with the
smell of onion, garlic, and spices. Little did we know that our chef, Alem, was
famous for his culinary masterpieces. He soon approached us, dressed in a
traditional chef’s uniform (hat included) and announced to us that dinner was
ready. As with each remaining night of our trip, we were treated to a four
course meal including freshly made soup, pasta, chicken, four to five different
vegetable dishes, and dessert of cookies and pineapple. He eagerly watched us
scarf down our food and like our mothers back at home, made sure we cleared
each plate. Now this is camping.
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| Our campsite. To the right is the hut where we would have our meals and stay dry by the fire |
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| Our living quarters |
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| Karen and I enjoying the spectacular views |
The next day we were lucky enough that the sun was shining and we headed out on our first big six-hour trek. We passed through hoards of Gelada baboons, who are completely docile and have no fear of humans, caught views of incredible waterfalls and giant cliffs emptying into lush green valleys, and forged rivers cold as ice. It was a perfect hiking day, except for the fact that I was suffering from the habesha GI virus. That day definitely squelched any shame I had remaining in me. Talk about being one with nature. I was lucky enough that my body felt well enough to keep on trekking, but it was definitely suboptimal. This day we were led by our scout, as our guide Tesfy, was escorting Sara (who unfortunately was not feeling well) back to Gondar. According to park regulations, every group traveling through must have a scout escort them at all times and he must be armed with a gun. Our particular scout carried an AK-74 and was fond of singing to himself, making sheep noises, and habesha dancing early in the morning to the radio. He loved my repeated enthusiastic replies of “gobez” which I had been told meant “good” but actually means “clever.” Again, people here are fairly amused by my idiocy. Our scout had a warm place in all of our hearts. He watched over us protectively and guarded us each night from jackals that apparently like to steal shoes. It is still unclear as to whether they were referring to animals or people when they discussed the jackals surrounding us. Our scout even lovingly covered Sandy’s vomit with dirt when she too came down with the habesha GI virus. Needless to say, he received a very large tip at the end.
Again
that night we were treated to coffee and tea, a four-course dinner, warm fires,
and much to our delight, ice cold St. George beer and Coca Cola. We played
Yahtzee to our hearts content and retired for bed at a normal 7:30pm. When it
gets dark and it begins to really freeze, there is no better place than
cocooned in two sleeping bags in your tent with 5 layers of smokey clothing
clinging to your body. Sleeping in the clothes you wear on a daily basis is
incredibly convenient I’ve noticed, especially when hygiene only really
consists of wiping your face with a moist toilette and brushing your teeth. I’m
telling you, I made roughing it look good.
Unfortunately,
our luck of weather died with that night and we spent the remainder of our hike
draped in foggy mist. While it wasn’t raining thankfully, it remained cold, and
most of our views were obstructed by the fog. On the third day of our trek, we hiked
7 hours to the peak of Mama Mia (much Abba was sung on that mountain). The peak
stands at 4100m and we were breathing quite heavily as we summited. Although
our spectacular view (Tesfy was quite fond of this phrase, almost as much as he
liked to sit us down to discuss our program for the next few hours) was
blanketed in white, being up on top of that mountain felt incredible. It was
the highest I have ever been and felt really proud and happy that I had made
it. The wind began to blow in earnest on the peak and soon, we began to eagerly
bound back down the mountain towards camp. As we approached our last night in
the Simiens we anxiously awaited our sure to be amazing meal from Alem, our
scout’s loving watch, and Tesfy’s reiteration of our program that lay ahead.
That afternoon at camp, we even caught a glimpse of the elusive Ethiopian
ibex—a huge beast with horns that were literally 2/3 of its body length.
Although we spent the majority of the time cold and muddy, a good portion of
the time completely wet, and all of the time short of breath from climbing and
singing, trekking through those mountains was a trip we will all remember for a
lifetime.
The
next morning we spent some time hiking around hoping the clouds would clear for
some more views, but unfortunately, the mist persisted. So we loaded up our
trucks and headed back to Debark and Gondar. Well some of us did. As I’m sure
most of you can imagine, underdeveloped roads during rainy season tend to get a
little muddy. The truck carrying Karen, Steven, and Emily plowed ahead and up
the mountain, while our truck had some difficulties. We slide up and down on
the muddy road, literally five feet from a cliff, trying to make our way up. I
was desperately clutching Ira’s sunburned arm much to his chagrin, exclaiming
that I had much more to give in this life fighting back a tear or two, while
Tesfy laughed at my absurdity. Apparently, fearing that the tin vehicle you are
in which the driver has no control over while in spitting distance of a cliff
leading to sure destruction is very funny to Ethiopians. Finally we were
ordered out of the car and all of us began to mentally prepare, as we stood in
the pouring rain, for the guaranteed 4 day hike back to Debark, when out of
nowhere, at least 30 Ethiopian men began to mobilize into action. A short, 4-foot
rope was tied to the bumper of the car and a man chain was formed. Some men
grabbed the rope but the majority of them were clinging on to each other as
they began to literally pull the car up the mountain. It was one of the most
ridiculous things I have ever seen.
Their strength and dedication paid off and soon enough our truck was out
of the mud and up the mountain. We paid them generously for their efforts and
off we went.
I
wish for time’s sake that I could say that our adventures stopped there, but
much more ridiculousness was ahead for us. The four star service of our guide
and his crew was again evident when we found out that our hotel in Gondar had
been booked and paid for already so we were soon on our way to warm showers and
clean beds. Our hotel was beautiful and when we arrived they prepared a
traditional coffee ceremony for us. We wandered around the city of Gondar and
then headed to dinner at The Four Sisters Restaurant. The restaurant was stunning,
covered in traditional Ethiopian paintings, and we knew we were in for a
delicious night. We ordered shiro, tibs, and the fasting plate and went to
town. Unfortunately, as we were getting to leave, it began to rain (I can
imagine you are getting the idea of rainy season in Ethiopia now), so we
decided to wait out the storm before heading back to the hotel. At this time,
Steven was already up making friends, and playing one of the traditional
musical instruments. All of the sudden, the sisters started singing, and we
were up in a dance circle as they tried to teach us how to habesha dance. We
had a soul train line and we chanted and danced in circles as everyone else in
the restaurant clapped and laughed at us. As the music and rain died down, we
sadly said our goodbyes and headed home. There at the hotel, we resumed our
dance party as we shimmied our shoulders, jutted out our chins, and flipped our
hair to Teddy Afro much to the delight of the hotel staff. It was a great way to
end our final night in Gondar.
The
next morning we got up early so we could visit the castles of Gondar before our
afternoon flight. Gondar is part of the northern historical circuit as well and
is known for castles that stand in the center of the city. We were delighted
when a certified tour guide was there ready to take us through the history of
the city and the kings that had ruled there. We had no idea what was to come
ahead. I’m sure most of you have seen Ferris Bueller’s Day Off at some point in
your lives. Most of you actually probably watched it due to my repeated insistence.
Remember when Ben Stein gives that riveting lecture on voodoo economics? Got
it? Now imagine sitting in that lecture for one and a half hours. Welcome to
our tour of Gondar. I’m not quite sure how, since I was zoned out pretty much
the entire time, but we somehow covered all of Ethiopian history, talked about
psoriasis, the Empire State Building, the Sistine Chapel, and had a quiz in the
history of water filtration. Of course, being the good medical students that
they are, Sandy, Ira and Chris absorbed and enjoyed most of it, but the rest of
us were slowly dying and losing our minds. Luckily, we were able to cut the
tour short so we could catch our plane back home to Addis.
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| Castles of Gondar. Most of them were destroyed during the various militant activity that has taken place over the years |
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| Fasilides Castle built by Emperor Fasilides |
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| One of the castles in Gondar |
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| Sandy and Ira in the lover's window. |
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| Ira, Sandy, and Chris learning during the tour |
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