Rift Valley Road Trip

I had been eagerly awaiting this weekend as we had planned on a trip to Awash National Park. It is about 100 km from Adama and follows the paved Dire Dawa road along the southern part of the Rift Valley. The trip did not disappoint!

Leaving Adama around 9:30 am Sunday, we saw the usual heavy transport truck traffic - so many huge trucks carrying a variety of items - from other trucks to camels! Yes, we saw camels... first in a field but weren't able to stop for photos, then peeking out of the back of a truck in front of us. Luckily on the way home we had a great photo opportunity when we saw a whole herd following the road in the late afternoon. We also saw a dead hyena along the side of the road at one point.

It was interesting to see how the landscape changed along the way - there were the usual agricultural fields and grazing sites with cattle, goats, donkeys and their herders; but we also saw irrigated sugar cane fields, dry scrub, dark volcanic rock and to the north, evidence that we were in the great Rift Valley based on the cliff-like areas to our north in some spots. There were lots of little settlements where it looked like several families lived and farmed together.

At one high point, we looked out and saw what seemed to be a very large body of water. Turns out this was Lake Beseka, 5 minutes outside the small town of Metahara. The road crosses one edge of the lake and it must flood easily since it was already partially under water and it hadn't even been raining.  According to the guide book, this is a shallow lake that is expanding and it attracts a lot of birdlife and houses crocodiles. Unfortunately we missed out on a potential night light show - the volcano in the park, Fantelle Volcano, apparently spews fireworks from the crater on a regular basis.

Only 5 km further on after Metahara was the park entrance. The rules of the park are posted in English, and the fee schedule is in both Amharic and English. We paid 90 birr per person - less than $6. A guide was assigned to us (70 birr) and since he was armed with a rifle, maybe he was also part guard? We drove into the park and the guide led us out into a savanna area dotted with acacia so we could find some big mammals. Not too far in, he spotted a Soemmerings gazelle. Then the guide spotted oryx, but I couldn't see them. He suggested we hop out of the van and walk towards the game - we were more than happy to stretch our legs. In fact, Deman had just said that the grasslands were so beautiful she wanted to run through them, arms outstretched like in a Bollywood movie! We walked several hundred yards off the dirt road in search of the oryx and from quite a distance, could see at least the outline of these large animals. With my zoom, I could even get a decent close-up look. After lots of photos out there, we trudged back to the van and almost immediately the guide spotted a huge number of oryx on the other side of the road. We went off-roading and Amir guided the van towards the herd. We got magically close and although some of the animals were skittish, they didn't bolt away. We weren't able to get out of the van, but we took probably a hundred photos or more, between us. It was quite exciting! We also saw some more gazelle at that point, too. There are supposed to be about 80 species of mammals in the park - mostly bats and small rodents, but also the gazelle, beisa oryx and baboon we saw, plus kudu, waterbuck and warthog which we did not. Predators have been reported but not frequently seen - lion, leopard, cheetah, hyena and jackal. Zebra have not been seen for years. There are tons of birds and we saw a few colorful ones while touring around.

After that, we made our way back out to one of the main park roadways and drove about 10-11 km to the Awash falls. Wow - they are amazing! The river widens up at the top so there are probably 5 to 6 separate falls areas, at least. The water is brown, but it's such a beautiful spot. Supposedly Awash translates from Oromifa as 'the beast that consumes everything in it's path' - based on the falls, maybe I can see why.  There was a little stairway down to the river at the bottom of the falls and we had a great time posing for photos, skipping rocks into the river, and just enjoying the lovely spot. It was great to be out of the dusty, exhaust-fume filled city and into a bit of wilderness. It really felt like we were definitely in Africa! Especially after we saw the big croc sunning itself on a rock across the river.  I also spied a baboon doing a little fishing and resting just a few yards away. It didn't stay long, but long enough to get a few photos.

We hiked back up to the top and had lunch at the Kereyou Lodge overlooking the falls, the only accommodation in the park. After lunch, we headed back to the main gate, saw a dik-dik (looks like a miniature deer), dropped off our guide/guard, and started the 2 hour journey back to Adama. More of the same as on the way in, and once we made it back to our hotel, we were all exhausted - especially Amir, who had to drive the entire way. Because of all the trucks (and livestock!) on the road, it's no easy, relaxing Sunday drive here.

A few words about the Great Rift Valley before I end this post. Most of this is paraphrased from the Bradt Ethiopia guidebook, 5th edition. It is the largest geographical feature in Africa - visible from space - and in Ethiopia runs from the Red Sea to lake Turkana on the Kenyan boarder. The rifting process began about 20  million years ago along a 4000 km faultline. Where were at the Kereyou Lodge, they said the continent is breaking apart in 3 directions.  The expansion of the Valley has been accompanied by lots of volcanic activity and will eventually lead to part of Africa 'breaking off' as the Valley fills with ocean water. In northern Ehtiopia, the Rift Valley forms the Danakil Depression - at some points up to 110+ km below sea level, one of the lowest spots on earth. It is barely accessible and definitely inhospitable. In the south, many parts are covered in acacia woodland and dotted with lakes, making it one part of Ethiopia that definitely looks 'African'.

SRS Training Week 1 - how rewarding!

Today we finished up with the Specimen Referral System Training of Trainers which will facilitate the national roll-out of the program. I can hardly put words to how rewarding the experience has been. For all the time we put in, I got more out of it many fold over. And I was a bit surprised that I almost got choked up at the end during the closing comments. The students really were a wonderful group.

This week, we worked with students who were engaged, enthusiastic and really passionate about how they can apply what they've learned to strengthen the laboratory referral system here in Ethiopia. They participated fully in all the activities and discussions, they challenged us with their questions, and we all had a good time doing it.

I've never been responsible for so much training at one time - 4.5 days of teaching several modules per day and all the facilitating involved, never mind the prep work. It's been exhausting and energizing at the same time. Thankfully, I've had a wonderful team to work with in Debbie, Joan and Adrian. Of course I have to mention the awesome team of curriculum developers who came up with the material, the group who must have worked tirelessly to print and pack the binders, and the teams who provided feedback from the 2 pilot programs back in January and August. Last but definitely not least, a great group of attentive students, willing to learn. Actually, I feel like a lot of the students knew most of the content we were delivering but they were still all ears and eager for more.

Today the groups gave their teachback training sessions and they were all very good - I even picked up some pointers from them! It was just as great to hear the praise and appreciation their colleagues heaped on them during the feedback part of each session, along with some astute observations and constructive criticisms. The feedback continued on the evaluation forms the students filled out. Most were very complimentary of the curriculum and the training as a whole, but several took the time to include constructive feedback on the class and how it can be improved. I really liked how Getachew, the EHNRI partner, suggested the students think of themselves not as teachers but rather they were facilitators yesterday as we sent them off to prepare for the teachbacks. Based on today's performances, I think they took this to heart.

Comments like, "The program is very interesting and it should be given for all lab personnel at health facilities level because most of results from the lab wasn't quality due to unawareness." and "I got many things, even things that are minor that I should know before. Surprisingly, I find many things from my instructors." lead us to believe the course content is relevant to their needs. One person even wrote something like "are you crazy?" when answering the question about what was least valuable about the course!

I've had a great time this past week and I can't wait to see how things work out in 2 weeks' time when we help new trainers from 2 of the Regional training centers give the first roll-out sessions to health care workers in their regions.

Working on the Process Mapping tool exercise

Drawing a safe packaging system

Alex demonstrates packaging safely with his cool PPE

Debbie, Deman, Getachew, Adrian, Joan in the front row - 2 students in the back

Group shot - SRS Training of Trainers, Adama, Nov. 28 - Dec. 3, 2011

Food and water

One of the other team members, Joan, mentioned something the other day about how thankful she is for unlimited clean water. Here, we are only drinking bottled or boiled water - including for brushing our teeth.  There aren't always a lot of options during meals that are 'diet', so I find myself drinking a lot more water than I usually do. It's also very dry and often dusty, so water is the thirst-quencher I'm looking for. I find I get into a bit of a hoarding mode when it comes to having enough bottled water available. What is 'enough'? What if I get thirsty at night? What if I run out and don't have any for brushing my teeth? What if we can't find any on a long drive? What if, like this morning, my mouth is so dry during training I feel like I can barely speak?

It's kind of eye opening. I mean, I know that not everyone has enough water - let alone clean and safe water. I think of it at home sometimes when I'm doing dishes or the sprinklers are on. But here, it's kind of an in-your-face reality. I don't think the locals are affected by any lurking bugs in the water we've been exposed to so far - they know these bugs! But our stomachs do not and it means that we have to be careful when we think about choosing what we eat or drink - were those yummy-looking fruits and vegetables washed in water that wasn't boiled or from a bottle? What about the ice in my drink? At the Hilton, we were pretty confident everything was OK. Today I decided to eat the cabbage salad during lunch at the training and so far, so good.

Now, on to the fun stuff - the food! The food here, on the whole, has been pretty good. Yes, it's injera at breakfast, lunch and dinner, but there have been other options thankfully. After my bout with whatever that was on Sunday, I'm having a hard time getting back to the injera. What's injera, you ask?  It's made from a grain - usually something called tef - but sometimes from barley or other grains. It's fermented so has a sour flavor, and then is made into a very thin and spongy circle. They cut it into sections, roll it up to serve, and then lay some down on their plate before adding the rest of the food. More is taken to eat with - it's kind of like a utensil. Ethiopian meals are eaten with your hands - your right hand, specifically - and the injera serves as a vehicle to get the food from the plate to your mouth. You tear off a piece, kind of wrap it around the bite you want, and shove it in your mouth. For those of us without a lot of practice, it can be kind of messy.

The tibs (strips of meat in sauce) has been one of my favorites - I've only tried the beef, and it's definitely well done, but generally it's a pretty decent dish. I haven't tried any of the 'wot' dishes yet and there are lots of mystery things I see in the lunch buffets. Plus the super spicy berber sauce. Since there are 'fasting' days (Wed and Fri?) they have a lot of vegetables, rice and pasta which is nice.  There's this one lentil-based dish that is my favorite - I hope I find out what it's called before we leave. It's all very colorful - beets, green beans, carrots, the red berber sauce, spinach, potatoes, and more! Plus they have wonderful breads here - probably because of the Italian influence. I think that influences the lovely little cookies and cakes they have out at tea time, as well.

I'm pretty sure I'm forgetting something - like all the Western food we've had available, the great Italian lunch we had in Addis before coming to Adama, and the cheeseburger I had for dinner tonight - but maybe I'll sneak things in to other posts along the way. Initially I also wanted to mention smells in the post, but it's probably worthy of a completely separate post of it's own!

2 kinds of injera, berber sauce, and some tibs along with rice and  ?

lunch buffet at the hotel where we are training in Adama

'Western' meal of roast chicken and vegetables from Kelly's in Adama

had to add this one in - Coca Light (Diet Coke) in Amharic

Training Day 1

Today was training day 1 here in Adama. Before I get to that, though, I had a pretty much 'lost' day yesterday. Our first night here I woke up at 2:30 am and was pretty ill all night and most of the rest of the day. I was worried it was from dinner and since 4 out of 5 of us had the same thing, that would have taken the whole team out!  Turns out it was just me, and thankfully I was on the mend by about 7 pm. I wasn't too helpful when we went to the training site to set up the room and assemble the tote bags with the training binders, etc. I think it was Deman who helped make me feel better when she joked during a photo op. The 4 volunteers had our company T-shirts on and asked her and Getachew, the EHNRI training coordinator, to get in the photo. When we said they should get in the middle, Deman shot back, "Why? Because we are black?". We all howled with laughter. I'm sure this will be the joke of the trip - in fact, it came up again today already!

So, back to training today. Somehow I slept well last night and wasn't up tossing and turning, being nervous about the presentations today. That probably helped things go as smoothly as they did. We were up early and at the hotel a few doors down well before 8 am, doing the final set up and settling ourselves down. We started with 21 students (we were expecting 30), but by the end of the day we had 25. I was surprised that only 4 of those were women - I figured it would be more evenly matched based on photos from the previous pilot trainings. Another obvious difference was the participation rate in our group - apparently in past sessions the students had been too shy to say much until a couple of days into training. Today, we had no trouble getting a great level of engagement during the various activities, and there were even some heated (but good-spirited) discussions.  It's very gratifying teaching a group of people who are so interested and willing to learn. Our group is a little bit different, being higher level managers and/or trainers from regional centers versus the local health care workers in the other sessions. Our training this week is a Training of Trainers session so these students are expected to go back to their regional centers and deliver this material to other groups, making the program sustainable once our involvement in the SRS program is over.  We also have 2 CARDNO external consultants observing - they are a 3rd party group assessing our public/private partnership and this was one trip they were able to coordinate with.

Overall, it was a great day and makes me excited for the rest of the training this week, lab assessments and prep work for some of the new 'trainers' next week, and finally observing and mentoring the trainers when they in turn deliver this material at another region the following week.  Off to review materials for tomorrow's sessions....

Today's joke came about after I had climbed the 4 flights of stairs back up to the training room after the break and as soon as I sat down, Deman asked me to fetch her a cup of coffee. Debbie asked, "Why? Because she's white?"...

The photos below show the students working on various parts of the Process Mapping activity, which can be a bit confusing and difficult, but makes for great team building and discussion opportunities.

Adventures in Adama

I'm falling behind on blogging - sometimes because I'm too tired, sometimes because the internet connection is so slow it's painful... This was supposed to be posted yesterday.

Yesterday we made the trek from Addis to Adama - we were expecting worse, but it only took us about 2 hours to get here, even with the Saturday traffic. Our driver said that this is the road to Djibouti where there are major ports, so it's quite busy. Lots of huge trucks - lots of overwhelming fumes. We followed the 'China road' which is in excellent condition almost all the way here. I think this means it's another projected funded by or contracted out to the Chinese.

I jotted down some impressions along the way.  As we were leaving mid-city, Avril was blaring from our driver's speakers - as Adrian called it, we were definitely in the 'party bus'! I also saw they had kind of bus lines in the middle lanes of the highway in the outskirts of town.  It's very pastoral - lots of agriculture going on. Comments in the bus were that it looked like central California. There were Brahma bulls and cows all over the roadsides, along with donkeys and goats. We also started to see donkey carts as a mode of transportation (and some little 3 wheel taxis!). Then the dwellings changed and there were more of what we are told are the typical rural round huts with mud/straw walls and thatched roofs.

The hotel looked pretty good upon arrival with a very nice lobby area and a pool, but based on the rooms, it's a far cry from the Hilton - which itself needed some updating.  Pretty small, no storage, 3 hangers, 2 outlets (both occupied) and mosquito netting over the bed. Wow - we've finally made it to something closer to the REAL Ethiopia!  And did I mention, the rate is around $27 a night - more than 10x less than the Hilton. So it keeps looking better - except for the crazy road noise.

Oh, don't let me forget. After practicing the Process Mapping exercise for a couple of hours, Friday night Deman took us to a cultural restaurant for dinner. We ate from an Ethiopian buffet, compete with a hand-washer at the beginning of the line! There was typical Ethiopian music and dancing - definitely the best part of the evening.

Thanksgiving in Addis

Back home it's still technically Thanksgiving - here it's already Friday morning. Yesterday was a busy and exciting day! 

We finally met Deman, our local Global Health participant in the SRS training volunteer program from the Nairobi office. She took us to the EHNRI office (Ethiopian Health & Nutrition Research Institute), which houses the local CDC building among others.  We were in search of the 56 boxes of training materials sent over from the US so that we could assemble and organize the materials for the Train the Trainer session next week, plus the subsequent 6 regional trainings to follow. We ended up moving all the boxes out of the crowded lab they were in to better get into everything. And in the end, we schlepped them all back into the lab in a much more organized fashion!

After all that work, we picked up some wayward luggage at the airport and then did some shopping in a neighborhood market area. We all got some nice souvenirs & gifts to bring home.  Deman was kind enough to find us somewhere to celebrate Thanksgiving with a buffet dinner at a nearby hotel, so apparently if you look hard enough, you can find a little bit of home wherever you are.

I'm also adding a few links to the blog so check those out if you're interested.

Tourist day

This morning I was woken up by the front desk calling to see why I wasn't down at the shuttle to the airport... geez, I just got here! At least that meant I didn't oversleep and miss meeting the gals for breakfast and our quick tour of the hotel grounds - tennis courts, huge swimming pool, mini golf, basketball court - all kinds of stuff!   We had a bunch of housekeeping to do after that - we all needed to exchange some money, Debbie & Joan both had to change rooms, and I had to find evidence that I really did book my first night's stay on points....   Anyhow, after a late start we finally met up with our driver, Sami, and got off to see some of Addis!

First impressions - bustling, noisy, chaotic city of ~ 5 million where vehicles have no traffic lights or signs (or laws?) to obey and everyone does what ever they want. Thank goodness Sami is a great driver! California smog checks are obviously not happening here - the exhaust fumes are pretty hard on the nose and lungs.

He took us past the palace, Piazza, the University and the roundabout Siddist Kilo (Yekatit 12 Monument) up a sharply winding road onto the Entoto Mountain. We passed a lot of women going down, carrying huge bundles of eucalyptus wood branches on their backs. Apparently they cut the wood and carry it into town to home or the market to sell and it gets used for cooking fires. There is eucalyptus everywhere, so not sure why they have to go all the way up and carry it all the way back down - there might be plantations where it is 'farmed', perhaps. I found this link reading someone else's blog - check it out for more info on the Women Wood Fuel Carriers: http://go.worldbank.org/S9UF4PDRN0

Sami let us out to take some photos from a high vantage point and we all got in a bit of a situation that started when I took a photo of one woman's donkeys. She asked for money for taking the photo - I had just got some changed to Birr and had no idea what the small bills were worth. I gave her something and she wasn't happy - apparently 1 photo = 10 Birr. In any case, I guess I did get her included in an earlier shot so not that big of a deal. Poor Joan got surrounded by other women, though - but we all made it out OK and the women got a few extra Birr this morning.

We went up higher and ended up at our goal of the Entoto Maryam Church. 50 Birr each for entrance, not including the museum, and we didn't get to go inside because there was a service going on. Our self-appointed guide did take us around back to see the very modest palace of the Emporer Melenik & his wife Taitu. It was a collection of mud and stick buildings with high and intricate ceilings, hand hewn wooden floors, and thatched roofs. I think one was a living room, one was a dining room and storage area for meat and other foods, and one was maybe a living quarters. The floors, ceilings and inner walls were supposedly original from the 1880;s. We also saw one of the 'ladies' or nuns in the monastery area behind the church along with all the spices and foods set out to dry in the sun, an old guard and his 3 sheep, a small barley field, and beside the current working church, the small, round church that is supposed to be the first built in Addis.  Tombs for Haile Selassie, Melenik and Taitu (all now moved to another location) and for some aristocratic families are also there.  Reading the guidebook, looks like we missed out on seeing a 13th century rockhewn church that was only another 2 km away.

After coming down the mountain, we drove through the Mercato - the biggest shopping area in Addis. I had been picturing a pedestrian area with open sided stalls, but not so. While there are a ton of pedestrians, they are all competing with the cars, trucks and 'blue donkeys' (taxi minibuses) that clog the roads of the Mercato area. It's HUGE and has sections for everything under the sun - produce, textiles, jewelry, shoes, clothes, spices, building & construction supplies, and what our driver called the most dangerous area with all the, um, reclaimed car parts! It wasn't really somewhere we could get out and roam around, so we just took in the sights from the car.  From the Mercato, he drove us by the huge and very new-looking American Embassy, and later the Canadian Embassy with a Canadian flag painted on the gate.  Then he pointed out the almost complete, shiny new and very tall headquarters of the African Union. It's quite a modern and impressive campus - and it's a gift from the Chinese government. On the way back to the hotel, we also saw the UN offices, the Sheraton which was all decorated for Christmas, and a lovely park that was all gated and looked like it might have been closed to the public.

Pretty good first day! Tomorrow we probably have some of the morning off, but after that it's time to start prepping for the upcoming week of training.