Day 3 - Boroma
Arrive in Boroma after a long “road” journey of several hours.
We swerved past a giant tortoise leisurely crossing the road. Also
there are baboons and camels loiter in the distance. Other drivers
pass with people hanging from all grabable parts. It’s surprisingly
green as this is the rainy season. Usually this area is a yellow
barren wilderness. Arrived escorted by an SPU security vehicle in
convoy with two soldiers for our protection.
Boroma is a small town about one mile from Ethiopia. I have
never walked around it in my many visits here so don’t know exactly
what it is like, but it does look a bit like Haiti after the
earthquake in terms of rubble strewn across the “roads”. There’s
hardly a car in sight, but goats wander the main streets with no
I orientate myself to Ray’s hotel - the place to be in Boroma -
if not the only place in Boroma. We are a short walk to the Fistula
Hospital, but we can never walk there without our armed guards.
This is a heartbreaking place where women whose lives are ruined by
obstetric misadventure have their lives returned to them by a
relatively simple surgery.
We can however cross the road. It's about five metres to the
venue for the final medical exams. Nine students wait anxiously for
their obs and gynae exams. This morning they had surgery.
This is OSCE format. There are many amazingly and disconcerting
anatomical specifications to do a removal of a placenta, deliver a
baby and other tasks all in eight minutes. The exam is now over so
I can reveal one of the OSCEs was a discussion with a woman (actor)
whose baby had died. The actor gave a wonderful performance. Most
candidates were sensitive and empathic to the plight. Maybe in some
way our mental health training last December helped this group. If
I wasn’t a psychiatrist I would want to be in obs and gynae after
seeing what happens here to women and the dreadful problems of
giving birth in this country.
I met Dr Jibriil who is doing fantastic things for mental health
in Boroma. I taught him some years ago as a medical student and now
he is developing psychiatry out-patients in Boroma, a maternal
mental health programme and community services along with the
support of the wonderful Faduma. Faduma is a Somalilander who lived
in Canada then came back to her homeland. She devotes herself to
developing maternity health in the region but also is a strong
supporter of mental health work. I always come away enriched after
speaking to Faduma who in her quiet way has improved the lives of
so many people in direct clinical training contact, and by her
selfless devotion to others around her.
Looking around at the medical students and nurses, I acknowledge
that I have taught mental health to just about everyone. I am
unsure if I feel a sense of accomplishment or just old! Abdel Ghani
is another keen nurse who now works in mental health and helped me
during nursing teaching last December. Everywhere, I see my old
students who are now working, teaching and giving life to the
principle of sustainability.
It is now raining with thunder and lightning. So much for the
tropical weather and break from the UK. However this is not a place
to go for a walk. We are allowed to walk around the hotel and that
is it. There isn’t a feeling of poor security as we follow the
rules and 8pm curfew, and never walk around outside of the hotel
It has been reported that there is a risk of attacks on
foreigners since the death of Osama Bin Laden. Al Shabab in Somalia
have taken to using women as their preferred method of weapon. Yet
Boroma has been a peaceful place relatively for some years. We are
about one mile from Ethiopia.