Quite a last day in Addis!!

Well, we had a busy day today!!
First, here is Lemma who I am sure everyone is wanting to meet.

picking us up this morning

?flirting at lunch time.  Well, he does know everyone.

one last crazy moment in the car
The camera just never does these justice.
The truck driver was pretty surly.

We were sad to say good bye at the end of the day.  He also drove Sister Berhane and us around to see other hospitals after we were done making rounds with the residents.  

Here are some of the residents and babies from today.

The residents in the morning before morning report

That's Abebe standing to the right.  He was one of our favorites
though all were actually very nice and we enjoyed them.

The first baby we put on our new CPAP design.  Now off all
respiratory support and about 10 days old.  I think a success.  Sister was
worried about her having no respiratory support but she is doing well
without it!  

another one on our CPAP circuit.  Breathing very comfortably--our CPAP or
perhaps the baby didn't need it?  We can certainly hear the CPAP sound now
in his chest much better.  His prongs also were slightly bigger.

Cindy making rounds in Room 2.  The baby they are discussing
has Trisomy 18.  There was good discussion about the baby, his prognosis,
what the family had been counseled and about doing comfort care.
The residents were going to talk with the family about taking the baby home,
something, I don't think they otherwise would have considered.

Our CPAP circuits are now at every blender location in Room 1!!
And Sister also put a bag/mask at each location.

Cindy and I took Rosie to lunch at Ambassador Park and then we visited 3 other public NICUs in the city including Yeketit 12, Zewditu, and Gandhi Hospitals.  Here are some photos of our afternoon and some commentary (of course).

Incubator at Yekatit 12 NICU

Those ubiquitous oxygen tanks

Rosie and Cindy and I had to gown up to enter the NICU.
These were heavy!! the Head Nurse is next to Cindy

CPAP bottle

LIttle baby on CPAP.
Their set up was different.  Two separate cannulas, one down each nostril.
Otherwise, like the old one at TA before Cindy and I revised.

Two Medical Students collaborating on the Ballard Assessment on this little 29 weeker.

They use an Oxygen concentrator to modulate the FiO2.  We saw two of them

Their medicines.  The nurse told us families have to get them and
bring them in.

O2 sat monitor and glucometer

A little better few of the CPAP circuit.  

Cindy leaving the hospital.  It's a Children's Hospital

The Yekatit 12 monument just outside the hospital

On our way,we saw Sally's Beauty Supplies Store!!
I managed to get a photo.

Gandhi NICU, one of the rooms

a baby on CPAP at Gandhi.  similar set up to Yekatit.

The CPAP "t piece" set up, held together with tape.

a lovely little spot on the grounds with the Hospital namesake
in the middle

A close up

Our cameras were not allowed in at Zewditu.  Luckily, we had our
i-phones for this photo-op.  Can you see?
This is a 10 day old 770 gram baby (likely SGA) who has
been kangarooing with his mother.  Here she is doing his feeding through
his feeding tube with a syringe.
We Americans have a lot to learn about kangaroo care from
our Ethiopian colleagues.  

There was also an entire room of babies with spina bifida.  All meningomyelocele repairs in the country are done at this hospital.  Unfortunately, at least according to the pediatrician who was with us, other needs for these children aren't not as well addressed.  This is probably another opportunity for quality improvement, though we may not know the full extent of what is being done of course.

Sister also took us shopping for coffee!!

Rosie and I bought 4 1.1 pound bags of coffee beans.  This is
Sister's favorite type.  Everyone we asked favored a different brand!
We'll see.  These 4.5 pounds of coffee cost us $18.  

Here is Rosie at Ambassador Park for the first time before our trip around
the city.  Cheeseburger and Fries.  I went with the Lasagna.  Cindy had spaghetti
with meat sauce.
and 3 Coke Lights of course.  

Tomorrow, we will list our 10 most memorable parts of our time here in Ethiopia.