Never in the UK

A random neck x-rayI well remember one of my anatomy lecturers at University College London Medical School describing the anatomy of the neck, especially around the spine, as “lion country”. It is easy, he said, when operating around the spine in the neck to do huge damage very easily (he was a surgeon). “if you cut something you shouldn’t”, he explained with a wry smile, “hand your instruments to your assistant, say to them ‘you carry on – you’ve always wanted to do one of these!’ and then get on the next plane to Mexico.”

Which is why I have not referred one of the patients I saw this week (let’s call him Melaku – not his real name) to a surgeon. He certainly has a problem with a disc in his neck, but I am not confident there is a suitably qualified and experienced surgeon here who could fix him. He has seen me many times with his neck and shoulder pain, and if I manage to find a pain killer that helps then I’m his hero. If not, then he won’t talk to me for weeks. He spent a few weeks last year sporting a hard neck collar which seemed to bring a lot of temporary relief. As he left my consulting room this this week holding both his neck and a prescription for a new medication, I was regretting not being able to refer him to a suitable neurosurgeon for a definitive cure for his difficult problem. Sister Elsabet (who had been translating) and I exchanged knowing looks – he’ll be back, but let’s hope he gets at least some help from the pills. “Did you know that there’s an alternative meaning to the English phrase ‘a pain in the neck’?” I asked Sister Elsabet after Melaku had left. Elsabet grinned – she likes learning English idioms. “Yes”, she replied, “and you corrected me for using another word for a pain in something else a while ago.” Indeed I had. Her English is excellent, but sometimes she comes out with things she’s picked up that would raise eyebrows in a similar UK situation. On that previous occasion it was an alternative and somewhat impolite way of saying the phrase “a pain in the posterior”. We laughed, and I asked her to bring in the next patient. In he came, and we greeted each other warmly. “What can I do for you today?” I asked him in Amharic, but his reply needed translating. “He’s got a pain in his … bottom” replied Sister Elsabet, professionally, and without so much as batting an eyelash.

How Alarming
Me, at 5:30amIt was around 5:30am the other day when we were both rudely woken by a loud continuous whining, moaning noise echoing around the neighbourhood. Chris sprang out of bed; I sort of, well, slithered blearily (I’m no good at 5:30am, although I could have sworn it was much earlier judging by how I felt). It was totally dark still, and from our elevated vantage point we managed to identify a small tanker parked by the gate of the wood business just outside the Bingham compound wall as the source of the awful noise. It was either pumping something in, or (more likely) pumping something out - of their septic tank I expect. With all the windows shut it was still loud enough to leave us both sleepless, and it went on for another half an hour. Given the flimsy nature of the dwellings around the cacophony, I can’t imagine anyone was asleep for quite a distance. Burying our heads under pillows, we both wondered what would happen in the UK, if a tanker making that amount of noise were to strike up in the middle of a residential area at 5:30am?

Stickers Galore
The UK practice of making sure your vehicle is clean, shiny, unscratched and undented at all times would be a mystery to most Ethiopian drivers, who, in addition to not appearing to mind dents and scratches, enjoy emblazoning their vehicles with names, pictures and religious phrases. You still see the occasional lorry with “Obama” proudly plastered across the top of the cab (I have yet to see “Trump”…) I can read some of them now: “The gift of St Michael”, “Mary is my mother”, “the Holy Trinity” – that sort of thing. A variety of head images and silhouettes are everywhere – Emperors Haile Selassie, Menelik II, Tewodros II, Prime Minister Meles Zenawi, Che Guevara, Ronaldo, Bob Marley. It makes for entertaining taxi rides each day, trying to read what’s plastered across the back window of so many minivan taxis.

7f6b0a6f62063bd11bd023bc808794a1-2But recently a host of new images have appeared – of politicians, and most significantly Dr Abiy Ahmed, the new prime minister and the person responsible for what the BBC has recently called “the most extraordinary story of reform in the world today”. His image is on numerous vehicles, private and public, accompanied by a number of other significant politicians and ethnic leaders. Wondering what would happen in the UK if people drove around with pictures of Mrs May stuck on their vehicle’s door and windows makes for an interesting thought experiment.

Whose Car?
One bumper sticker we see quite often on numerous private cars and the occasional truck says “I belong to Jesus”. Judging by the number, Jesus seems to own a significant proportion of Ethiopian vehicles.


if you didn’t see it, the BBC “Our World” documentary from 12th January 2019 about Dr Abiy is available on Youtube. It’s on iplayer for another two weeks of so. Its full of the sights and sounds Chris and I have become so familiar with. Fergal Keane does a very good and fair job:

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