1130a
The details at this point are unclear, but the Decha Woreda Health Desk sends information to CHC regarding a “disease outbreak” in Dishi. No other information is available at this time.
1200p
David, the CHC project director, communicates this to Jessie, the clinic manager, and Edwin, the medical director. He asks the two doctors, who can go, and when is the soonest we can leave.
“We’ll need our general manager, a translator, and you should take the camera,” Edwin says to Jessie.
Jessie responds, “you should go because, you know – you’re ID.”
“Well, I’ll go get lunch going and you two can figure out who’s going. I’ll tell the health desk we’ll leave at 1:15,” says David as he leaves the room.
1:18p
After contemplating whether sitting with one of the trainee nurses in clinic or investigating a “disease outbreak” is more interesting, Edwin climbs into the Land Cruiser.
The details at this point are unclear, but the Decha Woreda Health Desk sends information to CHC regarding a “disease outbreak” in Dishi. No other information is available at this time.
1200p
David, the CHC project director, communicates this to Jessie, the clinic manager, and Edwin, the medical director. He asks the two doctors, who can go, and when is the soonest we can leave.
“We’ll need our general manager, a translator, and you should take the camera,” Edwin says to Jessie.
Jessie responds, “you should go because, you know – you’re ID.”
“Well, I’ll go get lunch going and you two can figure out who’s going. I’ll tell the health desk we’ll leave at 1:15,” says David as he leaves the room.
1:18p
After contemplating whether sitting with one of the trainee nurses in clinic or investigating a “disease outbreak” is more interesting, Edwin climbs into the Land Cruiser.
His equipment: a camera, a flashlight, and a pen.
He sets off to pick up the team. The team is made up of four men: the CHC general manager, Haile; a nurse from the health desk, Tekele; one of the health desk’s administrative heads, W/marion; and another random guy from the health desk, Abiot.
Their equipment: papers, pens, and a hat Haile brought for protection from the afternoon sun.
1:50p
Edwin asks W/marion, “so what did you hear about Dishi?”
“Ah…someone said that there are many people sick. Yesterday. Someone told to Bonga. I don’t know. We will go and see,” he replies.
Haile interjects, “ya, ya, many people. They are sick, I don’t know, maybe we will see.”
Edwin tries to ask how they are sick, but only learns that a message was communicated to the zonal health desk yesterday or today, and they are going to investigate.
2:10p
The Land Cruiser is a must in rural Ethiopia. Nothing is paved outside of the major cities. The roads are all in different stages of development and/or maintenance. The road to Chiri was made about ten years ago. Since then, two other roads have been made that leave Chiri. One road goes west about 33 Km, the other is an extension of the original road to Chiri. It runs in a southerly direction, splitting off once for two destinations – one being Dishi.
The road to Dishi is about 24 Km long. It winds up and down through the rolling hills of the Ethiopian highlands. The road is just wide enough for two vehicles to pass by each other, but not wide enough that the less ballsy driver doesn’t slow down to a crawl to do it. This is a dirt road with occasional patches of rock to supply some traction. Because of these conditions, the last four kilometers to Dishi are nearly impossible to traverse during rainy season.
After nearly an hour of driving, Edwin is focused on the steep climbs and descents of the road. The others happily chat away in Amharic. Haile clues him in that they are talking about “politics and social life.” Although tempted, Edwin refrains from asking Haile what the hell that’s supposed to mean. As he moves from first gear to second gear, then back again to first, Edwin recalls a Spanish joke about referring to hilly, rural cities in Bolivia as “first class.” The joke plays on the dual meaning of the phrase, which could also mean that your car is always in first gear when you are in the city. He thinks of a way to explain it in English and convert it to an Ethiopian joke, but instead just keeps on driving.
2:15p
The team drives into Dishi. “Where should we stop?” Edwin asks. “No, not here, farther,” they respond in unison. Edwin furrows his forehead and keeps driving.
2:30p
The team reaches the site of the “disease outbreak” – Shash. Instantly, a small crowd of people start to gather around the car. The team steps out of the car and walks down to the health post.
W/marion jogs over to a nearby house to learn what’s going on. Haile goes to assess a nearby stream, while Abiot and Edwin step aside to “water” the plants.
2:40p
The Chiri team meets the local health workers who direct them back to the small crowd of people. While walking up a small hill, they mention something about a sick ox, not cooked, and eaten.
The team encounters patient #1 sitting under a large tree. She is a 20-something year old woman, being propped up by an older man. The first symptom they report is headache and that she is pregnant. Next they tell the team her abdomen hurts and she was hit by her husband. The team looks at each other in confusion. Haile says, “This is not our patient. She is somebody else. I think they are still coming.”
Quickly, the real patients arrive. First is an old man, who walks over, accompanied by four or five young children. The team learns that two days ago they ate cow meat and yesterday had vomiting and diarrhea. The old man says that the meat was cooked. Haile jots down his name and symptoms.
The next patient gives a similar story. She says the meat was cooked, and yesterday started having vomiting and diarrhea.
“Any blood or mucous in the diarrhea?”
The patient shakes her head no. Haile writes down her name.
Haile continues to write down 14 names, all who report (except for patient #1) vomiting and diarrhea one day after eating the same meat. As more people show up Haile turns to the group and says, “I don’t think we need to take everyone’s name.” Fortunately, the team also learns that no one is critically sick.
3:15p
After exchanging a few words, the team decides that this is a case of food poisoning. Tekele has a translator tell the crowd to drink fluids and that they would return tomorrow with medicines.
As the team begins to motion for the car, chaos ensues. In addition to assessing the “outbreak” the team decides to take patient #1 back to CHC for evaluation. First her husband moves to the car, but then runs into the crowd because he needs to gather money before he can go to Chiri. The older man with the patient, who turns out to be her father, steps into the back of the Land Cruiser. As Edwin steps up into the car, two veterinarians (one holding an injector that looks like a hand gun) ask for a ride to Dishi. As they get in, a police officer makes hand motions meaning that he also wants a ride. Feeling more and more claustrophobic from the growing crowd, Edwin yells for everyone to get in the car. He starts the motor, which scares away most of the little ones around. Two people begin to tap on the passenger side window, asking for something. Edwin quickly maneuvers the car 180 degrees back toward Chiri, careful not to hit anyone, but briskly enough to scare off the crowd. With open road ahead of him and the crowd at bay, Edwin gets set to leave this “first class” town only to hear everyone in the car telling him to stop. Patient #1’s husband, now with the necessary money in his pocket runs to the car. He’s quickly let in and the Land Cruiser literally leaves Shash in a cloud of dust.
12:30p (earlier that day)
Jessie: “Maybe it’s a measles outbreak.”
Edwin: “Maybe it’s ebola…”
He sets off to pick up the team. The team is made up of four men: the CHC general manager, Haile; a nurse from the health desk, Tekele; one of the health desk’s administrative heads, W/marion; and another random guy from the health desk, Abiot.
Their equipment: papers, pens, and a hat Haile brought for protection from the afternoon sun.
1:50p
Edwin asks W/marion, “so what did you hear about Dishi?”
“Ah…someone said that there are many people sick. Yesterday. Someone told to Bonga. I don’t know. We will go and see,” he replies.
Haile interjects, “ya, ya, many people. They are sick, I don’t know, maybe we will see.”
Edwin tries to ask how they are sick, but only learns that a message was communicated to the zonal health desk yesterday or today, and they are going to investigate.
2:10p
The Land Cruiser is a must in rural Ethiopia. Nothing is paved outside of the major cities. The roads are all in different stages of development and/or maintenance. The road to Chiri was made about ten years ago. Since then, two other roads have been made that leave Chiri. One road goes west about 33 Km, the other is an extension of the original road to Chiri. It runs in a southerly direction, splitting off once for two destinations – one being Dishi.
The road to Dishi is about 24 Km long. It winds up and down through the rolling hills of the Ethiopian highlands. The road is just wide enough for two vehicles to pass by each other, but not wide enough that the less ballsy driver doesn’t slow down to a crawl to do it. This is a dirt road with occasional patches of rock to supply some traction. Because of these conditions, the last four kilometers to Dishi are nearly impossible to traverse during rainy season.
After nearly an hour of driving, Edwin is focused on the steep climbs and descents of the road. The others happily chat away in Amharic. Haile clues him in that they are talking about “politics and social life.” Although tempted, Edwin refrains from asking Haile what the hell that’s supposed to mean. As he moves from first gear to second gear, then back again to first, Edwin recalls a Spanish joke about referring to hilly, rural cities in Bolivia as “first class.” The joke plays on the dual meaning of the phrase, which could also mean that your car is always in first gear when you are in the city. He thinks of a way to explain it in English and convert it to an Ethiopian joke, but instead just keeps on driving.
2:15p
The team drives into Dishi. “Where should we stop?” Edwin asks. “No, not here, farther,” they respond in unison. Edwin furrows his forehead and keeps driving.
2:30p
The team reaches the site of the “disease outbreak” – Shash. Instantly, a small crowd of people start to gather around the car. The team steps out of the car and walks down to the health post.
W/marion jogs over to a nearby house to learn what’s going on. Haile goes to assess a nearby stream, while Abiot and Edwin step aside to “water” the plants.
2:40p
The Chiri team meets the local health workers who direct them back to the small crowd of people. While walking up a small hill, they mention something about a sick ox, not cooked, and eaten.
The team encounters patient #1 sitting under a large tree. She is a 20-something year old woman, being propped up by an older man. The first symptom they report is headache and that she is pregnant. Next they tell the team her abdomen hurts and she was hit by her husband. The team looks at each other in confusion. Haile says, “This is not our patient. She is somebody else. I think they are still coming.”
Quickly, the real patients arrive. First is an old man, who walks over, accompanied by four or five young children. The team learns that two days ago they ate cow meat and yesterday had vomiting and diarrhea. The old man says that the meat was cooked. Haile jots down his name and symptoms.
The next patient gives a similar story. She says the meat was cooked, and yesterday started having vomiting and diarrhea.
“Any blood or mucous in the diarrhea?”
The patient shakes her head no. Haile writes down her name.
Haile continues to write down 14 names, all who report (except for patient #1) vomiting and diarrhea one day after eating the same meat. As more people show up Haile turns to the group and says, “I don’t think we need to take everyone’s name.” Fortunately, the team also learns that no one is critically sick.
3:15p
After exchanging a few words, the team decides that this is a case of food poisoning. Tekele has a translator tell the crowd to drink fluids and that they would return tomorrow with medicines.
As the team begins to motion for the car, chaos ensues. In addition to assessing the “outbreak” the team decides to take patient #1 back to CHC for evaluation. First her husband moves to the car, but then runs into the crowd because he needs to gather money before he can go to Chiri. The older man with the patient, who turns out to be her father, steps into the back of the Land Cruiser. As Edwin steps up into the car, two veterinarians (one holding an injector that looks like a hand gun) ask for a ride to Dishi. As they get in, a police officer makes hand motions meaning that he also wants a ride. Feeling more and more claustrophobic from the growing crowd, Edwin yells for everyone to get in the car. He starts the motor, which scares away most of the little ones around. Two people begin to tap on the passenger side window, asking for something. Edwin quickly maneuvers the car 180 degrees back toward Chiri, careful not to hit anyone, but briskly enough to scare off the crowd. With open road ahead of him and the crowd at bay, Edwin gets set to leave this “first class” town only to hear everyone in the car telling him to stop. Patient #1’s husband, now with the necessary money in his pocket runs to the car. He’s quickly let in and the Land Cruiser literally leaves Shash in a cloud of dust.
12:30p (earlier that day)
Jessie: “Maybe it’s a measles outbreak.”
Edwin: “Maybe it’s ebola…”
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