Gimbie Reports

http://www.youtube.com/watch?v=bQl1pS0-jBE

“Hin jiru,” is one of the first Oromifa phrases most foreigners learn. It means, “There isn’t,” and it is often used in sentences with the Oromifa words for “water,” “electricity,” “money,” and important people’s names. This time it was used in reference to the illusive bus ride to Gimbie that Renee and I sought.

I was really frustrated. Renee and I had come to Nekempte to deal with an outgoing nurse who was mismanaging the clinic more and more as his termination date approached. The other employee I had been counting on to translate wasn’t comfortable being part of the conversation. I talked with the head nurse, but ideas were getting crossed, and he was becoming extremely belligerent. I tried to stay calm and invited him to come to Gimbie where we could talk with the personnel manager. After that extended tense encounter, I was really looking forward to a restful evening at home. The sun was still high in the sky, and the city was still bustling. Why wasn’t there a bus to Gimbie?

Asking the head nurse to prepare beds for us at the clinic didn’t seem like an option, so we set out in search of a hotel. First we went to the nicest one, figuring that 150 birr would be worth having a safe place to stay, since we would be two girls alone. “Impossible,” the concierge and then the manager said. Only married couples could stay together. We would have to rent two rooms. I contemplated educating them on lesbianism and homosexual marriage rights in the US. But that probably would have been a leap from the frying pan into the fire. We might have gotten stoned. So we just said, “Impossible,” and walked out.

Desta took us to several other hotels until we found one that seemed passably clean and safe. The sheets didn’t smell, and the window was high enough off the ground that no one could crawl in. It was also close to the bus station. It cost only 30 birr. I tried to call the hospital to send word of our hold-up. There was no service.

Sitting in the hotel, I started reflecting on my feelings. Why was I so upset? I was in a fairly safe place, and I wasn’t missing an appointment in Gimbie. Besides, Renee was there. I realized I was upset because I felt trapped and impotent—emotion I don’t deal with very well. “This is a lesson I should have learned months ago,” I mused. Accepting my limitations should have been lesson number one in Africa. I guess I’ve been a slow learner.

The lesson is useful in regard to life, too. I have certain hopes and expectations that may or may not be realized. I can try to pursue my dreams, but I also need to realize that much is beyond my control. I may be able to influence my circumstances, but I can only control my attitude.

So next time I am stranded . . . or the Internet is out for days on end . . . or the Land Cruiser isn’t available for a clinics trip, I’ll take deep breaths and try to turn the frustrations into a character-building exercise. (Maybe if I’d learned the lesson sooner, God wouldn’t have let me get stranded so often. . . .)

Chapter 5

Thursday as I was coming home from Dalati, I ran into Renee, Priscila, and Damaqa’s mother with the two boys. They were leaving the hospital as I was coming in, and Renee and Priscila were obviously distraught. I gave Renee and questioning look, and she told me that there was a major problem with the home we had arranged for Jirata: The father was coming home drunk and beating the boy.

They were on their way to the Adventist Field (equivalent to a Conference in the US). When they came back, Renee said that the pastors didn’t seem very surprised or moved by the situation. They suggested that we send Jirata home with the same family for the weekend while they searched for someone willing to take him in. “Times are tough,” they warned. “It will be hard to find anyone.”

It’s a very lame excuse, considering the fact that he would come with a generous food allowance. The real problem is that he is HIV-positive. Poor kid. He must wonder why everyone hates him. His relatives beat him and throw him out into the street. Now his friend’s father beats him. I wonder if he’s formulated an explanation in his young mind. Does he think the world is just an unfriendly place? Does he think there is something wrong with him? Does he realize it’s because of his HIV status?

Chapter 6

Gamachis and I visited the department of social services the following Monday. I hadn’t known such a department existed. The official had an aquiline appearance, with beady eyes and a hooked nose. His shoulders were slumped forward, and his head protruded forward like a turtle. He seemed to be glaring at us from the moment we walked in, but he turned out to be surprisingly helpful.

He listened thoughtfully to Gamachis’s account of Jirata’s plight. Then he explained the legal process we would have to undertake in order to send him to an orphanage. The first step involved a social worker who was out of the office for two weeks. When we expressed the fact that we had no home for him for the time being, the official thought for a moment. Then his face lit up with an “Aha!” expression. He began speaking rapidly to Gamachis in Oromifa.

He said Gamachis should appear before the local court. He should explain that he had taken this orphan in off of the street and had been caring for him. However, given the high cost of living and the fact that he is a student, he wouldn’t be able to continue caring for Jirata. He needed to send him to an orphanage. If Gamachis would do this, the court would give approval, and the papers could be ready within a day or two.

Gamachis agreed to do this, but he was unable to find witnesses willing to tell a white lie while swearing on the Bible. Understandable. So we went in search of the evil relatives who had thrown Jirata out.

They said they had already been to court and gave us a couple of legal documents to photocopy. As we came back from making the photocopies, one of the women met us at the road. Jirata stopped dead in his tracks when he saw her. He sat down as Gamachis and I covered the 20 meters between us and the woman. We handed over the original documents and turned to leave. As we did, she yelled to Jirata, “Hin gudadu!” which literally means, “Don’t grow!” Jirata started to cry, and Gamachis and I had to lift him off the pavement and drag him a couple of meters before he started to walk.

Chapter 7

That evening, Renee, Joel, Gamachis, and I took Jirata to Warka’s Bar and Restaurant. Warkanesh, the owner, is a saint of a woman. She’s an Ethiopian Orthodox Christian who runs the restaurant and uses the income to care for orphaned children. She usually has about eight children living with her at a given time.

She welcomed us warmly and brought us food. She also brought a plate for Jirata, even though it wasn’t clear whether we had brought him or whether he had simply followed us in.

After dinner and some small talk, we broached the subject of Jirata. She seemed to delighted to take him into her care. Her attitude was not grudging or martyr-like. We handed her 50 birr to cover his food for the first week, and she refused the money. “Why?” she asked. We tried to convince her it was a thank-you gift, and finally Joel just dropped it into her hands and refused to take it back. She didn’t charge us for dinner.

Warkanesh is someone I truly feel privileged to know.

They arrived in Karra, a small town semi-close to Green Lake Clinic. The overcrowded Land Cruiser’s ultimate destination was the capital, Addis Ababa; Karra was just one out-of-the-way stop of the journey. The outer clinics director and team expected to find Green Lake’s guard and some mules to escort them along the footpath to the clinic. However, they found no guard, no mules, and no place to stay. As it started to rain, the party crammed back into the Land Cruiser to make a decision. Knowing there were many patients to see in two days, the decision was made to drive the roadless hills and forge through rivers in the Land Cruiser to Green Lake Clinic.
Despite the rain, they safely arrived at the clinic a bit jostled but grateful to have arrived before dark. After unloading the tarp-covered bags and supplies from atop the Land Cruiser, those remaining in Green Lake waved goodbye to the mud covered vehicle. Inventory was taken, the pharmacy restocked, and a game plan for the next day was revised all before bedtime.
Patients came to see Tseguy Umeta for dental complaints and Ali Hassan for medical concerns. School kids came to stare at the farenjis (foreigners) through clinic windows and doors. In two days many prescriptions were filled, lab tests done, and lifestyle advice given. A total of 90 medical patients were seen those first two days. From those patients, Gamechis an 18-month-old baby boy, stands out.
Gamechis’ mother brought him because of an ugly, open abscess on his outer thigh. Instead of baby-soft skin, his thigh was covered with rotting, infected flesh. Antibiotics were given to the mother with the instructions to get this baby to a hospital immediately. It was explained, via a translator, that the boy was too young and small to fight such an infection, even with the help of antibiotics. After the mother and baby were sent home Ali doubted if the family, discouraged by the cost, would ever go to a hospital. Ali later realized that this baby was a candidate for the children’s fund at Gimbie Adventist Hospital. It wasn’t the closest hospital, but we could squeeze this mom and baby into the Land Cruiser, thus providing them with free transportation.
The rest of the team agreed that a tight ride was worth saving the baby’s life. So the guard was sent to find the mom and baby and deliver the news, instructing them to be at the clinic at 8 am ready to go and with money for a return trip on the bus. At 8 am the mom, dad, and baby were ready and waiting. Ali and translator had already been working, in hopes of seeing just a few more patients before the Land Cruiser arrived. Time passed and soon it was 10:30 am. With no sign of the Land Cruiser, work finally stopped for breakfast. About noon, word was received that the Land Cruiser had not left Addis yet and it wouldn’t be there till about 5pm. So Tseguy, Ali, and translator kept working, seeing about 50 patients that day.
To everyone’s delight the Land Cruiser finally arrived at 7:30 pm. However, the back was full from floor to ceiling with two large donated lab machines, and personal bags filled any extra space. Thus, space for Gamechis’ family was nonexistent. The back seat is bench style meant for three people, although we often squeeze four. The back seat was needed for Tseguy, the translator and two other staff. An incoming medical student from the US squeezed between the driver and Ali in front. Thus, no space was left for Gamechis and his parents.
Knowing this boy’s condition, they shifted around the equipment in the back to create space for one of the parents. However, the parents were insistent on coming together. There was no possible way for both to fit, so the dad was urged to send his wife and child and take the bus the next day. However, the couple would not separate. So Ali handed the family some money for bus fares and explained, with the help of a translator, that they had to come to Gimbie or their son would die.
A few days later, Gamechis and his mom and dad were at our hospital. Soon, he was admitted and treated under the children’s fund and sent home a happier baby.

At 6 a.m. Scott Barlow, the previous head nurse, handed his keys to Ansley Howe, the new head nurse. Scott climbed into the minibus along with his family, a translator, another hospital doctor, and two patients needing special care from Addis Ababa, Ethiopia’s capital. Then he slowly closed the door, soaking in his last moment; fresh morning air dancing in the hospital entryway and friends and coworkers gathered near. Despite the early hour, about 20 people had gathered to give one last handshake or hug and wave goodbye.

In the past days usage of “Goodbye,” “It was a pleasure,” and “Remember when . . . ” has increased in the vocabulary of all the staff. Meanwhile, “Hello,” “Glad you’re here,” and “Can you say your name again?” increased, as well. Ansley is excited to get to know the nurses personally and is committed to increasing the quality of patient care. Before coming to Gimbie, Ansley was the head of Pediatrics at the Bere Adventist Hospital in Chad.

Hello Ansley, we are excited to have you on board!
Goodbye Scott, you are loved and are missed already.

Chapter 1: “El hombrecito”

Jirata arrived at the hospital in the arms of Markos, a nursing student Scott Barlow has been mentoring. Markos found the boy, who appeared to be six or seven, on the street. The homeless, HIV-positive orphan was immobilized with pain. He had a massive abscess on his thigh. Antiretroviral treatment is given at no charge at the hospital, but Jirata hadn’t received any for over three months.

His hospital records revealed he was actually ten years old, and his disproportionately large head suggested that malnutrition had stunted his growth. He was, in Priscila’s words, “un hombrecito con su trajecito”—“a little man in his little suit.” He bore the scars of more emotional pain than most people experience in a full lifetime. He lay on his bed and just stared into nowhere. He was completely impassive.

The expatriate volunteers began showering Jirata with attention. Priscila checked on him constantly and spent her spare moments coloring with him. She even hand-fed him his first few meals, because he refused to eat otherwise. The Barlows and Petra read him stories, and Jonah Squires shared his toys.

Jirata also started receiving visits from Damaqa, a boy of about eight, who brought him bananas and eagerly took part in the coloring. Eventually, Damaqa began staying with Jirata 24 hours a day. The hospital and especially the faranjis were a lot more fun than his home. The Barlows bathed the boys and bought them each a set of clothes, and a nurse took scissors to their hair.

Suddenly, the dam inside Jirata’s heart broke. His soul changed from that of wounded old man to that of a playful little boy. It’s amazing with a little love can do. He became the most affectionate child I have ever known. Every time he saw me, he would grab my hand in both of his, kiss it, and then nuzzle his head into my side and wrap his arms around me. He did the same with most of the other faranjis.

As Jirata’s health improved, he and Damaqa grew bored with the ward and began exploring other parts of the hospital. They spent lots of time in our offices, distracting us and causing trouble. We’re used to throwing people out—believe me—but these kids we tolerated most of the time.

Thanks to the Children’s Fund and some affection, Jirata seemed be getting his childhood back. But what would happen after he was discharged?

Chapter 2: A Victim of Ignorance

Jirata and Damaqa were enjoying living in the hospital and being spoiled by the faranjis. Jirata’s abscessed was healed, though, and Renee and I became increasingly convinced of the need to discharge him so as not to consume too much of the Children’s Fund. But where would we discharge him to? We couldn’t conscionably send him back to the street, especially because he needed antiretroviral medications administered three times a day by a responsible adult.

We heard a rumor that he had some relatives in Gimbie, so Priscila, Gamachis, and I asked Jirata to take us to his house. He led us to a very nice dwelling connected to the Pikook Hotel. Inside were sofas, a television, and other signs of affluence. There were several middle-age women and a middle-age man, all well-dressed. The man cordially invited Priscila, Gamachis, and I to sit on the sofas. Jirata followed us inside and immediately dropped to the floor in a defensive position, with his hands over his head. He didn’t move during the rest of our visit.

We made small-talk with the man and then explained why we had come. “Jirata used to live with us,” he said stiffly, “although we’re not his relatives. Four or five months ago he decided to leave, but we don’t know why. You can leave him here, but he will surely run away by tomorrow.”

Something was incongruous. This affectionate, love-starved boy would not leave a good home, and these people obviously had the financial means to care for him. What was going on?

Lots of things were being said in Oromiffa. I leaned over to ask Gamachis for a translation. His lips were tightly pursed, and his eyes were narrow. He shook his head and whispered that he would fill us in outside.

Priscila and I followed Gamachis’s nonverbal signals and rose to leave. We spread handshakes and smiles all around, lifted Jirata from the floor, and walked back to the street. “What was going on?” I asked Gamachis. “As soon as we walked in,” said Gamachis, “the women started yelling at Jirata: ‘What are you doing here?!’ ‘Why did you come back?!’ ” That is why he fell to the floor.

Gamachis turned to Jirata and started asking him questions. The boy said that these people were indeed his relatives. His mother had actually died in their home. On her deathbed, she made them promise to take care of Jirata. Instead, they physically and emotionally abused him until he decided he would rather fend for himself on the street than live in an affluent hell.

Gamachis attributes their despicable behavior to ignorance. They simply don’t understand how HIV is transmitted and are deathly afraid of having him in the house. You would think that with all the billions of dollars being spent on AIDS education in Africa, people would have learned how the disease is spread. Apparently not. This is a definite mandate for a concerted public health education campaign.

Chapter 3: At Home with the Faranjis

Priscila and I came back to the hospital discouraged about the state of humanity. How can you promise a dying woman you will care for her child and then beat him and send him away?

There was no way we could send Jirata to live with them, and there was no way we could send him back to the street. Scott had recently introduced Priscila to a man in charge of an orphanage in Addis for HIV-positive children. The man happened to have studied in Cuba during Ethiopia’s communist days, and he spoke fluent Spanish. Priscila explained everything to him in detail and wrote down the paperwork we would need in order to send him to the orphanage.

While we were discussing the matter and making the phone call, Damaqa’s mother arrived. She greeted me very warmly. “I heard a rumor that you were taking my son to Addis Ababa tomorrow,” she said through a translator. I informed her that the rumor was false. She started over. “I saw my son go to your house for lunch yesterday, and then I saw you with him in town today.” She was wrong on the first count and right on the second count, and I told her so. “You can keep him here at the hospital,” she said. “I will visit him weekly.” I laughed out loud and turned to my translator. “Explain to her that her son has only been visiting his friend and that as soon as his friend is discharged, they will both be leaving the hospital. They’re not living with me or with any of the other faranjis!” “Ishee, ishee,” (“Okay, okay”) she said, smiling sheepishly. She gave a quick nod and slipped out of the room.

The next day, finding a temporary home for Jirata was at the top of my priority list. Gamachis and I walked to town with the boys to offer Damaqa’s mother 50 birr per week (about 5 USD) to house and feed Jirata. She accepted and agreed to come to the hospital before to collect money and Jirata’s medicines. She is a single mom who was abandoned by her alcoholic husband.

As we waited for her to come to the hospital, I became increasingly indulgent toward the boys. I let them play on the keyboard in my office for about an hour. Then, when Renee and I were setting up for Jonah and Ansley’s birthday party, they showed up at the house. We told them to go away several times. They ended up on the porch, where Renee was sweeping and bringing tables out. They helped her, and then while the door was open they came inside. We were in a hurry and decided it wouldn’t be worth the time and energy to throw them out. They discovered Petra’s exercise ball and began bouncing it around the room. They giggled and squealed with delight.

I swallowed a few tears as I watched them and thought of the day before when Jirata had been curled up on the floor receiving verbal abuse from the only family he had in the world. The contrast was overwhelming. “This is what Jirata needs:” I thought, “a family, a safe place where he can laugh and just be a child.”

Chapter 4: Back to Gimbie

People started arriving for Jonah and Ansley’s party, and no one could believe we had let the boys inside. It was out of character and probably against policy (sorry, P&P). I took them by the hand and led them back to the hospital, where we picked up Gamachis and made our way back to Damaqa’s home. His mother was there, and I explained Jirata’s medications to her, gave her fifty birr, and commended her for the good deed she was doing. She expressed her concerns about the boys sleeping together, and I assured her that the only way Jirata could transmit his HIV to someone in her family was through blood. I told her to come back to the hospital in a week to see what we had worked out for Jirata.

Gamachis told the boys what was happening and that they shouldn’t come back to the hospital until Damaqa’s mother took them. I said, “Chau,” and waved good-bye. They looked at me blankly, and I turned to walk away. Jirata started whimpering, and soon it grew into all-out bawling. Damaqa joined in. Jirata chased us up the road, and Gamachis turned around to deal with him, urging me to go ahead.

Maybe that’s how a parent feels leaving a child on the first day of kindergarten. But this time I really wasn’t going back for them. I really was abandoning them. The faranjis at the hospital were probably the first adults who had treated Jirata with love in months or years, and now we were abandoning him.

I know we are doing the right thing by sending him to an orphanage for HIV-positive children, but it is still painful. I hope the orphanage turns out to be a loving place.