Goals

Goals:
- to establish Centres of Excellence in each country where malaria is endemic;

- to train local people to implement their own successful operational Integrated Vector Management programs;
- to significantly minimize the number of adult mosquitoes towards creating vector free zones at the community level;

Thereby, significantly reducing the transmission of malaria and the impact of the disease within communities.

April 5, 2011

Canamancan Travel Blog Entry No. 3

This blog entry is written again in my hotel room in Juba while waiting for my second meeting with Dr. Samson Baba. The meeting scheduled for today, Wednesday, was postponed until tomorrow morning.

I'll start this blog with the morning of March 25 at the hotel in Jimma.

I woke up around 6 a.m., it was light and I was drawn to the window by a noise. Below was a man with a screw driver working at opening the door of the SUV next to ours. I decided not to sound the alarm. It was probably the driver of the vehicle which looked to be worse for wear than ours. I commenced packing my gear and a short time later went back to the window. The vehicle door was open and the hood was up. I heard the whirring of the starter motor and the strained chugging of the engine that was failing to fire. A white man stood patiently by the opened passenger door.

I turned from the window in response to Simon Turial wrapping on the door to my room, "Dr. Barry, Dr. Barry….. we have to leave now; the road is not good in town and we must leave before the traffic!" The time was 6:45 a.m. or 45 minutes, Ethiopian time.

I opened the door and there was Simon dressed and ready to go. I looked up into his eyes, they were red and watery.

" How are you feeling Simon?" I asked.

"Dr. Barry … there is no air passing through the left side of my nose, I have never had this before! I have got your Canadian cold?!"

Indeed …. I went over to my medical kit and took out the bottle of cold and sinus pills and emptied the bottle onto the bed, splitting the pills into two equal piles – one for Simon and one for me. "Take two every four hours," I directed. My symptoms had returned just when I thought that I had it licked.

Kevin and Simon Hughes were up and taking some movie footage in the room. They had a restless night with a band playing until the early hours on their side of the building. A little later the band was replaced by the yapping of street dogs scavenging for food.

We finished packing and made several trips down the stairs with the luggage, paid the bill and headed out to the vehicle. The SUV that had been beside ours was gone. Apparently that driver was also a mechanic.

Simon was calling Bedru on his cell phone to come before the appointed time. It seems that just about everyone has a cell phone. Mr. Mo Ibrahim, a Sudanese-borne billionaire who built one of the first mobile phone networks on the African continent and his like had done a thorough marketing job.

It was not long before Bedru joined us. We loaded up and somebody mentioned breakfast …it was free, included with the price of the room. "It is free Dr. Barry," Simon Turial echoed with a smile. The priority of beating the traffic dissipated and just the thought of our two shots of Ethiopian coffee put smiles on all of our faces as we headed to the restaurant.

An hour later, we hit the road. We passed relatively quickly through the part of town with construction and then stopped for fuel.

Finally we were on our way and with any luck we would be in Gambella before nightfall. Simon had called his son on his cell phone to make reservations for three rooms at the Ethiopian Hotel. This disturbed me a little as I had specifically asked Deng to call Simon to do this several weeks prior.

We were passing through the highlands of Ethiopia and would continue to do so for most of the day. The air was relatively cool at 2000 metres altitude and the ride comfortable although cramped. Every three hours or so, we would stop and one of us would rotate to the front passenger seat for more leg room. The road was a paved for most of the way and greatly improved since the last time I travelled along it in 2008.


Breathe taking - driving through the highlands of  Ethiopia
from Addis Ababa to Gambella (March 2011)
Around noon I asked Simon Turial if he had taken the cold meds that I gave him. He replied, "No, I will take medicine of my village when we get to Gambella." I responded, tongue in cheek, that I wanted the pills back that I gave him that morning. I was assured that I would get them back – never happened. Many Ethiopians believe that the white man's pills, any pills including aspirin, are a treatment for malaria.

We passed through several towns sharing the road with a multitude of pedestrians, both two and four legged. Dogs, mules, cattle, sheep, goats and more goats were common. The cattle were always accompanied by herdsmen in and around the towns but often along the open stretches of road we would see animals meandering alone. I think we all wondered if these wayward animals would be missed by their owners.

We passed by huge tea plantations that went as far as the eye could see over rolling hills, banana trees were abundant, sugar cane and coffee plants. Baboons and other assorted monkeys were fairly common but flighty, so only a few pictures were acceptable.

A tea plantation in the highlands of Ethiopia
(March 2011)
About mid-day Simon received confirmation from his son that we had reservations for three rooms at the Baro Hotel in Gambella.

Ascending along the winding roads was worrisome at times when Bedru would overtake a truck or bus on a curve – no clear line of sight. There was always an audible sigh of relief when we safely passed the vehicle and were back in the lane.

Around 3:00pm we began our descent along a steep windy road with switch backs. Close to the bottom we were stopped at a police check point where we all produced our identification papers and the vehicle underwent a modest search. I did not mention earlier that Simon Turial had forgotten his identity papers when he left Gambella to meet us in Addis. He was challenged each time we entered a Ministerial compound in Addis when we were working on the camera issue and each time he talked his way in. When village raids occurred in Gambella Region, it was Simon's job to negotiate peace as representative of the Regional Government, his skill at negotiating became apparent the few days we were in Addis.

As we left the check point, Simon noted that the President's car was driving past us in the opposite direction. President Omod Obang of the Gambella Peoples' National Regional State Council would apparently not be available for a meeting with me this visit.

The last 140 kilometres to Gambella were at an altitude of 800 metres with a consequential increase in humidity and rise in temperature to 38⁰C. Foot and vehicle traffic waned as evening approached. The scenery continued to be magnificent with rivers and lush vegetation.

We crossed the Baro River bridge and entered the Town of Gambella with 777 kilometres between us and Addis Ababa. A short time later after refuelling the SUV we entered the Baro Hotel compound. The guards with their AK47's were preparing for the night's watch. Kevin and Simon Hughes unloaded our luggage and I was squaring up with Bedru when Kevin called out, "They only have one room for two."

The Baro Hotel Reception
Gambella, Ethiopia (March 2011)
Rooms at the Baro Hotel (Gambella, Ethiopia; March 2011)
I went over to the reception where I was greeted with a smile, the fellow recognized me from the three previous stays. I had learned several years back this was the best establishment in town with clean bedding, rooms with fans, running water, toilet and shower, a restaurant and a generator that ran most of the night. I wasn't particularly surprised at this situation. I was disappointed. I had words with the receptionist and later with Simon. Nobody was smiling. It was suggested that I come back tomorrow, there might be an opening. I knew there would not be, it's the African way of trying to end on a positive note.

I told Kevin and Simon that I would arrange for them to have the room that was available because accommodation quality in terms of North American standards went down from here. 

Inside the room at the Baro Hotel, Gambella, Ethiopia
(March 2011)
Kevin sprays the rooms with permethrin to keep the critters
down, Baro Hotel Gambella, Ethiopia (March 2011)
Then Simon and I headed out with Bedru into the night to find a place for me to stay.

Three places had no available rooms, at another I was shown a room but with no lighting it was pitch black inside. I declined. I like to see the critters I would be sleeping with.

I remembered a compound where Ouvry and I had spent our first night in Gambella Town, four years prior. The rooms were small with one light hanging from wires in the ceiling, a cot with a mosquito net, wooden shutters on the window with no screening, an outdoor guest shower and a toilet that was a hole in the ground. We drove over to find it was closed but the manager was outside and said the owner had a second establishment called the Park Hotel just outside of town. He made a call and there was one "excellent" room left.

We arrived in complete darkness and were greeted by a boy no older than twelve. He led me by the light of his cell phone to the last room and unlocked the padlock to the steel door. I took out my flashlight and had a look. The boy left and a generator started up and there was light. It looked fine, it was 10:00 p.m. and I was tired. We unloaded my luggage and I bid goodbye to Bedru who took Simon to his home. I don't know where Bedru would have slept that night. He assured me during our journey that he did not sleep in the vehicle.

I had closed the door and was unpacking when I heard a faint wrap on the door. It was the boy with an insecticidal spray canister in his hand. He directed the spray up into the cracks near the ceiling which brought forth a rather large black spider, the likes of which I had not seen before. Being an entomologist, my fascination is with six- legged critters, I dislike eight-legged ones. I reached into my pack and brought out my heavy duty spray bottle which I always carry with me in Africa and finished it off and the boy kicked it outside. Some might think this unusually cruel especially for a "bug" person" but to better understand my ruthlessness I should tell you that I have been bitten by spiders while I slept and was left with necrotic areas on my torso that took three weeks to heal and over a year for the scarring to fade.

After I paid him 70 birr the boy left, I sprayed the rest of the room including around the windows and doors, killing the roaches and crickets while they scurried around. Master of my domain, I continued unpacking when the generator stopped and the light went out. Where did I put that flash light?

The next morning, Saturday the 26th, the same boy came to my door and informed me there was no food but soft drinks were available for 5 Birr each. I ordered a Sprite and continued packing. The boy returned with the Sprite and I gave him 10 Birr. Apparently, he was impressed with the tip and asked would I like to upgrade to a better room for 90 Birr. The upgrade included an actual porcelain toilet (no seat) not just a hole in the floor, a large ceiling fan over the bed and thick spring mattress, better water pressure and all the plumbing was present – decedent! I paid for the room, included a tip and was helped to transfer my luggage.

Simon Turial arrived in a small three-wheeled vehicle with a young driver. This was the typical Gambellan taxi, painted blue and white. If you are a Gambellan you can get a ride anywhere in town for three Birr. If you are white, 10 Birr – still a deal. We were off to meet Kevin and Simon Hughes and arrange the agenda for the day.

Typical Gambellan taxi
We crossed the Baro River bridge and headed into town.

The Baro River Bridge (Gambella, Ethiopia: March 2011)
Transport barges on the Baro River waiting for the rainy
season and the water to rise (March 2011)
Dugout canoes for short trips and fishing
on the Baro River (March 2011)
Simon Hughes and Kevin had had breakfast and were busy filming and organizing the equipment. It was almost 11:00 a.m. and Simon Turial and I had not eaten. Over lunch, Simon agreed to obtain an extended cab pickup truck for the afternoon and early evening. He would also arrange for me to meet with Deng's wife to pass along some gifts from Canada. Being Saturday it was not likely that Khor Puoch, the Minister of Health, would be available to meet.
Mr. Khor Puoch, Minister of Health,
Gambella Region (November, 2007)
Simon Turial was good to his word, as he generally is, and the Minister of Health supplied our vehicle of choice. Simon also had convinced one of the Ministry drivers to moonlight for us through the weekend.

Ouvry and I had developed the vector control strategy for the Town of Gambella in 2008. The task now was to develop a presentation to obtain funding. If a picture is worth a thousand words, then what would movie clips be worth?

Simon Hughes clambered onto the back of the truck, positioned the camera, steadying it with his elbows on the cab roof. It was hot in the cab for us and had to be hotter for Simon in the back, exposed to the sun. Simon filmed where we directed while Kevin, Simon Turial, the driver and I made comments. It wasn't long before we purchased bottled water and not long before Simon's elbows were bloodied from steadying that camera.

Simon Turial (our man in Gambella) explaining how
this flood plain area becomes a major larval habitat
in the rainy season (Gambella, Ethiopia; March 2011) 
Kevin larval sampling in a pool remaining from
the last rainy season (Gambella, Ethiopia; March 2011)
Kevin training budding vector control specialists
(Gambella,Ethiopia; March 2011)
The afternoon's filming went well and during a brief break I met with Deng's wife.

Over supper and St. George's beer, we discussed our departure from Gambella by air around noon the next day. Kevin gave me the spray that was left after treating their room. I had a feeling that I might have use for it in my upgrade.

After the meal I was driven back to the Park Hotel, arriving just after dark. The generator was running and lights were on. I unlocked the padlock on the door to my room, turned on the flashlight, found the switch and made light. Hmmm ….what are those dark spots on the wall? Ahhh …the spider from the other night apparently had three relatives in this room - two black and one opaque. Raising the sprayer Kevin provided, I nailed the spiders and then targeted the nooks and crannies. Rather large ants were scurrying around the base of the bed … so .. sprayed the floor, sprayed the bed, sprayed under the bed ….went to sleep!

The night went well; an added feature of the new room was that the electricity remained on all night which meant the ceiling fan kept the air moving and the CPAP was working. Definitely an upgrade!

Around 6:00 a.m. I showered, packed and then found a chair and sat in the shade of the mango trees in the compound. The morning air was cool. Most of the other guests had left and it was quiet except for the staff sweeping the dirt. The boy brought me a Sprite and I read an article on Mo Ibrahim. Rested and relaxed, I waited for my ride to the Baro for coffee and breakfast with the boys.