Facilities Perspective (11/15)

After the arrival of the container on Thursday, 11/12, many members of the group turned their attention to the physical clinic building for three days, jumping in with Mark and Leo, who had been working on the building all week. Mark Kuiper is an engineer who came on the trip with his wife, Kristen Austin, MD. He was kind enough to provide a wrap-up on facilities as of Sunday, November 15th.

Facilities Perspective (11/15) -- by Mark Kuiper

When we arrived on Saturday, Nov 7, the basic clinic structure was in place with walls, a floor, and a roof. However, there were no functional toilets or sinks, storage shelves, or supplies to fill the shelves. There was lots of work to be done in our seven working days in Addis. We wanted to get it in working order for basic exams, even if laboratory facilities, x-rays, and other major technologies would have to wait.

Leo and Mark began the shelf construction project with a visit to the Merkato, the Ethiopian version of Home Depot, Fabrics n Things, and Fred Meyer. The Merkato to is a large open air mall that stretches for a half mile in each direction. One can find just about anything there. We found the building supplies section and proceeded to bargain for tools at a dozen different shops. With the help of Selam and Masresha (BNCO Executive Director and clinic administration volunteer, both Amharic speakers) we drove away five hours later having purchased some basic tools at a reasonable price. It was Monday with six working days to go.

Leo and Mark spent the better part of three days planning and constructing the pharmacy shelves. There were moments when we weren’t sure if we would finish in time. For example, while the Merkato shops did have the basic supplies we needed, the shops did not have the tool and screw size variety one might find at a home improvement store. Leo and Mark settled on sizes that seemed appropriate and moved ahead. During shelf construction, they discovered the need for longer screws. Without the luxury of longer screws, they looked at what we had and decided to pre-drill a deep hole in the wood. This technique would enable using the shorter screws. Unfortunately, the correct drill bit size to pre-drill the hole was not available. In the spirit of Ethiopian resourcefulness, they drilled a hole with a smaller bit, wallowed out the hole as much as possible, and finished the job by burning the hole to size with a nut driver bit and a healthy dose of friction. It was Thursday with three working days to go.

With the pharmacy shelves complete, Leo and Mark began constructing the records room shelving. During construction of these shelves, they taught Dante (BNCO carpenter) how to safely operate a power drill. It was Friday morning with two working days to go. The file room shelves were about 50% complete when news of the shipping container status arrived.

The container had been on its way from Seattle to Ethiopia since July. It contained many of the supplies needed for the clinic debut. Only there was a problem. The truck blew a radiator hose and was stranded just a mile away from the clinic. The truck driver borrowed the shelf construction hand tools, some plastic wrap, and a pop bottle and set out to fix his truck. Leo, Mark, and Sisay (BNCO public relations) joined him to help out where they could. The driver fixed the leak in short order. With the help of a siphon tube and a five gallon jug of water resting on top of Mark’s head, the radiator was filled and the container was on its way again. By nightfall with the help of a crane, the container was resting on foundation blocks at the clinic. It was Friday night with one working day to go.

On Saturday, an army of volunteers began sweeping out four clinic rooms, washing walls, and cleaning sinks. Leo hack sawed off the two customs locks and cracked opened the container. Clinic beds, chairs, and tables were unloaded. Clinic supplies were organized on the freshly painted pharmacy shelves. A 2000 liter water tank was erected onto a 4.5m platform using only Ethiopian human strength and ingenuity. Mark and Brian (BNCO photographer) visited the Merkato with the plumber to buy water pipe and couplings. Leo coordinated proper attachment of the sinks to the clinic walls. The clinic facility was shaping up.

The morning of Sunday, November 15th was a busy time. The medical staff arranged the rooms to suit patient needs. A patient medical history area was developed, complete with calibrated bathroom scale and pencil lines drawn on the wall for patient height measurement. The city water was now up and running which made additional clinic cleaning much easier. However, the sinks had never been tested with water before and several leaked. A crescent wrench and some silicone caulk improved the situation considerably.

There are still many items on the “to do” list at the clinic. The records room shelves need to be completed. Glove staging shelves must be built for each clinic room. Additional clinic rooms need cleaning. The reservoir and hot water tanks need attachment. The concrete floor needs sealing. Many of the clinic room doors need adjustment. And the clinic doors, walls, and shelves need a final coat of paint. Surely, it is a work in progress. However, progress surely has been made this past week.