JINGS CRIVENS, HEEELLP!

IN JULIA'S WORDS

Sunday, September 8, 2013

[For those without the benefit of a Scottish heritage/friends, Jings Crivens is a mild oath along the lines of “Holy Moley” or “Thundering Typhoons”.]

There’s a stack of thoughts and snapshots accumulated in heads and cameras since our last posting, but all of it will have to wait for now. Because the thunderous fact overwhelming everything else right now is that our dearest Rehana is sicksicksick.

This in itself is a zigzag tale which I will try to summarise (Rehana’s too sick to write, although she’s done the online posting).

She left Addis on 27 August with just a suggestion of sinus/a cough, for which we got some over-the-counter medicine with hardly a further thought.

On our second day in the quite unbelievable medieval Muslim town near Somalia called Harar, Rehana came to a screeching halt over a toasted cheese sandwich when her sore throat felt too raw to swallow, and herself too flou to go on.

Rehana strong enough to tour Harar

Finally getting a photo with one of the many men who henna their beards

Rehana on the top of the world before she fell

We found our way to a very clean, quiet and efficient hospital where a young doctor (too inexperienced?) took one look at Rehana's inflamed throat and confidently diagnosed tonsillitis – which would be the very first time in Rehana’s near 50 years on the planet that she had such a thing.

Still, we went away fairly relieved with a fistful of antibiotics and tucked her into bed at the very quaint (and VERY noisy) guesthouse we were staying at in Harar, expecting that it would all go away in a few days as the antibiotics kicked in.

After all, Rehana has a well-earned reputation as an exceptionally healthy person who gets sick once in a decade – maybe – and then only for a day.

Straight to bed after seeing the doctor

The nedeba (family room) at Rawda's Guesthouse in Harar.

I wanted Rehana to take a bit more time to rest up in Harar but Rehana, Mike and Carol were eager to get on with our travels and concluded she’d be just fine.
The next leg of our trip was to the town of Lalibela, famed in particular for its churches hewn into rock (as you can tell, this is a nation of passionate believers). It being about 1 000kms from Harar, we expected to do it with two overnight stays along the way.

Our first stop was a crap resort-thing on the edge of the Awash National Park, a five-and-a-half hour drive. Not only was the décor prison-like and austere to the point of not even having a fan (for an incredible R500 a cell), but it was parching. 
Plus, here’s something Rehana will never ever get over: She collapsed soon after we arrived, stripped down to her panties in the hot hut we found ourselves in. While lying half naked and shivering with fever on the bed not once but TWICE did posses of staffers burst into our room, without so much as a knock or a “Do you mind”. 
First, to put drinks to cool in the little fridge in our room – presumably the only one working in the place! 
Then three men accompanied the one staffer bringing threadbare towels to the room and hovered and watched her from behind the screen door as she lost her shit with all of them.

They scuttled off apologetically eventually, but what remains is a cultural chasm we can’t (yet?) get our heads around – this Ethiopian penchant to completely disregard personal space and plunge in where angels fear to tread.

I swear they’d settle themselves to watch you showering or changing your tampon – not so much because they’re perverts (as we would conclude in other settings), but because they clearly understand things differently. 
The fact that we’re foreign bodies – although Rehana often is mistaken as a local – surely is a factor too. What the…? Any theories/explanations welcome.

A staffer at the Animalia Lodge in Awash National Park

Afari men are very attached to their weapons - these two are friends

And it was here, in this forsaken nowhere with nothing but beautiful sunsets and stretches of incredible wilderness to recommend it, that Rehana went from being a tad under-the-weather to out-and-out SICK.

She collapsed into bed as soon as we arrived, declined to eat, and was clearly burning up – not helped by the relentless heat. 

Trying not to panic, Carol, Mike and I gave her a malaria test from our kit, but it came up negative. I froze two flannels in the freezer compartment of the bar fridge, and they quickly dried out on Rehana's brow.

The morning after a fevered night. Now she's really sick

The next morning we got up at dawn. Our departure was delayed because one of the staffers at the lodge had fainted and had been laid out on the floor. They asked Mike to take her to the clinic in the town of Awash, about 60km away in the direction we weren't going.

Mike took the woman, accompanied by someone to help, to the main road where they could get a taxi into town. Then he came back for Carol and we finally set off.

Our journey turned out to be 11 looooooong terrible hours. Very terrible is that we both hardly appreciated our bevok mountainous surroundings: I was concentrating on getting over treacherous roads, and Rehana felt too terrible to look at it.

A small snippet of the sumptuous view on the road to Dessie

Rehana's too sick to look

Rehana was flopping rag-doll sick in the passenger seat as we rushed as much as was possible through the milling streets of Dessie. We were heading through it, as per blog recommendations and Garmonia’s instructions, to Lake Hayk. I felt my blood start boiling from the pressure of it all just as my blood sugar started to drop; I was seriously hungry, and seriously stressed.

As the sun prepared to set the nicely tarred road was jammed with people and their livestock returning home. I eased our way to Lake Hayk’s waterfront where Garmonia promised the hotel would be. 
We arrived, near dusk, in a muddled traffic jam – because, as we soon found out – the hotel had been booked out for a wedding. BRC is a tank and the parking lot was small and muddy but I found a parking place and left Rehana there as I went to find out about a room.

A pleasant but stressed staffer (there was a wedding underway, after all) showed me a chalet with a rotting thatch roof and no plumbing nearby to a raging sound system so I declined.

I returned to the BRC and ailing Rehana. While I had been viewing the not-place-to-stay, the parking lot had filled up even more with the vehicles of wedding revellers. The muddy half-metres on the slope I had to manoeuvre our BRC tank free panicked me. 
Now despairing, I prevailed upon Rehana to help guide me. She wanly, fraily got out of the car to help me jigger BRC without hitting the parked cars and buses and taxis, the weaving revellers or a tree. 

We drove the cluttered road again, back the way we’d come. Rehana had by now keeled over. She’d got herself a pillow from the backseat and was twisted half horizontally across the passenger seat, resting her aching head on the pillow where it lay on the lock-box between the front seats.

We roared uphill on windey roads in dying light as fast as mad car, taxi and truck drivers, donkey carts and milling livestock would allow, until we reached the nearby village-town of Hayk. There was little visibly on offer in terms of accommodation and Garmonia was short on ideas. The only several-storied hotel seemed promising. We stopped outside.

Just then Big Silver arrived with Mike and Carol. My three fellow travellers waited while a dodgy young tout took me to see the rooms on the hotel’s first floor. What a fiasco! We wove up and down stairwells and along corridors with khat discards rotting everywhere, goofed people meandering everywhere, and he showed me a room that surely a pig-skollie had just vacated!

We swore and shook our fists at each other, Hotel Tout and I, before BRC and Big Silver dodged our way again up the darkening mountain road towards Dessie. It had several tarred, main roads lined with everything from six-story buildings to pokey shoplets. It was a seriously built up town for the Ethiopia we’d seen so far. Dessie was our one hope.

Outside the no-go Hayk hotel, Carol and I had discussed the bare minimum for accommodation in view of Rehana’s terrible state. It must be on the ground floor and I would prefer it if Mike and Carol stayed in a room close to us. Rehana was beyond climbing anywhere and I needed their help if pear-shaped turned to grenade.

BRC followed Big Silver (we were still very battery-paranoid). There were several hospitals as we drove along the main road but I only noted them. Rehana and I had talked about her going to a hospital but decided we’d give it another night in the hope she’d start feeling better as the antibiotics she was taking kicked in.

Mike spotted a four-storied hotel and we turned into its parking lot. He and Rehana stayed with the cars while Carol and I sought out a person.  We were told there was only one room available and it was on the top floor. Well, that was both of my no-nos in one.

But Carol decided we had to look. Despite my incredulity, Mike’s incredulity, and a semi-comatose Rehana desperately seeking rest, Carol insisted that she and I march up the four flights of stairs and look at the (ok) single room. Carol! What were you thinking?! And what was I thinking trudging after you when there was not a moment to lose?!

Thankfully it was but a few metres up the main road that we then found a much more low key, but single-storeyed, hotel, with two rooms not far from one another. The room was low key as in too small to swing Piccachu around in, but it had a bed and it had a semblance of a loo and shower. I was too beyond it to notice the hotel’s name. I only remember it as Pension Panic. 

Rehana was seriously finished, shuddering with fever, weeping with exhaustion and altogether wretched as she held onto me while we made our way from the car to the iffy bed where she lay down. 

I gave Rehana her antibiotic, paracetamol for the fever. She had no interest in food, even though we hadn't eaten since dawn.  Mike, Carol and I went a few metres away to a restaurant in an old hotel. And then I laid myself to rest too. But didn’t sleep for a long while, listening to the moaning, gasping, too-hot Rehana lying next to me.

And so it was that we arrived on Monday morn (2 Sept) at Selam General Hospital in our Big Red Car. Rehana was too weak to move, so I put on the most purposeful of my personas and, ditching my billowing fears at the door, strode through the grungy, misery-packed corridors to find us a doctor.

My Amahric is sadly restricted to “hello” and “thank you”, which meant a ravine of non-understandings before I found a chemist (complete with white coat and good English) to help me admit Rehana as an emergency.

A ray of hope in Dessie

And so we were introduced to Dr Yimer Ali, a 50-something doc of trim figure and unshaven salt-and-pepper chops, who speaks great English and took Rehana’s imploded state most seriously. She was admitted immediately, and ended up staying for 3 nights.

Here we were faced with two terrible facts: 
1) No quick and clear diagnosis was possible. Malaria, pneumonia, tick bite fever, river fever (eh?), were all mooted. River pneumalbite fever perhaps? Tests for all were negative, but the fever and headaches typical of each were acute. 
Klap-it-out-of-her treatment was the immediate response, which meant full-voltage drugs in the drips needle-sliced into her.

2) The hospital is a stinky grunge-hole, and not for lack of cleaners or intent. The building DOES NOT HAVE ANY WATER. Rehana’s room – a big one in the “First Class” section and all her own – had an en suite bathroom whose stink had to be kept at bay with liberal sprinklings of Dettol and burning mosquito coils (both we brought with us. We deserve the Golden Gloves of Good Planning for such supplies).

The nursing staff are stupendous, and not just because they work in a stink-pit with high volumes of desperate people needing their expertise – they’re just really good. They would find an Eastern Cape hospital a snap AND manage to be gracious and professional, they’re that good.

Angel nurses. Who could ask for anything more?

In these ways I was a great success in finding Rehana the care she needed; in the eyes of my Ethiopian fellows, however, in an important way I was an abject failure. It is their norm for friends and family to sleep on the floor of their ill loved one’s room to help care for them.

Accordingly the nurses brought in a grass mat and grey blanket for me. They may just as well have offered raw rats intestines for me to swallow. I could in no way find it in me to lay myself down in direct smell-line to the suppurating en suite cesspit to spend the night on a dirty floor under a dubious blanket.

I felt fucking treacherous and wrong, but non-the-less retreated to the clean and calm environs of Hotel Time with Mike and Carol for the night. It’s no more than a 10 minute drive away from the hospital. Rehana thankfully fully understood. 


It was, I admit, heartshattering to close the door on my dearest so ill and weak in place unknown, alive with stink and sadness and death, and drive the broken road to my much better accommodation. But I did anyway.

The quiet corridor outside Rehana's ward

Our routine became me arriving sparrow’s fart with Rehana’s breakfast (pancakes and honey from Hotel Time - only once could she keep it down) and then spending the morning giving her a bed bath and hearing her horror stories of the night’s racket and toilet trials.

Then I would leave her as she fitfully slept to eat and nap at Hotel Time, returning for “fever hour” at around 4pm when her teeth chattered as if from cold in her yellowed, drawn face as her temperature climbed above 40 degrees. 

Dr Yimer would then make his rounds; often, he was more frown than confidence when he assessed her. Then we’d do the wet-wipe bedridden ablutions once more before I again betrayed her and drove off in the BRC, hoping not to lose my way nor myself on the black and often storming road.

I got lost, found myself in cul-de-sacs, trapped on a road that ended in a ditch. Even when I went the way I knew, I got lost. I could find my way back to Hotel Time, getting to the hospital in broad daylight was the killer. 

Then the next two problems reared their snarly faces. First, despite being given kick-ass antibiotics, quinine and painkillers, Rehana’s fever and pain persisted. One morning she explained (gaspingly) how it felt as if an evil timpani-playing midget was using her teeth as an instrument. Every breath sent a spasm of pain through her pearly yellows. She wasn’t responding as expected to the treatment – which meant the treatment was wrong.

And here’s the second thing: her arms freaked out at being jabbed with IV needles and swelled up, refusing to reveal any veins. Beyond appalling was watching her silent scream while she bit on bedding as nurse Solomon tried, and failed, to find a willing vein in her feet. 

I fetched a head torch in the car to help Solomon see in the dim hospital room. Finally the slightest bulge of a vein in an arm yielded to a new needle. But her hands were by now knuckle-less obscene puffy gloves, her arms stained with bruises, her shoulders, elbows, wrists stiffened in refusal.

Rehana's arm swollen four times its size

When I arrived the next day as agreed at fever hour, I was horrified to find Rehana's bed empty.

By then I had nurse and other friends who sign-languaged to me that Rehana was having her lung x-rayed. 

The xrays showed an issue at the bottom of her right lung – revealed itself as a pale non-shape – and suggested pneumonia. But as always, the diagnosis was qualified with “suggests”, “likely to be” – never definitive.

By the dawn of her fourth day in Selam General Hospital, both Rehana and I were clear: if it was even slightly possible, she HAD to get out of there. Her body could no longer deal with needles, nor the all-pervasive stench. She HAD to come back to Hotel Time where actual rest and a shower were possible, and I could finally care for her without having to bed down with the creeping goggas.

So when Dr Yimer arrived with his attendant nurses on his morning rounds, I had firmly slipped on my Most Persuasive Persona, determined to state our escape case in terms unrefusable. My sole serious hurdle was that she was again limp with fever – how were we to manage this away from hospital? And the vomiting?

Dr Yimer easily agreed. In fact, just the mention of foul toilets and non-showers was enough. And yes, her medication could be taken by mouth, and she need only come back to the hospital every afternoon for an antibiotic injection.

I could have howled for joy. As it was, I did a dance as you might expect an overwound coil to do and pumped my arms like any self-respecting victorious tennis player. With bloodshot eyes Rehana sat on the bed’s edge and gasped, “Yay”.

And then a hero comes along ... Dr Yimer Ali

Our exit was laborious, Rehana taking the flight of steps one by agonising one until we finally heaved her into the BRC. Probably the best shower of her life followed – once we’d laboured again up two flights of stairs at Hotel Time and then onto the (too hard) mattress she again collapsed.

The next afternoon we returned, again painstakingly, to the hospital and Dr Yimer. He’d now honed in on the issue with her lungs, and we went to a room next door for a scan. 
That triangular no-go area of her lungs was the focus – fluid, they concluded. Not good, not good at all, in an organ that is supposed to be a dry breathing bag.

Dr Yimer measured the oxygen saturation level of her blood – the result a pathetic 77%, instead of the norm of about 90%. After clarifying things in Amahric with the radiographer, Dr Yimer then skilfully plunged a needle in between Rehana's ribs and, to another silent scream from her, he drew out half a syringe of brownish-yellow fluid from her lung. 

I marched down the corridor to take the syringe to the white-coated staff at the tiny laboratory, fetched Rehana from Dr Yimer's rooms and we limped and swayed and groaned and gasped our way back to our hardy BRC and the haven called Hotel Time.

Finally, an outpatient

The night and the day that followed were, for both of us, shocking. Mike and Carol had said goodbye and continued with their journey. Now Rehana was in my care, loving and attentive but my medical know-how is rudimentary – hell, I’d only bought a thermometer the previous day, and realised when Rehana was again limp with fever that I didn’t really know how to read it.

Subduing rising panic I at last spotted the line of mercury in the glass tube and aligned it with the numbers – fucking over 40 degrees! She was cooking!

Once again donning an indefatigable persona (I’ve a full wardrobe full of such handy characters), I dosed Rehana with paracetamol, put a wet cold cloth on her forehead, and commanded her to calm herself so her breathing returned to mere gasping from impossible ragged. 

She slept in a moaning breathless kind of way, me with tenterhooks attached to my eyes and heart next to her. What is this? At what point to call Dr Yimer and call it an emergency – and risk her being admitted to the horrendously harsh hospital again?

But we made it till dawn. And then until lunch. And then until we visited Dr Yimer at 5 o’clock, all the time Rehana almost unbearably crunched by fever, never catching her breath.

Like drunk octogenarians we weaved together slowly, unsteadily once again to Room 6, Dr Yimer’s (thankfully on the ground floor). The nurse outside his busy door let us in, and a somewhat happier doctor greeted us. 
He’d sent a message to Hotel Time that we should come in asap that morning– we hadn’t got it. 
Rehana’s ailment: bluddy Tuberculosis. Her treatment, 4 pills every morning before breakfast for the next 6 months. She should start feeling more like a humanoid within a few days, says Dr Yimer, very much like Rehana within a month, and cured in six months.

Ethiopia, like many African states, is part of a WHO programme which means all cases are notifiable, and there’s no such thing as getting TB drugs independently. The good doctor has written a referral note for us to present at public hospitals and clinics along our route. 
He expects us to be ok enough to continue with our “tour” as planned (Rehana equates the word “tour” with an English visit to Blackpool. Not sure exactly why), and his note asks other hospitals to give us the meds she needs, for free (as per WHO programme), as we need them.

TB!?!?! We both swallowed the news as you may a wrist-sized piece of chalk, both trying not to panic – although me doing better than our poor sickie whose tremors of terror even the staircase outside registered.

So here we are, day 4 for her, day 7 for me, in the apt named Hotel Time. Because time is what we’re both entirely determined to spend, with as much abandon as needed, until she’s regained herself. It’s still quite terrible – Rehana’s temperature soaring and then the vomiting, until again it all subsides into something like normalcy. 


In bed at the swanky Hotel Time

We had an outing today in BRC following quite exquisite mountain passes and stopping for a roadside walk so Rehana can relearn her legs, her lungs, herself. So quickly these are lost, it seems. Humbling doesn’t quite cover it.

I parked BRC at the start of bridge, maybe 200m long across a fast-flowing river. The road across the bridge was flat and pretty enough as a place for Rehana to start regathering herself.  Her stumbling gait attracted a few stares, and one young man stopped, asked what was wrong and then cupped Rehana's one elbow in his palm and walked us across the bridge.

Possibly, we shall go on to Lalibela, Axum, Gondor, the Simien Mountains, as we’ve long planned. Possibly, we shall take ourselves back to Addis for other treatment, or a plane back to SA. 
Like a spinning coin caught in the air (heads? tails?), we’re caught at Hotel Time in Dessie until it lands, and we can finally decide which way to go. Will Rehana respond well to TB treatment? Should we hasten home? This is what the next few days will decide.