International Placement – Gondar, Ethiopia: Meghan Thurston

I have been fortunate enough to travel extensively and live in different countries throughout my lifetime; however, from the very start of planning this placement I was greeted with ‘Ohhs’, ‘Ahhs’, and ‘Wows’ along with looks of ‘did I know what I was doing’ and ‘aren’t you brave’, I knew that Ethiopia promised an unparalleled experience.ethopiablog1

Preparing and planning for the placement required a lot of patience and persistence but all good things come to those that wait! On arrival in Gondar, despite a few minor hiccups, I was overwhelmed by the genuine kindness and welcoming attitude displayed by the Ethiopians. Nothing was too much trouble and their candid warmth enveloped you and there was no other option but to embrace it and be thankful.

I arrived during epiphany, Timkat, where the streets come alive with colour, music, the mesmerizing Gondarian shoulder dancing, and an utter embrace of religion, and community. It struck me how fortunate I was to participate in such an intimate and cultural ceremony and that I never once felt like a tourist or outsider; the vibe was electric and an amazing induction to Ethiopian life. Being part of this experience you could almost forgive the 4am prayer calls that lasted over five hours because you knew and felt part of the celebrations and what’s more, that the Ethiopians completely adopted you.

Once the spirit of Timkat died down and reality set in I was able to visit the University of Gondar hospital site. I had arranged to meet the head of psychiatry and an introduction to the mental health ward. As with anything in Ethiopia, you work to Ethiopian time. Literally, their time is different; Ethiopians use a 12-hour clock starting at 6am. They do also assume a casual approach to schedules. Initially, this proved quite the contrast to working in the UK where meetings, appointments, conferences, are arranged and times are adhered to. On reflection, this made me consider the importance of flexibility and how adaptable their approach was; whenever I unexpectedly asked someone directions or randomly arrived in their office I was always welcomed.ethopiablog2

My first impression of the mental health ward was overwhelming. The ward is set up to support seven females and 12 males; during my two-week visit only four of the female beds were occupied. Patients are admitted only if there is family support that can attend daily. On admission patients are sedated and often chained to their beds due to their perceived aggression. Many have been chained at home prior to admission, some for up to six years. Often females are not admitted as their difficulties are identified as not requiring hospitalization and treated with ‘holy water’. I spent quite a few days on the ward and slowly I was able to develop an understanding of their current practice. Limited resources both staffing and material wise meant the nurses (the sole profession on the ward) were working beyond their job capacity, embraced enormous responsibility, and attempted to help the patient at the heart of it all. The difficulties faced on the ward: staffing levels; resources; time constraints; were reminiscent of difficulties faced in the UK just expressed through different cultures. I wondered how many potential patients were excluded based on the lack of social support on admission to the ward but also how this dynamic influenced recovery? Culture and religion were significant factors in understanding mental health difficulties; the emphasis placed on these aspects was enormous. A lady approached me and asked me to ‘touch her and heal her’. This certainly made me mindful of understanding the individuals’ experience of their difficulties and maintaining a non-judgmental and open dialogue to ensure a complete appreciation of the situation.

Gondar

I was also able to spend a significant amount of time at the University of Gondar’s psychology department. Through their request I provided a substantial amount of teaching and support to the course. A useful exercise and good revision in being culturally sensitive, and also, via feedback, a good experience and useful input for both staff and students on the course. I transported a generous donation of textbooks from the University of Leicester to the University of Gondar, which was most gratefully received. Both of these experiences highlighted to me in Western culture, in particular in education, how much we take for granted, being accessible, and our choice. I learnt that students do not select their course or University but based on grades are told where to go and which vocation they would be suited to. Internet was considered an extravagance and most people did not even have basic needs such as shelter or water. Sometimes it is fruitful to take stock of what we have in our lives and simply be grateful for these luxuries; this is something that will certainly have a lasting impression on me from my time in Ethiopia.

ethopiablog3Most of the placement was spent at the hospital or University however; I did also visit and learn about other projects. The Kindu Trust – a project supporting extremely poor children. Most of these children prosper through this organisation and attend University and work at the hospital. I spent time working with the children and writing reports for the trust. Despite their tragic stories the contagious laughter and smiles on the children faces was heartwarming – their hugs were pretty amazing too! I learnt about and spent time with the community mental health project, which aims to promote awareness and allocate resources where necessary. The drive to provide health care facilities was admirable to see. I noticed most services were focused on the younger and working age generations and severe mental health difficulties – partly a reflection of awareness and the average age of Ethiopians. The community rehabilitation project, which I visited, was a pioneering scheme to support children with physical and learning disabilities. It was great to see that consideration of support was being offered to these individuals but again limited through understanding and resources.

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My preconception of Ethiopia was a country plagued with a narrative of famine and poverty. What I was met with was quite different; yes, poverty still does exist and Ethiopia remains one of the poorest countries in the world. However, I was left with a sense of community, support, and an infectious desire to progress which made the daily commute of 25 people in a 10 person bus, diet of injera, and constant covering of dust all worthwhile.ethopiablog4

Incidentally, ‘Meghan’ in Amharic means you are patriotic about your country – well, Ethiopia, you have certainly sparked a passion in me! Amesegenallo!

 

Meghan Thurston is currently a 2nd year trainee on the DClinPsy.

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