My 101st Heated Stew attempt.

Our small church has two congregations. At 9AM we have a service for mainly older white people, you might label us a ‘dying’ church. But we do have an outreach into India, South Africa and Ethiopia where people from an overseas church which was disrupted have scattered to other places. The outreach is by the internet. Then we have a much younger Indian congregation which meets at about 10.30 for a service and then an all age Sunday School. Once a month we have commenced a combined service with communion. Today was the first such combined service.

You might wonder what a dog staring at a Television set has to do with church services. I’ve written about my dogs before. Sadly they are both dead, euthanized, because they got into my sheep and started killing them. Here is Liesel staring very intently up at a very colourful, very active packed scene. What is she thinking? How is she reacting? I talk to animals, I may be even more stupid as I sometimes talk to myself. They recognize expressions, they respond to moods but I don’t know what they are thinking. I guess when I talk to myself I can tell myself what I’m thinking!

So what has that got to do with church this morning? The Indian adults, although from a different background have been in Australia for long enough to understand our ways of thinking. But I wondered what the kids thought. Their church services are in their own tongue, Malayalam, and this morning was the first time some children have been in an adult English speaking service. The kids’ English is good, but there are real differences in styles of worship.

In the morning tea afterwards I called one of the little kids to talk to me. He was a bit shy and his older brother came to guard him. He’s in grade 1. So I asked him if he could add up. ‘Yes’, he said. I asked him to add up 1+1, then 2+2, then 6+3 and he got them all correct. I saw him counting on his fingers. I knew that kids in grade one don’t deal in thousands so I asked him to add up 6 thousand and 3 thousand. He looked at me with his head on an angle to the side, thought for a moment and said nine thousand. So I asked him if he knew subtraction. The bigger brother said that his little brother hadn’t learnt that yet. So I told him, the older brother, to let his brother try to answer. So I asked 2-1, then 4-2, then 9-6 and he got them all correct. I then asked what if he took 4,000 from 10,000. And sharp as a tack he told me 6,000. For you and me very easy, but I thought for a grade one boy, that was excellent.

I wonder what people think and how much they understand when a church service is going on. The Indian children sat perfectly well behaved – not a noise out of place. But how much did they or any of us hear of the prayers, the songs, the preaching, the communion? I guess it will be told in the way we live our lives this week.

Please note the small skateboard under the table, in the dog picture above. It hasn’t been used for many years. The small boy seen below playing below with two of my grandchildren was run over by a train and lost both legs and an arm. We were allowed to bring him to Australia for medical help but not permitted to adopt him. He used the skateboard and the little ‘do-dad’ in front of him in the picture below to get around. He is now a University student in the USA. We still correspond but I’d love to see him face to face before I die!

He used to love sitting in front of the TV, conducting Andre Rieu as he watched a DVD.

The day I first met him he was about to be discharged to be a beggar on the streets of Ethiopia. I brought him home that evening and it was the beginning of a long friendship. He knew no English, but we had Amharic as a common language. I asked him if he had to get up to pee at night. He said ‘no’. I asked because I knew it would either mean a wet bed or me getting up to carry him to the loo. Then I asked him if he ever woke up screaming at night after the accident. I was surprised and delighted when he replied ‘There is a God in Heaven and I have left it in His hands.’ He was somewhere between 8-10. It was drizzling rain and, on a dirty road, I kept having to use the windscreen wiper and following behind other vehicles when the rain stopped I had to use the water spray jets to clean the window. I tested him when he asked where the water came from. He had never been in a car. I told him that there were two little boys under the hood and I would give them a little electric shock and they would pee for me. I kept a straight face. He looked worried for a moment and then burst out laughing. ‘Now, tell me the truth!’ I knew we would get on well, and we still do.

People can think! It’s what they do with what they’ve learned that counts!

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

People make or break your day!

Often one hears of, or reads about, nasty experiences dealing with people across the counter. Well in the last two days I have twice experienced just the opposite. That is I’ve had contacts where people have made my day! I am in a run of seeing doctors and having tests which isn’t always the most pleasant of experiences and being made to feel comfortable is great.

First up I had to see a specialist whom I had known during his early post-graduate training in a department where I was a senior. I saw him late in the afternoon on the day when he had just arrived back from his Christmas break and I’m sure was exhausted and just wanted to get off duty. But for the first half an hour we talked about the past, he obviously had in some way or other followed my path when I had returned to Ethiopia. He even knew that I had had a period of teaching French! Then he dealt with me in a most kind and professional way, explained his thinking and ordered several more investigations which he wanted performed. And at the end treated me pro bono!

Then this morning I had to go to the X-ray department and sort out a tangle of appointments. At the end of of last week they had declined to carry out a CT scan because of things from my past history. They had ordered other blood tests, the results of which I was carrying with me. I also had the request for the test which they had declined to do earlier and two new requests one of which I wanted added into the previous CT request and the other which was totally different. There were obvious advantages in combining the two different CT scans.

Approaching the desk when called we (my son and I) were met by a beautiful very young looking (that’s almost everyone these days) receptionist. She expected to just open the book and give me an appointment but it wasn’t that easy. She had never, I think, been faced by an old man who knew what he wanted and would, if possible, like his own way. It was not easy for her because they had to contact someone to read the results of the previously ordered tests; she had never dealt with a patient wanting to have two requests ordered by two different doctors rolled into one; then the third test couldn’t be done in their radiology unit and the barium needed for it is difficult to find. I think because of Australia-Chinese relationship at the moment it is hard to get. Then the possible alternative to be used as a contrast in the examination had to be approved by the surgeon ordering the test, and he could not be contacted as he was operating. She sought help from a senior, another young looking very pleasant lady, and together they worked on the problem for about 45 minutes.

Through it all she was calm, professional, friendly and nice to work with. Thus I have had two very pleasant contacts in two days. Now I remain hopeful that the tests will be as comfortable and that the results are decisive and nice! I don’t know her and maybe we’ll never meet again, but she made my day! I was very happy to tell her so.

Dominic Cartier