Thursday

Greetings, everyone.
I understand that there may be some new readers as it's been somewhat difficult to get news around to all those concerned with the members of the team here. The good news is, we are all well. We did have a nasty intestinal thing take a few of us out in shifts over our first five days. Me, Dan, Matt, Kurt, Dennis and Linda all had bugs (we'll leave it at that). The medical folks here were pretty well equipped to take care of us, so everyone is on their feet and working very well together.

Now that I seem to be recovering from basic Africa shock, I am loving being here, though I miss my family. The Ethiopian staff, together with the Americans and interns here are all pretty great people, seem to love each other and love working together. Each day I've met numbers of people who were basically dying a couple of years ago, but who have put on weight and are living pretty healthy lives as participants of this program, which addresses everything from the most obvious threats of AIDS and Tuberculosis, to nutrition, rent and transportation. They are still desperately poor, and don't look super healthy to my eyes, but they are alive and gaining strength. I don't want to paint a rose colored picture, but when you are as good as dead, to be alive and laughing about it seems utterly miraculous to me.

I've also been impressed by the skill of the physicians and other medical support folks who are on this trip, and the way the program here has managed to maximize the resource of visiting health care providers. Each day serious situations are diagnosed and addressed by the Docs as they huddle up and speak their highly technical medical vocabulary. Because of the methodology of the program here, these situation are addressed beyond the sort of treatment that can be offered on the spot.

HIV+AIDS Care and Treatment (They decided on a very functional and descriptive name. I don't know how to pronounce or write the Amheric version) notifies the leadership of the kebele's when there is going to be a community clinic available to non-beneficiaries of the program (those who aren't already in the network/system they've created.) They then issue a certain number of tickets to be passed out for any given day, so that those who come are the ones who need it the most and can spend as much time with the providers as they need to. It is extremely well organized and efficient. Taking a page from Partners in Health, the program here is trying to address systemic issues as well as give needed treatment. So full records are created for each patient, if they are new to the program, and aggressive follow-up takes place once they have been connected. They may not be addressing the sheer volume that they could if they did nothing but hold massive clinics all the time. But for those who come into the program, the changes in their lives are pretty comprehensive.

We've been gathering footage everyday, and I've been talking to everyone I can about everything I can think of. Slowly, the picture is starting to come into focus, at least way better than it could without seeing it for myself. Like many successful programs I've seen, there is a vital partnership here with folks who have brought expertise and resources from the west, and highly skilled Ethiopians, several of whom were doing this sort of work in Ethiopian hospitals before joining this program, but with greater frustration and not as much impact, according to them.

I'm tired, so will close for now.