• Hotels and restaurants
  Only the top-of-the-range hotels in Addis have fully functional accessible bathrooms, lifts and wide doorways. Outside of Addis I found no bathroom doorway wider than 70cm, so options vary from being lifted into the bathroom (for people who cannot walk) to showering with buckets in the open air. The latter is indeed an invigorating feeling and you'll find your wheelchair dries in half an hour of Ethiopian sunshine. Restaurants are normally ground floor or up a couple of steps.
• General access
  The biggest problem with access to public buildings (banks etc) is getting to the entrance; there are almost always steps from street level. There are however, always people desperate to help, and as long as you give good instruction on how best to lift your chair and remain in control of the situation, then steps are no problem. When visiting banks, this ability to 'remain in control' or at least to appear to be confident is of great importance, as you are obviously vulnerable and will be carrying more cash than normal. People who help you like this in the street do not usually expect tips; it is done purely as a gesture of goodwill.

• On foot - In most towns, but especially Addis, pavements (if there are any), are crowded, often potholed, and have high kerbs. I found it easier to use the streets as I normally had enough of an entourage to be visible to motorists and cyclists and it generally feels less 'claustrophobic'.
• Taxis - Taxis are cheap and readily available, but are often old saloon cars (Fiats and Ladas) and the seat padding (if present) won't provide much of a cushion between you and the bumps. If you use a pressure-relieving cushion on your wheelchair, then it may be wise to use it in taxis too. The driver is normally very happy to help with transfers, and I'd always offer a bit more cash for this help. 2wd Toyota Hiluxes are also often used as taxis and may be more suitable for people without a folding chair as they have more room for storage.

• Buses - Whether or not you can use public transport will depend entirely on your ability to transfer into buses and sit long periods in dusty, hot and uncomfortable spaces without being in control of journey times. It isn't all bad - if you can use Ethiopian buses you will experience much more of the local culture and your costs will be greatly reduced.
• Private vehicle hire - Four-wheel drives (usually Toyota Landcruisers) can be hired from tour operators in most of Ethiopia's main towns. This not a cheap option (normally around 125$ U.S. per day) but that does include driver and fuel. These vehicles are higher than normal cars, making transferring from a wheelchair more difficult. The driver will always be willing to help and an increased tip would only be reasonable. This method of transport gives you the freedom to choose when to take a break from the continuous rumble of Ethiopia's gravel roads, is much more 'bum-comfortable' than local buses and obviously gives you much more itinerary freedom.
• Flying - If you have limited time, then flying is the only way to cover the distances in Ethiopia. Ethiopian Airlines generally provides a very good (and flexible) service, although there are some points worth noting.
  1. Medical report. It is unlikely, but wheelchair users can be asked for a 'medical report' before flying within Ethiopia. A form can be obtained from any Ethiopian Airlines office and must be completed by a doctor after a quick medical examination (blood pressure etc). The medical will cost about 15 birr. Another option may be to take a letter from your doctor at home stating that you're fit to fly, and outlining reasons for any medication you carry. This should satisfy even the most fervent airport official.

  2. Transfers and seating. Ethiopian airports don't have aisle chairs, so anyone unable to walk can expect to be carried manually from ground level to their seat. The staff doing this are seldom trained and it's not a good idea for them to discover that they don't know what they are doing halfway up the steps, with you in their arms - they may need firm guidance! The safest solution is for you to take entire control of the situation, and demand to be lifted as suits you best.

  3. For people with pressure relieving cushions, using your own wheelchair cushion is even more essential than normal, as some internal flights only have unpadded canvas seats.

Health
Ethiopian hospitals are basic and none too clean by western standards, but doctors are experienced - especially in illnesses typical to Africa - and therefore should be trusted. It is essential for anyone with special medical needs (catheters etc.) to completely understand their own care requirements and carry ALL clean, spare equipment they may need, as it is unlikely that the hospital will have anything useful. Cash will be required there and then, and receipts for your insurance company will normally be given on demand.

Climate
Most of the country - due to the high altitude - is fairly temperate, but it can still be hot. Common sense applies here - if you struggle in severe heat then try to do your travelling and sightseeing in the mornings and evenings. A plant spray-bottle of water is an ideal sweat-replacement tool.

Assistance
It is relatively easy to find someone to assist with tasks like washing and dressing etc. Africans are (through necessity) resourceful and adaptable people, which are two qualities required in this job, and throughout Ethiopia there is huge unemployment. The best way of finding someone reliable is by asking for recommendations from tour operators.