Category Archives: Essays

Ethiopia: A Convergence Of Support

In our fury to obtain water and find sources of clean vegetables and resolve the insect biting problem and find the latest irrelevant lost object, we sometimes forget why we are here in this dusty, remote village of Mota. Bekaset’s story is a jolting reminder of the desperate need for help in this region.

Bekaset’s pregnancy progressed normally until she went into labor. As she labored, her pelvis was too small to deliver the baby, and the baby became wedged in her birth canal. She knew something was terribly wrong, but she lived far from any health care and there were no midwives in her village who could help her. Her labor became obstructed, and the contractions forced the baby lower and lower into her birth canal. The relentlessly intense pressure eventually tears her uterus open, and the baby quickly dies.

Had Bekaset not heard good reports about Mota Hospital, had she not made the decision to leave her safe and comfortable home in her village of Debrework to try to find help here, had she not felt physically able to make the long bus and foot trek to Mota Hospital, had the men in her life not supported this journey by carrying her as she labored, had she suffered in silence like so many Ethiopian women do, she would be dead today. This would have left her children motherless and her weary, loving husband, who toils all day in the fields, uncared for. It is apparent in the eyes of her husband, Niguss, that he is desperate for her to live. He looks at her tenderly, his fingers slowly stroking the edge of her blanket. Words are unnecessary at times such as these, and cultural differences disappear. His pleading, yearning, silent eyes say everything. They will haunt me for life.

Instead, Bekaset is now under the care of skilled midwives and our medical team. A decision is swiftly made to remove the dead baby and her uterus, so she does not perish. Her surgery proceeds without issues, and her recovery is quick.

Days pass, and it is now time to go home. Her husband and father, who have been patiently caring for her and bringing her food during her days of recovery, are there to walk with her to the bus terminal. Her face is drawn; she has lost the baby she had come to know within her, and she also realizes that she will never bear another child. Yet, there is a deep respect for those who helped her here at Mota Hospital: she is alive, well, and able to return to her other children and household duties.

We give her a pair of donated KEEN shoes to make her walk home a bit more comfortable, and I watch as her family take tiny steps behind her to ensure that she is supported. The love is so apparent, more so than I have witnessed in many recent years of observing my own culture. They know what Mota Hospital has done for their lives, and without words, we all know why we came here.

Eyes speak, hearts leap, hands join.

Ethiopia: Birth!

I am a mother three times over. My offspring are away at college, and I try hard to release my hold on them and not hover like a mama bear. But it is an undeniable truth that they are a physical part of me, each one, with all of their idiosyncrasies and troubles and joys. I feel them, like they are appendage, even when they are miles away.

Before I had my first child, I never thought I would be changed because of the experience. I had grand plans to return to work after a respectable six weeks off, only to hold my firstborn son Ben in my arms and sob uncontrollably, knowing that my decision making was altered for life. Everything, everything, began to be centered around what is best for this child. My own desires seemed lofty and were suddenly not so important.

My first pregnancy progressed well, and I ballooned a 60+ pounds. I was proud of my spindly legs carrying such an enormous belly. People stopped to stare when I was only in my seventh month, thinking I was about to deliver any minute. I soaked up that attention and felt like a queen everywhere I went. Doors were opened, chairs were offered. The whole while, I felt glorious, never sick or weak, only blissfully content as a felt each kick.

Ben announced his entry into this world almost exactly on his due date, and all seemed fine at first. Then, after laboring for 17 hours and pushing for 3 hours, it was determined that he was in extreme stress and he simply could not fit through my birth canal. A whopping 9 lbs 11 oz of a baby he was! He also broke the hospital’s record for being their longest baby at 23 1/2 inches long. I was proud of my Big Ben.

I reflect on this now, as I watch a mother suffering her labor after walking miles to get to Mota Hospital. Had I lived here, I would surely have died during childbirth. I would never have come to know my three children. I would not have seen Ben write his first magazine article, or Aaron develop his love of the electric bass, or Brynn fly effortlessly on her feet while she danced. I would not have settled countless arguments or worried late at night when they did not come home or cry when they said they hated something I did.

I am now in the birthing room, and I watch Adele suffer. She repeatedly pulls on her ragged dress in pain, and I see that the baby is not easily coming. The midwives scurry to get the vacuum and swiftly adhere it to the baby’s head. With mighty force, they begin to pull, as she writhes in pain. They pull harder. They yell at Adele. Two people pull even harder together. They must cut her to widen the opening, determining she does not need a C-section. They pull with all of their might. Dr. Philippa steps in, and tells them to alter their angle: lift up, not down. Finally, after much screaming and fierce pulling, the baby is out. Adele stares at the ceiling, her eyes not searching for the baby at all. I can’t fathom what she is thinking. I watch her, and slowly she turns her head in search of her first born child.

The midwives ask her to get down from the table, and she walks over to the door where her mother and grandmother wait for her. They will assume post care, feeding her, keeping her warm.

I am in complete awe of the midwives here at Mota Hospital, and it is a true honor to even be in their presence. Tedele is quiet as I acknowledge his skill. He looks away, then down at his bloodied hands. I am sure that not all of these situations resolve so easily. He knows that I am only seeing one small aspect of his job.

Tedele turns to the buckets of water and silently washes his hands.

Ethiopia: For The Love Of Water

Water. Glorious, delicious, comforting water.

Much has been said in recent years about the importance of water, the impending worldwide scarcity, the droughts that countries suffer. Yet it can never quite hit home or feel like a reality until the loss of water is personally experienced, when each drop is precious.

We knew this hospital would not have running water. We stocked up on drinking water before we left BahirDar, and made sure that we had sufficient cleansing wipes for our hands while working in the hospital. But what happens when a bottle of ketchup drops on the floor, splatters everywhere and there is nothing to clean it up with? This leads to an invitation for cockroaches, an increase in mosquitos, and a myriad of other issues. Or when we need to clean a dish, or fry eggs for a dinner, or wash a utensil or wash our hands after handling something we know is contaminated? Do we use precious bottled drinking water for that?

We conserve the best we can, yet find ourselves battling with the wash lady over how much water she is using, literally fighting with the handle of a bucket in order to keep one in the house for other uses. We get water from the government a few days a week, but as soon as it it turned on, the hoarding begins, and it quickly runs out. We join the hoarding by purchasing more buckets to fill up with the scarce resource, and even collect the bad water from the leaking sink to use for flushing our toilet. Swiftly, we join the thousands of other Ethiopians who live in extremely unsanitary conditions.

Public health posters plead for people to wash their hands to prevent the spread of disease. This action is embedded into our Western culture, yet what do you do when you have no water?

Animals pass on the road, their bodies thin, bones protruding. Every day, there is a multitude of decisions over who gets how much water and when. Bathing goes to the wayside, and still, we have trouble choosing how we will use our supply. We decide to drastically reduce our cooking, which uses more water than we can spare. Boiling eggs requires little clean up, and we can use the water for something else, so that becomes our staple protein. And when we sparingly use water to occasionally wash our hands, we do so over the toilet so that water can flush waste.

We stop drinking water, from subconscious thinking, and I faint one morning from lack of fluids. We have no car to retrieve more water, so our minds turn to how we can pay someone with a donkey cart to help us. All the while, we see women and small children carrying, for miles, large plastic containers full of river water. And we realize how fortunate we are: we have the means to purchase water. Now I know why kids fight their way to the firenji when we stop in villages, scrambling to get the last bit of water in our water bottles.

Wash your hands to prevent the spread of disease? This sentiment seems a joke to me now. And it makes me incredibly sad that water is scarce here at this hospital, a place where sanitary conditions are expected. A well would serve this health care community in ways that are immeasurable. A simple system of collecting rain water and saving it for the dry season would drastically have an impact on the lives of the doctors, patients and students who long to be of health service in this isolated terrain.

Ethiopians have a right to water just the way we do in Western society. I think of this every time I face the sink at home. I say a silent “thank you” every time my hand turns a faucet. I long to be able to build a big pipe that travels across our continent, under the sea and over the mountains to be able to flow here in this little village in Ethiopia. Surely we can find a way to conserve, and share, this resource.

I accept this time of extreme difficulty without the luxury of flowing water. It teaches me many things. And knowing that it is a temporary situation gets me by. But oh how my heart aches for those who will remain here, struggling each day to find their drops of glorious, delicious, comforting water.


The Mota hospital scrub room.

Ethiopia: Reading, Writing and Arithmetic

In the Melega Dugaya village in the Konso district in Ethioipia, women take part in learning how to read and write by a Mercy Corps Livelihood Project learning facilitator. They begin by learning how to write their names, how to form numbers on a page, and how to perform simple arithmetic. This learning beginning only fuels their desire to learn more, and they repeatedly ask to learn higher levels of reading and writing. They especially want to learn how to create their own business name and know how to write it on papers, signs, etc.

Through the same Livelihood Program, many women are learning how to run a small business and how to save and re-invest earnings. They express joy that they can now read the numbers in their savings account, whereas before they had to rely upon others to relay this information.

They sit in the shade and practice writing for one hour each day, for five days a week. This is usually done in the morning, well before their daily chores begin. While they do this, their older children take care of the younger ones in order to support their mother’s education.

Mercy Corps facilitates fourteen of these learning groups in the Konso district in Ethiopia. The groups are still in a pilot phase, but each group we visited were clearly passionate about their learning, and their enthusiastic thirst for more advanced topics was apparent.

Some of the women’s children have been exposed to a bit of education. When asked about how the children feel about their mothers being educated on reading, writing and math, one woman, Korate Sagoya, was quick to answer: “My children asked me if I really was still in the first grade! They tell me: Be strong. You can do this.”

Ethiopia: Dorze Village

His name is Mekkonen, and he is the village leader of a small village named Dorze, near Arba Minch, Ethiopia. He lives at the entrance to the village, where his parents and grandparents and great-parents lived for many generations. He shows the interested occasional visitor how the village uses every part of the enset (false banana) tree: for making bread, furniture, weaving roofs for their houses. I find myself lost in thoughts about how wasteful we are in other parts of the world. Imagine taking one tree in our yard, and using every last piece of it for food, shelter, comfortable chairs, food containers, and planting another tree to take its place.

The Dorze people are renowned for their cotton weaving and their tall beehive-shaped dwellings that resemble an elephant’s face. They speak an Omotic tongue, similar to languages in the Lower Omo valley, and are believed to have occupied their present highland land for at least 500 years. Every Dorze compound contains at least one loom which is constantly by a family member. The shama cloth produced here is regarded as the most desired in Ethiopia.

The Dorze house is unique to the world: the domes measure up to the equivalent to a two-story building and are constructed completely by organic materials. The base and frame aren made from bamboo sticks, with a combination of enset leaves and grass woven around the bamboo scaffolding. The spacious interior has a center fireplace for cooking and generating heat in this high mountainous climate. Around the perimeter, separate areas are set aside for sleeping, housing animals (which also generate heat), and cooking.

One Dorze hut can last a few generations. However, as termites eat the bottom perimeter or it rots from the rain, the bottom must be cut off, which lowers the size the the dome. The older the dome, the smaller it is.

Mekkonen shows us his traditional tribal wear, which is mainly used for dances and performances these days. In earlier days, it was worn for fighting or to intimidate others. Animal skins, donkey hair, a spear and a shield made from hippo skin comprise the look. Indeed, it would scare me away.

I tell Mekkonen that I don’t want the typical tourist photo…that I want to represent what really goes on in his village. The true day, the true people. He seems to like this, and jumps in our vehicle and directs us to the church. There, we encounter a Timkat celebration, and we find ourselves swept up in the joyous celebration. My trust in Mekkonen soars as he guides us about, keeping people from mobbing us. Soon, he is carrying some of my gear, and dancing vigorously at the same time. When I get a better internet connection, I will upload a video of this!

Mekkonen then takes us to a bar, where we are quickly engulfed by spirited dancing and drinking of “dej” (often spelled “tej”), a very potent drink that is served in glasses that look like beakers. Cheers, indeed!


Meskerem shows us the false banana tree, enset

Ethiopia: Utopia!

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.

Ethiopia: Education & Health Care Support

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.

My Son At A Close Distance

He reeks.

Days of going without a bath because he lives in a house with no walls and no heat and he’s too cold in the morning to take a shower have taken a hold of him.

He’s leaning on me now, cuddly, warm, all 24 years of him. He is petting my hair as I sit with my face buried, expressing his response and shame over getting caught bringing pot in his tattered suitcase after I asked him to combine his clothes with his brother’s.

He thought we might want to have some fun.

The redeye plane is full and silent, except for the insomniacs. I watch Ben play the trivia game, win after win after win. How does he know all of those answers? Other players look for his seat, to find out who the hell AIUIOO is.

He sleeps now.

And I’m wide awake at this insane hour, listening to Hello Good Morning under my noise canceling headset while reading The Alchemist.

Musky kinda smell. Earthy and unsettling, pushing forward memories of another time and another distant person.

But this time he’s my son, of frail 6’4″ stature and desperately wanton of a normal mind.

Ethiopia: Doctors Without Words

When our bodies are ill, we are in a most tender state of being.  This is a time when support is needed in many forms.  When a woman walks miles to a hospital and becomes one of the lucky few who will get to see a doctor, she is at a most vulnerable state.

Here in the US, we ask questions, we are told how our procedures will unfold, we read about conditions, we know the risks.  In Ethiopia, a woman sets aside her fears and bravely surrenders herself to the hands of the doctors who have arrived to help.  She is scared.  She has heard of tales from other women’s experiences at other hospitals where they have experienced excruciating pain due to the lack of anesthesia.  They have seen the infections, disease and early deaths resulting from poor care.

Each woman enters the operating room with hesitant steps, eyes wide open, and silence.  We have interpreters on hand to try to communicate with them, but words rarely are spoken.  The trust level is enormous.

Even when David, the anesthesiologist, has difficulty finding the right spot in Tarike’s back to insert his needle due to her tiny frame, Tarike does not question what is happening.  David’s kind demeanor knows that she is frightened, and he stops often to look into her eyes to try to communicate that all is well.  He frequently asks the interpreter to let her know what is happening, and he softens his voice to try to temper her feelings.

It takes a special doctor to know how to administer care without words.  It takes a special doctor to give up the comforts of a well stocked operating room, with an educated staff, to come to a place and perform surgeries where 50% of the patients have AIDS.

I start to see this operating room as a ballet.  Each movement coordinated and deliberate, graceful hands, tender expressions, bodies flowing together.  At the center is the prima bella, and all eyes are on her.

Ethiopia: A Band Of Surgeons

The surgeons push on late into the night, assessing patients, prepping them for surgery, waiting for instruments to be taken out of the autoclave, and discussing efficiency improvements.  They are exhausted, yet thrilled to be working so hard together.  One of them makes the remark that this feels like when they were interns, working around the clock yet incredibly interested in all that happens.  A camaraderie builds, and out of their weariness, humor rises.  I bring in my iPod speakers, select some blues music, and spirits soar.  I’m glad I ended up packing that heavy thing after all.

Four surgeons are rotating patients and assisting each other with any menial task.  There is no questioning of roles, no ego, no positioning of power.

Dr. Rahel Nardos, a uro-gynecologist fellow and native Ethiopian, is here to assess the hospital’s capabilities and create a proposal for Oregon Health and Sciences University (OHSU) to send rotating residents and staff to perform surgeries and train local doctors.  It is vitally important to make sure knowledge is increased at the local level, so that more expertise is developed with Ethiopian doctors, otherwise our mission is more altruistic than humanitarian focused.  The residents benefit as well, as they will see a vast variety of pathologies that they would otherwise not see in years, if ever, in the US.

Dr. Michael Cheek is a gynecologist from the Lincoln City, Oregon area, and this is his third trip to Gimbie.  His cheerful nature helps everyone get through even the most intense situations. He works alongside his brother, Dr. David Cheek, a brilliant anesthesiologist. Together they make a great team, especially when they break out in harmonic song at any given time, their voices intertwining in a perfectly matched manner.

Dr. Kim Suriano and Dr. Philippa Ribbink are OB/GYNs and owners of a private practice, Everywoman’s Health, at Legacy Emanuel Hospital in Portland, Oregon.  They are familiar with each other’s surgery styles, and move about the operating room needing very little words to convey what they will do next.  Dr. Tekle is the only local Ethiopian doctor in the room, and he is joined by an exceptionally talented local Ethiopian nursing staff.

Patients come and go, bizarre pathologies are seen in addition to the prolapse cases, and soon the operating room’s activity is like a finely tuned band of musicians.  My daughter Brynn enters the room, scrubbed and ready to do whatever is asked of her.  I am a bit stunned that this is permitted, and even more surprised that she was willing to come in to observe the surgeries.

Before I can process my thoughts, she is handed some instruments and is asked to cut suture, spread cavity walls, and dab blood.  She does it all, seemingly unfazed by the fragility and rawness of life that rests vulnerably in front of her.  She stays throughout the four hour completion of the surgery, and is clear headed and confident as she leaves to go work with the outer clinics with their dental activities.

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