Pampering and Progress

It has been a busy week for the Real World Addis house members! This week all of our Emory faculty mentors decided to pay us a visit and see how we were getting along in our research. Additionally, the dean of the medical school, Dean Lawley, came along as part of Emory’s efforts to secure a global health partnership with Addis Ababa Unversity and the other surrounding hospitals and healthcare systems throughout the city. We are one of four universities (Emory University, University of Wisconsin, Johns Hopkins, and University of California, San Diego) included on a MEPI (Medical Education Partnership Initiative) grant awarded to Addis Ababa University and as such, serve as partners in global health projects and research both here and in the US. The crew included Dean Lawley and his wife Chris, Dr. Henry Blumberg (infectious disease attending), Dr. Russell Kempker (infectious disease attending), Dr. Carlos Del Rio (bigwig at the Rollins School of Public Health) and his wife Janette (a pathologist), Dr. Glass (a neurology attending and specialist in ALS) and his wife Dr. Gross (a psychology PhD and teacher on grant writing), and Dr. Goedken (my mentor and an OB/GYN attending).

On Tuesday in honor of our independence day, we hosted all of the mentors at our house for an American BBQ. We had to be creative but we managed to grill actual burgers, make coleslaw, heat up baked beans, slice watermelon, and I even pulled off vegetarian lasagna cooked in a wok! Overall the dinner was a success, though not without a few awkward pictures courtesy of Dr. Del Rio, and we ended the night lighting sparklers and bottle rockets. As house DJ, I ensured Bruce Springstein and John Mellencamp was playing on repeat.

The next day, Dr. Goedken and I went full speed ahead on our project. Unfortunately her flight had been delayed and she missed all of her connections (sounds familiar, huh?) so we were short on time with a long to do list. We met with Dr. Hezkiel Petros, the OB/GYN at Black Lion who is our main contact now that my main Ethiopian principal investigator, Dr. Dawit, is out of the country, and discussed lots of issues and potential challenges we saw. Through our discussions, we have designated a clinic space, have started advertising for staff within the pool of OB/GYN nurses at Black Lion, have run literally all over Addis buying examination lights, CO2 cylinders, and other medical supplies, and are brainstorming advertising for patient recruitment. Overall, I am exhausted but very happy that everything is working out! During this week I have also met the Dean of Addis Ababa University Medical School, Dr. Mahlet, and the Provost of Medical Education at St. Paul’s, Dr. Lea. The latter meeting was actually quite interesting because I somehow got dragged into what was supposed to be a meeting with Dean Lawley, and I was instructed by Dr. Del Rio to describe our medical school curriculum and share my thoughts on it. I was definitely not prepared in the slightest to discuss it in front of several bigwig people from Emory, but I think it went ok!

Last evening, Dean Lawley took all of the Emory faculty and Emory medical students currently here in Addis out to dinner at Shaheen, the Indian restaurant at the Sheraton. The Sheraton is a monstrous presence in Addis and takes up a large portion of the city. It is quite decadent, draped in marble, and dotted with crystal chandeliers. Even though it’s in Ethiopia, the rooms still run $400/night so only the very wealthy manage to stay there. Needless to say, nothing in my wardrobe was adequate for such an event! The Dean insisted we sit next to him and throughout the dinner (which was mouth wateringly delightful) he asked us a multitude of questions about our backgrounds, our projects, and where we wanted to go in the future. He particularly enjoyed my camel story. How can you not want to hear about a rabid, gurgling camel named Bruce? Even though the dinner was easily the culinary (and schmoozey) highlight of the trip, I was literally falling asleep at the table. I hadn’t been home since 8am and had been barreling through the city in a tin can with diesel fumes coating my lungs. By 11pm, my bed was sounding pretty amazing.

Tonight Dr. Goedken leaves and won’t return until our training, which will officially take place August 6^th-August 10^th. So it will be up to me to ensure that all of the materials we ordered are ready and delivered, and to re-work the JHPIEGO curriculum to fit our crash course training. Although it is a lot of organizational work, I am feeling very confident that this is going to be successful. Sustainability is another issue, but I continue to insist that nurses need to be trained and serve as the backbone of the clinic. The nurses I have met here are so passionate about this issue and I am sure that with their support, this clinic will really fly.

Throughout this week I have also encountered a lot of global health politics, which I find particularly interesting. One of the main organizations that has worked on bringing VIA/Cryo to Ethiopia is Pathfinder International. Pathfinder is a women’s health organization that focuses on a multitude of issues but since it is partially funded by PEPFAR, only caters to HIV+ women here in Ethiopia. This is the same group that trained and helped start the VIA/Cryo clinic at St. Paul’s that I shadowed my first week here. JHPIEGO (an affiliate of Johns Hopkins) is another international health organization that worked with Pathfinder to create materials for a universal training course that would allow for the method to be implemented anywhere. For some reason or another, JHPIEGO and Pathfinder have had a falling out, but we are continuing to use JHPIEGO materials for our project. We had been hoping to actually pay Pathfinder to run a training session for Addis Ababa University (AAU) physicians to start a non-HIV+ clinic, but one of the physicians we are working with (Dr. Hezkiel) irritated Dr. Shumet (the head of Pathfinder here) and they now will not work with us. Great. We also had been hoping to work further with St. Paul’s to utilize their facilities and nurses, but there is tension there as well because St. Paul’s is starting a residency program, which further depletes the academic resources for AAU students working there. Luckily, we have navigated the issue well and both programs seem to be ok with us working with them simultaneously, but there has been lots of bribing with examination lamps, gloves, and CO2 gas cylinders to make that possible. To further complicate matters, we were hoping to recruit patients from the Family Guidance Association (FGA) for the physicians to practice on during the training. The FGA actually performs pap smears for women here in Addis, but since the results take over a month to get back, the program has been less than successful. We just found out that Pathfinder is actually running a VIA/Cryo training session for them this week, so we doubt they will be willing to send patients from their clinic to us now that they can utilize the method. Oh well. We are still hopeful that with the help of both Black Lion and St. Paul clinics we can recruit enough women to make this project a success!

Now I am currently waiting around for Keyline Advertising to deliver a prototype of the manuals we are printing and then I am off to the US Embassy with my roommates for a happy hour/Farenji meet and greet. It should be fun to meet other potential non-Ethiopians here in Addis! Our public health friend, Katie, has left us sadly, as has Eddie, a recent graduate from the infectious disease fellowship program at Emory, so the house is feeling a little empty. But, in a week or so, Ira (Sandy’s fiancé), Steven (Karen’s boyfriend), and Emily (Karen’s sister) are joining us for our trip to Gonder and a big hiking and camping trip through the Simian Mountains. I hear there are baboons there and I can’t wait.