Sunday, June 3, 2012

Report to the City of Hawassa on Street Women and Children

Martha A. Nathan MD
Fulbright Specialist, Hawassa University Referral Hospital
Assistant Professor of Medicine, Tufts University Baystate Campus

To: Mayor, Hawassa, Ethiopia and City Committee on Street People
From: Martha Nathan MD
Re: Preliminary report on Study of Hawassan Street Women and Children
Date: May 24, 2012
Subject: Street Women and Children Preliminary Report

This brief preliminary report summarizes my investigation of 19 street women and 26 children that I conducted from April to June in Hawassa town.
I am a visiting physician acting as senior staff at the Referral Hospital Internal Medicine Department at Hawassa University since October 2011, teaching medical students and interns. My husband is a professor of anthropology in the Department of Behavioral Sciences at the university. We are both United States Fulbright Scholars. We have collaborated on anthropological research on the nutritional and health consequences of settling of pastoralist children.

Like most visitors who come to Hawassa, I came in contact with beggars and young people selling items on the street. It was disturbing to me, because most looked destitute and homeless. In asking Ethiopian friends about their situation, I was told that many of them were criminals, the women borrowed each other's children to beg, and they were seen as pests and “eyesores”, destroying the beauty of the City of Hawassa.

With the assistance of a University student and interpreter, we have conducted 45 interviews. All of the the women and children 1) beg on the street and/or 2) are homeless. Most of the homeless also beg though a few have a street “job”: selling toothbrushes or other small items, shining shoes or carrying things. The age range of the children and youth is 5 to 17 years. Most of the women are mothers, some of them beg with their children, some do not.

This is not a random sample, though we tried to find street people in all areas of the City. Thus we cannot be sure that it is representative of the more than 489 children and youth and 95 women that the City identified in its recent survey, but we believe that it is a start.

Summary of our most important findings:
1) Street Women
  • All of the women were beggars. One had been able to stop begging two years before (after having been born on the street and begging for 18 years) and was married and working selling enjera and washing clothes.
  • Nearly half (42%) of the women were homeless:
    • Four of the women (21%) were living on the pavement or on hard ground with no shelter. Three of them had small children sleeping with them, including two nursing babies.
    • Another four (21%) lived in what we have come to call street shelters – grass or plastic temporary shelters on the street without permanent roofs and providing only partial protection from the elements.
    • The rest (58%) lived in Sidama houses in nearby villages; in Qerchu, the tin-roof division near St. Trinity Church, with up to eleven people per apartment; or in rooms rented for 3 birr/night. Most of these women had been sleeping on the pavement previously.
  • All of the women said that the reason they were begging (or in the case of one woman, had begged in the past) was lack of other means of support and facing hunger for themselves and, if mothers, their children.
    • 63% of the women interviewed had no husband: they were separated, widowed or never married. Most of those who were separated had left husbands who were violent and/or alcoholic.
    • 16% were married to husbands who were disabled.
    • The remaining four women (21%) lived with their husbands who worked but did not make enough to support the family.
    • 14 of the 19 women either had looked in vain for work or had worked or continued to work small jobs that did not pay sufficiently to support them and their families: cleaning dung from yards, baking enjera, selling sugar cane.
    • Six of the women (32%) were themselves disabled, one from an accident, one from epilepsy, another from depression and the other three from chronic infection.
    • We only asked eleven of the women their educational status, but of those, seven (64%) had never been to school and the highest grade obtained by any of the women was grade 4.
    • Only two women did not have dependent children. (Both of them were disabled by illness.) The average number of dependent children these 14 women supported, not counting married children, was 2.0 per woman, the youngest child only 38 days old.
Thus these women are mainly without the support of husbands, are frequently disabled by physical disease and lack of education, have small children, and have looked for and sometimes found jobs that have not supported their families.

2) Children
Our findings show that the children were even more vulnerable and had few options that they were not already aggressively pursuing for survival.
  • Sixteen (62%) had lost at least one parent through death. 
  • Almost one-third (31%) had mothers who were begging to survive, either in Hawassa or elsewhere.
  • Only 31% still lived with at least one parent.
  • All who had left their families in Hawassa or the rural areas did so because they said their families could not support them. Two were told to leave their families who lived in the rural areas because the family could not support them when coffee was not being harvested. With one exception, the children described their families as poor.
  • For half (nine of the eighteen children) who had left their families, beating was a factor. One child was permanently disabled (burned) by his mother.
  • All but the youngest (5-6 year old) said that when they left their families, they were looking for a job.
  • More than ¾ (77%) of all children were homeless, sometimes (in two cases) with their parents
    • The majority of the children (58%) slept on the street under shop awnings or on the pavement,
    • While another 5 (19%) slept in rented temporary street shelters.
  • 17 of the 26, all but one of those above the age of 7, had jobs: carrying things for people at the bus station or on the street, shining shoes, selling toothbrushes, shining or washing cars or motorcycles. The vast majority, though (82%) of those with jobs continued to beg, at least for clothes and food, because the jobs did not pay enough to cover necessities.
  • The highest level of education for any of the interviewed children was grade 6. Four of the children were still attending school including one homeless child.
    • Almost all children (92%) stated that they left school because they could not afford school supplies, shoes and clothes. For most, this was the first step in going to the street.
Thus these children by their own report were forced by the poverty of their families to beg with parents or on their own, to leave home and work street jobs with long hours and little compensation, usually sleeping homeless and hungry. That poverty was frequently compounded by violence in the choice to leave home for the homeless.

Life on the Street
  • None of those whom we asked wanted to remain on the street, women or children.
    • One woman indignantly asked us how we could ask such a question! Others talked about hopelessness, the exposure to the elements and the hard ground, and their attempts to “get out of their predicament.” One described living on the street as like “being in hell.” The smaller children particularly talked about fear of violence and theft from bigger boys (including those with homes) and “gangsters”.
    • All had dreams of other lives. The youngest children wanted to be jet pilots and doctors and teachers, the more mature would be satisfied with a home and a job, most commonly as a merchant.
    • Mothers routinely, without prompting, stated that they wanted their children to have an education so that they would not face the fate that their parents did.
  • 58% of women and 81% of children and youth interviewed reported being victimized by theft, extortion, threats or violence when on the street.
  • All except the one woman who had been able to stop begging stated that they were “sometimes” or “always” hungry. Many stated that they often ate no or one meal a day. The children were more likely to say they were “always” hungry. Several mothers said that they went hungry so that their children could eat.
  • All who had been on the street for more than a month said that there were many more street people than before, and that that was decreasing the number of available jobs and increasing the threat of violence, extortion and theft for them.
  • The few women and children of whom we asked their usual earnings from begging or their street jobs stated that they made 10 to 15 birr per day. One industrious teenager who polishes cars makes up to 30 birr per day.
  • It is very important to note that, except for one woman who stated that she received help from SOS Children, and two children who are going to school at Alito, the organizations that were identified as actively helping these destitute folks seem to be the Orthodox Church, which distributes food and clothing, particularly on holidays and the Mother Teresa Center, which takes in the sick homeless.
  • Support in terms of donations of food by individual restaurants and citizens is admirable and is critical to the survival of most of the people that we spoke to.
  • The provision of the housing units at Qerchu behind St. Trinity Church apparently by the municipality acting with the Orthodox Church is much-needed reliable protection from the elements appreciated by those who live there.

  1. Poverty and its associated hunger. Food supplements or assistance to destitute families would have an important impact. We never found people who wanted to beg, but begged in order to eat.
  2. Homelessness, for children, adults and families. The development of the Qerchu area as a secure location for the homeless to sleep is certainly an excellent start, but there are, unfortunately, too few units to serve those in need. More long-term shelter needs to be found to protect women and children (and men) from the elements, disease and crime.
  3. Lack of education for both women and children. Since lack of school supplies and clothes was identified as the key factor in many children and youth leaving school, provision of school supplies would seem a key intervention for maintaining these children, and probably many others, in the classroom. For women, the task is more difficult, since childcare is a barrier to further education, but it should be considered.
  4. Adequate wages for those who work. We realize that this is one of the most difficult issues to engage, but the majority of the children and women we spoke to themselves work or had worked, or another family member works but wages were not sufficient to feed them. As long as this is true, people will be forced of necessity to resort to other means of support, the least criminal being begging.
  5. HIV/AIDS treatment: Family disruption and poverty through death and disability of parents and spouses was a major source of eviction to the street. Fortunately, due to universal access to Highly Active AntiRetroviral Treatment, the AIDS epidemic is somewhat less of a threat than in previous years. However, we found one woman not in treatment because she did not know it was available. Others said that lack of food made regularly taking the medicines impossible, putting control of the virus in jeopardy. Finally, the precarious social situation of street people exposes them to increased risk of the virus and worsens the risk that children on the street now will become infected and create another generation of missing parents and spouses. While expanding and continuing HIV treatment is absolutely necessary, finding a stable home, food and income for these vulnerable people will help to prevent new cases of the disease.

We submit this report as a way to humanize Hawassa's street women and children. They are victims of poverty, neglect, lack of education and violence. As the City approaches this terrible problem, an eye must be trained to those driving factors, not just for moral reasons, but to understand that until these problems are rectified, the numbers will continue to grow.

Thank you very much for considering our findings and recommendations.
Martha A. Nathan MD


The following are just a few of the stories that we heard in our interviews. We chose them not because they are the most dramatic, but because they are typical.

I. Three young street boys discovered fishing in the gutter on University Boulevard

None of them was truly sure of his age, but they decided on 5, 6 and 7. All three were bouncy, polite and talkative. All were born in Hawassa, and two had lost their fathers, and their mothers were living and begging at St. Gabriel's Church. They didn't stay with their mothers, but slept on the street together with other street children under an awning across from the bus station. They said the children “cared for each other”, were often chased away from where they tried to sleep, but were actually protected and watched out for by the local police. Both of them had been to school for a little while, but one left because he couldn't pay for his school supplies and the children “acted badly” toward him. The other left because his shoes were stolen at school and his mother beat him because of that. He said she beat him often. He was the quietest and most reserved of the three.

The third child had both parents and he slept with them in a cardboard and plastic structure built by the Hawassa dump in Korem. He had never been to school, though he thought he was the oldest.

How did they get food? They begged in front of the University, house to house and from restaurants from which they received leftovers. Were they hungry? Always. They begged food from Ethiopians but money from foreigners. What did they spend money on? Biscuits, bread and candy. Did anyone every try to hurt or beat them? This was interesting, as by now a crowd of older boys, young adolescents, had gathered around where we were sitting in an outdoor cafe until they were forcefully chased away by cafe management. The three told us that these and other boys with homes and families beat them and stole their money. However, each of the three after finishing his breakfast, cheerfully took leftover bread and gave it to an older boy, without appearing to respond to force or threats. It seemed this was a more complicated relationship than we would be able to understand.

Did adults hurt them? Sometimes, but they had more trouble with the “big boys”. Was there any support from organizations or the adult community for them? None that they could name except for the informal network of restaurants and individual Hawassans that fed them.

Their clothes were given to them and they didn't remember ever having any immunizations. They sometimes picked up discarded pills off the street. (We had a doctor-patient chat about that one.)

Finally we asked them what they wanted to be when they grew up. Two wanted to be pilots and one of them illustrated by brrrrm, brrrrming with arms spread around the cafe. The third wanted to be a doctor.

II. A young child abused and neglected

8-year-old “S.” was born to parents who were themselves beggars in Hawassa, was never sent to school, and suffered hunger and abuse in his parents' care. He left home three years ago after his mother burned his left hand, leaving it permanently disfigured and disabled. He has slept on the street, carries people's burdens, begs and works for juice houses running errands in return for food. He is bullied and stolen from by bigger boys (both street children and boys with homes). He has dreams of becoming a doctor.

III. A boy who refuses to give up.

15-yo “D.” was born in Gojam, Amhara. His mother divorced his father when he was 4 years old because his father abused both of them, leaving “D.” with a permanent scar. His mother moved with him to Shashomene but then she and then his maternal grandmother died, leaving him in the care of his father (who then left because he allegedly killed another man) and stepmother. His stepmother refused to allow him to go to school and physically abused him. Because of this, four years ago he ran away to Hawassa to work, where he has supported himself through shining shoes, selling small things on the street, begging, and now cleaning cars. He sleeps in clothes bags on the street has suffered violence and theft of all of his belongings. Yet he has enrolled in school again, is in the fifth grade, third in his class. His goal is to “get out of this life”, which he describes as “hell”. He wants to continue his education, get a decent job to make a living and send his twin sister to school.

IV. A child from the countryside

M.” is a 12-year-old from Gorche who has lived on the streets of Hawassa for the last three years. His father died, mother sells enjera house-to-house in Gorche to support her nine children since “M.'s” father died eight years ago. He came to Hawassa to work and carries things on the street and begs to support himself. He left school in third grade due to lack of funds for supplies and sleeps with other boys under a shop awning. He did well in chemistry and biology and dreams of being a teacher.

V. A Mother Who Grew Up on the Street

One woman escaped abuse and neglect in the Wolayta rural area from a stepmother who replaced her own mother who died when she was a toddler. She came to Hawassa at the age of 8 and has been on the streets ever since. She is now married and with a child, but her husband, a construction worker, makes so little that she must continue to beg and sell sugar cane on the streets to feed herself and her child. A year ago she moved to Qerchu from the pavement. Her dream is to become a merchant.

VI. Another Woman Born on the Street

Z. was, literally, born on the street, on the pavement in front of St. Gabriel to a mother and father that are still forced to beg there. She begged on the streets all of her life until very recently. Two of her three sibs died, but she has, finally, been able to stop begging and instead support herself by washing clothes and making enjera for the other families in the her neighborhood. A year ago she and others moved from the pavement in front of St. Gabriel's to a shelter at “Qerchu”, behind St. Trinity Church. Her dream is to get a home for her family and parents, to educate her children to become doctors so that they can “care for us”.

VII. Hopeless and hungry all the time

A.” is a young woman from Yirgalem who was orphaned in her childhood and worked as a servant in other people's houses. She was never able to go to school. She married a man who beat her and then left her and her child. She came to Hawassa looking for work to support herself and her infant. Her estranged husband followed her but rather than support her, demanded the first child and fathered a second. She now begs with both children, never making enough to stem the hunger. Her dream is to have a job.

VIII. Living with her child on the pavement

 "B.” is a 35-year-old woman from Yirgalem who has lived on the pavement in front of St. Gabriel's Church for the past six years with her now-6-year-old daughter. Her husband died when she was pregnant and her husband's family refused to support her. Her own parents had died when she was a baby and she grew up as a servant in other people's houses. She came to Hawassa looking for a job to support herself but was unable to find one and began begging. Her baby was born on the pavement in front of St. Gabriel's Church. She sometimes gets work cleaning animal dung in the yards of houses. Her daughter is in second grade at Alito School. They “sometimes starve”. Her only hopes are to see her children get an education and to get a decent job herself.


  1. Somehow the summing up
    brings scale to pain
    confines it so that its weight
    is dense
    and small
    and easier to bear.

    1. You know that I agree that pain cannot be quantified, but I hope its presence can be communicated to those who have not felt hunger, dehumanization or hopelessness. I have learned much of what I know from you. Thanks.

    2. Just wrote the above right off the top of my head-- was thinking about the homeless families we're organizing with and it sometimes feels like an oppressive gray sky just before the rain-- but when I focus on one family, or the families in a particular shelter or motel, I feel like I can get a grip on the issue, because people are then humanized but also confined in scale.

      I hope people pay attention to what you wrote, especially those in a position to do something about it.

    Thank you for doing this tremendous work and for sharing it, Marty. It’s hard to understand how some people can blame and denigrate the victims of such extreme poverty. I guess if that were not the case then such a level of deprivation would not exist; once it exists it has to be rationalized in some way.

    The street women and children of Hawassa and the surrounding area strike me as more human than those who would fix the blame for their plight on them. You certainly did succeed in humanizing this class of unfortunate human beings with your research and interviews. It’s clear that born into such circumstances, none of us would be different or would manage without begging for a living. I think you do a great service to call attention to what is happening in Ethiopia. Surely some good results will come about as a result of your impressive work. Even here in Greensboro, it seems there is a noticeable increase in the number of people begging in the street over the past several years. That is borne out by what I have heard of the overcrowded homeless shelters and soup kitchens.

    Love and peace to you and El,

  3. Wonderful work, Marty and Dagim. You've given a voice to women and children living on the streets of Hawassa. I hope that the Mayor and the Committee will take what you've presented them and take some meaningful steps in the direction of addressing some of the roots causes of the "begging problem" in the city. Your unceasing devotion to make heard those voices that fall on deaf ears is a constant inspiration.

    1. Emilia, thanks for the kind words. We handed in the report to the Mayor, but did not speak to him. We did speak to the Head of the Office of the Mayor (City Manager?) who engaged us for quite a while and agreed that the problem was one of systemic poverty in the countryside and they actually are considering providing subsidies to families when children want to go back, and also providing schooling for children who want to go. Also more housing. Hmmmmm... We will see. Dagim is going to translate the official report so we will know more. Miss you!!!