Three days’ rest with a bunch of teachers and their families at the SIM lakeside retreat of Babogaya should have been a break from work. Most of the time it was. Except for Saturday afternoon. Whilst hovering my quadcopter over the tennis court videoing a few of the youngsters playing a form of the game quite hard to identify, I was told someone had fallen down the stairs and knocked themselves out and could I please come?

I quickly popped the quadcopter and its remote control into a safe corner and attended the injured. Fortunately for both of us what had actually happened was a twisted ankle followed by a brief loss of consciousness because of the severe pain. No head injury. Phew! However the ankle was swelling and severely painful. Elevation (easy), ice (available), compression (where’s the first aid kit?) and an x-ray… oh dear. We’re an hour or so south of Addis near the small town of Debre Zeit and no-one in the know would recommend going to any local clinics. I think there’s a distinct possibility of a fracture, so we have no alternative but to get an x-ray. A phone call to an orthopaedic consultant and a plan is formed – I’ll get my patient x-rayed at an Addis clinic we trust (sort of), then the consultant will check it for me to help decide what to do. He’s out shopping for chickens but should be back home by the time we get there.

Fortunately I had driven 11 people to Babogaya in a minibus, and there was a seat that allowed an outstretched elevated leg to be accommodated reasonably comfortably. Many pillows were located, an overnight bag was packed just in case, charged phones and bottled water were found and I turn from doctor to ambulance driver and set off for Addis. It’s a reasonable drive and I try to avoid as many bumpy bits as possible – after all I don’t yet know how many pieces the ankle could be in and anyway shaking it about is very painful. However I’m aware that on the way down on Thursday afternoon I’d been diverted off the main road across a very rough dusty track for a few miles because of road works. This involved crossing a rickety-looking bridge underneath which should have been a pretty river but instead there were literally thousands of plastic bottles. I wanted to avoid shaking my patient to bits driving this off-road track, so I took a diversion, after leaving the astoundingly well-built toll motorway, which proved rather longer than anticipated (there are no maps). In fact we ended up circumnavigating not only the airport but pretty much the whole southern half of the city. After coping with half-finished roads, traffic jams and the usual obstreperous minivan taxis we made it to the clinic after a two hour drive. A very helpful guard who looked to be about 90 gets us a wheelchair and we locate the x-ray department. There are no receptionists (it’s Saturday) and the unhappy guy doing the x-rays demands “paper?” “What paper?” I ask, puzzled. Suddenly all the electricity goes off. Doctor that I am, I know electricity is important for x-rays. “Prescription” he clarifies, “from the doctor.” “I am the doctor” I announce proudly, although I don’t look like one – I’m in jeans and I’ve not shaved for three days. He grunts, goes into an office, points at a pad of investigation request forms and tells me to complete it. I do as asked, present it to him and he says “you pay”. Off I go to the cashier’s kiosk and pay 130 Birr (around £4.50). Back to x-ray and he now does the business – fortunately the power has returned. My patient made a joke to him about power and x-rays – not a flicker. Once the pictures are taken we retire to the waiting room to, well, wait. 20 minutes later Mr Happy brings the film. I check it out. I’m no expert, but I think there’s a small crack in an ankle bone but otherwise it looks alright. We get back in the van (quite a struggle) and head off to the consultant’s place. He’s not back from buying chickens yet, so we wait and chat to his teenage son about computers. When he arrives we check the films and yes there’s a small crack which means the ankle needs plastering and we also need some crutches. I remember seeing some crutches in my clinic store room (a veritable Aladdin’s cave of several decades of contributed medical equipment) but I don’t have my clinic keys. Someone who does have clinic keys lives a short drive away, so while my patient is being plastered I drive to get the keys, then drive half way across the city to my clinic. Getting into the compound takes a while as several guards and other assorted Ethiopians want to greet me. We ask each other how we are, ask after our families, praise God together then I run up to the clinic to get the crutches. I’ve had no lunch so I grab a bit of chocolate from the secret supply in my office and head back to my patient who is now plastered and more comfortable. We say our thanks and goodbyes, load back into the van and head off back to Babogaya.

I don’t have to be quite so careful on the return journey as the ankle is now comfortable and I know I’m not going to shake it to pieces. Optimism that the road will now be open fades into resigned acceptance that it isn’t and we have to take the south-bound cross-country off-road detour again. We bump into a stationary queue of huge trucks a couple of hundred yards before the rickety bridge and despite being out in the middle of nowhere young men pop up apparently out of the ground clutching bottles of water and bags of bread sticks to sell us while we wait to get over the bridge. Eventually when we start moving again we have to take a detour off the detour (on to a hilly dusty track I’m not entirely sure my minivan will cope with) and we soon see why. An enormous thankfully empty car transporter has tipped off an elevated part of the track approaching the bridge and is completely stuck in the dirt, blocking the way. We shimmy and slither around it and eventually cross the narrow fenceless metal bridge. At least if we fell off we’d land comfortably in all those discarded plastic water bottles.

We arrive back at Babogaya six hours after leaving having successfully investigated and treated a sprained and fractured ankle. Result!

If this had happened in the UK we would have called an ambulance, some nice paramedics would have taken my patient to a local A&E department where an assessment would have been done, an x-ray ordered, a medical opinion obtained, plastering done, crutches supplied and follow-up arranged. And it wouldn’t even have cost £4.50. You just gotta love the NHS!