Ethiopia: Fistula At All Ages

Not all fistula patients are teenagers and women.  Some of them are children, such as Aynababa, age four.  Although child marriage is illegal in Ethiopia, many ancient cultural practices support this tradition, which is one situation that can result in fistula due to the young girl’s body not being fully developed to be able to handle childbirth.  Other situations, such as rape, does occur, however it is infrequent due to the gentle nature of most Ethiopians.

Educating the rural community about fistula is vitally important to the Hamlin Fistula Hospital organization. Each midwife is trained to perform education outreach to the most remote areas of Ethiopia.

Although Aynababa suffers from fistula, one can see how the Ethiopian spirit cannot be easily broken. Each person she meets is greeted with an infectious smile and a degree of expressed happiness I rarely see in my own country.

I fall in love with the Ethiopian spirit again and again and again.

Ethiopia: Brave Women

They have been called some of the bravest women in the world.

When a woman suffers obstructed labor in rural Ethiopia, she often has no place to go. She labors for days, and fistula can develop due to excessive and prolonged pressure on internal organs. The Hamlin Fistula Hospital is devoted to the repair of fistula and the psychological healing of women who suffer this devastating condition. They also are dedicated to helping to prevent fistula from occurring at all.

In November 2010, Dr. Hamlin’s dream came true when the first Hamlin midwife graduates started working in the field, offering prenatal care and a referral service to pregnant women in the countryside. The midwives work alongside the Ethiopian government to help reduce instances of fistula by providing much needed care to these women who live so isolated from health centers.

Each Hamlin health outpost has an ambulance to assist with referrals to regional hospitals where C-sections can be performed in emergency situations. The midwives, all coming from various villages around Ethiopia, are selected via a rigorous interviewing and testing process. Once they complete three years of training at the Hamlin College of Midwives, they return to their villages to work for six years. During this time, they are also educating villagers on maternal healthcare initiatives as well as building trust with the village as a whole. Their days consist of prenatal care, assisting with difficult births, education, and referrals of extreme cases.

It is not an easy job, living so far away from their colleagues and a team of ready support and modern equipment. But they are well equipped for support when they need it. This does not mean that they do not face extremely difficult situations alone. Rural women still prefer to give birth at home, and often go to receive help after it is much too late.

The Hamlin midwife becomes a wise health official rapidly.

Ethiopia: Magic Village

My friend and driver, Danny, invites me to join him on a visit to his home village and I jump at the chance to go.  On Sunday, he arrives clad in bermuda shorts, t-shirt and his shades and off we go, driving through possibly the most beautiful landscape on Earth. Rolling hills give way to massive cliffs and rocky pointed mountain tops with wind blown trees dotting the fields like staccatos in a pulsating Led Zeppelin song. Yes, Led Zeppelin. Deep. Dark. Mysterious. Commanding.

We arrive in his village, Gulett, a few hours away, and my mind is so far elsewhere. How can I leave this enchanting land? Maybe I should strop right now and turn back. What if at some point I won’t be able to?

We enter his compound and are greeted by his 87 year old “Mama”, his great grandmother, followed by “Imiyea”, his grandmother who raised him after his mother died when he was ten years old. It is love at first sight. Words are not needed to hold someone’s face, look deeply into their eyes, your own eyes filled to the brim with tears, and communicate feelings of joy for this chance meeting.

We visit for awhile, eat some gonfo, they teach me how to catch a goat, and I try to say something each time Mama tells me to “just say something”.  I wish I knew more Amharic, but she settles for the few words I know. We decide to take a walk before dinner and Danny leads the way over unpaved roads filled with large rocks, gently watching my stance so he can quickly right my fall should that begin to occur.

We come to an area that looks like paradise decided to drop some magic. I find out that Danny’s friends decided to pool their resources about three years ago, taking a stretch of incredibly unattractive land and making it into a lovely garden with pathways lined with beautiful plants and flowers. Small tables are set up so people can enjoy coffee (best I have had in Ethiopia so far!) and conversation.

They show me one structure that is not yet complete and tell me they are building a “Couple’s House”.  Apparently, if two people spend time together and after much dialog decide to culminate their relationship, they can enter the Couple House. If they do enter this house, marriage plans will follow.

As I sit there marveling at the storybook feel to the day so far, a small boy around the age of seven comes up to our table and begins to dance the moon walk and many other dance moves that Michael Jackson so flawlessly perfected.  I clap my hands, excitement building as his moves get more complicated. Dear Mother Sky…am I in heaven?

One of Danny’s friends starts to move his hands wildly in front of Fetena’s face and I realize this little boy is deaf. How can he feel the rhythm to be able to dance like this? I ask where the men learned sign language and my question is met with a shy smile. It is “just natural sign language”, they relay to me. And they go on to talk with Fetena about trips to Addis, how his mother might feel, what they need him to do, how they feel.  I try to catch a glimpse of a gesture I can understand and it is impossible. I fall in love with both of them. Like real love, the kind that makes you feel a bit twisted inside, and safe, like there is no end of it in sight. Ever.

I capture Fetena’s dance on video, and he commands the camera with intensity. My heart stretches to the moon, and I look up to see everyone watching my joy. I cry. I cry for Danny’s life without a mother.  I cry for this little boy who has not let his deafness keep him from feeling and expressing rhythm. I cry because this marvelous little boy is very poor and has to beg others for food. I cry for anyone who has never felt love like this. I cry because I feel so deeply.

Danny tells me it is time to walk a bit more, and a short way down the road I see a woman looking out of her window, head perched comfortably as though she spends much time watching the activities surrounding her house on a daily basis. Danny relays to me that indeed she is there all day, and she is blind.  Yet she looks like she is watching every move passing by.

I call this village “Magic Village” and I truly feel like I have dropped into my childhood’s most desirable dream village. And oh how I love it. When Mama says she will adopt me into her family, I feel a sense of peace rush over me, knowing I will never leave this village.

 

Ethiopia: Humor!

Spend time with an Ethiopian for very long, and you will soon see that they have a wicked sense of humor. Biting, playful and sarcastic, they take complete control of your sense of self through humor. I often wonder how they can possibly know me that well in such a short period of time.

This week, I have laughed so often in such a short period of time like no other time in my life.  Even with language barriers, they know how to tease a spirit in the most delightful way.

Ethiopia: Educating Countryside Women

Women in the rural countryside of Ethiopia are smart, resourceful and highly creative, yet they rarely get a chance to be educated. Their days are spent fetching water, gathering firewood and tending to the home fires while the men work in the fields. Simply getting food on the table for the family requires incredible stamina and devotion to keeping family nurturing as first priority.

When a woman comes to the Hamlin Fistula Hospital and as her body is healing, she has the opportunity to learn many things: the visual alphabet, reading and writing, simple arithmetic and even nursing procedures. Some women are even hired as nurse aids after completing their education. What better person is there to care for a new patient than a former patient?

Educating a woman from the rural areas builds confidence psychologically for her eventual return to her village. The last time she was there, she was weak and lacked any kind of function whatsoever. She also most likely was ostracized and shunned.

Can you imagine how it must feel when she arrives home months later as not only a physically healed woman, but she can also read and write and alert other women to the signs and devastating effects of obstructed labor?

She may never completely eliminate the stigma of once having fistula, but she is well prepared to deal with this adversity with much more confidence. She also has become a crucial resource in educating other village women when they must seek outside care, rather than remaining at home during difficult labor.

                                                                                                                                                                                                                                                                                                                                                                         

Ethiopia: Strong Bodies, Strong Spirits

When Asnaku arrived at the Hamlin Fistula Hospital, she was extremely weak. Women who suffer from fistula cease eating and drinking, so that their body does not produce waste, thus contaminating their villages. The shame they feel is enormous, and they try to minimize the effects they have on their surroundings and loved ones.

Often, they arrive emaciated and dehydrated. Before they can have surgery, their body must be strengthened by nutrition and physical therapy. Each day, they are required to eat one egg and one piece of bread, and drink plenty of water. Nurses aides, former patients themselves, help them perform exercises so their muscles begin to strengthen.

Foot massages are given daily to increase circulation. This is a most intimate time, when a nurse aid gives a patient her massage, looking deeply into her eyes and ensuring that the patient feels loved and supported.

Asnaku also continues with her exercises after surgery until she is strong enough to return to her village. From the very beginning when Dr. Hamlin developed the program for the hospital, she and her husband Reg knew that whole body wellness was of vital importance.

As Asnaku becomes stronger, she also becomes part of the support circle for newly arriving patients, helping them to become stronger physically and spiritually.

 

Ethiopia: Asnaku Finds A Community

One vital function of the Hamlin Fistula Hospitals is to provide a sense of community for the women who have suffered the socially ostracizing condition of fistula. In the home village, a woman with fistula is shunned and left to live out her days in a nest-like shelter, often fending off hyenas which are attracted by her scent.

It is not hard to imagine how devastating this condition can be for a woman who only wants to raise a family.

When Asnaku was brought to the Hamlin Hospital by her brother, she was scared and ashamed of her body. When she walked into the compound, she instantly was embraced by many others who share her condition. She found not only acceptance, but also a sense of supportive community, even humor. Once again, her mind is freed and she feels hope that she can once again join her village as a healthy and confident woman. Her shame abates.

Her days are filled with new friendships and gestures of love. The women brush each other’s hair, eat together and attend group classes.

While Asnaku’s body heals, so does her spirit.

Ethiopia: Meet Asnaku! An Empowered Woman

It is an honor to introduce Asnaku, who comes from the Merabita kebele (village) in Ethiopia. Ask her how old she is, and she will say she does not know. I wish we all could have such a peaceful mindset.

Asnaku is a lovely woman, graceful and poised, and is an exceptional handcraft artist. She spends a great part of her day selecting colors and embroidering beautiful patterns onto fine cloth table runners that are sold at the Hamlin Fistula Hospital. One hundred percent of the proceeds of these sales return back to her. I talked with her instructor and she enthusiastically relays that Asnaku’s handiwork is some of the best she has ever seen.

When women find their way to the Hamlin Fistula Hospital, they are in for a great surprise. Not only will they be tenderly cared for from a physical standpoint, they will also find a community that rallies around who they inherently are. No longer are they labeled as “woman with fistula”; they become artist, educated woman, and caregivers themselves. Some of the patients even secure work at the hospital as all nurses aides are former patients who have learned much about healthcare during their stay.

Asnaku has developed many leadership capabilities in addition to her stunning artistic skills. Her quiet and confident demeanor have enabled her to make many friends here. She is a strong and assured woman. I could see her as a shop owner, a doctor, a CEO.

Today, she focuses on making the best stitches as she can: even, precise, and secured so they will not unravel with use. As she moves through physical therapy sessions and meals and classroom work, she is never without her stitchery.

Focused, steady and kind, she is the bastion of an empowered woman.

Ethiopia: A Visual Carnival

Hoo boy. I have traveled to Africa so many times now, and I forget about that “third day” of acclimation.  How could I forget?

The two days of flights don’t bother me. Gives me time to think. And once I circle the Bole airport from above, I get a surge of energy no matter how little I have slept on the planes. It’s ETHIOPIA!

Plane touches down, and I don’t mind that my friend Daniy is not there to fetch me. How could he possibly know that I finagled a seat near the front so I could flee downstairs to the Visa room and not have to wait in the hours long line? Hey. I am getting this stuff DOWN!

I negotiate a taxi, pay way too much because my Amharic is a dead giveaway that I am trying too hard and I am still as firenji as a firenji comes. I search for familiar words I learned last year, wanting to say yikirta (excuse me) but I say kiriftu instead, which is the name of a hotel in BahirDar. So I watch with fascination, and in silence, the scurrying of life as it is in Addis Abba.

It’s one of my favorite visual carnivals.

Busy-ness at its most fevered pitched, everyone has a place to go. Fast and furious. Chances are they are only going a few streets away but the way chaos meets mayhem here, one has to fight their way through roadways, avoiding buses, motorcycles, goats and an occasional posse of boys having fun. Crossing the road is like swimming in the deep blue sea, through multiple schools of fish going the opposite direction.  I literally put my hands together and try to imagine what it is like for a fish to get from A to B in the sea at rush hour. And where is that fish going anyway?

So upon touchdown, my senses are peaked and I sniff the familiar smells in the air while drinking in as much as I can within the shortest amount of time. Look at THAT! Did you see what he was carrying? Wow…they are playing a game over there…looks fun. WAIT! That’s a cow ahead!

Bump, bump…roads are conducive to new dance moves. Music is everywhere. I try to feel the beats of the deeply pitted roads match the Ethiopian sultry sounds coming from the scratchy CD player.

One word: fun.

So, I don’t sleep. I want to hear the priests chanting and the birds calling out in the wee hours of the morning. Hell, I am not tired at all! Let the adrenaline work its magic on me. Holy moly, I am invincible!

And then…WHAM. Around the third day it all catches up on me. I lose things. I forget where I wrote down important information. I mistakenly eat a mouse turd in my eggs. I can’t figure out how to turn on the video of my camera even though I have done it a million times. And, I see vast suffering and it starts to really sink in how difficult life can be here.

Communication is at bay, slow at its very best if at all, and I start to fall down. Tears and worse: I just sit and stare, nothing coming to mind. Nothing. I am not invincible, I am close to being crazy.

I realize I am in the culture impact zone, and I try to just let it pass. I pop onto the sedated internet and alas, a friend is available to chat. Geesch how she gets the brunt of it all. Where is the $%^# button I need to push? HELP ME! Look at what I saw today. I need help with capturing sound, and where the *$#%^# did I put that manual? I can’t fathom it all.

And then, sleep comes with a heavy thump and I wake up as though it is the best day of my life.

My first thought: I want to go ride the merry-go-round.

Ethiopia: Grace + Empowerment

We have all suffered to varying degrees. A lost relationship, death of a loved one, a missed chance. This summer has been especially difficult for several of my friends and also within our family due to various losses, to the point where I adopted a much practiced mantra: our happiness is in direct relation to how well we can grieve.

Grief comes in many forms, and I marvel at how often we try to push it aside and “get over it”, whatever the loss is. Lately, there has been so much of it in my life, I decided to try a different twist and embrace it. Learn from it. And I found that I am not very good at keeping that philosophy front and center.

I arrived at the Hamlin Fistula Hospital yesterday and within seconds was surrounded by women who suffer perhaps the most heinous condition a human being can endure. Fistula is not only physically debilitating, the effects are psychologically and socially devastating as well. And even if a woman finds her way to this miraculous hospital by the river, she still faces her return to her village where she often finds additional difficulties, and even a recurrence of fistula if she does not follow what she has learned while being cared for.

Yet all I see here on these grounds are beautiful women, with easy smiles, loving temperaments and deeply moving eye contact. They have felt the depths of pain that is unfathomable, only to reflect outward a generosity of spirit that is rarely encountered. It is as if their ability to suffer silently has instilled within them an ethereal aptitude to connect to humanity, instantly, at our most vulnerable level.

I am honored to be in their presence.

And as each women engages with profoundly perceptive eyes, I feel like a child, inexperienced, fumbling, uninitiated. They seem to know this, accepting this ferenji who lives such an easy life, and they take me into their graces with a tender hand, as if they know how easily I can break. These women are strong beyond imagination.

The Hamlin Fistula Hospital’s focus is not only to repair fistula, but they have built a comprehensive program that helps these women become empowered through prevention education and outreach, psychological counseling and community building. I spent the day with the patients, and followed one young woman as she showed me her daily activities.  I will share Asnaku’s experiences in the upcoming blog posts.

For now, here are some of the women who helped me deepen my understanding of grace.

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