Super Heroes

I think my admiration and appreciation for the women of Ethiopia is obvious. I really enjoy the time I get to spend with other women - when women are alone together here we can laugh and joke freely - there is a feeling of freedom and it's very relaxed. If it's a mixed gender space it can still be fun and playful but in my experience so far, it feels more censored and contained and the women defer to the men. Gender roles are very clearly defined here. As an outsider I think I can get away with saying things that local women wouldn't be able to say. For example, a joke I made the other evening - I was sitting in the kitchen with the women of the house chatting when my host father came home, came into the kitchen and playfully asked in Oromifa if I was going to make buna (which he likes to ask me nearly everyday). I playfully responded in Oromifa with 'I'm sorry, I don't understand.' Everyone got a kick out of it because they knew I understood but was pretending I didn't to avoid having to make buna. (I only felt comfortable to make a joke because I have lived with my host family for awhile, we are comfortable with each other and my host father likes to laugh with me.) Since then I have heard the story recounted a number of times by my host mother & sisters to other women always resulting in a good laugh. I'm glad it was well received and that I can give them something to laugh about! I'm sure I've been a source of humor for them in more ways than I even know.

The women of the house have taken great care of me and taught me so much. They are like superheroes, they can do it all. The other day it was raining, windy and muddy. The animals go out for grazing during the day, they always go out in the same general direction but it's open grazing so they are not contained in any way. They return home around sundown but this day the mule didn't return. So my host mother has to go out in the dark and the cold, pouring rain to search for the missing mule. She didn't waste any time - she put on her lace-up shoes, her heavy scarf and seemed undeterred and unafraid. This after a full day of preparing every meal from scratch for everyone in the household, washing dishes and clothes by hand, making buna from scratch, attending to anyone who happens to stop by the house during the day (there are always people who drop by), and milking the cow. They told me they were afraid that the mule may have gotten stuck in the mud somewhere but I suspect they were also afraid for their mother to go out in the dark and the rain. No one goes out in the rain unless they have to, the mud is no joke - it's very slippery. But in true superhero form she found the mule, brought him back home like it was no big deal and then continued with business as usual. 

My host father is also admirable. He seems to be a savvy business man, he has solid connections in the community and surrounding area, has a charming personality and a very firm handshake. He always dresses sharply even when he's working around the compound. He is usually gone all day doing business around town or traveling to other towns. One day he took me by surprise. For a reason unclear to me someone had brought their herd of sheep into our yard. One of the sheep had an injured leg and had trouble walking. The herd was sent out to graze while the injured sheep was left behind. He was quite distressed to have lost his friends and was very vocal about it. (Side note: I love to hear the animals communicate with each other, they have distinct voices and they know who their posse is.) He tried to find his way out of the compound a few times to reunite with his friends even with his broken leg. He was so sad and pathetic looking, as it was one of his back legs that was hurt so sometimes it would give out and he would just plop down on his butt. I was working in my room when I happened to look out as my host father and two other men who were hired to do work in the yard were attending to the injured sheep - they were all gathered around cleaning and massaging his hurt leg, my host father making sure they were doing it right, while the sheep laid there very calmly and seemed to appreciate their efforts. I think they really helped him feel better because from that point forward he stopped his excessive calling and decided to just relax in the yard rather than escape. Later on in the afternoon a heavy rain came through; as we all ran around gathering the almost dry clothes off the clothes line, I see my host father swiftly pick up the injured sheep by the fur on his back and stand him up next to the house so he could be out of the rain. It was so sweet. The animals here work very hard and some are treated poorly so to see these acts of kindness towards this one little sheep really struck me.

The pathetic little sheep and a chicken, waiting for the rain to pass. 

Ethiopian healthcare system as I understand it...

Ethiopia has a very well organized healthcare system. There are health centers and health posts - health centers are in the bigger towns and serve a certain catchment area. The health posts are in smaller villages within that catchment area. For example, at my future site there is a health center because it is the biggest town in its area and it serves 4 other smaller villages that each have health posts. The health center is where everyone in the catchment area comes when they are sick or if they need antenatal, delivery and postnatal care. (Pregnant women are encouraged to travel to their local health center for delivery rather than delivering at home, in an effort to improve maternal and infant mortality.) So the health center is staffed with nurses, midwives, a laboratory, a pharmacist, a cashier, they have a room for health records/registration, and someone doing health information management. Paperwork, record keeping, data collection and reporting is a big deal. (So it turns out there is no escaping it!) People pay for the care/treatment they receive when they receive it with the exception of perinatal care, family planning, vaccinations, etc; those services are free/covered by the govt. The health posts provide some treatment but they are more focused on illness prevention and health promotion. Each health post is ideally staffed with two health extension workers. HEW's complete some health training beyond high school and they are charged with making home visits to provide health teaching and outreach to their communities. So let's say it's a village of just 500 - that's still a lot of ground for 1 or 2 workers to cover! They have very nice educational materials (provided by the govt with international support) that cover a range of topics - nutrition, family planning, sanitation, hygiene, etc. There are families that readily adopt the HEW's health information and begin to practice health promoting behaviors so they become 'model families' - these model families are expected to share their knowledge and have a positive influence on their community as well. Each model family (they are actually part of what's called the 'health development army') is assigned 5 other families. It's a very organized, strategic approach for disseminating health information and encouraging behavior change in the community. 

There are private clinics in the bigger towns as well, so people can pay to go there when they are sick if they want. I presume it's more expensive. And of course there are hospitals in the bigger towns. Anything that the health center can't manage they will refer to the next level of care. 

Although I am a nurse, my role here is not to provide clinical care. There are plenty of qualified individuals who work at the health center and health posts - who know their community, are respected by their community, and will continue to serve their community long after my two years are up. My role is to support the work they are already doing, to assess the needs of the community and motivate the health center and health post staff to work with me on projects targeting the needs identified. I don't know yet what those projects will be! But it is my intention that they be relevant and of value to the community, that they have a long term vision and are sustainable, and that everyone has a voice and is part of the process. My first several months at site will be spent integrating into the community and completing a 'community needs assessment'. When I have enough information to start making plans I'm sure there will be a blog post about it!

This week we practiced building a pit latrine/squat toilet/mana fincanii/shint bet

It started out as just a hole in the ground, here it is almost finished - still needs a roof and wall covering of course. 

Proof that I contributed to the cause!

Our crew! I've spent a lot of time with these guys during training - I'll miss them when I move to site. 

Love from Ethiopia!

It's the little things

I can't manage to change it on the 'contact' page of this blog, but this is my address going forward. I can still receive mail at the Addis PO Box - but only if I know something has been sent there so then I know to go and pick it up when I happen to be in Addis. 

It's the little things... Like when I'm really looking forward to bathing and we have water! (We always have enough saved for drinking, cooking and hand washing but sometimes have to wait for the water to return before washing clothes etc.) Or the feeling when I first wake up in the morning and reach to turn on the light switch and it works! It's so nice to not have to get ready by flashlight. You never know when the electricity is going to be out. Luckily it's on more often than off. If it is the evening and the electricity returns you can hear the neighborhood give a collective cheer as their lights turn back on. A reminder that we are all in this together! 

One of my favorite meals so far was a heaping plate of green beans with carrots and cabbage with potatoes (atop the mandatory biddeena, of course). This country knows how to do vegetables right. 

And the not so little things... I have been feeling the love with the cards and packages I've received! I know it takes time, effort and hard earned money to send something across the globe to little old me. Your generosity, thoughtfulness and support is remarkable. And the emails, texts and phone calls (when I am able to get them) really keep me going especially when I'm having a "what am I doing here?" kind of day. How did I get so lucky to have such a great group of people in my life? I can feel the love from 8,000 miles away. Thanks a million! 

What I've been doing these past few months... During pre-service training our days are full - we are in "class" from 8 to 5:30 Monday thru Friday and Saturday mornings. Most of our time is spent in language and health classes. Health topics include: the Ethiopian healthcare system, nutrition, maternal child health, family planning, HIV/AIDS, malaria, behavior change communication, neglected tropical diseases (trachoma, schistosomiasis, soil transmitted helminths, onchocerciasis, lymphatic filariasis, podoconiosis, leishmaniasis & Guinea worm) & WASH (water, sanitation & hygiene). A few weeks ago I presented a brief health lesson to a 9th grade class at the secondary school here in town. And this week in small groups we hosted a community education event where we invited members of the community to learn about nutrition. Both went surprisingly well. Permagardening is another thing we learned about and practiced doing. I love the concept and find it interesting that I learned a lot about permagardening and saw it in action when I went to Cuba and now here I am potentially teaching it in Ethiopia. Who knew. 

Our classroom for health. 

Working on our permagarden. 

Still no access to email or most of the Internet for now. If/when it returns you'll know because I'll finally respond and also be able to make phone calls!

Love from Ethiopia!  

Uncomfortable bus rides, even more uncomfortable bus rides & horse carts

After a week of traveling and spending a few days at my future site (near Bale Mountains National Park), I'm coming back to training with a new perspective. Inchini feels like home now. Things that used to feel difficult or stressful here are now easy and no big deal. It was so nice to be welcomed back to town, I was really happy to see my host family and return to the comforts of 'home'. I know my site will eventually feel like this too, it will just take time. 

Traveling to and from site is no small feat. From Addis it's an 8 hour bus ride to the main town (including a 1/2 hour stop for lunch & bathroom break) and then an hour long bus ride to my rural village. The first bus ride is not that bad except it's 8 hours, with your bag on your lap, you're touching your neighbor and it's hot - in general, people are only willing to open the windows briefly so there is very little air circulation. The second bus ride leaves more to be desired. It's a very bumpy dirt road, the bus is jam packed so you have to push and squeeze yourself onto the bus, this time you are up close and personal with multiple neighbors while holding your bags. It turns out a person doesn't really need that much personal space. 

I ended up drinking so much buna during my site visit. In Inchini I had an established routine of one little cup everyday after lunch. But sharing buna together is an important part of building relationships so it's actually something I *have* to do. My second night of site visit I had just locked my door to go to bed when the landlady knocks on the door with a cup of buna with milk for me. No more than 2 minutes later here come the neighbor kids, their mother had sent them over with a cup of buna and some snacks! Of course I had to drink that cup too. While I would rather not drink any coffee before bed I had resigned to the fact that I would be drinking two cups, oh well. And this is on top of two cups earlier in the day - it would have been three but thank goodness I declined the first one offered after lunch. Then the landlady returns with the kettle of buna and milk and while I thought I was declining another cup it turns out the language barrier was in full effect because I ended up with a third cup of coffee. It was delicious but I don't want to make it a habit! Ethiopians are extremely generous. 

When it was time to return to Addis, I of course had to take the bus from my village to the neighboring main town where I would stay overnight and catch the 8 hr bus ride the next day. My counterpart and a nurse from the health center were also traveling to the neighboring town (to visit their families for the weekend) so we were going to catch the bus together. I was anxious to get going because I would be meeting some fellow trainees in the neighboring town and just wanted to get going on my journey. There was supposed to be a bus but if there aren't enough people then the bus won't go. So, there's no bus. Luckily my counterpart has a plan B. We can take a horse cart (garii) to the next closest village (5 km away) and maybe catch a bus from there. Maybe? 50-50 chance, he says. So we summon a horse cart. Horse carts are common in rural areas for transporting people and goods. It's literally a horse pulling a cart. So the three of us climb aboard with our belongings. There is room for 3 people to sit, the 'driver' has to sort of walk/jog alongside until the horse picks up speed and then he can sit on the edge of the cart/wheel well. I felt bad for the horse - it seemed like we were a heavy load. The horses and donkeys work very hard here. That garii ride is one I think I will not forget. It's the end of the day, at the end of a stressful week, we're riding across the Ethiopian countryside, mountains in the distance, and I'm sitting in the middle of a very spirited discussion between my future colleagues about the respective economies of Ethiopia and America. Is this real? How did I end up here? Sometimes I have to pinch myself. Shortly after we arrived in the next village there was a bus to take us to town, thankfully. But it was the fullest bus and most uncomfortable ride yet. I was just happy to be going where I needed to be. 

My first garii ride - from my new house to the health center. He just happened to be outside as we were leaving our compound and offered us a ride. This is my little town!

And here I am on a mule the day after I returned to Inchini. It was my host mother's idea and she would not take no for an answer. My favorite part of this picture is her laughing hysterically!

I am not able to access much online for now, the best way to reach me for the time being is WhatsApp.

Love from Ethiopia!