In general, I am not a landscape photographer, but in this environment, I could find my way to being one quickly. This was taken a few steps from our sleeping room, in Arba Minch, Ethiopia.
The plane touches down in a chaotic fashion, jarring us forcefully in our seats, and waking me from a jet lag stupor. Arba Minch’s airport is small and seemingly vacant. We watch as a few men come toward the plane; doors are opened and we disembark into steaming hot air. We stream into the airport silently – no one wants to talk much in this heat – and we wait for our luggage.
Once the baggage cart is filled with all of the luggage, we are amazed to see that there is no vehicle to carry the cart to the airport. Instead, the two men we saw earlier take off in a running start and push the cart over toward the terminal, picking up considerable speed when they hit the small hill that is in front of the door. Wow.
We arrive at our hotel only to find out that our reservations were not in place, so we set about finding another place. We follow a young man who says he knows of a place, and we quickly find ourselves walking on the main street, carrying our gear, dodging trucks, tuk tuks, goats and motorcycles. Several feet turn into yards which turn into…..”How far away is this hotel?” We finally reach it, and instantly feel uncomfortable. It very well could be that our expectations have not yet leveled from our comfortable lives in the states, but this “small compound” with its indifferent proprietor and couches filled with staring men did not seem like a good option. And it was oh so hot in the barren and stale smelling rooms.
Being Timkat holiday, we know our options are slim. We reluctantly throw down 200 birr ($12) for our first night’s stay. To find a cooler place to relax, we ask our tuk tuk driver to take us up to a lookout point near Paradise Lodge and we soon find ourselves in truly a paradise haven. Standing on the edge of a mountainous cliff, overlooking treetops on the edge of the Rift Valley with views of lakes Chamo and Abaya in the distance, I get an urge to fly. I want wings! Birds whip past, taunting us with their abilities, beckoning us to join them. I wish I could.
We are told that there are sleeping rooms available on the cliff down the road, and we excitedly ask to see if any are available. Indeed, for a mere 300 birr ($18) per night, this paradise can (and will) be called home for the next four days.
We said goodbye to Dr. P and Darlene, and off to Mota they went. We were excited to know there was cell reception in Mota when we got our first call from them. The news was equally as exciting. In less than 24 hours, they had been harassed significantly in BahirDar, found themselves in the middle of a religious celebratory mob scene in Mota, learned that there is no internet in Mota, found out that we would have water only three days per week, and that no cook existed for us.
The good news: sheets are pretty clean, the hospital staff is warm and inviting, and the air is cool without too much threat of malaria carrying mosquitoes. And the rooms are in the hospital compound so we can be locked in at night.
From all accounts, they are navigating the obstacles the best they can. This does not come without a bit of sleeplessness and anxiety….and lots of “what ifs”.
What if a women dies while we are there? How will Dr. P and Darlene feel about removing a dead fetus? What if a woman is hurt? What if a referral needs to be made, knowing there is no place to refer in the vicinity? What if the village gets angry? Will they accept a female doctor?
Most of these questions seem less of a concern during the daytime. But when the head hits the pillow, we all lie awake churning the scenarios over and over.
Holy cow! An interview with Dr. Hamlin!
We thought we would be lucky just to be able to meet her and shake her hand. Never in my wildest dreams did I think we would be granted an interview and the ability to photograph and film her. We make our way back to the hotel to pick up the equipment and Jay and I cannot help but express our giddiness…and concerns. We had not had time to test out all of the equipment and work flow, thinking that our first interview would not occur until days later. Some of the equipment was purchased hours before we got on the plane, so one can only imagine how we felt going into this interview.
Sound levels ok? Camera functioning? Will everything talk to each other?
We then turn to preparing some questions for her. She is 87 years old and still performs surgery. She came to Ethiopia in the 70’s, thinking she and her husband would stay here for only a few years. The fistula patients made a great impression on their hearts, enough so that they decided to dedicate their lives to this work. A very interesting subject indeed!
On the bumpy taxi drive back, Jay is still testing sound levels to make sure the H4N works properly. I am lost in my head, thinking about how to set up the camera with the least amount of fuss and intrusion.
Dr. Hamlin enters the room, her tall and graceful stature filling the space. Her kind eyes fix on us, and we are instantly at ease. The door opens again, and in walks Mamitu, the famous illiterate surgeon who was once a poor fistula patient and learned how to repair fistulas by working alongside surgeons rather than complete formal training.
My eyes fill with tears as I look at these two women who have had such a profound effect on fistula patients’ lives. It is such an honor to be in their presence.
Jay and I quickly set up the equipment, and we get started on the interview. Our questions were not really a necessity, as Dr. Hamlin has many things to say to us from her own agenda and determination.
During this past year, I have kept in contact with the communications director of the Hamlin Fistula Hospitals. I promised to bring her several bags of KEEN shoes that were graciously donated so that patients could walk home more comfortably, even though the weight of these shoes would add a bit of complexity to our travel. Getting the shoes through customs can be difficult, which often means having to be held back for questioning.
Sure enough, we were stopped by the customs officer, with his incredulous question: “These shoes! Are they all yours?” (Really now, do Americans give the impression they would travel with 40 pairs of shoes?) I put on my most confident stance, and picked up the heavy bags, explained that they were donations, and turning on my heel to take off, did not give him time to ask me anything else.
We arrived at the Hamlin Fistula Hospital the next morning, and were instantly astonished at the site of this hospital. Lush gardens were the dominant feature, overshadowing the buildings. It felt as though we were in a fairy tale. We talked with Feven about many things, but one topic was of utmost importance: which direction we should take with our documentation and film.
Feven explained that young girls are often married off young to avoid abduction and rape. When the girl becomes pregnant at an early age, her pelvis is too small to give birth to her baby and she labors for many days and sometimes weeks. The constant pressure of the baby creates many problems.
When the young girl who lives in the rural countryside realizes that her baby is not able to be delivered, she usually has little choice but to wait for the baby to die in her womb. Even after the dead baby shrinks and is able to be delivered or extracted by a family member, she is often left with a fistula condition, where a hole is formed between the bladder and/or rectum and the vagina, and waste continuously flows, resulting in ostracizing from her village and abandonment by her husband.
A girl with a fistula usually will live on the outskirts of the village, afraid to walk for fear of contaminating her surroundings. She sits in a makeshift nest, and waits out her days, sometimes having to fight off hyenas due to her constant smell.
Sadly, this can all be prevented if there was better access to health care in the rural countryside. The Ethiopian government is building hospitals and clinics all over the country to address this. However, most of the clinics stand idle, in desperate need of doctors.
Our time here will be spent in a tiny hospital, which has no running water, in Mota. Dr. Philippa Ribbink will be training Ethiopian Health Officers how to perform emergency obstetrics. We know that this work will have a profound impact on all of us, but sitting here and listening to Feven, we are energized to do this work.
Feven asks us to focus on the inaccessibility that a young pregnant girl faces. Sometimes this means lack of access to hospitals, sometimes it means that while a hospital may exist, no doctors are present. Often it means that the young girl cannot get to the hospital. Foot bridges are washed away, the terrain is too rugged to walk during the 4th or 5th day of laboring, or family men cannot leave their farming work to be able to carry her on a makeshift stretcher. We also hear that more donkey carts are desperately needed to help facilitate her ability to get to a hospital during prolonged labor.
A few weeks earlier, I had made a request to meet Dr. Hamlin. Nothing was promised, as many people ask to meet her and her time is extremely limited. I watch as Feven picks up the phone and dials a number. It is a apparent that she has called Dr. Hamlin, and she asks if she has time to meet us. After a bit of dialoging, we make a plan to come back at 3pm, with our cameras. We have been granted an interview and approval to film her.
We could not wait to be able to taste authentic injera again, and we were not disappointed. The colorful array of spicy sauces, anchored by salad with an orange/lemon dressing was just the ticket after a hot day on the streets. We usually don’t eat raw foods here, but at this hotel, we are assured that raw foods are cleaned with bleach.
We arrived in Addis Ababa at our favorite hotel, The Mimosa, only to have the proprietor great us from his memory of when we were here last year. We felt like we were coming home. First night jet lag is always a favorite time for me: I love getting up before the first rooster crows and listening to the hustle and bustle of life on the streets starting up.
No matter how many times I come to Africa, I always seem to forget about just how amazing the sound of birds is at dawn. I really feel our world when I am here: those singing birds; the heavy smells of eucalyptus, coffee roasting and grass; the wake-up whiplash of being bounced around in a vehicle on rocky roads; the unrelenting eye contact. Addis is a sensory playground and we don’t have a choice but to participate. And, we want to.
Herds of goats strive to keep out of a chaotic stream of cars and trucks, men carry 5-6 squawking chickens by their feet, children run barefoot and amok trying to hustle you into buying a few sticks of gum, girls walk seductively along the sidewalks seemingly quite aware of their effects on the masses of young men, Muslims socialize with Christians, music blasts and songs compete for your attention everywhere, business people stroll in their finest attire. Even an occasional street sex worker beckons in a whispered and hopeful breath. It’s all here, fast and furious.
And it seems that every time we walk outside, it does not take long to get exhausted from so much visual and audio richness. Addis is alive!
We have been busy setting up cell phone communication, making last minute travel arrangements and running errands to prepare for our month here. Dr. P and Darlene will take off for Mota, and Jay and I will fly to Arba Minch to fulfill an assignment for Mercy Corps.
We are happy, and fortunate, to be here. Ethiopia, we love you.
In rural Ethiopia, a young girl marries early, often by the time she is ten years old. She often becomes pregnant before having her first period, yet her pelvis is not large enough to give birth. Many severe maternal health conditions occur in rural Ethiopia; some can be devastating and ostracizing such as fistula. And too often, young girls die during childbirth.
A rural Ethiopian girl’s common purpose is to become pregnant and raise her family. Over the years, her body will bear the brunt of extreme water and wood gathering pressures as well as childbirth injuries, and she rarely is offered the choice to not have more children. However, it is a great honor to bear a child and nurture it with vigorous focus and determination.
To witness a young woman struggling hard to stay well enough to feed her children here is very disheartening. A human life is precious, and when I look into each child’s face I encounter – whether found wandering on the streets, or in the arms of a loving mother, or working hard to shepherd a herd of cows – I feel a sense of awe in that they are able to survive at all despite so many obstacles. And yet, they continuously find reasons to express an easy smile.
According to Partners In Health, nearly 1600 women and more than 10,000 newborns globally die every day from complications of pregnancy or childbirth. And it is well known by now that statistics indicate that poor education aligns with fertility issues.
As I contemplate the needs of Ethiopia in particular, I think of several priorities right away: educating young girls, establishing reproductive and health awareness, getting more doctors and midwives to be willing to train and work in rural areas, building more rural hospitals, obtaining sources for clean water, and developing better transportation options for those who are ill.
It can be overwhelming to see so many problems intertwined and having a domino effect upon each other. People frequently ask me why I become involved with such difficult and seemingly dire conditions. When I take the time to think about this, the thought of new spring growth comes into my mind. Is the crocus intimidated by the cold, hard, winter packed earth? No, the fragile flower transforms into new life by slowly pushing a tiny bit of dirt away at a time in order to make its way to its fullest expression. How does that flower break through the heavy earth?
Perhaps this is how we can all work together to help a young girl in Ethiopia: one small gesture at a time. Ethiopians teach this lesson every day as they move forward navigating one obstacle after another, one small step at a time, consistently focusing on solutions rather than the issue they face.
Please join us during our time in Ethiopia by reading about the forthcoming stories we will encounter during our extended stay. We will be visiting schools, hospitals and programs where devoted support has been established for many young girls and women in rural Ethiopia.
We welcome your comments and ideas. Together, one small gesture at a time, we can work toward effective solutions.
I had the exciting pleasure of working on three articles for the Winter 2011 issue of 1859 Magazine. Traveling to the wilds of Oregon’s most remote SE corner to the town of Plush, I photographed the conflict over mining sunstones. For another article, I met several people who chucked their corporate jobs and re-invented themselves. And I met a most special man, John Callahan, the literary executive of Ralph Ellison’s unfinished manuscripts.
Thank you, Kevin Max, for giving me these assignments. They rock my world.