Gimbie Reports

Friday afternoon found me in a skirt and rubber flip flop sandals, walking with determination up the high street towards market. I bought five tin buckets to plant zinnias and herbs in, two kilos of green beans imported from Addis, and a jar of local honey. I bought mangoes, lemons, carrots, and potatoes.

The rain caught me by surprise, sneaking up from behind, as I walked back down the hill towards home. It was a rain that saturated my clothes almost immediately; it slowed my pace as I tiptoed around instantly appearing puddles, trying not to slip, perching the buckets and beans and lemons in my slick arms.

Suddenly the streets were empty—I was alone in my plod back to the hospital. The locals huddled under awning and roof lip, watching. Watching the foreigner and her load pass by.

I’m not really one to be stared at. I joined them soon enough, becoming another solemn observer of the rain and wind and droplet-pocked muddy puddles.

We took shelter together under the tin roof of a tiny store, six Ethiopian men and a thin teenage girl, two small boys and me. The Muslim owner and his wife sat behind the counter and pretended to ignore us. The rain thundered on the tin roof. The store was the kind that sold everything—razor blades, tiny packets of yeast, candles, sweet smelling ostrich soap, lentils, plastic bottles of sesame oil, coarse sugar, black market antibiotics, and flour sifters made from the recycled food tins donated from the United States.

I soaked it all in. The smell of wet pilgrims around me, the sound of rain hitting our exposed toes, this peace that hung on us, and, as the deluge eased, the weariness that propelled us onward, back home.

We left Dembi Dollo at 6:30 AM Friday morning, heading back to Gimbie after a visit to Mugi Clinic. Mark Squires was at the wheel, Ayantu and Yohannes were sitting in the other bucket seats, and Petra, Kristin, and I were bouncing and sliding on the vinyl benches in the back. Our goal was to make an 11:00 AM inspection appointment at Guliso Clinic.

All of a sudden, we were skidding and fish-tailing on the gravel road. Once we had come to a stop, Mark and Yohannes jumped out to investigate. “Is it a flat tire?” we called out to Mark? “No, it’s worse,” he said. I went out to see for myself. The front left tire was perpendicular to the other three. Seeing it gave me a sick feeling just like an out-of-joint limb would.

Mark sent Petra, Kristin, and I in search of a fallen nut and washer. We combed the road for 100 meters back and dredged the puddles but didn’t find anything. We definitely entertained the hordes of children and adults who gathered to watch us, though.

Ayantu met us as we trudged back to the ambulance. Yohannes’s finger had been “cut,” she said. Actually, the tip had been cut off! He isn’t a mechanic and didn’t methodically ratchet up the safety stand as Mark jacked up the ambulance. The jack gave out, and the ambulance fell . . . on his finger. About a centimeter of it lay on the ground for a couple of hours before someone tossed it into the bushes. We were all sick about it. Yohannes is a carpenter by trade. He received some informal training in optometry in January and came on the Mugi trip to sell eyeglasses. But his primary job is to be the hospital’s carpenter.

So the situation was basically bad. The ambulance was broken down 6 hours from Gimbie without the proper parts or tools to repair it; the inspection appointment in Guliso would be impossible to make; Yohannes the carpenter had lost the tip of his right pointer finger; all of us were tired and dirty and were grumpy at the prospect of not being home for Sabbath.

I was trying to roll with the punches and not get terribly frustrated, but I wasn’t being a Polyanna either. I wasn’t expecting to find a reason for our problems. I tend to think that God allows for a great deal of chaos to reign in the world because of sin. He interferes sometimes, but I don’t believe that “everything happens for a reason.” That’s why I was surprised by all of the convenient coincidences we started to encounter:

1. Right before we started skidding, the ambulance (which has an automatic transmission) switched into low gear. Mark was puzzled, because we were on a flat stretch. This resulted in our being at a slower speed when the bolt dropped and the tire turned sideways.
2. Ayantu, Kristin, and I walked about 40 minutes to Chanka to try to buy a match for the bolt that had been stripped and a corresponding nut and spring washers. I was worried, because the ambulance is an American vehicle, and it seemed unlikely that we would find the exact part we needed. At the edge of town, we met a mechanic. Ayantu explained the situation to him, and he immediately led us to another mechanic’s shop where he disappeared for a moment before producing the exact bolt and nut we needed. The washers required some more explaining, but he eventually found those, too. It was easier than any encounter I’ve ever had at an auto-part store in the US!
3. Mark was thrilled with the bolt and accessories, but he still needed a mallet to bang the front suspension swing arm loose from where it had lodged itself. He asked the men helping him if he could find one somewhere. One of them immediately went to his hut and produced one!
4. Shortly after Ayantu, Kristin, and I returned from town, a Land Cruiser pulled up and stopped. We started chatting about our problems and noticed their back seat was empty. “Where are you going?” we asked. “Gimbie,” the responded. We explained Yohannes’s plight, and they agreed to take him to the hospital. Petra and Kristin climbed in, too, because 3 people can sleep in the ambulance much more comfortably than 5 people. As they pulled away, I stood there dumbstruck. I’ve hitchhiked along that road a couple times and unsuccessfully TRIED to hitchhike along that road many times. I’ve NEVER had a nearly empty Land Cruiser on its way to Gimbie stop for me.

Mark and his helpers exceeded even their own expectations and had the ambulance in working order about 90 minutes after the Land Cruiser left. We set off eastward. I sat in the front seat, enjoying the comfort and the view, and pondering all the day’s blessings. “If God is concerned enough about us to work out all these details, why didn’t He just keep the accidents from happening? Wouldn’t keeping the wheel bolted together have been just as easy as forcing the engine to shift down? Wouldn’t have holding up the jack and saving Yohannes’s finger been just as easy as sending a Land Cruiser for him?”

An answer was waiting in Inango. A large crowd of people blocked the street. They parted as we approached, but a police officer waved for us to stop. There had been a lightning strike, and he wanted us to take a victim to the hospital. We cleared off the bench, and people carried in a man without a pulse. “Nama sedi,” he said: “Three people.” We thought that meant the patient and 2 relatives, but 2 more men were carried inside and set on the floor where the gurney should have been. Following them were 2 others with less severe burns. The patients were accompanied by 3 relatives and, for part of the way, by the policeman.

The first man was pronounced dead-on-arrival, but the other 4 are doing well. It seemed to me that our arrival in Inango at that precise moment with plenty of room in the back justified our difficulties. But then again, if God went to all that trouble to coordinate our arrival, why didn’t he just prevent the lightning strike?

God’s ways will always be mysterious to us. It is fruitless to try to untangle His providence from human choice and from the forces of nature and of evil in the world. God has promised to “work for the good of those who love Him” in any and all situations, but I still don’t think that means He engineers tragedies and other difficulties. I could be wrong, though.

However . . . as far as the finger is concerned . . . this accident might be Yohannes’s ticket to optometry school. His carpentry days are likely over, now that he is missing part of his right index finger and still suffers the effects of an earlier accident in which he cut the tendons leading to his left hand. There isn’t exactly workman’s comp in Ethiopia, so the least the hospital could do is find a sponsor for him and set him on a new career path. It would be great for the hospital to have a trained optometrist, too. And I think Yohannes would gladly give a whole finger or two for a chance like that. Any sponsors willing to contribute $30 a month?

Bananas in Ethiopia are a bit different from the readily available bananas in the US. Often described as finger bananas by farenjis, the Ethiopian bananas are a shorter, spottier version of the long spotless yellow bananas we love in North America. However, there are two types of finger bananas available in Gimbie: muzi habaisha (bananas that locals like) and muzi farenji (bananas that foreigners like because they are a bit smaller, smoother, and sweeter than muzi habaisha).

The other day Tafari, a boy claiming to be 14 but looking about 12, came to Gimbie in hopes of adoption. Although we are not an adoption agency, we are Christian and strive to practice “pure and faultless religion” (James 1:27). Through Gamechis and Mulissa, fellow office workers here at GAH, we were able to understand his story.

Tafari’s father died, and his mother remarried. His new step father did not like him and kicked him out of the house, claiming Tafari had a mental disorder. For a while he lived with his grandmother, but when she ran out of money he had to leave her too. Tafari talked with some police in his town, and adoption seemed like a logical rejoinder. They put him on a bus to Gimbie and told him to find the Adventist hospital.

Here is where bananas, Shaunda, Petra, and I, enter the story. Tafari hadn’t eaten in a while, so Shaunda when back to the house and got him a plate of food, including two muzi farenji, and brought it to the office. He awkwardly ate the food with a spoon. (Injera, a type of pancake, is the only utensil used here.) Then he asked how to eat the banana. We did not understand the question and replied “nothing special, just eat it.”

Then Tafari stuck one end of the unpeeled banana into his mouth and chomped down. The three of us stared at him in surprise and after shutting our gaping mouths we demonstrated how to peel a banana. He happily ate with a bit less confusion.

The next day, he came back for more food. Again, we gave him a plate of food with two bananas. Again, he asked how to eat. We motioned to peel it, and he broke it in half. We figured that he’d proceed to peel it before eating it, but again we were surprised as he took a big bite of unpeeled banana.

Later Engadaye, a nurse who has specialized in psychiatry, stopped by. We told her that Tafari had been eating the bananas without peeling them. She addressed the boy and after hearing his response, a huge smile wiped across her face accompanied by a chuckle. She explained that he hadn’t eaten muzi farenji before and thought that foreigners ate the banana, peel and all! We had a good laugh and had her explain that we too dislike the peel on our muzi.

The next day Tafari was back again wanting food. We gave him the normal, a plate of leftovers from our kitchen and two bananas. We watched as he picked up a banana. He paused to look at us, this time without a doubt or question in mind. He smiled and started to peel the banana.

Bashatu sits and writes in the hospital delivery room, keeping record of a busy night in the obstetric ward. It’s 5:30 am, and she’s tired, but still smiles when she sees me pop my head in.

“I’m glad it’s quiet here now, Bashatu,” I say, “Are you about ready to go home and rest?

She sighs, “Yes.”

“Do you need anything?” I ask.

I take a quick glance at the stock on the shelves—bottles of lidocaine, boxes of gloves, spare gowns and plastic drapes. There are plenty of sutures, gauze, and rubbing alcohol.

“I think we’re okay,” Bashatu tells me.

All is calm and bright.

Not two minutes later I’m about the climb the stairs to male ward when I hear the thundering yell of a woman in labor.

There is a commotion on the ramp between the floors and suddenly this crowd is right in front of me—siblings and parents and elderly ladies and one of the guards and a nurse from upstairs, all pushing a stretcher that carries a bellowing and grossly pregnant young lady.

I run ahead of them and swing open the double doors to the delivery room. The gurney gets stuck as Bashatu runs up behind me.

Suddenly there is a brand new baby, slick as a fish, in Bishatu’s surprised and bare hands.

Everyone is startled, perhaps the mother most of all as she looks down and realizes the worst is abruptly past.

The guard had been in the process of shooing the family members out—family members are not allowed to witness births—but now that the baby is born and right here in front of us, it’s hard to shoo their wonder and excitement away.

Bashatu hands the baby to me and I take it for vital signs and weight. She then brings the gurney the rest of the way in and begins her gentle care of the post-natal patient.

She sends me a little secret scowl while she works.

“What did you say about ‘quiet?’” she asks. And then she laughs.

Priscila pulled me aside yesterday afternoon in the Emergency Room.

“Ansley, I found Jirata today out on the street, he’s so dirty, do you mind, well, I mean, would it be okay—“

I interrupted her, “To bathe him in our shower? Of course! Priscila, you don’t even have to ask!”

She beamed at me, already imagining the scrubbing the little boy from head to toe.

Jirata is an orphan. We think he is somewhere between 8-10 years old. He recently had a long stay at the hospital due to a leg ulcer, complicated by his HIV-positive status. Priscila told me that at first Jirata was reserved and hesitant to accept the attention from the hospital staff. You would never guess it now.

Jirata runs up to us when we leave the hospital gate and nuzzles his face into our clothes. He hugs us and kisses our hands and looks up with a shy sweet smile. Then he’ll take our fingers in his and walk with us, wherever we’re going in the town.

We are trying to find a home for him, a family to give support and love and a daily routine, especially because he needs regimented anti-retro viral drugs every day.

In the meantime, Priscila has appointed herself as surrogate mother. She makes a point of feeding our leftovers to Jirata and his friends, and has washed his clothes and repaired his shoes several times.

Later in the evening she brought him to me, after perhaps the first hot shower of his life.

“Smell his hair, I shampooed it!” she said, fluffing out her mother hen feathers, “See how nice he looks!”

She loves him so much, this precious ragamuffin of a child.

“What’s wrong with this x-ray?” said our volunteer surgeon, James, with the verve of a game show host. He slapped an x-ray against my white office wall, and Renee, Jeremy, Kristin, and I gathered around. The x-ray was of a small child, and in the throat we saw a perfectly round white circle, about the size of an American quarter.

“It’s a coin!” he declared. He snatched the film back and darted out the door, calling over his shoulder that Jeremy could follow to watch if he wanted.

In the operating room, James inserted an endo-tracheal tube. He reached down the child's throat with bent tweezers, but he couldn't grab the coin. The child was becoming increasingly distressed, and, after several tries, James was afraid he would have to send him on the ten-hour trip to Addis Ababa.

Then inspiration struck. He inserted a sterile urinary catheter so that the tip was below the coin. Then he inflated the balloon at the end of the tube with water. He pulled gently upwards and used the balloon to dislodge the coin and lift it to where he could grab it with the tweezers.

Voila!

“Oooh, Paatra! You have become fat!” Kuliche exclaimed excitedly as she wrung my hand and showered me with a series of shoulder-bumps/hugs that are traditional in Ethiopian greeting. “Why… thank you!” I responded, forcing a smile from my somewhat startled countenance. I had heard that this was a typical compliment, but having never received it before, I was caught off guard. Paul and I had just returned from a month’s vacation in the U.S., and it was possible that we had gained a couple pounds while feasting on our mothers’ home-cooking. I decided to shrug it off as a good-natured expression of Kuliche’s pleasure at seeing me again. But when a second staff member delightedly shouted the same comment, I became somewhat concerned. “Paatra, you look wonderful! You are so fat!” The third comment was too much. “Paatra! Look at you! Really, it makes me happy to see how fat you are!” Slipping away from my chaplaincy duties, I stole into an exam room that had a weighing scale. With a sigh of relief, I beheld the dial which verified that I had not become a lumbering blubbersome chubster. In fact, I weighed exactly the same as when I had left to go on vacation. I returned to my work with renewed confidence. My admirers did not sincerely think me fat. They were simply “filling my ear with sweet nothings.” I decided to give it a try myself the next day. Tsegaye, who is as skinny as a rail, entered the office and effusively expressed his joy in seeing us returned safely. “Thank you, Tsegaye! I am so happy to see you.” I chirped, “And my, look at how fat you have become!” He chuckled somewhat self-consciously, and left the office beaming. Everyone likes to be complimented.

By Petra

Mulu (short for Mulunesh) put her hand on my shoulder. “Sister, do you know where Dr. Priscila is?”

It was late in the day and I sat in the nurses’ station in the male ward, working on a new schedule for the practical workers. (I like sitting at that station while I work; from one spot I can see almost everything that’s going on in the ward).

“I haven’t seen her since lunch,” I told Mulu, “Maybe she went back to the house early?”

Mulu frowned at me. “I have a big bite in the ER,” she said, “I need a doctor.”

I was confused. “A big bite?”

She nodded, impatiently, “Yes, a big bite! A little old lady got a bite from her big!”

I couldn’t help laughing. “Oh! A pig bite. Aha.” I shook my head, “I’m sorry, I misunderstood you.”

Mulu wrinked her nose at me as if to say, of course.

She wandered off in search of Dr. Priscila. I sat there, staring over the patient beds, still pondering the unfortunate woman with a pig bite.

We’ve had some strange cases this week. There was a five month old baby who choked on and aspirated a piece of raw onion (per his parents’ story) and then developed a bad pneumonia. Also, a young woman was admitted after she was kicked between her legs by a cow.

And now a pig bite, of all things.

Later, after lab work and tests and IV medications, she is awake again. Tolesse translates her story for me. He speaks with her in Amharic; she is from a distant village and does not speak Oromifa.

It is an unwanted pregnancy. She is unmarried, and was rejected from her home by her parents when they learned of her condition. She came to Gimbie looking for her sister, a school teacher, but has not been able to find her.

We tuck her into a bed in the female ward for further monitoring. The next morning as I make my rounds I am happy to see her sitting up in bed, eating bread from the kitchen. Safe and sound, at least for now.

In The Driveway

I look up to see Mark Sr., a hospital volunteer from California, standing in my office doorway. His face is concerned, urgent.

“There’s a lady, she’s unconscious in the driveway, will you come?”

I grab my stethoscope from the shelf and follow him out the front door of the hospital. We find a woman about my age lying on her side at the edge of the road, breathing rapidly and unresponsive.

As I begin to assess her a crowd of curious Ethiopians gathers around.

“Go to the ER and get the stretcher!” I tell them.

Her heart rate is fine, she is warm and well colored, I don’t see any bleeding or obvious injuries, no paleness noted to her eyelids. Pulses strong bilaterally. But as I touch her and talk to her and pinch her fingers she does not respond.

When we turn her gently over it is obvious that she is about seven months pregnant.

Her rapid breathing is unnerving to me. I look in the plastic bag next to her for a clue.

Aha. Orange-capped insulin syringes, tossed in with some clothes and papers. Maybe she has diabetes.

We transfer her to a stretcher and carry her to the ER for further assessment.