Category Archives: Essays

Ethiopia: Desperation

We reluctantly leave Barhirdar to start our next leg of travel.  There is so much we want to do to assist Dr. Andrew Browning at the Fistula Hospital, and we make a commitment to spread the word about his devotion to helping these suffering women.  As we board the plane that will take us back to Addis Ababa, we all feel a longing to find a way to help in the most effective way, whether that takes the form of fund-raising, connecting resources, or returning to actually perform work there.

In Addis Ababa, we rejuvenate by eating spicy plates of injera and attending a traditional coffee ceremony.  Morning comes quickly, and we join the larger group of doctors to start our nine hour drive to Gimbie, where prolapse surgeries will take place at Gimbie Hospital.  Women suffer prolapse as a result of prolonged laboring during childbirth.  Unlike fistula, there is no odor or fecal spill, but prolapse is a highly uncomfortable condition and results in the same social ostracizing and abandonment effects.

We wind along curving highland roads, dodging cows, donkeys, baboons and an occasional horse adorned with flowers.  People turn to stare as our entourage glides through small villages.

In Gimbie, we are given a warm greeting by masses of orphaned children who live around the hospital grounds. It is striking how many of them surround us, and we can see the effects that the Western visitors’ handouts have had on these children.  Energetic and hopeful, we hear the same story over and over: how their parents have died from AIDS or some other affliction and they need to get money to buy school books, pay tuition, eat a rare meal.   They are relentless with their begging, and it is difficult to walk from one building to the next without persistent demands to help them, with frequent competitive fist fights breaking out in attempts to get our undivided attention.

Little did we know that this experience with the orphans would only serve as preparation for the larger issue of watching grown adults positioning for the chance to see one of the doctors.  Rural bush communication is lightning quick, and within a day, women are lined up to try to get into the hospital.  Many have lived with their prolapse condition for years, and they see this as their opportunity to be healed so that they can then go back to working in the fields.  A few members of our group have raised funds to provide for 50 surgeries.  From the desperation that is readily apparent, we quickly see that this is a drop in the bucket against the need.

I find an interpreter, and begin to interview each woman.  Over the next few days, I watch the desperation level increase, as they know that the doctors will not stay for long.  For the women, they express this quietly in the longing in their eyes.  For the men who have come to fight for a chance for their sisters to be seen, the desperation comes in the form of pushing, screaming and shoving at the hospital entrance.

A guard stands by to perform the difficult task of deciding who gets to enter, and who does not.

Ethiopia: A Labor Of Love

After trying to outwit the mosquitoes, I decide to just get up and start the day at 3:20am.  I shower (tepid, not cold, water in this one – hurray!) and go out on the balcony where I can better hear the cacophony of day break sounds: priests singing, birds chirping, monkeys screeching, an occasional pair of shuffling feet from down below, and security sirens.  The sirens remind me that I am in a place that will soon have an election, a typically deadly time.  According to those here who are familiar with the elections, there is high hope that this one will be relatively tame compared to past elections.

Today we go to see Mota, a rural bush area of Ethiopia where Dr. Andrew Browning, medical director of Bahirdar’s Fistula Center (a branch of the Addis Ababa Fistula Hospital), is trying to coordinate preventative surgical care of pregnant women who are laboring long hours or have other complications. Andrew arrives at our hotel with Dr. Rahel Nardos, the Ethiopian OB/GYN and resident Urogynecologist Fellow from Oregon Health and Sciences University (OHSU).  They have worked together at the Bahirdar and Mota hospitals in the past, and while Rahel now works in Portland, Oregon, Andrew, by the grace of his own personal fundraising, works in Bahirdar and Mota.

They tell me that when a woman heavy labors for many days or weeks, several problems can arise.  If the woman is lucky, she will eventually deliver a baby.  Death is another common outcome. And there is yet another situation that is far less talked about: developing a fistula, where a hole is torn inside of the woman and her waste then comes out of her vagina. She constantly leaks urine and feces, and is most often shunned by her husband, family and village.  She hides in a tiny corner and is embarrassed to emerge.  She smells horribly, and her clothes are badly stained. She eats at night so that others do not see her.

Fistula repair surgery exists in several developing countries, but most families will not admit to the problem, nor can they easily walk hundreds of miles to the closest hospital, let alone transport the affected woman who often is very weak and cannot walk.  If they do take on the exhausting trip to the hospital, they have no funds to pay for the repair surgeries.

Andrew, a spirited and kind Australian, nurtures a deep devotion to helping these women.  He repairs fistulas at the Fistula Center, but he also sees the vital benefits of establishing surgical centers out in the rural areas so that Cesarean Sections can be performed and fistulas are prevented.  The hospital at Mota has been constructed, the surgical rooms are ready, donated supplies are sitting in boxes.  Yet there is one halting issue: getting doctors to be willing to work there.  We walk along the corridors of the hospital and a sadness prevails as other Ethiopian doctors perform outpatient duties, passing the empty yet ready surgical rooms all day.  Even sadder is when a woman shows up after laboring for weeks and there is nothing they can do for her.

Andrew relentlessly follows his course, and little by little, he makes progress.  This June, several doctors from Holland will be arriving as a team to perform surgeries.  Yet, when we face the hospital administrator at his desk and Andrew announces their commitment to coming, joy does not come easily.  The administrator has heard this before, hopes have risen, and then doctors back out of the commitment to coming.

This time, Andrew believes the surgical team will follow through. The conversation then turns to preparation needs, such as establishing a steady supply of clean water and painting the guest houses.  We ask how the Ethiopian people will trust that doctors will treat them if they come, and Andrew assures us that the bush communication is strong, and word will circulate quickly through the villages.

As we turn to leave, I hear moaning from behind a door.  They let me go inside, and Rahel explains to a woman on a gurney that I am there to make images that might possibly help the hospital.  We find out that she has been in heavy labor for three days.  She nods her head yes – anything to help the needs of her sisters.

Ethiopia: Fearless Curiosity

Day Three and sleep still evades me.

As my mind and body ache for a hint of rest, I can think of a myriad of reasons why, instead of sleeping, I have my laptop propped up in bed acting as a magnet for aggressive mosquitoes that find their way under the bed net. Repetitive music hypnotically blares outside the window as people yell back and forth to each other late into the night.  Frequent footsteps outside of my sleep room door beckon for attention and my 18 year old daughter Brynn sleeps peacefully next to me, her breathing almost syncing perfectly with the music.

I look at my daughter.

These past few days were not as I expected, which is true about any other time I have spent in Africa.  I have come to plan for the occasional lost luggage, flight cancellations, missed communication and long confusing waits. But this time I suppose I do have fantasies of mother-daughter bonding occurring as we tenderly experience a new part of the world together. Instead, we are bickering like cats after our long flights and spending the night staring at the ceiling in the Nairobi airport “dungeon” (as it is affectionately called by ex-pats).  Anything I advise her is fodder for heated debate, and when I allow my frustration to escalate, it only catapults the tension.  I realize it is only Day Three, and experience informs me not to get hyped up about anything that happens during the sleep deprived and cultural shift transition period.

But this angst about Brynn is not what is keeping me awake, nor are the sounds coming from the bathroom that eerily sound like a gigantic  fang-toothed rodent coming up from the sewer.

It is that girl in the museum.

I saw her from the corner of my eye as we looked at artifacts in the National Museum in Addis Ababa this afternoon.  She stood there, right in the center of the room, and stared at us, as though we were from another life time.  Left arm crossing her body to clutch her other arm, she looked braced and strong.  Her arms were hidden by dozens of gold bracelets pressed tightly into her skin.  But it was the glee in her eyes that caught my attention.  She looked giddy as she unflinchingly stared at Brynn’s blond hair.  When my eyes caught hers, instead of becoming shy and looking away, she seemed to lock in harder with her gaze, and with this, she looked like she was from another galaxy.  Or that she knew something very sacred that we did not know, living in our Western haughty ways.

I could not refrain myself from staring, and this did not seem to bother her in the least. She stood tall, muscles rippling down her arms and legs from hard work of some kind.  Her head was shaven, and tiny scars lined her skull in a swirling pattern.  Her ear lobes were dangling long, with wide open circles where her gauges once were.

She was one of the most mesmerizing persons I have ever seen.  She somehow seemed to exist outside of her body. A spirit in the flesh.

Her curiosity about Brynn was fearless, and as we made our way from room to room, we could feel the magnetic force that was in the room.  Our friend and guide Seyoum identified her as most likely being from Southern Ethiopia villages, and as he started to tell me more about this part of the culture, I found myself not able to hear him even though I wanted to know everything about her tribe. The visual of her was overwhelming any other sense.  I turned my eyes toward Brynn, and could see the same level of wonderment coming from her. As the girl stood firm, I slowly walked over to her and said hello as best as I could without words, reaching my hand out to her and holding eye contact way longer than is comfortable for my cultural influence.  I heard a catch in her voice as she tried to bridge the gap between our languages, her words barely audible.  I motioned for Brynn to come over and I silently watched as they shook hands, giggling nervously.

Mankind began here in Ethiopia and this girl seemed to wear that distinction in her every gesture.  Yet here she was, enchanted with Brynn’s exoticism.  This haunts me at this late hour for some reason, and I wonder:  what could she possibly see in us that we don’t see?  With her grace and level of ability to engage, I felt that we were far less interesting, and coming from our expedited Western culture, that we could not see humanity such as she could from the vantage point of the heart. I felt humbled by her, and a tinge of longing crept in as I knew we couldn’t follow her and learn more from her.

As Brynn lies curled up next to me now, I think about her and our mother-daughter complexity that mirrors us together and propels us apart as she begins to lead her own life without my constant oversight.  Through the Ethiopian girl’s gestures and honor toward toward Brynn, I realize something.  I think I can see my daughter more closely from afar.

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