A Day Out.

My orthopaedic surgeon allows me to take, once every few months, a high dose three day course of prednisolone to allow me to have a pretty pain free couple of days. I use his permission for special events. I used it this week.

In retirement my wife and I live with two of our sons on a small 100 acre (40Hac) property. About 40% of it is taken up with 2 hills steep and covered with my enemy the Chonkee Apple. That leaves us about 60 useful acres. One of my sons is adopted and younger than many of our grandchildren. He is an apprentice mechanic. The other much older has a part time job as pastor of a small church, and makes caring for us and the farm the rest of his job.

So what do we do on the 60 acres? We are developing, I guess you would call it a hobby farm, with Dorper sheep. Initially we bought 12 ewes and a ram. We got 11 lambs, sadly one of which was stillborn and the dogs got at two of them. The dogs have since gone to dogs’ heaven even though we loved them very much. A farmer cannot tolerate that behaviour, and I refused to see them chained up all the time.

So we have 8 lambs nearly ready for market (males) or putting back into the breeding flock (females).

Here the lambs are separated in a small paddock to finish fattening them.

As we separated them from the small flock we counted 8 of them. I think if you try you can count 8 heads. The brown in their ears makes counting a bit difficult. But there were 8. Yesterday there were 9!

Now if you count correctly there are 9!

All our ewes have ear tags. None of these have. The 2 uncastrated ram lambs are easily identified and there are still only 2. So How? I don’t have an answer except maybe our neighbour who has a few now has one less. Something about grass on the other side of the fence being greener! At any rate they are looking in good nic.

But what has that got to do with my use of prednisolone? Nothing! We decided to buy some more ewes. Hopefully by getting a good percentage of ewe lambs we hope to run a breeding stock of about 50. The only place we have been able to get them is a round trip of about 1,200Km. This area around us is a cattle area, so there aren’t many sheep, and not many have dorper sheep. (These don’t need shearing, they shed their wool.) So I, usually limited to small trips and often in a wheelchair these days, wanted to go with my son. Hence the three day course.

This son, whom I think is extraordinarily capable, has built two crates to fit a ute and a trailer plus a ramp

So setting out at about 10 in the morning, we arrived back and by midnight had unloaded the extra 15 ewes and were in bed by midnight. I thoroughly enjoyed the outing.

Sunset on the way home over the long Western Queensland plains. It has been a good season.
The new sheep waiting in the yard the next morning. They are a pretty colourful group.

Now we’ll have to wait and see how many lambs we get. They’re all supposed to be pregnant.

Dominic Cartier.

What’s in a picture? Memories

I certainly didn’t expect to see this picture when I opened my computer this afternoon. But there it was straight in front of me.

It’s not the best quality picture but it holds lots of memories.

  • Our only daughter was born when we were home on furlough in Australia but then we returned to our work in a mission hospital, where I was a surgeon. For our daughter’s sake I had better not tell which year it was, as ladies are so conscious of their ages. It was however well over 40 years ago. She is as lovely and beautiful a daughter as anyone could wish for.
  • The young man, a late teenager, was employed as a gardener but took on the role of her constant carer and companion. He loved her heaps.
  • One morning he arrived late for work and we asked if he had had his breakfast. He hadn’t, so we asked him to eat with us. We were having fried tomatoes and onions on toast. He ate it all but then said something I will never forget. ‘You foreigners don’t like all our food. Now I understand why. That was terrible.’ Innocent lovable honesty.
  • He had tuberculosis of his neck glands that responded to treatment’
  • We attended his marriage some years later. He has a lovely wife and beautiful children. Sadly one shortly after graduating from University died.
  • He’s still alive but has known tribal persecution and suffered several major health problems, but is still a man I’m delighted to call a friend.

All that flashed through my mind from just seeing a poor quality old photo. I loved the kid, loved the man and his family and still even in his relative old age think very fondly of him.

Dominic Cartier

Maybe Malnutrition plus ?….

Don’t you wish that you had a better memory. I have a terrible memory for names and it gets me into trouble. My wife accuses me sometimes of not being interested in people. But that’s not true. I understand why it frustrates her and when we meet up with people we’ve not seen for a while she has learnt to say to me ‘Dominic you remember ….?’ The stock answer is obviously ‘Of course I do! So lovely to meet you again.’ Unfortunately, if I’m not very careful I’ve forgotten almost immediately. Not that I’ve forgotten the person, only the name and I can go on chatting about past memories, but not using names! Well, in truth, it’s not quite as bad as that but you understand. On the other hand hand I have little trouble remembering the events of our previous getting to know each other.

Don’t you think she’s beautiful? I do. Don’t you think that she’s skinny? I do. Besides her malnutrition can you pick her diagnosis? We have a lady come in every second Friday afternoon to help a bit. She is a nurses aid. So I showed her the picture and asked her what was wrong with the girl. She said ‘you mean apart from her being malnourished?’ She is pretty skinny but I don’t think is actually malnourished but certainly a bit underweight. But look at her left shoulder. I’ll bet that there was more than 100 cc of pus in that abscess. From the way she is sitting leaning on her elbow I’d be surprised if it is a pyo-arthritis; more likely an abscess in her deltoid muscle. Still pretty painful but not as bad as if there is pus in the joint. And it looks as if the glands are affected in her axilla.

I know how it hurts to get ‘bitten’ by a rose thorn. And if dad or mum couldn’t get it out, a child in our land would be taken to the hospital emergency or the doctor’s surgery. They obviously were not the poorest of the poor, (look at that pretty pillow), but even so she didn’t turn up at the hospital until the abscess was this size.

Seriously thank God and the government and a slowly changing attitude to illness, things are a lot better than they were fifty years ago. But the need in Ethiopia and many countries is still huge. At least momentarily it makes you wonder if you or I can make any useful difference. Our grandkids and great grandkids have already so much more than we did or our kids did when we/they were young. So we have (except when they are very small) stopped giving presents. So for Christmas in all their names we give a larger gift to an organization who we believe we can trust to deliver aid on the ground. For birthdays we tend to give smaller gifts in the person’s name to a worthy cause – and there are so many of them around. Do any of you have good suggestions to pass on? If so please let us know.

Cain years ago try to fob God off when he was asked a question about his brother Abel (whom you might remember he had murdered) by saying ‘Am I my brother’s keeper?’ Well I’m not going to run around wringing my hands because I can’t solve every problem, but the question is thought provoking.

Two loveable imps. One having lost most of his right arm; the other with half a thumb gone and having lost his scalp to a hyena. You can see the dressing under his cap. Lovely kids!

Dominic Cartier.

Looking at a picture..

You can wander through your photos and think different things…..

  • Why did I take that?
  • I can’t remember what that was!
  • Weren’t we stupid to do that.
  • I wonder where they are now? etc
There are no other nasty pictures to follow and this is just a little six week old baby boy.

This photo takes me back over a lifetime of medical practice.

The past…As a first year intern in Adelaide, in the days when specialists were not as plentiful, I was sidelined into being a temporary anaesthetic registrar for six months to cover a shortage. It would be not even an option in this day of many more available people. But it gave me the opportunity to have a hands on experience which has served me well throughout my years of practice as a surgeon. Almost all of my time in Ethiopia I had to give/supervise all of my anaesthetics when I was the surgeon. So for chests and abdomens, orthopaedic and urological procedures the responsibility for the anaesthetic lay with me. Sometimes I even had to unscrub and deal with a problem before getting back to the operation. And tiny babies are a special problem; this boy was vomiting and needed to have his abdomen opened. I was, once the child (everyone knew that he was a boy, in spite of the troubles which politicians seem to have these days!) was properly anaesthetised going to leave the management at the head end to a cleaner. The length of the trachea in which the tube had to stay was only a couple of centimetres long – if it moved up he couldn’t be breathed for; if it went in too far, one of his lungs and maybe even one and a half of his lung capacity would be blocked off! I can remember my years of specialist surgical training; I can remember leaving my parents and siblings for a life in a land with, to me, a variety of unknown languages and a totally different culture.

The present….Here was the first born son a young family whom they had watched for a couple of weeks as he vomited everything they fed him and they were afraid that he would die. They were unsure if they could trust this young foreign white man, in their eyes an infidel. But they came and all their hopes were hanging on this moment.

The future…He survived and they were very, very happy. But here I have to let my mind float away into the ether. What sort of education did he get; is he married; did he become a good boy and make wise choices; is he a blessing or a curse to those around him. But that is the future of every patient you treat – some you get to follow and know, others are just passing in the night. Do you wonder why I like looking at the photos on my computer?

Dominic Cartier

Jimma – a city of Ethiopia

The road which we walked from our home to town or to the hospital. Before we got onto the asphalt there was about 400 metres of dirt or mud depending on the season
Our little local shop. Muhammad was a lovely guy and became a friend.

The administrative parts of the University were well built. The hospital was an old Mission Hospital and not up to date or adequate.
The tea room for the University staff was very pleasant. The one for hospital workers was very different!
The hospital doctors tea area, as seen from sitting at one of the chairs.
There was much building being undertaken, including a new hospital. It is now, about 12 years after its planned opening, being used. There were many large hurdles which had to be surmounted..
While we were in Jimma there was a period of Christian persecution. About 90 Orthodox or Protestant churches and many of the Christians’ homes were burnt down. We were living in a rented home on the town church compound and hundreds of people fled and were housed on the compound.
At Jimma we found and adopted our seventh child! He’s now much taller than Robin.
This was taken the day the first 4 doctors were granted their postgraduate surgical certification. From left to right : One of the graduating surgeons – he was very capable but very hot-tempered and the last I knew he had be ‘shifted sideways’ for threatening to kill the medical director; An Egyptian surgeon on staff; another of the graduates – after further training he is now a pediatric cardiac surgeon in Addis Ababa (he did further training in Israel and Melbourne); a graduate who with further training is now a plastic surgeon in Jimma; a girlfriend; a graduate who has worked in Africa but outside Ethiopia; me; a doctor in postgraduate training who has now his certificate and has started his own private hospital; a hanger-onerer!

Dominic Cartier