Under African Skies.

I always thought the term African Skies would be a false idiom. I mean really, how different can the sky be in Africa from the sky in Newfoundland and Labrador? How can the clouds in Ethiopia be different than those in Calgary? The earth may be large, but we all share the same sky and the geophysics of clouds is the same no matter where you live. Or so I thought.

A team of 10 of us arrived from Canada after a thirteen-hour flight from Toronto to Addis in Ethiopia, followed by a one-and-a-half-hour flight to Goba, a rural town of approximately 30,000 people. The plane lands and the thing that is most striking as soon as I walk down the stairs and across the dirt path is the sky. It somehow seems larger, bluer, the clouds closer with their borders more exact like they were carefully placed by an obsessive artist.  

After quickly dealing with a luggage mishap, we departed in a vehicle for our hotel. It felt good to lie back on a bed for a few moments after such a long trek. I took a deep breath but found my chest feeling a little tighter and my lungs a little stiffer. Which is exactly when I heard one of the team members say, “did you know we are at almost 10,000 feet above sea level?” Well that explains it. Perhaps it also explains the sky as well, but I don’t think so. That was something more than altitude.

The towns we drive through are like many found in the developing world: makeshift markets surrounded by donkeys and chickens running along the side the car with refuse and old cans embedded into the uneven surfaces of the roads. Tin huts and partially constructed small buildings line the streets. This is set against the backdrop of the mountains jutting up to touch the bluest sky you’ve ever seen. This country is as beautiful as it is poor.

There is no water in the hotel for showers (I know, I know…first world problems), so the team decides to leave and investigate the town. It’s safe here and easy to explore. It’s full of incredibly friendly people, waving and stopping to speak on the side of the road. The familiar smell hits me immediately. It’s a mixture of a burning open fire kitchen, coal and dust, balanced with sweet aromas of flowers, evergreen trees and fresh air. I cannot put my finger on it, but somewhere in my memory there are flashes of Haiti combined with British Columbia. 

It’s incredibly dry here with seemingly no humidity. And even though the sun is bright, it doesn’t make any of us sweat as we walk. It’s the type of dryness that sucks the moisture from your breath before it leaves your lungs. As the sun sets, the team returns to the hotel as the temperature drops quickly.

The next day we depart with our host, Dr. David Allison, for a tour of the hospital and to meet some of the participants of the Trauma Course we are here to teach. The hospital is a series of buildings that’s a sight all too familiar in my past tours of low-income country medical facilities. The buildings are connected by a maze of loose, partially covered walk ways where patients huddle to get shade from the direct sun. Inside the buildings, the halls are exceptionally crowded, and poorly lit, often with a single light bulb hanging from a wire. The patient rooms are full of patients and their family members trying to help with care for their loved ones. The beds are all too familiar as well. All are of different makes and models, and in various states of disrepair. In fact, in one room there is a bunk bed or two. That sight is a first for me. The rooms carry the smell of spilled sterilizing alcohol and human despair. The patients all smile as we are toured through the rooms, and I wonder what they must be thinking as the parade of Canadians with North Face backpacks walk by.

The hospital is on bust. There are patients everywhere. Our host tells us that the hospital provides services for 300,000-500,000 people. They are the regional referral center for a population the size of Newfoundland. And there are only two operating rooms, each with one light and full of antiquated equipment. But they are functional and servicing surgical and obstetrics patients effectively and well. This becomes a theme throughout the hospital’s twisted maze. Equipment that functions on the will of the people. In fact, at times they function without water for weeks at a time. Weeks? Can that be right?

Empathy is a mixed blessing in that carrying it will exhaust you both physically and mentally. That night, I collapse on the bed. Asleep before my head hits the pillow. I don’t remember what I was dreaming but I could smell coal burning and flowers. I hear the clack of tires on tin embedded in the road.

The next day is the first day of the Trauma Course. We will be providing training for 50 frontline providers. It’s a team approach to trauma. Nurses, doctors and surgeons all working together to treat the most critical patients. One thing that was evident from yesterday’s tour was the burden that road traffic accidents present to this center. This course is welcomed and needed.

The course itself is a combination of lectures and skills stations. The participants will have a chance to learn and then practice. We have completed this course in four countries now and it always brings a smile to my face to see the participants start out shy and not answering questions at the beginning and then smiling, laughing and asking for more at the end. People are people no matter where you go. To see teachers like Mike Hogan and Darrell Boone transferring the skills of life saving emergency procedures on mannequins, or Tonja Stothart and Sonia Sampson teaching basic airway management, it all reminds you that the sacrifices we all made to be here are so worth it. These opportunities exist because our volunteers and donors care so much.  

At the last station of the day, the team of Ethiopian students and surgeons gather to perform a simulated trauma scenario being directed and evaluated by our staff. Dr. Chris Patey is the director and the fake patient is Karl Smith. Even Karl, our newest board member and former CFO, is getting into the action and letting the students examine him as he responds appropriately to their interventions. I love it. And those same students who were too shy to say hello this morning are now running around yelling for IVs and X-rays.  

That night, the president of the university, which has 23,000 students, welcomes us with a traditional Ethiopian dinner. It is outside, and the air is cool and dry. In the middle of an open space, there are logs stacked 6 feet high in the shape of a tent. A traditional bonfire. It feels like home. Like I’m on Topsail Beach with the lights of Bell Island twinkling across the tickle. Here we are in the middle of Africa with people gathered around a fire telling stories and laughing. The only thing that is missing is the gentle crash of waves on a rocky beach and we could be at home.

The next day we set out to repeat the course. On the walk to the hospital we pass children headed to school. They all smile in their Sunday best. Their uniforms are pristine. They can go without water and electricity here for weeks and yet these kids’ uniforms are perfectly white. They are laughing, teasing and high-fiving the team as we walk past. Kids being kids.  

One of my New Year’s resolutions was to try and run more. It’s not my favorite activity, but I am committed to try to run several times a week. I took my running gear on this trip. Art Rideout and I decide that we will run early in the morning. It’s a 5:30 AM start. As we are running, what is immediately evident, other than the physiologic effects of the altitude, is the sky. The stars are still up, and they are the brightest clearest I have ever seen. It is as if you can reach out and touch them. Makes you aware of your tiny place in the universe. It’s humbling. 

As we continue our run, the sun begins to rise, and some locals join us for small portions, running alongside of us for short distances. Others we pass wave and give the thumbs up in encouragement. The sun is out now, and the smiles are evident on their faces. In the distance across the plains of browned sunburned grass are mountains that provide an amazing backdrop to this incredible sunrise. Cattle herders are now bringing their cows to the pastures, and we have to stop multiple times to let them cross the road. They move slowly with the bulls in the front. Their guide smiles and says good morning with almost a Newfoundland nod.  

I needed this now, this month. With Haiti never far from my thoughts and the hard decisions and hard anniversaries still sitting on my chest, I find peace in the smiles here. You can see hope on the faces you meet. Whether that’s a patient hoping for a positive outcome or the cattle herder about his daily business while always offering a prayer for rain. Or the medical staff we were teaching as they are eager for better health for their community. I remember as a kid hearing someone say the sky is blue because it is a reflection of the earth. I know now that’s not true, but I like the poetry of the idea. Maybe that is what’s special, even magical about this African sky. It’s a reflection of this place. A mirror held to the face of hope. The bright colour of a better tomorrow.