Day 2 in Istanbul....happy birthday # 65

 Birthday themes:  running, marathon running, Hagia Sophia, eating, cats...

The order of things isn't right!!

The sign at the start of the Hagia Sophia.  25 Turkish Lire to enter
Quite a line.  

some Turkish mosaic in one of the mausoleums.  There were five of them
with many sarcophagi.  Lots of little ones for the Sultan's kids 

a mosaic in the big mosque.  Mary and Jesus.  

more tiles

the ceiling was way up there in the mosque

a very big chandelier in the middle.  That's Rosie underneath

We walked down to see the run.
First man, at the 40k mark in 2:03.  I think about 2k to go
That's the Bosphorus Strait on his right. 

first woman

first person overall, wheel chair runner a couple of minutes before the first male runner

You will have to imagine the food.  Moussaka, simit and cheese snack, enormous breakfast that included yogurt/fruit/granola and more halvah.  

Many cats live in Istanbul.  Here are a few.  They are all very well fed and we believe they are protected.

Here are a couple more photos from the square.

The fountain was on in the main square

Another view of the news stand

Istanbul food fest day 1

Perhaps just photos can tell the story of our first day in Istanbul....some walking, viewing the mosques around the hotel, eating eating....oh, and a hot shower to die for.

The breakfast buffet....coffee, halvah, eggs/cheese, zucchini  blintzes, cheese
olives.  fresh squeezed juice.  Yum.

the front door of the hotel from the lobby area

the breakfast area from a different angle

day time view from the terrace out to sea 

the front door of the hotel from the outside

one of the mosques that we haven't entered just yet. 

The square--a news stand

all of the world's papers--including weekend International Herald Tribune 

artichoke appetizer and Turkish flat bread

dessert--chocolate souffle and ice cream  

the terrace view at night.

Istanbul and Addis

We arrived in Istanbul early this morning.  We had a couple of false starts with our visas and passport control and then baggage was quite slow coming.  But then the woman from the Esans Hotel was waiting and we drove there.  Our room wasn't ready but we had a lovely breakfast and walked around the Sultanahmet area for a bit.  To get money from the ATM machine and see some of the sites.  Lots of mosques and hand crafts.  Also lots of hawkers wanting to sell to the tourists, dogs and cats and people.  Tomorrow is the marathon and we ran into Finns who have come here for that.  I wish I had known.  We will come next year.

The city is a stark contrast from Addis and I found myself feeling a bit sad about Addis and Ethiopia because there is so much opportunity there and I think it will be hard for it to ever be realized.  Ethiopians are lovely people and what we saw was also beautiful and historic.  Like our Wyoming, I don't think it will ever be discovered; unlike it, there is much suffering and poverty that will remain unattended to.

So what were the most memorable parts of the time in Ethiopia?

The NICUs of course, at Tikur Anbessa and also the other NICUs we saw yesterday.  There is much to  be done to improve the quality of care.  It will take an ongoing big commitment from those in Ethiopia and those who can supply knowledge and resources from elsewhere.  Physical and digital infrastructure, working equipment, supplies, more staff, more education and training are all needed.  Like the roads, it will be bumpy but of course, it can be done.

We met wonderful people there--the residents who are full of energy and like their American counterparts, very much committed to their professional responsibilities; likewise Sister Berhane and many other very dedicated nurses;  likewise the mothers who remained at the hospital and in the NICU watching over and caring for their babies.  All welcomed us into their world, let us take their pictures, asked us to teach them and help them--and of course they were our teachers as well.  Lemma, quite a character, Zewedu who was always ready to drive us and the gentlest of souls; the people who fed us and took care of us at the Red Cross, the aerobics class in the morning some of whom ran a little with me around the compound, the waitress at the Loyal restaurant and the waiter at Ambassador Park who were always smiling when they saw us, our three entrepreneurial guides during our Northern tour and more.  It didn't hurt that 100% would have voted for Obama given the chance.

Asfaw, his family, his schools, the teachers and especially the children we met and saw there were all amazing.  Quite a remarkable accomplishment and I think a shining example of the possibilities that come from creativity, focus, persistence, stubbornness of one person over his lifetime.  Hedgehog and fox.

Asfaw

One of the classes

Addis Ababa--chaotic, polluted, crowded, crazy drivers, people walking everywhere in every direction, city boys, hidden quiet places, markets, stick scaffolding, potholes, people living on the street.  The airport--we made several trips through there coming, getting Rosie, getting Rosie's bags, traveling to and from the North, and leaving, each a bit of an adventure.  We never did retrieve the pulse oximeters Cindy brought.  And after many electric shop visits, we never did find a converter.

In this picture of Addis from our van, one can see the grey smog and the blue sky above.  

Axum, Lali Bella and Gondar.

Ethiopian airlines--all our flights left early and one even arrived before the scheduled departure time.  But the price was right.

The University and the ethnological museum there.  St. George's Cathedral.  Lucy.

The food of course.  We did have some Ethiopian, lots of "Italian", burgers and fries, vegetable soup in Debra Zeit, coffee and tea.  And one Chinese dinner.  Coke Light when we could find it.  We are bringing home coffee beans.

There were more so, I guess, to be continued.  It's drizzling today in Istanbul but I'm going to run.  

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.