Chapter 13 – My Tent Clinic
SIM Ethiopia had an impressively good administration. When we arrived in Ethiopia in 1966, SIM asked for my nursing registration from Canada. They put it through the Ethiopian government system for an Ethiopian registration for me. Back then many little clinics and hospitals run by Missions like SIM made up the medical care in Ethiopia. It was a good system and continues to this day but with more regulation from the Ethiopian government.
On the basis of my registration, the current SIM administration suggested we go ahead and start a clinic.
I was delighted to hear this. A clinic, no matter it’s size would require some kind of building. So we decided that a tent would get us started on a temporary basis until permits and a building materialized. Even if it did have a dirt floor!
We had been given a square white tent with a large flap that opened one entire wall. We decided to erect the tent under a large tree not far from our little tin house. With a makeshift examining table, some wooden shelving and “BD boxes”, I was ready for business.
These “BD” wooden boxes were about the size of a small trunk in which our SIM Business Department sent supplies from Addis Ababa, including all the medications. Steel banding was used to secure them. They were recycled over and over again.
We opened in early November with eight to ten patients each day.
I wish you could have visited my clinic. It was a hive of activity from 8:30 a.m. until 1:00 p.m.
Next to the 10′ x 10′ floorless tent were benches made of blocks and boards on which the patients waited. At this point, our fellow worker, an Ethiopian named Alemu, was my translator and clinic evangelist. As the patients waited, they heard the story of God’s love for them by tape in their own language.
As the clinic got better known, I treated up to 20 people on any given day. About a third of the patients were babies and were brought, sometimes a distance of up to two hours walk, snuggled on their mother’s back, covered over by her cowhide cape or homespun shawl. Some of the more common complaints were whooping cough, diarrhea, scabies and burns. I also saw a lot of malnutrition.
I wrote a clinic card for each patient, and sometimes with much giggling on the mother’s part, I had to help name the baby before I could give it a card!
It was really a blessing for the people to have cheap medical help like this. Our big SIM pharmacy in Addis Ababa made many of our medicines and MAP (Medical Assistance Program) in the States provided a lot of our bandaging, etc. A penicillin injection only cost 40 cents for an adult.
The miracle drug penicillin came to Ethiopia as an injection. So most people attending the clinic wanted their medication by injection. A pediatric sulpha solution the pharmacy made was a great help to me in treating babies with infection.
However, I wish you could have peeped in the tent when it was time for them to pay up! (They were just charged the basic wholesale cost for treatment.) First I had to convince them that this was not like the market; they could not barter for the medicine. But after that, they just sat and thought about it. Then Alemu would say, “Ok, now pay.” Then they started getting at the money. It might be tied in a corner of a man’s white shawl. That would only take about two minutes to be slowly parted with. But it also might have been wrapped in a small rag inside a tiny drawstring bag, and that bag might, in turn, be secured in the folds of a lady’s turbaned head scarf! These were poor people and cash was always scarce.
While this was going on there were usually one or two of the local elders at the tent door. I think they were making a decision about this new situation, a nurse in their territory. They also were trying to take an active part in the examining and treatment of the patient. Village elders seemed to consider this their privilege, and we seemed to spend a lot of time trying to convince them that it wasn’t. And the grannies were worse. Just gently try to tell a granny, who also doubled as the local midwife, that this baby she delivered a year ago didn’t need her to speak for it now — just mommy was necessary. Many times I just gave in with a smile. I loved caring for the babies.
Borema was Norm’s trusty helper not mine, but when I opened a clinic in a tent, if something interesting was taking place in the tent, he cunningly and unobtrusively made sure that he saw it. Often I had to sew up wounds. I injected a little local anaesthetic, used lots of antiseptic, and then simply took a needle and thread and sewed. Borema often watched.
On a day off, Borema and his cousin took off walking with their dogs, to see how their crops were doing. Men usually carried a spear and a walking stick. The spears were kept razor sharp. They could shave their faces with them, and cut off a hunk of raw meat (favourite feast food) with their spears. His cousin’s name was Gummeda. Borema was working for us, but also grew a field of corn near his mother’s little mud and thatched roof home. Probably the land had been given to him by his father. During the rainy season, farm lands in Ethiopia appear idyllic with their little homes, fields of corn and some chickens and goats.
I suppose they had walked a couple of miles, when on a grassy knoll, a baboon jumped on Gummeda’s dog. Gummeda tackled the baboon with his spear. But the baboon grabbed the spear also, and they wrestled over it. As they swayed back and forth, the baboon slit Gummeda’s leg, about a 12 inch gash down the calf of his leg! After the baboon left, Borema got Gummeda down to the river, and got his leg into the flowing water, ran to his father’s third wife’s homestead and got a big needle. (Needles obtained in the countryside market were intolerably huge for us foreigners used to small needles.) Someone had some string, and Borema sewed and sewed! At dusk, Borema, leading a borrowed white horse with Gummeda on it, arrived at our home. We took a look at the wound and were amazed at the story. He did a great job of pulling that wound together with even, tight stitches. Borema was smiling a lot. I gave Gummeda an injection of penicillin, and some pain killers for home, and the leg healed up beautifully.
Speaking of baboons, I remember back to when we first arrived at Langano. After lunch one day, we noticed about a dozen baboons sitting and munching on the wild figs that had dropped to the ground just behind our little tin house. So we went out, just as we were, sat on a log in the clearing and watched them. We sat there quite a while: them looking at us, we looking at them. God was certainly watching over us; so naive we were!
Eventually Norm constructed a building for the clinic. When we write about that, we will have more interesting clinic stories.