Sunday, June 24, 2012

Home

Dagim (left in striped shirt) translates our goodby to women and men and children at Qircho
Greetings from Northampton!
Leah and Gavin at homecoming supper
Actually we are starting this on the plane from Dulles to Hartford, where daughter Masaye will pick us up. Had a warm (in all dimensions – temperatures in the 100's) trip to Mt. Pleasant, DC with daughter Leah and son-in-law Gavin with our first taste of non-Ethiopian food in a very long time and sleeping in a very wide bed without a mosquito net and with the air conditioning on. No hyenas and no smell of coffee and incense pervading all.
Hardworking interns in Referral emergency room.
Interns and GP Dr. Saba (right) in emergency room
Dr. Birrie, Chair of Referral Internal Medicine
We each enjoyed a great going-away party by our respective sets of colleagues on Thursday before leaving. Marty's wonderful group of general practitioners led by Dr. Saba threw a party at the Lewi's Hotel in downtown Hawassa and Marty began to realize just how much these dedicated folks mean to her and how much she will miss them.
Patients and their families on Referral ward
Front steps Referral Hospital (unusually calm!)
Ethiopian medical culture is demanding and strict in its standards. One sacrifices much to become an Ethiopian doctor and continues to give despite much lower pay, huge patient loads and little backup in terms of continuing medical education and options for specialty referral of difficult patients. Marty was told for the first time that she was the first provider to stay and teach and treat for more than a month at Referral, and it took a while for her colleagues to invest emotional and collegial energy in the relationship. However, by the time she left she had shared responsibility for cure and for death of patients, had puzzled and gone to the books over more than a few, and had learned the tragedy of the limitation of care where the resources simply do not exist. There is a particular sinking feeling hooked to outrage at losing a patient to renal failure when one is used to taking access to dialysis for granted. Hepatitis B and C are treatable diseases in the United States, but not in Hawassa or, in fact, in any part of Ethiopia. She found herself embarrassed when she had unthinkingly expressed that outrage. Ethiopians are proud and she sometimes detected shame in admitting the lack of those resources, a lack for which they hold no responsibility but which they feel acutely and daily.
Ell's going-away party was much less formal – lots of beer over tibs at the local Bira hall (translated “beer”) where shining copper tanks of German beer tower over partying Hawassans. His relationship with his colleagues has also been rewarding: Walelign, Awoke, Wubayed, Aqmel, and Meskano are respected colleagues and friends, and he expects to stay in touch. Awoke will be coming to the States entering a PhD program at Washington State in the fall. He is an expert on the cultures and issues of the Southern Nations and already has contributed much to the Konzo, helping to build a United Nations Heritage Site in several walled Konzo villages.
The coffee ceremony at Qircho
A final, very different goodby greeted Marty at Qircho, where residents had prepared a coffee ceremony in the open courtyard for her departure and the women presented Marty with Orthodox Church pictures. It was moving and warm, and she was honored to be called the Mother of Qircho for her mini-clinics and her advocacy to the city. She felt welcome and at home among the women who beg for survival and wonders what will be their fate. Unlike our middle-class colleagues, there is no internet or even phone connection to these people to communicate births, deaths, movements among people that she has learned to respect. Marty left them her phone, and hopefully they can set up a small 'telephone business" for the neighborhood.
Women at Qircho
She and Dagim met with the Mayor of Hawassa to discuss her report http://elmartyhawassa.blogspot.com/2012/06/report-to-city-of-hawassa.html and the City's plans for the street people. Not too encouraging. The Mayor said he was a busy man and had not had time to read the report. He was angry that we were interfering and told us that what we could offer were money and medical care (both of which we had given directly to the street community, but not to the City for its plans.) This is something we have learned to expect from the government - very bureaucratic and highly authoritarian.
The City's plan has not been implemented because its appeal for almost 6 million birr ($350,000) for job training (in breaking rocks for cobblestone, shoe-shining, hotel service and garbage collection); return of kids to their homes (without, as far as we could tell, support for the families who could not afford them to begin with); and adoption of some had not been fulfilled by the NGO's and churches and businesses to whom the city had appealed. He seemed angry and frustrated and particularly irritated by our questions about the basic viability of the plan.
Qircho men, women and children at coffee ceremony.
Since most of the street kids are homeless and sleep under awnings (as do quite a few of the mothers) we asked about the lack of provision of housing in the proposal. He said that was for the subcities to deal with, that it is being taken care of. Further, since the core of the proposal is job training and many of the women, who expressed to us the desire for jobs, have been impeded in finding or doing any available work because they have small children (quite a few on the breast) but no childcare that would allow them to take those jobs, we asked what provisions would be made for them. Would free childcare be provided? There were no such plans in the City's proposal, but the Mayor did not want to discuss the issue. The transcendent issue, though, that was not on the table, and which he is in no position to address, was the worsening endemic poverty in the countryside that is forcing men, women and children into the streets of cities like Hawassa searching for a living, and finally into begging when they encounter no work that can sustain them. We tried to address this as he told us the meeting was over, but he was in no mood.
Woman coaxed to join us at coffee.
We have learned a little about the government's Safety Net Program, funded by international NGO's, which actually does provide very limited cash for work mainly for farmers in the non-harvest season and for the disabled. Though UNICEF states that disabled families get up to 350 birr ($18) per month in relief, all Marty could find on the web or in talking to those who administered the program was 70 birr per month (about $4) per family, given in return for 5 days work. Do the calculations: from a little over $.50 to $.13 per day for a family, which can easily be six people. There is about 50% unemployment in Ethiopia. Average wages for a laborer are about $1/day. No one that Marty spoke to was receiving even these miniscule Safety Net benefits, but were surviving frequently on $.25 per day in begging, enough to pay for one meal of coffee and bread. But then again this is Africa, where no country, with the exception of South Africa and possibly Rwanda, has any direct help to the poor and homeless.
Men, women and children of Qircho.
Marty sent her report to the Embassy, to USAID and to UNICEF in Addis Ababa. She was disheartened by the response by UNICEF, whose representative seemed to interpret it as requesting immediate help for these particular women and children, instead of being a plea for systemic intervention to support women and children forced by poverty to migrate to the cities where they become homeless beggars. Marty tried to explain her perspective, but detected here an all-too-common defensiveness on behalf of the government, which touts 9% growth but steers clear of examining increasing disparity in income between rich and poor and what appears to be accelerating impoverization in the countryside. She will pursue these contacts and hopes to widen the dialogue.
Two Days Later...
Home to a lush, green and hot-as-hell Northampton. Greeted by kind and thoughtful neighbors, and celebrated Arky Markham's 97th birthday yesterday with good friends who have borne her hip fracture like the family that every person should have when one gets to 97.
Northampton, with its sensible progressive politics and culture of kindness and intellectual honesty, is our home. We are so frigging lucky. 
Now it is time to weed the garden, to fix all the electrical appliances that we haven't had for 8 months – dishwasher, clothes washer, electric garage door opener, air conditioner – while we take a moment to ponder why we have them.
Horse-drawn cart stops bajajes at Hawass intersection.
Hawassa seemed like a dream while we were there. We often woke up wondering where we were in that fog before full consciousness. It is a function of the older brain that doesn't adapt to transitions too well. (We understand, Arky!)
But, of course, Hawassa is not a dream to our friends there, with whom we will continue to communicate and whose fates we care about. It is another country, but we know something about it and more, we care about it and those who touched us with their kindness, generosity, and courage in the face of adversity we have never before experienced.
Elliot on chosen mode of transport.
Donkey-cart solid waste management in Hawassa.
We will not miss the mosquito nets, the leaky pipes in the guest house, the furniture that disappears, the “You, you, you!' from street kids, the bajajes (motorized tricycle taxis) playing chicken at intersections, the lack of solid waste disposal and its consequences. We will miss Ethiopians – not just our friends, but the great diversity of cultures of Hawassa and their fascinating differences from our own. We will miss Ethiopian dignity that so quickly morphs into friendliness and generosity at minimal contact. We will miss the incredible physical strength of those who guide donkeys and plow-oxen, carry children, sugar cane and firewood long distances, and build streets from rocks. We will miss children who are still able to hug and sit in a lap, and women who nurse and comfort their babies despite homelessness, hunger, abuse and poverty. We will miss the intellect of professors and doctors building a modern society on centuries of feudalism and war.
Marty and Ell both have a tradition of looking for heroes that goes to our days in college. We found no dearth of heroes in Ethiopia.
We will miss the hyenas, the Abyssinian ground hornbills, the grey-back fiscals, the mountain nyalas, the fish eagles, the green vervets and baboons and the mountains that, no matter where we are, rise up at the horizon. We will miss the omnipresent smell of bunna and incense, of sweat and manure, of woodfires and over-ripe bananas. We will miss the constant cool, dry breeze and the sudden thunderstorms rolling over the Rift Valley. And both of us will miss the exotic sound of Amharic (which Marty now greets with a sense of familiarity but, unfortunately, not understanding), Sidama and Oromo.
It is a different country, but a country we have briefly been part of, and that we deeply respect and will remember forever.
Happy birthday to Elliot! Yes, we still need him, yes we'll will still feed him, now he's 64!
Marty and Ell

Monday, June 11, 2012

Responsibility and Friendship


 
 Greetings from Hawassa!
We didn't expect to blog so soon, but the emotional impact of events impels the fingers to tap the keys.
Marty just returned from interviews that she enjoyed tremendously because of the existential force and humor of the women involved, but also infuriated and saddened by the tales of perfidy, violence and grinding poverty that she recorded.
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She had met all three women weeks before. To one she had given amoxicillin to cure a bronchitis, but the young woman had developed a horrible rash for which Marty had felt guilty, but which disappeared with a short course of prednisone. All three were young, unclear of their ages because none had ever been able to go to school, but all thought they were about 20. They had become friends at Qircho (Marty finally has the spelling right, maybe.) the Beggars Village and sat down to encholal en siga en enjera (eggs, meat and Ethiopian bread) at the Ledet Cafe joking while babies slept in two of their sets of arms.
Though all had come from different parts of the Southern Nations, Nationalities and Peoples Region (Ethiopia's southern state, with Hawassa its capital) each had fallen in love with a man who abandoned her. The first whom we will call “Yelena”, was orphaned as a young child in the town of Dilla, and was forced to work as a servant in others' houses until she was 14. Then a seemingly kind woman told her that she would give her a good job in her house in Zoay. But it turned out that the “house” was actually a bar and she was expected to work as a prostitute. She escaped to work in a tea house where she fell in love with and lived with the owner, who was unfaithful to her and she left him. Soon she began to feel ill and was diagnosed with HIV. She came to Hawassa for treatment at the Holy Waters at the Orthodox Church five years ago (still probably only 15 years old but having seen a full lifetime of troubles). Two years later she again fell in love and was brave enough to disclose her status. He accepted it and Yelena UNTIL she became pregnant, at which point he denied he was the father and left her. The beautiful baby was born, and Yelena has loved and cared for her diligently, but she wants to find another home and family for her, so that she does not have a life like her mother's.
The second, “Ana”, was the child of an extremely poor farming family outside of Hawassa. She met a young man who promised to save her from poverty and took her to the town of Shashomene, where they both worked and lived together. One night she told him that she was pregnant. The next morning she awoke to find him gone, having taken all the money they had saved, and leaving her with a rent due that she could not possibly pay. A friend who was begging in Shashomene was able to sell her own goods so that Ana could pay that 200 birr and thus ransom from the landlord her few remaining possessions. The two moved to the streets of Hawassa where they lived in “street shelters” and begged to feed themselves. Young men threatened to rape her after she delivered, which she ultimately did, on the pavement in the street shelter.
The third, “Terry”, was born to poor parents who divorced soon after her birth. Her mother struggled to survive breaking rocks for cobblestones and carrying loads for people. Terry stayed home to help her mother. A man proposed to her and, against the wishes of her mother and brother, she left home with him. She became pregnant, but, in the seemingly endless refrain of poor young women, he ran out on her. Her mother was unable to support her, though Terry did live with her for a while, so she began begging. Her baby was stillborn. She has met another man, another beggar, who is alcoholic and constantly abusive. When Marty asked her why she does not leave, she asked in return what she could do, where she could go? Excellent questions.
All three live in Qircho, the Beggars Village, with up to ten people in a room. They beg on the street, none making as much as a dollar a day, Terry making only $.35 since she has no children. The two who have children are insulted on the street by passersby who tell them the only reason that they got pregnant was so that they could use their children to beg, and that they should give the children up to an NGO so that they can work.
Their lives and potential futures were put into perspective by the stories of two other, elderly women whom Marty and Dagim had interviewed just two days before. Both were in their seventies, and one, “Frances” had been thrown onto the streets by the revolution 38 years ago against Haile Selassie, when her husband disappeared into the forest. She has never been able to recover and now lives in Qircho with her youngest daughter, who also supports herself by begging. She usually is able to eat only one meal a day – bread and coffee – and describes her situation as like that of a “wild animal”, no better. Her friend “Tina” was orphaned many years ago and lost her husband after one of the Derg's involuntary resettlements to distant Gambela. She has worked her whole life, when she could, cooking for and serving others. Both are asked why they don't a) “get a job” breaking rocks on one hand or b) return to their homes on the other. Frances responds to the latter that she can't eat her bamboo walls.
In the face of the hunger, filth and degradation of spirit, two counteracting forces emerged in the interviews. One was the women's friendships that were displayed in their ability often to answer for each other or to express opinions in one collective voice. The second was a self-deprecating humor about their situation, their weaknesses, their men. Some have managed to retain religious faith, for others that seemed to be less important if it existed, though Marty did not delve deeply here.
Marty leaves Ethiopia extremely troubled by what she found on the streets. She has known poverty in the general and on an American scale but never taken the time to understand its victims in this way. Her sense of disgust at her own privilege, her helplessness in affecting lives of those who are truly suffering, constitute a big punch in the nose. Women look at her with longing and touch their mouths and their stomachs in what must be a universal language of hunger. She gives, but never enough, and it never really dents her own wealth.
She and Dagim will follow up on the letter to the mayor and Dagim plans on educating students at the University.
Where the little ones eat at Hawassa Children's Center.
Ell , Marty and Dagim have visited two wonderful institutions, the Hawassa Children's Center and the Mother Teresa Home. The HCC has an orphanage for about 100 children who have lost both parents. It schools them all the way through college. It also sponsors scores of Hawassa orphans who remain with extended family, giving them money for food and education. (There are 5,000 orphans in the City.) Finally, it runs training programs in computer sciences (for women only), electrical, wood and metal work (for poor young men in their 20's) and gives them micro-loans to start businesses. It is funded by German and American philanthropy and we were impressed.
Residents doing Saturday wash at Hawassa Children's Center
The Mother Teresa Home likewise was a source of inspiration. The spunky, outspoken Austrian Sister Servita talked with anger about the treatment of the Ethiopian poor. The home takes in anyone who arrives at its door – hungry, sick, physically abused, penniless, mentally ill – and gives nursing care and feeding and shelter. Sister Servita is interested in following up on advocacy for the street people, and there is a ferocity in her approach that demands admiration.
Marty with Dr. Birrie (to her right) and hospital administrators
Ell would say, “You have picked the most depressing subject to research. But Ethiopia is not just about poor people. Think of all the friends we made and places we have seen." Right. All is by no means hopeless poverty. This week was a week of celebration of our leaving. Saturday both friends Mulye of University of Hawassa Sociology Department and Dr. Birrie of the Internal Medicine Program at Referral Hospital hosted good-by parties. Mulye's was a low-key feast of tibs (roast meat) and enjera (teff pancake bread) and spaghetti and wine and beer followed by the coffee ceremony. Yum and thank you, Mulye and Achu! Then we had supper at our favorite hotel with Dr. Birrie, Chief of Internal Medicine, and the top administrators at Referral Hospital. It was a lovely surprise and honor to be appreciated like this. They presented Marty with two bracelets, a dress, and a beautiful commendation letter saying how appreciated she was by the hospital staff and how sorry they were to see her go. (Elliot adds this because Marty is way too humble to include this).
Achu and Mulye, second and third from left.
Elliot winds up his stay with, of course, grading and hosting the defense of their senior theses by his 4 third-year anthropology advisees. Marty is grading medical students and continues her work in the emergency room STILL amazed at the incredibly ill men and women that she sees every day and that the Ethiopian medical system does its best to treat.
We are deciding to whom to leave all our stuff to (bikes, fridge, extra clothes, books, DVDs, cookware, etc. We have it pretty well figured out between students, friends, folks at Qircho, and Mulugeta's family in Addis. We'd like to leave it all if we could!
What a year! How we miss you! Will be back in a week.
Marty and Ell

Wednesday, June 6, 2012

Bale Mountains Part II


Our final visit to Bale Mountains National Park

Mountain Nyala - gorgeous!





With only two weekends left in Hawassa, we decided to visit the Bale Mountains one more time. Besides being relatively close to us (2-3 hours) it really was one of the most scenic places we have visited in Ethiopia. The first time we went there (in February) we took a three day horse trek from Dodola town up steep river valleys and thick hemlock forests, spending a night in an Oromo hamlet at 9000 feet. Austere but beautiful.
This time we decided to go to the Bale Park headquarters in Dinsho, about an hour up the road from Dodola. We hitched a ride with Walelign and Beza, who were going to Addis where Beza will have her baby. They dropped us off in Shashomene on the main road to Addis, a very crowded and bustling town with a huge bus station leading to points all over the south of Ethiopia. We got a small bus whose driver was kind enough to take us to the park gate. For a sum of about $6 we entered the park and walked the two kilometers or so to the park lodge. This was an old stone building, with an out building for showers and water. It was completely deserted, except for the animals which we saw immediately as we started walking up the road. Warthogs, Mountain Nyala, Redback deer and Bushbucks were some of the few fellows who greeted us. 

Redback Deer
Pasture and Forest in Bale National Park
 There was no food in the lodge – we are not quite sure why they call it a lodge, so we walked back into town for a nice meal of tekavino and tibs (lentils and meat), bought some bread and bananas, and made our way back. An older man stopped us on the way; his name was Abdulai and he was the park guide/ranger/ everything. He let us into a small but comfortable room with two narrow beds. There was a much larger common room, with comfy chairs and lots of stuffed animals (by a taxidermist) and bones on display, including a warthog jaw with its two shiny tusks.
We read for a while on the back balcony – we were both immensely absorbed by the last Harry Potter (Deathly Hallows). Elliot had never read them before, and read all of them on his Kindle this year in Ethiopia.
Chilling with Harry Potter on the Kindle

 

But the mountain was too beautiful, so we put Harry down and went for a late afternoon walk into the fields above the lodge. We were at 9000 feet so the going was slow. But we were rewarded with a beautiful panorama, and lots of animals who walked around us as we sat quietly on the ground. A huge warthog family scampered around fifty yards from us, three adults and seven babies. So cute, the baby warthogs were prancing, dancing, and head butting each other practicing to be grownups.
 
"Look who just came in, God's gift to warthogs"(Gary Larson)
 

We saw a herd of Mountain Nyalas grazing, big dark beautiful antelope with white stripes on their chest. The males have large and beautifully curved horns, as you can see.
 
 



 

We headed back down at sunset and crawled into our beds – it was really cold up there but there were plenty of blankets – and got reabsorbed by the battle for Hogwarts and JK Rowling’s heartfelt message that you must fight fascism and never accept it! Good book to read during an election year.

The next morning, Abdulai was there when we woke, and we asked to take a shortish walk – 2 hours – as Marty was getting a head cold. He took us on a different route than the one we took the previous evening, up a river bed that opened onto a big pasture with many deer and the ubiquitous warthogs again.  Abdulai had amazing eyes; he could spot animals hiding in the trees long before we ever could. We walked into a forest, beautiful and quiet in its lush green following the recent rains. Abdulai explained various bushes and trees to us: “Those berries are poisonous; those flowers are used for medicine to clean the stomach.” “Does it help clean you out?” Elliot asked, familiar with the strong purgatives used by Samburu in Kenya. Abdulai smiled in embarrassment, ‘Yes, it moves right though you!”
 
Abdulai - our mountain guide
 A highlight of the trip was Abdulai taking us to a tree and pointing to a very rare owl – the long-eared Abyssinian owl which we would have never noticed. He said many birdwatchers come from Europe to see this bird. He was wearing a hat given to him by a German ornithological group; he really knew his birds, and could identify every bird call we heard. “That’s a flycatcher, that’s an Ethiopian mockingbird.”
A truly wonderful walk.
Abyssinian Long Ear Owl - a rare sight

Around 11 AM we decided it was time to go into town and find some food, and especially coffee. We figured it would take us the rest of the afternoon to get back to Hawassa by Sunday evening. We had met a lovely Ethiopian woman on the road, who told us her name was Sophie and had a coffee shop nearby (a tiny room near the road where she brewed fresh coffee) so we stopped there and were very happy that we did. We had 2-3 cups, brewed the Ethiopian way by roasting fresh coffee beans, grinding them, and soaking in water.
Sophia in her coffee shop 


Dinsho town Backyard. Cool!
 Abdulai joined us for coffee – he seemed to know everything that was going on in town. He gave us each a picture of an Ethiopian Wolf, a reddish animal that looked like a coyote. Although these are not found in Bale Park, they are the symbol of Ethiopian wildlife and we were happy to take one.

Not our photo, but just so you know what they look like.
 We then headed down to the restaurant where we ate the day before, this time ordering eggs and enjera.  Very few cars or vans were coming down the road. The guy who ran the restaurant posted another guy on the road to flag a bus or van down. But after an hour, Elliot went out there, and almost immediately saw a bus. We managed to stop it and got to occupy the last two seats in the back. Young boys come on board to sell roasted barley (a favorite snack), and there was a lot of jostling to get on. Once we managed to sit down, a young Ethiopian with stylish long hair (twists) and very good English introduced himself as Teddy (for Theodros). He worked for an NGO called PACT and was going to a three day workshop in Nazret. He played us the latest song by Teddy Africa, the most popular singer in Ethiopia who was jailed for criticizing the government’s lack of democracy. Teddy asked if I had any daughters his age to write to! The ride home was peaceful, through gorgeous Ethiopian countryside, with the Bale Mountains to our left. We got to Shashomene, quickly found another bus to Hawassa, and made it home around 6 PM. 

Marty and Teddy on the bus - bumpy ride makes the photo look like an art shot!
We arrived in Hawassa Sunday 6 PM. Church was getting out so the streets were full of folks, mainly Evangelical Protestant, we assumed (Orthodox women wear long white cloths over their head, Protestants seem to  purposely reject that.)We talked about religion to each other, a favorite topic here, especially as Marty’s assistant on the homeless project, Dagim, is so devoutly Orthodox and loves to explain his religion to us. We were a bit disconcerted when he told us that when the anthropology students took their long 12 day bus ride to the historic sites of the north, including Lalibella and Axum, the priests would not allow one of the Moslem students to enter unless she took off her head scarf. She refused (naturally) and was asked by the other students to sit in the bus, lest a fight break out. (The priests will physically attack those who wear Muslim symbols.) We were a bit astounded she would be rejected from not only a famous site in Ethiopia, but a UNESCO World Heritage site. But Dagim was firm that no Moslem should enter a church. I told him how I was welcomed into a Mosque in northern Kenya when I wanted to get away from the noise and the hustle bustle. He couldn’t believe it when I said all people –Christians, Moslems, Jews-- were welcome in our National Cathedral in Washington. Religion continues to plague us.

Last two weeks, and invitations are starting to come in – to visit a colleagues’ house for coffee (i.e. a huge meal) this Saturday, to be wined and dined by Marty’s medical colleagues Saturday night. Departure is coming, and we feel great that we got to go to Bale Mountains as a parting visit.