Tuesday, 17 November 2009

Mombasa, Kenya with Doctors Worldwide at the Khadija Centre

doctorsworldwide.org

khadijacentre.org


Coconut, mango, papaya, pineapple, banana, orange, apple, tamarind, melon – all the fruits of the tropics are here and they’re ours to devour!

We arrived in Mombasa to be very warm and humidly welcomed at the airport by Mohammed Mapapa, a friend and partner of doctors worldwide, the charity we are working with during our time here. As we arrived late on Friday night, we were told that we would be spending the night at his house before making our way to the Khadija Centre. We were expecting him to live in a small cramped house, offering us a single bed to share in a sweaty room; this couldn’t have been further from the truth. His car pulled up to the gates of his house which was draped by coconut trees and a guard opened the door, revealing what looked like a hotel with private swimming pool to suit. After acquainting ourselves with our lovely room with a four poster bed cooled by a fan and air conditioning, we made our way down to the grand dining table carved from solid wood. We were greeted by the Chef, named Safari who has massive dread locks tied together, lifted up and put in a white hat to make him look like he’s wearing a chef’s hat! We were treated to a fantastic homely meal which was a far cry from our deceased Rosemary friend.

The next day we walked to the picture-perfect white sandy shores of Nyali beach, with few people around except for the annoying local beach boys, who will do anything to chat to you and offer a boat ride, snorkelling session or water sports. We resorted to making out that we had come straight from Iraq and couldn’t speak a word of English, which worked a treat, probably because they thought we had explosives wired underneath our t-shirts! One man said that we were the first tourists from Iraq he had ever seen in Mombasa! We took a boat and sailed out to the coral reef to snorkel with the marine life, which was moderately impressive.

We later met with Mr Faisel Sherman, founder of the Khadija Centre- a school in a very remote, rural and poor area called Rabai, about an hours drive from Mombasa. He is a charismatic businessman who originates from Yemen but spent most of his life in Mombasa. His family moved to London about seven years ago so that their youngest son could complete his education, and this is where they currently reside. Faisel took us in his air-conditioned car and did a whistle-stop car tour of Mombasa, pulling over at various sites to breathe in the air and smell the spices. There is a deep charm to Mombasa, which is a mix of African fun and laziness, Indian spices and textiles and Arabic foods and language. Walk down the Jasmine-scented streets with fireflies lighting your path, gaze into the crystal clear start-lit sky and smile as you crack open a coconut and drink it’s sweet juice. The majority of Indians here are powerful businessmen and are the ones in the fancy cars and big houses. We stopped off on a cliff overlooking the Indian Ocean, where we ate deep-fried fresh Casava crisps with chilli and lime juice. Later that night Faisel invited us to his brothers house where we were served with a slap-up Kenyan meal followed by spicy Masala tea.

The next morning we made our way to the Khadija Centre and were welcomed by the bubbly and motherly Mama Hawa (Mother of Hawa; Eve), local manager of the Khadija Centre. She looks after us in every way possible, cooking us meals and making sure we settle in well. The centre is a very impressive, purpose-built complex with classrooms, offices, a mosque, teacher’s accommodation and a medical clinic, surrounded by acres of coconut palm and mango trees. The clinic is very basic and is usually run by Fernando, a retired nurse (clinical officer) with a background of obstetrics and gynaecology and serves the children at the school and all the people in the surrounding village (around 4,000). The nearest hospital is about an hour away on a terrible dirt track road and the majority coming to the clinic are extremely poor and cannot afford to get there anyway. This leaves a massive amount of responsibility on the clinic and the lone clinical officer running it, so Doctors Worldwide regularly send doctors from the UK there to support the clinic and improve its service and operation. Clinics run all day from Monday to Friday and cases typically seen include simple malaria, viral and bacterial infections and administration of childhood vaccinations. I was initially surprised to see mothers freely and openly breast-feed their children anywhere, be it during my examination of their child to quiet them down or in the waiting room! Someone has recently kindly donated a light microscope to the clinic so we’re taking blood samples and checking for malaria using thick films and have seen quite a few cases already.

The palm trees scattered all around the area are full of coconuts and whenever we want to drink their sweet juice or eat their soft flesh, we ask a man called Khamees (meaning Thursday) to climb up the tree and get us some. He would climb up the thirty foot palm tree with his bare hands and feet with no support and chop them down for us. Or there are the fresh mangos, papaya or any number of delicious fruits to delve into - simply divine!

It was very easy picking up the language with the local lads, I simply got a football out and off we started getting to know each playing footy on the slanted, cow-pat infested, crater mine field pitch. Just keeping the ball at your feet was difficult enough with all the natural obstacles never mind the players!

To get into town we take a Matatu which is a microbus that evidently has no maximal capacity. Hosting about fifteen seats, we have been on when at times there are some twenty-five people squeezed into every crevice, sitting on imaginary seats or on the window ledge, with the bus going at ridiculous speeds doing crazy manoeuvres it’s a miracle we’re still alive. Once we’re dropped off in town, we hop on a Tuk Tuk which is a cross between a bicycle with a motor and chasse and Brum from the children’s TV show. These guys weave in and out of the traffic taking short cuts down tiny alleyways and places vehicles certainly aren’t built to go down. But it’s all good fun in the spirit of Mombasa!

This weekend we plan on going on Safari in the Tsavo, can’t wait.

Marwan

Wednesday, 4 November 2009

Time's up in Ethiopia, the herds have moved on.....Next Stop: Mombasa, Kenya!

There Goes Ethiopia……

The two weeks following the departure of the surgeons left us with the responsibility of looking after the patients who had had operations, some of whom required more attention than others. It is truly remarkable to see how the patients coped with the aches and pains of the days following their surgery, a great ordeal within itself for anyone, let alone some of the young and lonely children/adolescents who had travelled alone, across the country for days to a strange and unfamiliar place. In addition to the dressing changes and wound care, moral support and reassurance was what they needed most, and there wasn’t much that a generous amount of TLC couldn’t fix. However the language barrier did present us with some challenges with the explanation and reassurance side of things. Then came the farewells. Day by day we were reviewing each patient and assessing their recovery in lieu of their fitness to return home. Along with Dawit, we arranged for them to return to their villages, sometimes in groups so that they wouldn’t be travelling alone, or along with their guardians who had come to collect them. Saying goodbye was a happy-sad affair. There was a reluctance to see them leave after having spent so much time getting to know them, yet simultaneously a huge deal of pleasure in seeing them fit, well, transformed in some cases, all happy to be able to go back home. As the patient numbers began to decrease from the original forty down to the current remaining six, the work at the Cheshire took less and less of our time. Following the daily morning round we often found the afternoons free for us to wander around the hillside, or take a ride into town, or as became our popular choice explore the surroundings on horseback.







We came to know of Eve, an English guy living in Ethiopia who owned some stables on the Cheshire premises. Since this was so convenient and easy to arrange we went out for hours trekking through forests, jumping over streams, galloping through fields. With Jigsaw and Polly as our noble steeds, we soaked up the sun and immersed ourselves in the beautiful highs and lows of the hills and valleys surrounding us. On route we spotted hoards of magnificent African fish eagles by a semi dried reservoir in the fields, as well as ibises and a mongoose.

Ethiopia has been a very pleasurable and hospitable host to us over the past six weeks. Our experience here has been unique in many ways and the links and ties we’ve made here are strong and sure to last. The people we have met have been so broad in their lifestyles from local Ethiopians to foreign aid workers or foreigners who have married and settled amongst Ethiopians, all of whom have inspired us in their own way. The lessons we have learned from the way of life here have taught us to appreciate the lifestyles we have back home and that we have much to be thankful for in way of opportunities and potential. Most of all it is a reminder that wherever you go, although life may not always be fair, it is still a life worth living.

Hiba

Farewell Abyssinia


“Meester. Meester. How are you. Fine?”
“Hey. Halo! Where you fram?”
“Ferenj! Ferenj!” (Foreigner! Foreigner!)
“Money-money-money-money-money-money-money”

Just a taster of daily tourist life walking around town. Whatever we do, we just cannot escape the fact that we stick out like tourists with sore thumbs. Change of dress, speaking the language, hanging around non-tourist areas- these are all futile efforts to blend with the locals in view of the one simple undeniable, unchangeable fact- our skin colour is not dark! There are so many poor people in the town asking for money that one cannot simply give to everyone, otherwise we’ll be out of pocket. So we have adopted the ethos of giving to those who are trying to earn money, rather than just expecting to be given by sticking their hands out. An example is the little boys who want to sell you a packet of chewing gum, tissues or mobile phone cards. Also it seems that any Arabs visiting here tend to be quite wealthy, and this is reflected in the amount of money they hand out. Therefore there seems to be an expectation of people that we will inevitably give out large sums of money to everyone. We’ve been followed by little boys about a mile or so down main roads and farm lands, continually asking for money and confronted by groups of woman wearing headscarves, speaking Arabic, telling us that if we don’t give them money we’re going to go to hell. All countries have people in need, but no country that I’ve visited so far has it so evidently placed everywhere you go. This is contrasted with the daily lives of the average Joe going about their business in the forest, the farm, the main road, the construction site- everyone from the tiny toddler to the withering woman is working. Be it herding cattle, building wooden tables, on the way to an interview or carrying firewood for a daily wage; each person has assumed a job in sustaining their way of life and the economy of the country, and I admire them for it.

After two weeks of operating, the surgeons left for home, having successfully transformed the lives of forty-three patients. Of course there were some disappointments and complications, but by in large the patients were grateful for the work we’d done for them. Before making their way back to the airport, the team made one last visit to the Cheshire where Dominique, the flamboyant Frenchman, orchestrated a masterful magic show, which was truly stunning by anyone’s standards. The team were sent off with a coffee ceremony and on they went back to their lives. For us it was emotional as we really felt like we made some good friends that we will endeavour to keep in touch with in the future.

One day whilst playing my guitar, marvelling at the splendour of Menagasha Mountain on the backdrop of a clear cobalt blue sky, a handful of local children etched their way closer to me. I knew what they wanted; cookies, a pen, some socks or something. But no, they wanted to play the guitar! With my fingers on the chords, they strummed the guitar and began dancing to the tunes we created. Like little energiser bunnies, they couldn’t get enough guitar playing until eventually I had, and I followed by constructing a little bow and arrow for one of the boys, named Aklilu. He is around ten years old and the son of one of the nurses working with us at the Cheshire. Using my trustee ‘Victorinox’ pen knife, a stick that had a natural curve to it and elastic band I proudly began carving and knotting the pieces together to make the bow. Every so often Aklilu would try and offer his own suggestions as to how I should tie the elastic, what materials I should use or the type of wood. Of course, knowing best, being older and from the West I continually shook my head telling him to just wait and see as to what perfectly crafted weapon I would eventually create for him. After fifteen minutes or so of frustration, Aklilu ran off to find his own stick and string and within a few minutes, while I was just finishing off my weapon, he had already created his with a bunch of arrows to suit. Comparing the two, his was slightly larger and more threatening than mine, however the real acid test would be witnessing them in action. I decided to go first and show him how a real bow and arrow should work. I stood tall, arched my back and placed the arrow in between my index and middle fingers before gently pulling back on the bow, picking my spot on a tree branch some ten metres away. I released my grip like Robin Hood and off the arrow went some two metres or so plummeting into the ground beneath my feet. What an anti-climax. With prayers of failure whispering under my breath, I watched Aklilu imitate the same motions as I, releasing his grip on the hand-carved arrow. This time, the arrow flew through the air some fifteen metres or so hitting the exact spot he had intended, leaving me humiliated in our tribal warfare. I was a broken man.

Marwan,

How are you? I am Belete. Today is Wednesday. Can you come to our program with your wife to participate? If you came you are Happy!

Your senserly, Belete


The weekly Cheshire talent search begins at 7pm on Wednesday’s in the restaurant wing of the centre. It is overseen by Ayo and hosted by a bright young man called Belete, whom I have gotten to know quite well and become somewhat fond of. He speaks good English and has surprisingly straight black hair for an African, with streaks of white flowing through. He is bound to a wheelchair due to being affected by Polio as a child, although he does not let this affect him in anything he does, be it playing table tennis, football or basketball. The show began like most things here; with music and dance. The traditional Ethiopian dance is something that cannot be described by words alone and exceedingly difficult to pull off by a non-local. It is a mixture of hip, chicken neck and shrug you shoulders in a jerky fashion movements accompanied by unique up-beat music that just gets you in the mood. After this, the room was organised into a central stage and circling chairs as audience. Belete began by introducing everybody and explaining the first game- a kind of ‘Family Fortunes’ quiz with two contestants on stage. The questions covered a wide breadth of knowledge areas and I was impressed as to the audience’s knowledge. If no one knew the answers to the question being asked, they referred to me, the supposed all-knowing British Doctor, who would unfortunately often disappoint! This was followed by a drama acted by some of the children. The story was of a young man as part of a family who was infatuated with a girl. The girl made him late for class and consequently his homework on the prevention of AIDS was substandard. Unfortunately the drama was in Amharic, so that’s about all I grasped!

We were invited to Sunday lunch by friends of Lilla, trustee of the Cheshire and teacher of English at the British Embassy and Ministry of Defence in Ethiopia. Over the weeks we have gotten to know her and have developed a nice bond talking about all sorts from politics to religion to home cooked food and work. She is an active senior lady with a fiery passion in what she believes in and actions she takes. David and Bruket live one hour from Addis in a remote, picturesque and fast becoming touristic town of Debrezeit. We arrived at their lovely bespoke bungalow, with the sitting and dining room offering spectacular views of a large lake. The garden was arranged in platforms with a charming path linking them together, ending by the last part of the garden with the lake water flowing onto its shore. The final member of the group was Molly, another friend of Lilla’s at the British Embassy. Together we sat, ate and chatted about many matters and topics. After lunch, we went on a walk to David’s farm and got to see where peanuts came from- I never thought them to be pulled out of the ground like carrots, but out they came in their monkey-nut shell. The small villages were surrounded by hedges which needed to be pruned but the scene was one requiring an artist to sit and paint.

Our time here in Ethiopia has been one of a personal nature where we’ve really gotten to know these caring and generous people in a way unique to any other of my previous experiences. We may not have seen all the touristic sites, but sometimes all that doesn’t matter when you get to know the true heart of a country; its people.

Marwan

Thursday, 29 October 2009

Mr Marwan Al-Dawit

Patients clean and ready- check.
Patients admitted and medically & dentally fit- check.
Presentation finished and copies printed- check.

It was the day everyone had been waiting for. The day the patients would find out their fate. Some would be told they were going to die and that nothing could be done for them. Others told they were going to get a new face. It was a day that everyone would remember for different reasons and from varying perspectives.

Dawit’s dirt-stained white Toyota Landcruiser rolled up the driveway on yet another glorious sunny day in Menagasha. The 4x4 car was met by a similar response to any vehicle arriving at the Cheshire- swarmed by tens of patients, peering into the dusty windows to see who or what lies behind the glass. Out stepped three world-renowned European surgeons; Dominique, Brigitte, and Larry. One was the first to perform weightless surgery in space, the other with over 60 publications to her name and the third with his own private plastic surgery business in the UK, on his third visit to Ethiopia with Facing Africa. All different personalities in their own right, they were united by a lovingness to offer all that they can to these misfortunate people. The surgeons were accompanied by two Anaesthesiologists; Bill and Patrick, and two project managers/ theatre nurses; Anthea and Mick. As soon as the surgeons stepped foot onto the Cheshire soil, making their way to the guest house where lunch was prepared, they got cracking and began pushing and prodding at the patients faces, discussing what kind of operation they might need to perform together and how.

After lunch, we started our powerpoint case-based presentation with each patient coming in the room, introduced and examined by the team. After a discussion (some lasting 1 minute, others 45!), a decision was made whether to operate or not. The team was limited due to equipment, time and relevant expertise. Unfortunately one of the surgeons who deals with tumours had cancelled at the last minute, meaning that these types of cases were automatically excluded. It was a long day and by the end of it we were all exhausted. The surgical team all headed off back to their hotel in Addis whilst we stayed at the Cheshire, ready to start operating after the weekend.

On Monday we got cracking and started operating- first up, our little princess; Mistikina- for eight dental extractions to be done by Dr Hiba. The patient was to have a short burst anaesthetic, so Hiba only had ten to fifteen minutes to do them all. As it was the first patient, the operating theatre was packed full of all the surgeons, anaesthetists and staff with all eyes on Hiba. Naturally, I scrubbed up to assist in her monumentous task and together we prepared ourselves for Hiba’s toughest challenge yet. Bill, the anaesthetist, injected the magical white potion into Mistikina’s veins and her eyes began to glaze over. After a few seconds, she was out cold. “Get going, you haven’t got long”, Bill said. Like a poet in motion, Hiba began preparing the mouth with her dental instruments then with one flick of the wrist, out popped the teeth, one by one. After they were all out, some required stitching up and as Hiba struggled on the final stitches, Bill reminded us that we didn’t have long and the anaesthetic would rapidly be wearing off. I gave Hiba a hand and put in the last remaining stitches but as I started the final one there was a hand movement from Mistikina, followed by another. She was waking up, fast. With the sweat building up on my brow, I put in the final stitch and the job was done. During the daily surgical schedule, two teams of surgeons were operating on patients at the same time in two different theatres, so Hiba and I would spread ourselves in between them and try to learn as much as possible by watching, listening, practicing and assisting. I even managed to intubate two patients.

After operating, we would head out to dinner with the surgical team. It was a real honour to be in company of so many diverse and interesting people, each with their own unique stories and achievements. We would talk about each others stories and how we came to be out in Africa doing what we were doing. The surgical team were interested in our own particular story and why we have decided to take a year out of work in the UK to come and work in Africa. I think the fact that we’re Muslim also adds to people’s curiosity as perhaps they wouldn’t normally come across Muslims being involved in such matters and experiences. I therefore feel it more important that Hiba and I continue to work hard, travel and be open to new ideas and concepts as these experiences contain a knowledge hidden like pearls in the ocean, requiring more effort than just picking up a book and reading.

Having had their surgery and in a stable state, the patients would return to the Cheshire home for post-operative care and attention. My daily routine would start with a ward round at 08:30 which would mainly comprise of wound inspection (for infection and healing), pain relief and nutritional issues. This would be followed by wound care and removal of stitches when the time was right. After all this was done for each patient (roughly 38), I would have time to relax and enjoy the clear blue skies, strong sun and fresh breeze. I managed to come across an old acoustic guitar that I re-strung and tuned, and I would sit on the freshly cut grass and play songs for the children. At first, they were shy and I played alone, but soon they became interested and one by one they sat down and listened to my tunes. After a short while, a small crowd of some twenty or so patients sat round in a little huddle, listening intently to the notes my hands strummed away. The mother of one of the patients, a woman in her forties, stood up and started singing an Ethiopian version of Hallelujah. She closed her eyes, clutched her chest with both hands, looked up to the heavens and began to sing and dance. She was followed by one of the noma patients, and everyone got involved and began to clap their hands together to the beat. It was great to see all the noma patients smiling together and really enjoying themselves getting stuck in the moment. I passed my guitar around the circle and each patient had a go at playing it, laughing and giggling as they made their attempt. As we sang and enjoyed the music, the sun set on our priceless day.

Interestingly, I found out that Dawit in Ethiopian corresponds to Dawoud in Arabic, which is David in English. I just knew there was a connection with our friend Dawit...

Marwan

Wednesday, 14 October 2009

A sports day accompanied by bats and monkeys, seasoned with Mary’s freshly picked British Consulate Rose



Rosemary, Rosemary, where for art thou Rosemary? That is the not the question! Once an elegant herb instilled in our minds as a quintessential roasting accompaniment, now a weed in our mouths tying knots around our tongues.
Tongue tied?
No.
A tad melodramatic?
Perhaps.

To put things into perspective for those of you who have no idea what I’m talking about, we are blessed to have all our meals lovingly prepared by a pleasant and hospitable cook, Feloku. She will cook us whatever we want and has even provided a timetable to fill in so we can advise her as to what meals we would like on certain days. The first few had sprigs of Rosemary delicately laid on top and several strands lightly mixed in with the sauces. The aroma and flavours were delightful and was a subtle reminder of back home in England. Feloku must have sensed our pleasure and carried on adding more and more Rosemary to each of our meals so that in turn, every dish was loaded with the stuff and ended up tasting the same with only variations in texture! We would now long for the day where our taste buds could actually appreciate some traditional Ethiopian cuisine and not be reminded of our lovely Rosemary. This day eventually came and Rosemary now rests in peace in our stomachs.

Monday brought about a second invitation to a coffee ceremony by a local neighbour, Ayo. Ayo is a social worker working at and living in the Cheshire. She was once affected by Polio, and offers the children counsel as well as general esteem support. She is a short lady, wearing a big smile and walks with a limp using a crutch as an aid. This ceremony was similar in essence to our first experience except the fact it took place outside under the crystal clear star-lit night sky and that the actual coffee making and serving process was carried out in the background by a maid whilst we all sat round a small warm fire. We were joined by Daniel, a manager at the Cheshire who has always been very welcoming to us and teaches us a lot about Ethiopian culture and re-iterates the fact that the origins of man are from these lands. We also became acquainted with a guy who originates from Ethiopia but immigrated to the US, DC. He is a graphic designer who was visiting family here and spoke of his hardships starting from the bottom of the food chain and working his way up to where he is now; waiting for a lucky break. He describes that the life there isn’t as rosy as it’s made out to be, and to our surprise, his desire to return to Ethiopia once he can.

The sports day finally came with a little push and shove here and there. I’ve organised things like this before back home, but here it was a totally different kettle of fish! Language barriers, new concepts and organisation were all obstacles I had to overcome in order to make this the huge success it eventually became. I had employed the services of one of the local teachers, Hailu to act as interpreter, instructor and authoritarian. After painstakingly arranging all sixty or so boys and girls into ten teams with their own chosen team names, I began explaining the games each in turn, beginning with the egg and spoon race. To be satisfied that I had tried my hardest to explain the game, we would show them a live example between us guys. Nothing got the kids laughing harder than watching me jump up and down in a potato sack 50 meters across the grass and back! After a sunshine-filled morning of activity and fun we eventually announced the scores and the final team standings. So what of prizes? The previous day a lady called Marie had arranged for us to collect clothes from the British Embassy, donated from the UK. There was an array of high-street wear ranging from Pierre Cardin suits to Ralph Lauren Polo t-shirts to Diesel dresses to Clarks shoes and even Arsenal football shirts still bearing the £45 UK price tag! We sorted the clothes out into male/female, children/adults and types. The winning team of the sports day (named ‘Aklilu’ due to three members of their team bearing this name) earned first choice of two items to take from our end of rainy season collection. The first two items to go were the Arsenal shirts! For your info, the English Premier League is followed religiously here and the nation’s two favourite teams are Arsenal and Manchester United. After everyone from the winning team had taken two items, the team in second place got their turn and so on until all participants in the sports day were fully kitted-out in designer gear, ready to walk down any cat-walk.

The day was completed when I beat my once table-tennis rival Dawit a much to be desired 4-0, finding a new nemesis in Gezahegn (pronounced Gezahin), one of Dawit’s friends who shares duties with him in transporting members of Facing Africa around town to the various hospitals and centres. However, no day could be complete or even begin without mentioning our new found friends at the Cheshire, the ever-inquisitive, adaptable and widespread Vervet Monkey. They surround our home, based on tree-tops, roofs and anything up high, waiting for the chance to ambush an avocado skin or left out stale bread piece and are a source of great amusement for myself and Hiba.

The monkeys have just recently been out done when one night after returning home after a long day at work we were met by two challenges. The first being the regular but short-lived occurrence of a power cut; no big deal. So we continued preparing and eating our candle-lit dinner for two until whilst chatting to Hiba I saw something whiz past her head. At first I thought nothing of it and continued our conversation. I then wondered what it might have been and whether I should mention it to her. This time I thought that it was probably a moth or some kind of small insect flying past and didn’t want to worry her. But my mind wouldn’t accept this and I told her that something flew past her head. I quickly shined my torch to the ceiling across the room to find a bat ducking and diving through the darkened air! After a brief unsuccessful spell of trying to force the bat out the window, I resigned myself to calling the local guards to come in and give me a hand in trapping the bat in an envelope and releasing it back into the wild. The next day we discovered a gap in the wall/ceiling and had it plastered up, allowing our minds to be at ease.

The surgeons arrived on Saturday and operations have already begun, but this will follow in my next post.

Until then.

Marwan

Sunday, 11 October 2009

Surgeons...Here They Come



Another week in and we're now into the second stage of our project here. On Monday the surgery begins. We spent last week making sure each patient was upto speed with their toothbrushing and medical checks. Betty, a second dental student from Addis spent the week with me helping scale all the patient's largely grotty teeth in order to make them ready for the weekend. On friday, the first of our team mates arrived, Anthea and Mick. We met them in the evening and enjoyed a meal at Serenade along with Roos, a dutch doctor who has been on many previous Noma projects in Ethiopia and will be a great source of advice and help to us over the coming weeks. And finally the day they'd all been waiting for.......Saturday which brought the arrival of the surgeons, Larry, Dominique and Brigitte. As a punishment for them being upgraded to business class, they were only allowed to drop of their luggage before being driven up the hilly road to the Cheshire where they were greeted by all the excited and eager patients. After a brief introduction and a traditional ethiopian lunch, the long and tiring afternoon began where each patient was seen by the surgeons and a decision made whether surgery would be done or not. This process was further slowed by a 3 hour powercut, which was eventually resolved but still meant we finished after the sun was long gone. Having sent the surgeons back on their way, the pain-staking process of breaking bad news began, having to tell some of the patients that they would not be having any surgery. Having spent 2 weeks feeding, entertaining, playing and bonding with some of the most lovely people ever, this was a truly heartbreaking thing to have to do. Having said goodbye to Abiot and Dawit, 2 of the safest guys ever, who did so much translating and rounding up and handing out milkshake for us, the tears were impossible to hold back. We were exhausted and decided to leave this for a day, they already had an idea from their talk with the surgeons and saying goodbye to so many was too much for anyone after a long day like that.