Training Day

What a wonderful day I had today in Addis Ababa. Thanks be to God for everything running fairly smooth, and getting through the day without any major issues. This morning I was told I am becoming a true Ethiopian because I was late to our meeting. Those of you who know me best will know I cringed at this statement – not because I don’t want to be Ethiopian (that was a compliment) – but because I HATE being late. The truth is, I was ready at 8:15, waiting for my ride that was going to come at 8:30, and who did not show up until 9:10 (our meeting was at 9). Oh well… they meant nothing negative by the comment, for it is true, Ethiopian time is being late. You say you will meet at 9, and maybe around 9:30 the first people will show up.  It was just the first cultural difference we ran into.

People started showing up throughout the morning, and about 10am we decided to start doing introductions. There were about 12 women there, 1 man, and 3 children (one who had Autism). Only four of the women there were going to be involved in the school and the rest were general ed teachers and mothers who wanted to be involved in my “training.” They did not speak English, so everything I said had to be translated. This seemed to work out just fine, except when they would have lengthy conversations about what I had just said. I would make a comment about something we do in my classroom, and the next five minutes would be spent discussing this back and forth in Ahmeric. When they were finished, the translator would look at me and ask me to continue without any explanation of what had just occurred. I was honestly very nervous about this… were they disagreeing? Did they not agree with what I was telling them? Are there questions they need to ask? What I have learned over the past couple of days is that Ethiopian people are very sensitive, so they do not speak up in fear of hurting your feelings. When I asked if people had questions, they would all just stare at me without saying a word.

I kept talking throughout the morning, and prayed that something I said would be beneficial for them to hear. The school did not yet have a schedule set up for when the kids would arrive so I made this my first priority. My initial plan was to take what they usually did, create a schedule of activities for the day, and then help them beef it up with activities that we usually do in my classroom, things that have worked well for me, and strategies that have been researched. However, they were not interested in sharing what they knew, they simply wanted me to tell them what I do at home. So, I spent the next hour or so sharing a typical day in my classroom, and creating a schedule for them that followed a similar timeline. I knew it worked well for my students, but without any feedback from these women I had no idea what they thought about it.

I frequently asked if they had any questions, but did not get much of a response. By the end of the training day, I was not sure how I thought everything went… but then they started to come up one by one and talk with me. Their questions poured out, and they repeatedly told me how thankful they were that I had come.  I now see what the issue was… as I mentioned earlier, they are very sensitive people. They did not want to offend me by making comments or asking questions in front of a larger group. However, one by one they came up after and I immediately felt relieved. The program director said she really liked the organization of the schedule, and that they would keep it. The school teacher (who had been teaching at the other Autism school for 8 years) came up and talked with me about the similarities and differences, and asked me how to teach certain skills. This woman has been teaching much longer than I have, but you could see how much she valued learning new strategies. All of the women involved have such a heart for these children, and this school will be a great place for the students.

Something interesting about Ethiopia is that there is no diagnosis for Autism. If you think your child is Autistic, then he/she is. There are no professional evaluations done to determine whether or not a child would fall into this category. One of the first things they have asked me to do is evaluate the children… However, this is not my training. I explained to them that when I receive a new student, I also am given their IEP, psychological evaluations, etc… it is not something that I do. – My answer was not good enough for them. “But you are the expert, and we have no one like you here… please, evaluate our children.” I have told them what I can do, and we will see where it goes from there. Starting tomorrow they would like to bring in a few children and their families for me to evaluate. Basically, they are looking for a number between 1 and 10 that will describe how autistic their child is – there is no way to do this even in the US. However, what I can offer them is a very basic IEP. I will talk with the families and write up a summary of their child’s strengths and weaknesses. They are less concerned with academics here, so the skills will most likely include: does the child make eye contact? Are they verbal? Can they use the bathroom? – Adaptive skills are key. I can then ask the families what they would hope for their child to learn in school. Again, most answers will be in the adaptive/independence areas. This will provide a very basic outline of the student that can be used to share with the new teachers that come into the school.

Finally… I want to say a word about the people here. They are wonderful – almost TOO wonderful. They are so giving and go out of their way to make sure you feel comfortable. Three women came to pick me up at the hospital today for the meeting, and the passenger seat in front was vacant when they pulled up. There was also a pillow on the seat for me to sit on. When we walked to the car it was slightly raining so someone made sure to hold an umbrella over my head the entire way so I did not get wet (which I wouldn’t have minded – I love the rain. I always ask Eric to go outside with me when it is raining!). They have all asked me to come to dinner at their house, and they made sure to plan the night so that we will make it happen. One woman even asked me to stay with her so that I would no longer have to pay for lodging. They are so wonderful here, and I look forward to getting to know them even more throughout the next few weeks. 

Ethiopian Wedding

Sunday

Today we got a wonderful look at Ethiopian culture. We walked into town (about 35 minutes) and passed by hundreds of people – all dressed in white and going to church. On a church day, the typical Ethiopian woman will wear a white dress made of many layers of thin cotton and a shawl over her hair and sometimes mouth. It was quite an experience to see all of these men and women (most men wore white as well) walking through the streets and grassy areas on their way to various churches. When we arrived at the church downtown the service had just ended – but our enjoyment had just started. There were people all around us, and we could hear singing still coming from the church doors. When we made it closer to the church, we saw many people – very elaborately dressed up – singing in formation in some sort of traditional way. There appeared to be two people of significance everyone was singing to and focused on, so we assumed it was a wedding of some sort. After watching for a while a woman approached us and spoke perfect English. She had lived in D.C. for many years and she was able to explain the tradition to us.

It was a wedding – but it was a very special wedding. She said that church weddings do not happen often. For one, they are very expensive and the couples are usually in debt to the church for the rest of their lives. They were intricately dressed and had an entire choir with drums lead them wherever they went. Secondly, church weddings can only be done two months out of the year. You must not have a church wedding during a month where there is to be certain fasting obligations, so this leaves very little time for people to schedule these weddings. Finally, church weddings were much more sacred than other weddings, because you were making a much more public commitment. If you are married in a church you could only divorce for two reasons: infidelity or not being able to produce children. There were two wedding processionals going on at this church while we were there and they were wonderful to watch. Pictures to come, if I ever get a good enough internet connection.

The rest of my day was spent preparing for tomorrow. I have had to pull many more resources together than I had initially planned, but I am SO thankful for the internet. I was able to download PDFs from DHAs website (desert-heights.com) about our life skills program and positive behavior management which will help me greatly in trying to describe some of the practices I use in my classrooms back home. I prepared a meeting agenda – although I am not sure how closely it will be followed. There are definite points I want to cover before Friday, but tomorrow will be a trial and error day of how the staff at Nehemiah would like everything to be structured. The teachers who will be coming do not speak English, so that will be another barrier to overcome. I will have someone able to translate, but the time it takes to do this is massive. Just trying to get through an IEP at home with a translator can be an agonizingly long process.

I can’t wait to see how Monday goes, and I will update you all when I get a chance!

Finally at Nehemiah

The last time I tried to post on my blog, the internet here would not allow me access to my page so my friend had to do it for me. When I awoke the next morning, I learned that I would not have internet again until Monday… MONDAY?! You mean I have to go 3 whole days without internet? I quickly realized how reliant I am on the internet – I use it for everything! Thankfully I was able to catch a break Saturday evening, but was still unable to access my blog. As soon as I can, I will post photos. Until then, thank you again, Brad, for posting my update!
Friday
This morning I joined Dr. Koning on his usual routine: breakfast at 7:10, doctors meeting at 8, rounds and OR to follow. After the meeting at 8, Dr. Koning took Linda and I up to the OR to see about getting us the necessary items to enter. We were promptly sent away to get permission from the Matron so we started to head her way. We stopped in the ICU for a bit and as we were standing in the room with the patients Dr. Koning started discussing ways to clear out catheter waste… I again became a little queasy and decided it would be best if I let the medical professionals handle that conversation. I left the hospital to put my scrubs on, praying that I could stomach the OR. By the time I returned I had missed Dr. Koning’s rounds for the morning and found him and Linda in a small office. He was conducting his office hours and anyone who needed to see him was brought in by a nurse, one at a time. The language barrier is very hard to overcome here in Ethiopia, as there is absolutely no relation to Latin or English. If the nurse needed to leave the room for a minute, the entire appointment would just stop, because even with gestures it was too difficult to understand each other.
After office hours came the OR. I put on my mask, shoe covers, and head cover and was ready to go. I REALLY wanted to be there and I REALLY wanted to be okay… how many other times would I have this opportunity? – Never. The first OR we went into was good… because they were already sewing her up. She had her gall bladder removed and it was sitting on a small tray in front of me with about a dozen little stones next to it that had been pulled out. Gall bladder, stones, no blood… no problem. The woman on the table started to moan, and I immediately had a concerned look on my face. Linda quickly told me this is normal when you start to come out of anesthesia, and that many patients do this.
The second OR we went into was fascinating… but it didn’t fare well on my stomach. The smell when we entered the OR was the worst smell I have ever experienced. One of the doctors was cauterizing the scar tissue off of a young boys deformed leg, and piece by piece it was coming apart like a puzzle. I lasted about 5 minutes and had to walk out of the room for some fresh air. Many nurses stopped to ask if I was alright and I was so embarrassed, but I just couldn’t handle it for long. I tried to go back a couple of times, in and out, in and out for maybe 2 minutes at a time but I eventually admitted I could not handle the smell and decided to leave the OR. Side note: it’s funny how we can become so familiar with a smell or sound that we no longer notice it is there. Customers would come into my family’s print shop and ask if they had just painted or comment on the rich smell of ink – something that we do not even notice when we walk through the door. One nurse said the same thing about the cauterizing of the skin – “oh, that’s funny, I didn’t even notice there was a smell.”
Lunch today was American spaghetti without meat – thank goodness. I did not tell of my first night’s meal, but I will just say after one bite of chicken I swore off meat for the rest of my trip.
Saturday
Today I finally made it on rounds with Dr. Koning. This morning he only needed to see one patient, but we ended up visiting three. The first was a man who had come down with Malaria 10 days earlier. He was treated for this but now was having other complications that were most likely caused earlier by the malaria. We looked through his CT scans, he pointed out all of the organs, and walked me through exactly what he was seeing. The second patient was one who also was treated for malaria and was trying to get back to Holland for more care. The last we ran into was the second patient’s roommate, who had just had surgery to remove the largest bedsore that they had ever seen. There was no dressing on him at the time we were in there as they were cleaning it… I will save you a description of what it looked like, as it was not long before I had to sit down again.
This afternoon we visited the Museum of Ethiopia and toured a large orthodox church. We immersed ourselves in Ethiopian culture for a few hours and had a wonderful time. However, I was anxiously awaiting our meeting with Ferdo (I know I am butchering the spelling terribly, sorry) where I would learn more about the school and how I could help. The medical aspect of my trip has been quite exciting, but I came here for a reason and was anxious to get going.
NEHEMIAH
I do not even know where to begin, because by the time I left Nehemiah my head was going a million miles a minute. From the very limited information I had about the school before I left the US (communication is not a strength of Ethiopians, and they will be the first to admit it) I was under the impression that they started up in the middle of May, were functioning as a school, and needed some structure, resources, training in certain areas, and support. What I found instead was a group of very passionate individuals who care deeply about children with Autism, and an empty house (some chairs, a few toys) for the students to arrive at on June 1st.
So, we are starting on the ground floor and hope to be up and running by Friday. The children were supposed to arrive on Wednesday, but the school is okay with postponing this in order to get everything together. The facility is very nice and will be great for the school. However, there are many details they are still working out. They do not have a van for transportation, they have no tables, they have no curriculum, no boardmaker, no classroom activities… They have big dreams for their school and I hope that we can make most of them become a reality in the next few days. The teachers should be coming on Monday and Ferdo has asked that I train everyone – the administrators, teachers, and assistants – on what to do.. This is a much larger task than I had ever anticipated, but I am so excited for the challenge. God works in mysterious ways, and I am honored to have been given this opportunity.

MCM Hospital

Well today confirmed I am in the right field – and I did not miss my calling as a doctor. We awoke this morning to a beautiful sunny day (which came and went throughout the afternoon). Breakfast was at 7:10 sharp, and the food served in the guest house throughout the day was Korean… all the food. MCM Hospital is better known in the area as the Korean Hospital, as it is run by Koreans. And, because they run the show, the food is theirs as well. It will take some getting used to, but I have met a few nurses who gave me great advice: “The redder the sauce, the hotter it is.”
After breakfast, Linda and I (Linda is the nurse from Oregon who came with Dr. Koning) were given a tour of the hospital. This is when I realized I was not cut out to be a doctor. I can handle the occasional classroom with a cold, or the student with the flu who really should have stayed at home… but to be in a hospital with questionable sanitation policies, surrounded by individuals who are so sick they have come to the emergency room was a bit too much for my stomach to handle. I thank God that there are wonderful people out there who enjoy this type of service, but it was not my calling.
The tour of the hospital was fascinating. I found myself being highly impressed with all that they have while at the same time being shocked at the things that they are missing. They have a brand new CT, wards for patients (3 floors, depending on your class), a NICU, ICU, OR, recovery room, ER, reception, cafeteria… from my very limited knowledge of a hospital, it seemed to have just about every room that it needed and they were all staffed and stocked. However, there were also things missing. In the ER there is nowhere for the doctors to wash their hands. There are about 10 beds, side by side, and 2 examining rooms. Not one of these areas has a hand washing station. Linda asked about this and the ER nurse said that sometimes they do not even have hand sanitizer or gloves. There was also an open tub of some sort of cleaner, where they would soak the ventilator tube (yes, singular) to be reused. Finally, with all the AIDS and other diseases in Africa, I was saddened to see that their method of disposal for needles in the ER is an empty water bottle placed on the floor. What a different world we live in. The bottom line is that these people are receiving incredible medical care, and the doctors and nurses at the hospital are willing to do whatever it takes to provide it.
After our hospital tour we had a Korean lunch, followed by a tour of the town. We did not go far – only within walking distance – but it was nice to see some of the culture of Ethiopia. There were fresh fruit and vegetable stands that looked delicious, followed by open air butchers with flies on the meat. There were also herds of goats on the side of the road that you could purchase and take home for fresh meat. The people are very friendly, and the children all wave and say “hi!” The people in Ethiopia do not speak English unless they went into higher education, so the majority of people that we will meet and almost everyone that comes into the hospital speaks no English. However, the hospital itself uses English to communicate with each other, as it is the most commonly spoken language between all the foreigners.
Tonight we were supposed to visit with the school director and his staff and visit the school building. African time kills me. We were supposed to meet at 5:30 and be done by 7pm and I was going to start work at the school tomorrow. The director did not show up until 6:30 (which is typical I guess) and we had gone to our room to wait for him. By the time he came, Dr. Koning had another appointment and we missed each other. However, I do have some good news that he shared with Dr. Koning. The school has 12 students and many staff (how many I am not sure yet). They were given furniture, a computer, funding, and a van for transportation. Just a month ago they were unsure how they were going to pull it all together, and today they can’t believe how much has happened. Thank you for your prayers! Please continue to pray that things move along, as I will be meeting with the school staff on Saturday afternoon and hopefully working with them there on Monday.
As for tomorrow (Friday), Dr. Koning has said I may spend the day with him in the OR since I will not be at the school. What a great opportunity! I don’t think I will be squeamish in there, but I guess I will have to try it first before I know. Good thing I brought my scrubs (thanks Sarah!).
Lindsay

P.S. Thanks to Brad for posting this since I can't from here!

I have arrived!

I made it! 28 hours of travel time +10 hours time change later, I have arrived in Addis Ababa. Our plane came in last night at 9pm so I was eagerly looking forward to looking out my window this morning. My view from the medical apartment window is the hospital itself! It is so beautiful and green here... although it is also pretty rainy (as you can tell from the photo). I am going to tour the medical compound with Dr. Koning this morning, and then visit the school for the first time this afternoon.

mehlkahm goozoh yehhoonehlesh (Bon Voyage!)

I leave tomorrow morning, and I can't wait to get going.  22.5 hours of flight time + 3.5 hrs layover in Germany + 10 hour time change will make for a long day... but arriving in Addis Ababa, Ethiopia will be more than worth it. I have all the supplies packed up and ready to go and I hope I haven't forgotten anything! The weather report for the next ten days in Addis is rain, rain, and more rain. The rainy season isn't supposed to start until June, but I guess it started a bit early this year. I have heard "when it rains in Addis, it pours" but I will be hoping for a few sunny days while I am there.
I look forward to keeping everyone updated as much as I can.Please continue to pray for safe travels and a positive experience!

Lindsay

Thank You

Thank you so much to those who have donated some of the supplies from my wish lists! I am so grateful for friends and family who are willing to help these children. Also, a HUGE thank you to Desert Heights Academy for purchasing everything that was left on my lists at the end of last week. I have such a supportive boss and staff at DHA and I am so grateful for their generosity and support.

Only a few more weeks and I leave for Africa! I have been talking with Rahel, the program director in Ethiopia, and have found out a few more details. The students will be between the ages of 4-12, and right now they only have enough funding for 10 students. At first I was surprised... 10 students!? Thats IT!?? But as I have talked with Rahel and more educators and professionals in the field, I realize this will benefit the school greatly, as they are just getting started and are needing more education and training themselves. Although the educators at Nehemiah have experience in this field, they haven't had access to all of the resources and new ideas that we are exposed to and the students are going to have very difficult and unique hurdles to overcome. I can't imagine the pain and frustration some of them must be holding on to without the ability to communicate or understand the world around them.

Please keep Nehemiah in your prayers, as they are starting up their program this month.

Lindsay