Ethiopia 2006

Without a doubt my two weeks in

Ethiopia

were amongst the most remarkable in my life. My visit confounded every expectation.

In many people’s minds

Ethiopia

has become practically synonymous with famine, a country plagued by drought and erratic rainfall. Deserts do exist stretching from the base of the elevated central plateau to the Kenyan border and the Red Sea and Somali coast but these areas are thinly populated. The vast majority of the population live on the elevated central plateau which is fertile and green. At the risk of over-simplification, the problem is one of infrastructure and politics. Often there is food in one place but not the means to transport it to where it may be needed. The country is, after all, the size of France and

Spain

put together.

Having been advised to book in to the Hilton, my first two days were spent in the lap of luxury. I’d been warned that I would be charged extra if I required my room before 12 o’clock so on arrival I telephoned Ermias (Abba Travel) with whom I had emailed previously. He arrived quickly and took me for a City tour. We did the museum and I saw the 3.5 million-year-old skull of Lucy. We visited Holy Trinity Cathedral where Haile Selassie is now buried and there is a monument to Sylvia Pankhurst in the church yard; her son Richard still lives in Addis and is a guru on everything Ethiopian.

We also walked in the Mercato, the biggest shopping area in Addis and as good an introduction to

Ethiopia

as anywhere else. In the afternoon, I got my bearings, changed my money, and lazed by the swimming pool. I only had a quick dip. It is fed by hot springs and was altogether too hot! The brightly coloured birds around the garden were a delight.

I had dinner with a Glenn Sparks, a Professor of Communication from the

who visits Addis intermittently to teach journalism. We talked politics! His students, who had previously been full of optimism, are subdued since the government crackdown on the opposition. Outwardly Addis is peaceful, indeed everywhere felt peaceful but there were nine small explosions in Addis the week before I arrived.

A vehicle from the Fistula Hospital had met me at the airport in the belief that I brought with me a bag of ‘scrubs’. In fact I had none. My flight had been altered and instead of flying from Heathrow I travelled a day later from Gatwick. This had prevented me taking delivery of the bag. Also, having at the last moment acquired a large bag of Stoke City FC football kit, the doctor I was assisting had, I think, decided that I had more than enough to carry. The Fistula driver kindly dropped me at the Hilton and it was arranged that on my second day I would take a taxi to the hospital.

In 1959, Catherine and Reg Hamlin, both gynaecologist-obstetricians, visited Addis to fulfil six month locum positions. They discovered women and girls who had suffered untold trauma during labour and as a result of obstructive childbirth had experienced tears, or fistulae, which rendered them incontinent. Urine and often faeces pour out and the women carry with them such an overwhelming stench that they are ostracised by their family and their community. They become outcasts and the detritus of a community without access to medical treatment or care.

Only two or three surgeons in the world attempted to rectify fistulae and Catherine and Reg Hamlin began to experiment to find ways of helping these girls and women. Although less common nowadays, girls are often married when they start menstruating, they are generally small and malnourished and, out of reach of medical help if labour is prolonged, their injuries can be serious.

The Hamlins never returned to

Australia

. They stayed in Addis and eventually established what is now known as ‘the hospital by the river’. They remained there throughout the Mengistu years when most ex-pats left and their work is now legendary. Reg has now died and Catherine is in her 80s. She is still a doctor and she still undertakes occasional operations. She lives in a simple mud house, with an over-crowded sitting room with easy chairs which have seen better days and Reg’s grand piano taking up space in the corner. She likes gardens and flowers and these are a feature of the hospital compound. The atmosphere is extra-ordinarily therapeutic. It is a bit like entering another world. The hospital turns no-one away. Somehow a space is always found for the steady stream of destitute women, in urine soaked clothes, who arrive daily. Women who need it will receive physiotherapy and many do because their condition has often resulted in muscle wastage and deformity. There are classes covering health, HIV/AIDs, literacy, handicrafts, and so on. Many of the staff, and those whom we would call health care support workers, are former patients. I believe two former patients have gone on to qualify as doctors. Around 1,200 operations a year are performed. Once operated on a woman will return home in a new dress to a renewed life. Meanwhile, all around compound women are sitting in groups, often knitting, in their night dresses but with multi-coloured knitted blankets around their shoulders. Only one ward smells of urine but, if you’re observant you will realize that many of the women are leaking.

What the hospital needs most is more doctors. There are more Ethiopian doctors in Washington than in the whole of Ethiopia .

Sadly some women are so badly damaged that they cannot be cured sufficiently to return home. These women will need life long support from the hospital. Recently Desta Mender, a farm village 17kms outside Addis has been established in an idyllic spot, at the foot of a mountain. It is now home for some 40 women with chronic, long term injuries. Various projects are in hand, fruit trees are growing well and from four cows there is now a herd of 12. The government has given adjacent land for a workers’ village and this is progressing well. It is a working community, growing vegetables and training women for a degree of self sufficiency although some will never leave.

I visited Desta Mender on my return to Addis, accompanied by Dr Melanie Newport, a Senior Lecturer in Infectious Diseases and International Health to whom Khalid had introduced me. Having found the Hilton rather over the top, I had booked in to Melanie’s budget hotel on my return to Addis. We met there. It was cheap, clean, friendly and agreeable!

Melanie knew of the hospital and had wanted an opportunity to visit. In Addis for a conference, she is also managing a Welcome Foundation funded research project on podoconiosis, or mossy foot. Usually she stays with Gail and Richard Nerurkar (one of

England

’s best marathon runners) but they were away. Melanie is also familiar with Sudan and has lived and worked in

Gambia

Besides visiting Desta Mender and being shown round by Sister Abebech Mekonnen, we had lunch with staff and patients before returning to the hospital where Dr Ruth Kennedy was on hand to greet us. With us on this occasion were two American nurses but they were suddenly rerouted elsewhere and Melanie and I were wafted away to have an ‘English’ tea with Ruth at her lovely on-site bungalow. Catherine joined us which was, I believe, was something of a compliment as many visitors beat a path to her door. Ruth, it is she and Catherine who foster the hospital’s unique atmosphere of love and care.

The hospital is self-financing and has a worldwide network of supporters but fund-raising is a constant requirement. Ruth told us that they welcome gifts of wool, old tights, toiletries and anything else that might be useful and enjoyed by patients. I must settle down to finding a way of inviting frequent hotel users to bring home and donate those little soaps, shampoos and creams provided for guests.

Five Fistula outreach centres are being established. I visited one of the first in Mekele, opened just four months ago and now with eleven patients. It will able to accommodate 40 and the most serious will go to Addis for their operation. It is hoped that these centres will begin to meet the demands of the 200,000 cases of women with vesico/recto vaginal fistulae and that the word will spread and that as more people realize the likely outcome of obstructive child birth more will seek help before it is too late. Women who become pregnant following a successful operation are welcomed to return to the hospital for a caesarean but they return home with their medical notes which they can take to their nearest medical centre.

On my second evening in Addis I took a taxi to the Fasika Restaurant on the Bole Road for a traditional meal and dancing. I was the only foreigner and it was amazing. The dancers built up to a crescendo which made Irish tap dancers look slow!

The next day, I met David Stables, founder of the African Children’s Educational Trust, for the hour’s flight to Mekele. On arrival we were met by Bisrat Mesfin and his assistant Binyam Leake and driven to David’s small house where Bisrat lives. A special lunch had been prepared by Rahel and Jerusalem .

All the houses in Tigrai are built of stone of which there is an over abundance. David’s house is part of a co-operative with a number of houses around a square which is currently scrubland but which may one day become a park. Houses are usually in compounds or behind secure gates. David’s gate opened onto a small, colourful garden. Off the main roads, the lanes are little more than rough and often rocky tracks.

After lunch, we went immediately to A-CET’s small office to sort the Stoke City FC football kit which I had brought with me. Each outfit was put in a small plastic bag and we set off for the Atse Yohannes School IV to make our delivery. The school accommodates around 4000 pupils and is a three-shift elementary, secondary and vocational school. The children were ‘on break’ and the playground swarmed with youngsters. They were excited to receive visitors and I was excited by my welcome. Teachers were introduced, the football team went off to put on the kit, and then it was time to take photographs.

This is Noel Blake, Academy Manager of

Stoke City FC who presented me with

the football strip to kit out a team in Ethiopia

I was given far more strip than I could carry. Happily on my return I was given permission to pass it on to the African All Stars, a team of refugees and asylum seekers who play in Hanley Park on Sunday afternoons. This was the beginning of my relationship with AGLAS, the African Great Lakes Agency in Staffordshire, a registered charity which offers a focus for activities for men, women and families from Zimbabwe , Rwanda , Sudan , Ethiopia and other countries in this region of Africa .

A-CET targets particularly vulnerable youngsters, physically or land-mine disabled, civil war or AIDS orphans, or ex-street children. A-CET supports around 500 of these children but support for a child means support for the family because it is not practical or desirable to select one member for special treatment. I spent two days visiting many of these families.

Girmay, his wife and son, Michael

Girmay is a survivor of the 1984/85 famine. He features as a little boy in Claire Bertschinger’s book ‘Moving Mountains’ which describes her work as a Red Cross nurse in Mekele during the famine.

It remained unclear to me throughout my visits where anyone went to the lavatory! Sometimes

I saw a hut resembling a closet but I understood that generally people ‘go’ wherever they can. There was never any smell and, of course, when it is hot everything is burnt up pretty quickly. Flies were not in evidence either. None of the houses I visited had running water. This is collected from a pump and carted by hand or on donkeys.

Mekelle’s market was chaotic, crowded, engaging and colourful. In one alley, two men blocked the way as they were breaking stones. Like in Bangladesh , breaking rocks into stones and stones into gravel is a common sight. We were at the market early as I had hoped to see the arrival of the weekly Camel Salt Caravan from the Danikil, the hottest place on earth. It transpired that it had stopped coming two weeks before. Instead I was taken to a breakfast café, which was an experience in itself.

The street children I met have a shelter for the night and one a meal a day and that’s about it. The toddlers looked badly in need of a cuddle and some stimulation. I think their minders were aware of their shortcomings but their resources are minimal. I ‘treated’ three street boys to doughnuts and fruit juice in return for a talk. The ones I met are not harassed by the police as they have a reputation for being honest. They may earn this in part by telling the police when new youngsters arrive in town. They earn a few birr a day, watching cars and running errands. One birr enables them to stay in a shelter to avoid night time exploitation. Once a week they trek several miles to a river to wash themselves and their clothes. At present the river is little more than a thin muddy stream. We sat in a café and chatted. They have such potential. One wanted to be a pilot, another a farmer and the third just wanted a job, any job.

Since A-CET started operating in

Ethiopia

national attendance at elementary schools has risen from 25% to over 60%. This has been accompanied by a population increase from 55 to 80 million. The government encourages a community to build its own school or class room and then they will get a teacher. A great many schools are very poorly equipped and A-CET is helping two communities in a poor rural area to build a second class room. At present many children cannot be accommodated and are therefore denied any education. I visited both these schools.

Fikre Alem (World Love) School in Aderak lies in an isolated, off-road area with no water or other services. But like all schools, it is the hub of a community of very poor peasant farmers living on the extreme margins of existence. Awareness of the value of education is growing but failing harvests mean that the community lacks the capacity to build or afford a class room. . They had built the first class room with local stone and A-CET is funding the building of a second class room, an administrative and a toilet block. There are mud floors, a few blackboards and I was there to witness the arrival of two lorry-loads of desks.

I also visited Adihana, an even more destitute community where local people are preparing the foundations in preparation for second class room which A-CET expects to fund. Adihana has 100 pupils but provided the new class room is completed on time – and the rainy season may interrupt progress – another hundred will join the roll in September. It was hard to see where all the pupils came from. I could only see a scatter of dwellings here and there in the far distance. The children must walk considerable distances to get to school.

Back in Mekelle, there was a lot more to see and do. I visited an Orthopaedic Centre which was making wheelchairs and limbs for war and land-mine victims and also for some elderly leprosy sufferers. I also observed the work of OSSA, a social services organisation which supports HIV/AIDS sufferers. I liked the man in charge, Ashebr Adane. He has a passion to do what he can but he is pitifully short of resources. He is trying to establish a children’s library and play room and I shall try to send him some books. I saw Winnie the Pooh displayed on a shelf along with Enid Blyton!

Soon it was farewell to Mekelle and to the Axum Hotel which I had found clean, comfortable and friendly. On several evenings I had turned on the television and obtained the BBC World News but also, surprisingly, on three consecutive nights a Maggie Smith movie.

I left Mekelle at 6.00am to drive to Axum . There were football squads out training, runners and cyclists on the road, and a man doing press-ups in the middle of nowhere! The journey to Axum was through red, craggy and awesome mountains with green valleys. The road twisted and turned and for the second half of the journey it was very rough and still in the process of construction. This did not spoil the grandeur of the scenery which commanded my full attention all the way.

Axum is famous for its stelae. One has recently been returned in three pieces from Rome where it was transported by the Italians during their occupation. Plans are now underway to re-erect it, a far from easy task as there are most certainly unexcavated tombs and tunnels beneath the site where it belongs. Within the compound of the Cathedral of Tsion Maryam I saw the small, undistinguished church in which the Tabot or Ark of the Covenant is said to reside. No-one has seen it or had access for many years. Dan Cruikshank tried to find a keeper with the key for a recent television programme and did, I’m told, demonstrate a certain insensitivity in the process!

I took the opportunity to walk between two sites which introduced me to the magical, labour intensive countryside. Walking with herds of cows and goats, and the odd donkey, up a winding track into the hills I was better able to appreciate the landscape than from a 4x4. While resting to take in the view – Eritrea was only 75 miles away - my guide leafed through my guide book and came across a picture of a priest in full regalia. He recognised him immediately as the priest of Debre Birhan Selassie Church (below) we had just passed. We retraced our steps and found him in his working clothes. He paused to wipe his brow and chuckle a bit before returning to his labours. Some little boys accompanying us scrabbled to kiss his hands and feet. Later I found his photo also adorned post cards so I suppose seeing himself in a book was common place.

I had an unexpected extra night in Axum because the plane to Lalibela broke down. Ethiopian Airlines returned us to our pleasant hotel and I thought about having a swim until an Australian mentioned that this would be a good way to acquire an infection! Instead, I enjoyed talking to some fellow Ethiopian stranded passengers and we were treated to a buna ceremony. I joined two Australians for dinner. Both were in their sixties, one a priest and the other an ear, nose and throat consultant whose wife refused to come because of too much flying time. They were humorous men, doing the historical circuit and visiting the great Muslim city of Harar . They were flying on to Mali for a flight to Timbuktu because ‘it was there’ and all this within three weeks!

Lalibela is a strange, isolated town, set high in the mountains and famed for its rock-hewn churches. The landscape is unlike anything I have seen before and I found it mesmerising.

The rock churches are huge but they are carved below ground level, ringed by trenches and courtyards, the sides of which are cut into stone graves and hermit cells. Hermits live in hillside caves and are fed by local people.

Leaving Lalibela on the way to the airport I met an interesting young social development worker, Phillipa Thomas, from

Zimbabwe

. She had been in Addis for a conference and had taken time to fly to Lalibela while she waited for a return flight to Zimbabwe . Her message about Zimbabwe was not to believe everything we read in the papers, that you’ll be safer in Harare than in most African capitals, and to visit now because the infrastructure for tourists is second to none but dying for want of punters!

Gonder is the fourth largest city in

Ethiopia

and is notable for its castles and for the Italian legacy of a number of large ‘fascist’ public buildings. I found it rather sprawling and squalid! My hotel was on a hill overlooking the city. The public rooms and gardens were attractive but the plumbing left something to be desired but I managed a hot shower and I took care to ration my use of water.

The sunken bathing pool above is generally attributed to Emperor Fasilidas and it is being restored. The pool is the central stage on which the Timkat or Epiphany Festival is celebrated. Led by colourfully clad priests carrying tabots and crosses, thousands of white-robed worshippers converge on the pool where they are blessed and sprinkled with holy water.

The next lap was again by road but this time through gentler countryside. I wanted to stop for some refreshment but there was quite literally nowhere to do so. The road was busy with people walking, often with herds of cows or goats, but the villages seemed to be little more than a row of shacks.

Bahir Dar is set at an altitude of 1,830m on the southern side of Lake Tana, the source of the Blue Nile. The main streets were boulevards, with palm trees and greenery. My hotel was by the lakeside and very tranquil. I had dinner with a young doctor who had been doing his ‘elective’ at four health centres and whose girlfriend had come out to join him. With the aid of a guide and two donkeys, they were going camping in the Simien Mountains . Every evening at around 5 o’clock we had experienced thunder claps and downpours. This evening was no exception. There was lightening and heavy rain. I wonder how they got on! The doctor had been surprised by the large number of children with genetic diabetes and adults with peptic ulcers.

I visited the Blue Nile Falls, now a shadow of their former self as a result of Chinese built hydro-electric power dam. There are plans to turn it off on Sundays so that tourists can see the Falls in all their glory. Notwithstanding the lack of water, I enjoyed my visit. We were ferried across a river and then walked through picturesque countryside until a path led down to the bottom of the falls and we could feel the spray. I didn’t see any crocodiles!

I am deeply appreciative of David Stables, Bisrat Mesfin and Binyam Leake for encouraging me to visit Mekele and to get to know A-CET. David alleged that he had bought the desks for Derek School from money I have raised for A-CET. This was generous of him and I shall do my best to purchase some more!

I am very grateful to Dr Ruth Kennedy for my visit to the Fistula Hospital which was a unique experience. I hope before long to be able to send some wool, toiletries and old tights!

Copyright © 2007 Angela's Just 70 Challenge