One month in Ethiopia

Hello MSF Volunteers and Staff, Greetings from the cold, wet and unusually heavy rains of Ethiopia. Counting this day, I have been here in Ethiopia for exactly one month. Time flies and the time spent working with MSF has never been dull and boring. Everyday seems to be a new day with new excitement, challenges and wonderful happenings. I am working in a MSF Kala-azar Epidemic Mission located in Addis Zemen town in the Amhara Region of Ethiopia. The place is very nice but basic. It is halfway between the two main and important cities of Ethiopia, Gondar (the old capital and a very historic city) and Bahar Dar (a bustling and very touristic metropolis with a very good asphalt road network). We are a big team, and in our MSF base close to the health center, there are almost 12 expats living in the compound but only 8 mainstays, the rest are with the emergency. We are also a very international group, with members from Austrian, Italian, Spanish, Uruguayan and of course me, a Filipino.  My work is very challenging. I am supervising two national Lab Tech staff and three others from the District Hospital plus doing in-service training for other health workers in the health center. I love my work. It is not a very boring routine of lab work. My lab is small but it is fully functional, thanks to the MSF resources. I spent my first two weeks organizing the newly opened lab and it was just last week that our international orders from the MSF Logistics center arrives. It was a little bit tiring doing inventory and at the same time working and keeping the lab functional but it's worth it. Now we have a very nice lab and plans are underway for its expansion. In the past few months, I have made connections and networks with different referral lab hospitals in the region for external quality assurance to ensure the reliability of lab services. With my Field　Coordinator and Medical Coordinator, we are also developing a proposal to build a blood transfusion unit and will explore possibilities of expanding the lab services to other pressing health issues on primary health care, HIV, malaria and TB. Our national MSF staff are amazing people. They are very hardworking and dedicated people which I find very "unusual", based on my previous experience working in another country in Africa. Our patients are usually sufferers of the Kala-azar disease and malnourished children in therapeutic feeding center. Everyday, throngs of malnourished children are being weighed and given supplemental feeding in our center. We have children as young as 15 days and as old as 16 years old admitted, and it is a joy seeing them recover after a week or two, but we also have our share of heartaches as some of our patients die due to complications. Now, every time we report for work in the morning, some of these children run towards us with such nice, sweet, innocent and lovely greetings that really makes our day worth living. Too many Kala-azar patients are in our health center; they range from as young as 5 years old to as old as 60. This disease is a little bit scary as deformities are very evident among our patients and because of this, they are ostracized by the community. But of course, our health center is the best of all (love your own!), we don't only have medical intervention, we also have a lot of social activities while the patients are staying in our observation tents.  Just this morning we had a traditional dancing session with the patients and they enjoyed a lot. It really breaks the monotonous and boring environment in the tents and it was a joy to see the patients smiling and finding it easy to mingle with us. I made a lot of compromises here, as well as experiencing contrasting realities, but when I work with my staff in the lab, I feel very privileged to be given an opportunity to share the simple experience and knowledge that I have with them, and it is worth it.  Working with them and seeing the future in their faces keeps me motivated. I put a lot of energy in teaching and supervising them and doing practical lab procedure demonstrations with the nurses. I have since then been able to communicate freely with them. Being a friend and a lab supervisor to them is very new to them because they were used to having a stereotypical relationship between a MSF expat and the national lab tech staff. There are still so many challenges that I am facing. One of them is the difference in language and cultural orientation. But I came to realize that there are many reasons why this is happening. Ethiopia is currently facing an almost annual imminent hunger due to extended droughts. The mortality rate is morbid, because of combination of factors like HIV/AIDS, malaria, tuberculosis and other neglected diseases. I came to realize that making a difference is what is expected of me rather than going with the flow. As much as we don't want it to happen, it is now the rainy season. However, here at MSF, we are prepared for its eventualities. Hopefully no epidemic will arise out of this unusual rainy weather. Nevertheless, as the old adage says, behind every rain cloud there are rays of sun to signal a bright new day, and this is Ethiopia, a timeless and a beautiful country. To end this letter, I invite you all to come and visit Ethiopia, forget the stereotypical image, experience the beauty! Ryan Jose E Ruiz

Filipino Laboratory Technician Ryan Jose E Ruiz joined MSF in 2007. From 2007, he worked in Kambia in Sierra Leone to provide basic health care service. In June 2007, he left for his first mission to Amhara, Ethiopia.