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.

Ethiopia: Extension of Ourselves

I have often tried to explain why the Ethiopian culture has such an effect on me. And words never seem to quite fit how I feel.

Something happens in this country that the structure of dialog cannot tame. A human connection at its most intimate and deepest form breaks down, bit by bit, my poised self and I find my heart beating a bit more excitedly at various turns. Grace, even under extreme pressure of the difficulties of life here, continues to be the base of existence. And I am seen. Not by what I have or how I look or how old I am or what kind of body I have, but I am viewed within a richer lens: my character is sought by those I meet.

As I struggled with laptop internet connection issues this afternoon, I experienced an example of what I am trying to articulate here. A soft spoken man at one of the many technical shanty shops was able to fix my problems after spending time with my laptop and CDMA communication device. When I asked what I needed to pay him for his services, he refused payment, citing that the problem was not difficult for him, he had the knowledge to be able to fix it, so therefore the right thing to do is share his knowledge with someone in need. He did not say this with a hint of manipulation. He eyes expressed truth and sincerity.

Life is hard in Addis Ababa. Shop keepers need every cent they can obtain, and there is extreme competition from other shops, all vying for the infrequent paying customer. I was astonished at this man’s generosity, and insisted that I pay him something for all of the time he spent on resolving my problem. I gave him 50 birr (approximately $3.00) and he seemed just as baffled toward me. He then relayed in Amharic to my friend Danny that he wished he could show me that the Ethiopian culture is not about repayment: it is more about extending to one another. His question: “Why does she think money has to be involved?”

I left with an uplifted spirit, once again being taught how to engage on a deeper human level.

Our lives in the US have been reduced to such transactional exchanges. I will do this for you, because you do this for me. I will pay you to help. I will trade something for what you have. And all too often, I will take what you have.

I pondered this all the way back to my hotel room and I had to think: What if we all started to live less via transactions and more by extending our hand, with no expectation from the receiver? What if our driving force was less about need and greed, and more about seeking ways to extend to others we engage with? I am not saying we should forgo getting a fair wage in exchange for our skills. But what if that was not what drove us in our interactions?

This extension of ourselves, a sincere and clear extension, appears to be the doorway to the ever elusive unrequited love for one another. And how might that feel, if we loved and never expected anything in return?

Many people in Ethiopia have very little in terms of possessions and housing and food choices. But they are stunningly rich in character.

 

Galebo Gambro helps women learn to read and write as part of Mercy Corps’ PROSPER program.

Ethiopia: Maternal Mortality

I took my first trip to Africa and Madagascar when my three children were in preschool. I set off to bring back images so they could see how children live in developing countries.

Fast forward fifteen years, and this time next week I will be working with the Hamlin Fistula Hospital in Ethiopia to document the work they do to heal and also prevent a devastating maternal condition that occurs due to prolonged labor.

Had I been born an Ethiopian woman living in a rural area, chances are strong that I would have died during the birth of my first child. Ben was too large to fit through my pelvis, and I had an emergency C-section to halt his distress and enable me to give birth to him.

When I look at my three grown children, Ben, Aaron and Brynn, the love I feel overflows into an insatiable desire to help these suffering mothers in Ethiopia.

Ethiopia: Hamlin College of Midwives

Join me as I travel to Addis Ababa, Ethiopia to meet some of the world’s bravest women as they support each other by reducing infant and maternal mortality and the occurrence of the physically and emotionally devastating condition of fistula.

It is a great honor to be asked to visit the Hamlin College of Midwives to capture the essence of their 2011 graduation ceremony. On October 15, 2011, the Hamlin Fistula College of Midwives will graduate a second class of trained midwives. After the ceremony, these newly trained women will return to their rural villages to care for new mothers and assist extremely difficult deliveries.

Every day, 1,000 women and 8,000 babies die due to complications from pregnancy or childbirth. And for each maternal death, at least 20 additional women suffer devastating injuries related to their simple desire to produce a family to help work the fields to sustain their food source.  These World Health Organization statistics are sobering, especially when contrasted with the kind of care that is received elsewhere in the world.

The Hamlin College of Midwives is responding to this crisis by training local rural women much needed midwifery skills and supporting them as they set up services in their rural home villages.

Come along as we celebrate these midwives and the mothers of Ethiopia!  I will be documenting this momentous occasion, as well as other aspects of the beautiful and innovative Ethiopian culture. I will also be writing guest blog entries on Phil Borges’ Stirring the Fire website.

We are hoping that a collective cheer from around the world will be heard as these Ethiopian women extend one of the most loving gestures to one another: helping a mother deliver the life that grew inside of her.

Each midwife has been able to be trained without having to pay fees, which they could never afford. Your help is critical in making this possible. Donations for the midwife college are being accepted now at the Hamlin Fistula USA website.

For Dr. Catherine Hamlin’s story, read about her book here.

ASMP Best Of 2011

My work documenting emergency obstetrics in rural Ethiopia was chosen to be in the American Society of Media Photographers “Best of 2011″ project list.  I am hoping that this will bring about increased understanding of the difficulties surrounding maternal health that are present in rural settings.  The Ethiopian government is actively developing solutions to address these problems as quickly as they can, with minimal resources.

Here is an interview that details this project and others that I am working on, plus some of my philosophies and business practices.

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