Training medical students in Ethiopia
Profile Dr Ian Fussell
Usual role GP in Newquay, Cornwall and community sub dean at University of Exeter Medical School
Location Wollega University Medical School, Nekemte, Ethiopia
I wake up to the sound of a day well underway in Nekemte, a market town in western Ethiopia. My room is filled with the noise of shouting, music, traffic, and squawking birds. I’m staying in one of best hotels in town, but it is still a lottery if there will be any water for a shower.
Ordering breakfast is longwinded. The order is taken in reception on raffle tickets - one for a fetira (fried filo dough) with honey and one for a coffee. But when it comes it is worth the wait: a thick crispy pancake drenched in delicious local honey with organic coffee that’s grown here in Wollega.
Over breakfast we confirm the plan for the day. We are an educational group from the Truro campus of Exeter Medical School comprising of two GPs, one consultant in medicine, a foundation level two doctor and four medical students. We are here to teach the students and lecturers at Wollega University Medical School, also teaching on the wards in the nearby Nekemte Hospital.
The minibus arrives and we are taken to the campus. The university opened in 2007 and the first cohort of medical students have yet to qualify. The school uses a problem-based learning approach and encourages self-directed learning just like we do in the UK.
We begin a teaching development session with the lecturers and researchers. They are experts in microbiology, parasitology, anatomy, midwifery, and public health. We spend time reflecting and constructively giving feedback on how we can improve our skills.
Lunch back at the hotel. Today’s offering is club sandwiches and ‘King of Rice’. No chips though, much to the dismay of our students.
The afternoons are hot. The classroom is up two flights of stairs and I get palpitations by the time I’ve reached the top. I attend a session run by our students, who teach cardiovascular examination to the local second year students. They are all enthusiastic learners and soon start practising on each other.
Some of our team spend the afternoon teaching at the local hospital. It is busy, dusty and very sick patients are crammed into small rooms. We try and teach the year three students how to do clinical examinations on real patients. They have been on the wards for only two weeks and their white coats conceal anxious young people eager to learn.
We examine people with TB, heart failure, interesting murmurs and advanced neurological conditions. One woman conceals her baby in her bed. She is unwell, but needs to look after her baby too.
It is difficult to work here. There are very ill people being brought to the hospital in mini-buses and trucks. We look on wishing we could do more to help. We are investing our energy in the future profession and we hope we are offering a degree of sustainably. The students and staff want help and I believe they are at the beginning of developing one of the best medical schools in the country.
The walk home from the hospital is about two kilometres and filled with donkeys, carts, bajajs, motorbikes, minibuses and people. Makeshift cafés are serving delicious coffee - people try and sell us cups along with haircuts, spices, and live chickens.
The hospitable local people are full of kindness and curiosity. Their life expectancy is somewhere between 54 and 60, so I am one of the oldest people here.
We eat dinner, and then I quiz my students on what they have learnt this week. I’m pleased to hear that they plan to keep in touch with the medical students they have met here, further developing the link between our institutions.
I finally climb through my mosquito net and into bed, hoping that there won’t be a powercut tonight.