 Day 3 - Boroma
Arrive in Boroma after a long “road” journey
of several hours. We swerved past a giant tortoise leisurely
crossing the road. Also there are baboons and camels loiter in the
distance. Other drivers pass with people hanging from all
grabable parts. It’s surprisingly green as this is the rainy
season. Usually this area is a yellow barren wilderness. Arrived
escorted by an SPU security vehicle in convoy with two soldiers for
our protection.
Boroma is a small town about one mile from
Ethiopia. I have never walked around it in my many visits here so
don’t know exactly what it is like, but it does look a bit like
Haiti after the earthquake in terms of rubble strewn across the
“roads”. There’s hardly a car in sight, but goats wander the main
streets with no fear.
I orientate myself to Ray’s hotel - the
place to be in Boroma - if not the only place in Boroma. We are a
short walk to the Fistula Hospital, but we can never walk
there without our armed guards. This is a heartbreaking place
where women whose lives are ruined by obstetric misadventure have
their lives returned to them by a relatively simple surgery.
We can however cross the road. It's
about five metres to the venue for the final medical exams.
Nine students wait anxiously for their obs and gynae exams. This
morning they had surgery.
This is OSCE format. There are many amazingly
and disconcerting anatomical specifications to do a removal of a
placenta, deliver a baby and other tasks all in eight minutes.
The exam is now over so I can reveal one of the OSCEs was a
discussion with a woman (actor) whose baby had died. The actor gave
a wonderful performance. Most candidates were sensitive and
empathic to the plight. Maybe in some way our mental health
training last December helped this group. If I wasn’t a
psychiatrist I would want to be in obs and gynae after seeing what
happens here to women and the dreadful problems of giving birth in
this country.
I met Dr Jibriil who is doing fantastic things
for mental health in Boroma. I taught him some years ago as a
medical student and now he is developing psychiatry out-patients in
Boroma, a maternal mental health programme and community services
along with the support of the wonderful Faduma. Faduma is a
Somalilander who lived in Canada then came back to her homeland.
She devotes herself to developing maternity health in the
region but also is a strong supporter of mental health work. I
always come away enriched after speaking to Faduma who in her quiet
way has improved the lives of so many people in direct clinical
training contact, and by her selfless devotion to others around
her.
Looking around at the medical students and
nurses, I acknowledge that I have taught mental health to just
about everyone. I am unsure if I feel a sense of accomplishment or
just old! Abdel Ghani is another keen nurse who now works in
mental health and helped me during nursing teaching last
December. Everywhere, I see my old students who are now
working, teaching and giving life to the principle of
sustainability.
It is now raining with thunder and
lightning. So much for the tropical weather and break from the
UK. However this is not a place to go for a walk. We are
allowed to walk around the hotel and that is it. There isn’t a
feeling of poor security as we follow the rules and 8pm curfew, and
never walk around outside of the hotel complex unescorted.
It has been reported that there is a risk of
attacks on foreigners since the death of Osama Bin
Laden. Al Shabab in Somalia have taken to using women as
their preferred method of weapon. Yet Boroma has been a peaceful
place relatively for some years. We are about one mile from
Ethiopia.
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