Gimbie Reports

She was about my age, slender, and with long wavy hair. We weren’t sure what her name was. One of the asternamies* from a neighboring bed thought they remembered her being called “Chaltu.” She lay in the corner, unconscious and all alone. It took me a couple of days to realize that she was permanently unattended. There was never anyone with her when I came through the wards, but I thought that this was because her caretaker had stepped out for awhile and would be back later. Finally, by the third day, I knew that something was unusual. I came through the wards at the evening mealtime, and there was still no one with her. I tapped Amanuel, the charge nurse, on the shoulder, “do you know anything about that girl in the corner?” “Oh, Paatira!” He said, “it is so sad. She was discharged three days ago. There is nothing we can do to make her well… she has HIV, and her family abandoned her.” “You mean, she has been lying there for three days with no family to take care of her?” I asked. “Yes… Her family was ashamed that she had HIV, so they left her.” Amanuel answered sadly. “So, she has had no food?” “No.” “She has not been washed?” “No.” There was a long pause. “Amanuel, I think we should wash her. Even if people have been discharged, it is important to take care of them if they cannot take care of themselves.” An expression of resolution settled on Amanuel’s face. “You are right. Let us wash her!”

I ran home to grab some wash clothes and soap and returned to find Amanuel collecting clean sheets and rubber gloves. I sprayed several thick clouds of bug repellent around the bed to disperse the flies. Amanuel carefully rolled her over. We stared in shock. She had been lying in pool of stool. Her back was covered with sores. The bed was crawling with a mass of white maggots. Amanuel and I looked at each other silently. There was nothing to do but set to work. It took us an hour to get her half-way presentable, and the whole time Amanuel was muttering under his breath about how sad it was. We decided that she simply must get some IV fluids and pain medication, even if we had to pay for them ourselves. We also forced some sugary juice down her throat. “Can you hear me, Chaltu?” I spoke loudly, “I’m praying for you, okay? God bless you!!” She continued staring blindly ahead, fighting for breath. Amanuel shook her strongly on the shoulder. “Say ‘amen!’ Say ‘amen!’” He ordered. She coughed a bit, probably from the juice, and moved her mouth silently. “See?” he smiled at me excitedly. “She said ‘amen!’”

We kept her alive for a little over two weeks. Every day, I stopped at her bed, shouted out a greeting, and read her a Bible verse. Perhaps something was getting through to her brain. But yesterday, as I was in the midst of shouting my greeting, a nearby asternamy frowned and shook his finger. “She will not hear you.” He said, “she is dead.” I froze. Dead? I looked at her again. Yes, she did look a little different then she had looked yesterday. And no, she wasn’t breathing. I ran to the nurses’ station and asked someone to come quick. The stethoscope confirmed the asternamy’s assertion. Chaltu was dead.

I have witnessed many deaths at Gimbie. But always, there is someone to mourn. Family and friends gather around the deceased body and wail and beat their breasts. But Chaltu’s death was silent. There was no one to mourn. A couple asternamies clicked their tongues. The nurses on duty offered a sad sigh. Amanuel would not come into work until later.

I gathered my belongings from my office and headed home. It was almost time for choir practice. She was so young… I left my Bible and keys by the front door and walked to the bookshelf to find my choir book. She was so alone… I took my jacket off of the hook and began to put it on. She was dead… I dropped my choir book on the floor and put my jacket back on the hook. I went into my bedroom and cried.

*asternamy – a caretaker, usually a family member of a patient.

Dear Stella,

Your comment was super encouraging. Thanks for that last sentence: “Just know you’re famous and you’re making a name for Gimbie.” I appreciate the complement, it’s encouraging too, but Stella, I want to be truly great.

Famous. Honestly? I’ve chosen to live in a muddy stagnate point some 7 degrees above the equator. Our friends are landing jobs that pay, starting grad school, celebrating weddings, attaining the Fulbright; and here? Here mediocrity and poverty reign. People don’t have shoes to wear. No one I know has a bank account. I wonder if there is a word meaning “save” in the Oromo language. People are afraid of fresh air, think it is manly not to drink water, and discriminate and reject people (and even children) with HIV even though they know it’s not transmittable via the air. We pray for rain because if it does not come neither does our food. The electricity is off every other day and it is super expensive for the hospital to run off of our gas powered generator. Tell me, where’s the popularity in that?

Last night I couldn’t sleep. I think the tea I drank at our 4th of July party was caffeinated. I thought about the future, specifically, my future. I mapped out every possible option and where it would lead: Spain to Boston to a Master of Science degree in Human Service Policy by age 25, or Chattanooga to Spain to Austin with a Master’s in Communication at 26, or Atlanta to Austin with a PH.D by 30. I want to be great, Stella, mud-free and making a difference.

Here at Gimbie, I answer emails, post some notes on Facebook, make sure guests have a bed made and a cook lined up, plan 4th of July parties, write snapshots about patients and happenings that probably skew the true picture of the hospital, and dream about a future of greatness.

I wonder if the greatness I seek—education, travel and broad life experience—is truly greatness. Am I just chasing sanctioned expectations and societal myths dubbed as greatness? What does true greatness look like? How do or will I know when I have attained it? Are greatness and simplicity opposites? Do fame and greatness always cohabitate? To attain one do I have to give up the other?

Most days I cherish my simplistic life: story time with 3 year-old Jonah, card games by candle light with friends, a diet of local unprocessed foods, raising support for our needy hospital, befriending orphan boys, singing with a Sister from the Catholic mission down the street, morning runs and morning devotions, a good book with tea, making bagels and guava sauce with my neighbors. It is great when we value the simple basic things in life.

The difference, I suppose, between the greatness of the famous and the greatness of the simplistic is not that one does and the other does not. On the contrary, both do much but they do differently. The greatness of the famous calls one to do things, expectations, meetings, style, money. However, the greatness of the simplistic beckons the heart and grows the mind. It focuses on people, quality time, and service of others.

I like living abroad, Stella, because I feel like the latter greatness is simpler to attain than in the States. I think it’s easier to adapt John the Baptist’s great attitude of “He must increase, I must decrease” (John 3:30) whilst living in a developing country. It’s so easy to forget about many of the great people who lived before us. They are recognized for their sacrifice. Who today asks themselves “what can I sacrifice” on their quest to become great? Honestly, not me.

Recently I’ve read the book Uprising by Erwin McManus. He talks about wholeness, generosity, faith, gratitude, love, responsibility all aspects of being great. He writes some deep stuff. He clarifies sacrifice by saying “The goal is not so much to have less, but to give more” (p. 113). That blew my mind. It’s not about giving away what God has given us until we have nothing left. It’s about being a channel that passes on the blessings that flow from God.

I appreciate how McManus acknowledges responsibility in the equation. After meeting a smart guy from UCLA with much potential who thinks life is about paying bills he writes, “Those who have the privilege of a healthy upbringing and a great education have to embrace more responsibility than simply paying their bills. If it were within his reach to produce great wealth, to create jobs for the unemployed, to provide income so that meals could be put on a table, if he had been entrusted by God with the skills and capacity to improve the quality of life for hundreds, if not thousands, it would be sin for him to do anything less” (p. 167). That quote raises some other questions. Who is to say that deeply influencing one person is less, or inferior to influencing thousands? Is it possible to lead a life of simplistic greatness and influences thousands? I know Jesus did it but honestly, it doesn’t seem possible today.

“There is a place where very few of us ever aspire to go, where the measure of our worth is not how much we have, but how much we give” (p 156). Those that venture to that land are great, with or without fame.

Thanks for listening Stella. I’m praying for you and your students.
Eat some kim-chee for me!
TQM!
Renée

“Hallo, Patiraa!” The Muslim family smiled and waved at me from the corner. I waved in reply, and carefully made my way around the other patients’ beds to pay them a visit. Ever since her first day in the hospital, Fatima had refused the prayer and scripture reading which I daily offered to each patient. “Would you like a prayer?” I would ask. “No thank you, I have already prayed.” She would say. “May I read a scripture?” I would suggest. “No thank you, I have already read my own scriptures.” She would reply. We would then smile at each other, I would say, “No problem! Have a nice day!” and we would shake hands. Fatima remained ambivalently tolerant of my visits… but her multiple aunts and cousins thought I was a rock star. “Listen to her!” they would twitter amongst themselves, “she is learning Oromiffa!” Every time I walked into their section of the ward, they would call my name and wave for me to come over. We always kept the conversation to polite pleasantries. Today was different, however. The fattest aunt, somewhat the matriarch of the bunch, grabbed my hand and asked, “Do you know Arabic?” I shook my head apologetically, “No, I’m sorry, I don…” Wait! I suddenly remembered a little piece of scrap paper I had in my Bible. A visiting Iraqi medical student had shared a few phrases with me several months back. I flipped through the pages and pulled out the little wrinkled note. I cleared my throat. “Kaf Halak?” I ventured. The corner erupted into peals of delighted laughter. “She knows Arabic!” they chortled, and then fired back a stream of unintelligible garble which I discerned to be the revered language. I smiled and nodded and shrugged my shoulders. They erupted once more, holding their sides, rocking back and forth. We shook hands all around, and I continued on my way to the next patient bed. Ah well. If I couldn’t share a Bible verse, I could at least give them a cheery afternoon.

The next day, I was hailed once again. “Hallo, Patiraa!” I made my way over to the corner, grinning. “Kaf Halak?” I said. The mirth was still present, but not nearly so deafening. A pudgy uncle was immersed in the crowd this time. “You see him?” the fat aunt pointed her finger at the honorable gentleman, “You must read your Bible for him. He is sick. His head hurts.” I could hardly believe my ears. “Does your head hurt?” I asked the man. He nodded sadly. “May I read for you?” Once again, he nodded. I surveyed the vast collection of relatives. Fatima sat quietly in bed, watching me. Was this a joke? Somehow, their faces did not say so. I opened my Bible with shaking hands and stumbled through several passages. As I finished, I glanced up at the crowd. They were nodding thoughtfully. “Amen!” Said the pudgy uncle. “Amen!” Said the fat aunt. Fatima simply smiled and nodded. We shook hands all around, and I went on my way once more. To think that “Kaf Halak!” could do so much…

Africa.

Just the word conjures up different impressions, pictures, emotions, and colors for each person. Hot, sultry safaris, blonde tall grass covering flat plains is one African stereotype that exists. If that’s what you think, I want to pop that preconceived idea right now.

West Wollega, Ethiopia has rolling hills and small mountains. Since the rains started, bright green grass covers the hills, evergreen and banana trees coexist, streams meander where they please, and it is cold.

It is not a wintery Canada cold but a windy, 60 degrees Fahrenheit, no heaters in houses or buildings cold. I deeply inhale the crisp morning air and enjoy the freshness as I walk to the hospital with a 26 ounce jar full of hot tea in hand.

Fortunately, I have socks, some long sleeve t-shirts, a fleece, a scarf, and pants that provide more warmth than skirts. Although we have no heat in our house, our windows close and we have thick wool blankets for our beds. Others are not as lucky. Some people wear all the clothes they own and still shiver.

Petra, our chaplain, told me she closed the windows of the crowded wards. (This was a monumental occasion because Petra always opens windows and preaches the benefits of fresh air.) The skinny patients, lying on their beds, with a thin sheet were quivering, so she shut the window to prevent the cold air from pouring in.

Sweltering, dry Africa was just one preset idea that was shattered. In some places it exists, just not in West Wollega, Ethiopia during rainy season.

The End.

I am intrigued by home remedies. As I’ve worked in different corners of the world, I’ve seen some strange home treatments.

In Peru the patients would show up to clinics with bundles of herbs pressed to their abscesses. In the States we make poultices of mashed charcoal and apply them to bee stings or infections. Chadians were known to spread rabbit fur over their burns, and to cut the uvulas of babies to stop vomiting.

In Gimbie, the treatment of choice is butter. Sour, oily butter, spread thickly over the heads of sick children and newborn babies. The idea is that the butter will absorb into their heads, and the richness of it will sustain the sick during their recovery. Or protect the newborns during their first few days of life.

Sometimes I forget this and rub my fingers tenderly over the head of a brand new baby. Instead of soft baby fuzz, I discover slick gooeyness. Oopsies.

Maybe that smelly butter will soak into my fingertips and sustain me as well.

Within the first few days of moving into the little house with Priscila and I, my brother Alban completely reorganized our kitchen cupboard; throwing away useless mismatched Tupperware lids and stacking frequently used items in efficient places.

His title for the summer, Outer Clinics Director, is abbreviated OCD. We tease him about how we find this fitting.

Alban brought some new games with him, most notably the random Italian cowboy card game, Bang! and Argentinean Truco. We fit in rounds of cards during our lunch break, and also in the chilly evenings with the ever-present cup of tea. Alban and I have also taken up the Review and Herald classic, Birds and Animals, which can be played with two people. We're learning to differentiate the Gemsbok from the Gnu.

Alban has many talents. He fixed the flushing mechanism in our toilet, built sturdy trellises out of branches for our pots of sweet peas, and he also bakes fantastic biscuits for breakfast.

Except for that rare Christmas vacation when we were in the same country, Alban and I haven't lived under the same roof for almost six years.

It's nice to remember how much we have in common.

We share good conversation as we wash dishes together with Ella Fitzgerald humming in the background. On an amiable walk up high street to the market we stop for a bitter shot of Ethiopian coffee, about 10 cents for a tiny cup, then sit and chat as the town wanders by.

We both like to be well prepared, to have a plan. We both like to meet new people and discover their quirks.

We both like to let the cows know exactly how we feel about them as they stand in the road and the car honks and honks and they don't move one inch.

I'm moping around the house at the end of a long, discouraging day. He meets my depression with wide arms, and pulls me into his blue sweatshirt. "Hug it all out," he tells me, "hug it all out."

The Goiter Project started June 22, just days after surgeon Greg Saunders arrived at Gimbie Adventist Hospital from Oregon, USA. He has operated on 25 patients, relieving them from the burden and pain of having a large mass protruding from their neck between their collarbone and chin.

About two goiter operations are preformed each morning. In the afternoon, potential surgery recipients are screened. Because of the quantity of people with varying intensities of goiters, we are not operating on a first come first serve basis. Rather, Dr. Saunders evaluates each potential goiter patient and chooses those with pain, difficulty breathing and swallowing. Those not selected are given a dose of Lipiodol (iodized oil in pill form) that lasts a year. Those admitted are normally in the hospital about three days; pre-surgery, surgery, post-surgery, and discharged on morning four. Chaltu and Wogari are two of our patients that have successfully completed the process.

Forty five year-old Chaltu is the mother of 9 children. Together, the family farms their land and then sells their produce to for an income. Chaltu, like most people over thirty from the rural community, has never attended school. She has lived with her goiter for at least 24 years. Chaltu is very thankful for the surgery and prays blessings upon her donor(s).

Wogari is 54 years-old. He too is a farmer and has suffered with a goiter for the past 25 years. He has wanted to remove his goiter for a long time but was never able to because of finances. He is thankful to God for the opportunity to remove the once inconvenient, problematic goiter. “It is very nice that I can move my head from side to side now” Wogari said, “May God bless all of you who made this possible.”

Our plan is to remove the goiters of 36 patients’ total. Surgery costs about 2,200 birr, only 200 USD. However, that is a price that many cannot afford to pay. The average wage is 12 birr, one dollar, a day. Thus, a family must save every cent for half of the year. This is the average. Most people with goiters, however, do not earn an average income. They cannot afford to buy ionized salt let alone have an expensive surgery; hence we provide these surgeries for free. Although, we only have collected the money for 24 patients we will move on in faith knowing that God is Provider and Sustainer. We are thankful to those who have already given to the Goiter Project and are thankful for those that will.

To donate go to www.gimbie.wordpress.com/donate.

Voice of America broadcasted a report in Afan-Oromo featuring an interview with hospital administrator, Paul Howe, on Thursday, July 2. To listen click the following link http://www.voanews.com/horn/afaan_oromoo_audio.cfm and then select your preferred player (i.e. Windows media, MP3, etc). It will be available online for a week.

Praying for milk

As Feyisa and I drive in the Land Cruiser (me driving, Feyisa shot gun) through chaotic Nekempt toward the East Wollega Health Bureau, I express my doubt that it's going to be a successful trip. Feyisa listens patiently, nodding his head.

He knows better than to be optimistic.

I was here just last Thursday, with the same mission: to pick up free UNICEF milk for our malnourished kids. It was a disaster--a dead end. After waiting for nearly an hour on creaky chairs in a damp office, we were told that the Pharmacy Guy with the only key to the milk stock room was sick, and wouldn't be coming in for the day.

Since he possessed the only key, I had jumped into the Land Cruiser with Ashebir the driver and Karessa the pharmacist and drove to his house to get it.

He wasn't there. "He's at the market today," his wife told us.

So we called this Pharmacist Guy. He said, "I won't be coming into work today, I'm sick. But I won't give you any milk powder, anyway. We don't distribute to the Gimbie area."

But I had papers from UNICEF in Addis, with specific instructions to collect milk powders at that office. I had an official request from our hospital as well, and plenty of stamps and signatures.

We tried to talk to the boss, the manager of the Bureau. "The managers are out today," the round-faced secretary told us. "Come back tomorrow."

That was a week ago. I have since collected more papers, signatures, and stamps, talked with the directors of Ethiopia's UNICEF Feeding Program in Addis Ababa, and received more instructions. But I'm still dubious that we'll leave the Bureau today with milk.

As we pull up to the gate I tell Feyisa that I'm going to pray. We stop the car and we pray. It encourages us, if nothing else. God knows our kids need that fortified therapeutic milk.

This time the round-faced secretary tells us that Pharmacy Guy is in the WHO (World Health Organization) stock room. Apparently they are counting vaccinations. A goose chase around the compound finally lands us at a small warehouse sort of building. The roof is rusted and cracked open in several places, floods of chilly morning sunlight pour in.

Pharmacy Guy shakes my hand.

The answer is yes. Yes, we have milk (we find it stacked to the ceiling in a small, dusty room, some of the boxes moulding and some chewed up by rats, none of it moved or touched in months and months). Yes, you can have as much as you want (we pack 60 boxes of 30 bags each into the Land Cruiser).

I am so happy. I don't know why it was so hard last week, and somehow so easy this time around.

I guess right now it doesn't matter. Feyisa and I smile all the way up and down the hallway, carrying armloads of boxes of milk powder.

The notes from the piano’s final chord died away, and the choir rose to collect songbooks and de-robe our flowing, blue gowns. The church service had gone well. Engidye, my fellow choir member and favorite hospital nurse, laid her hand on my shoulder. “Do you want to stay for foot-washing?” she asked. I couldn’t repress a shiver. It was a cold, rainy morning and nothing seemed more unappealing than sitting outside in the gloom while my feet were dipped in cool water. I politely declined, and began walking home. Halfway down the stairs to our compound however, I paused. The crowd of white-shawled women bustling about the church yard, basins in hand, towels over arm, seemed to draw me. O bother. I might as well stay. I re-ascended the stairs and began hunting about for Engidye. But after making a full-circle of the church and its yard, there was no sign of her. Somewhat relieved, I turned to the stairs once more. Before I reached them, an old lady caught me by the arm. “Do you have someone to wash your feet?” she asked, wearing a genuine expression of concern. “Well, uh, no.” I said. “Let’s wash each other’s feet!” she urged emphatically. Her upturned face was wrinkled from years of smiling, and a few gray locks peeked out from underneath her blue head-kerchief. I couldn’t refuse.

She managed to find me a couple spare basins and seated herself on the sidewalk curb while I went to get water. Carefully, she removed her soiled, hole-filled socks. They were still wet and muddy from her walk to church. She didn’t cringe as she placed her foot in the icy basin. I stared at it in awe. The top knuckle sported a large, cracked blister. The sole was flat and calloused. One of her toes was half eaten away by a cancerous sore. I delicately took it in my hands and dipped it in the water. “Does your foot hurt?” I managed to say. “Yes, very much.” She answered cheerfully. What burdens had these feet borne? How many miles had they travelled?

Then, it was my turn. I had worn my long, black stockings because of the cool weather. Not wanting to immodestly begin undressing right in front of the church, I simply offered her my foot, stocking and all. She asked no questions. She gave me no funny looks. She quietly took my foot in her hands and began scrubbing vigorously. I was glad for the stockings. I would have been ashamed for her to see my neatly trimmed toenails and soft soles. They had borne no heavy burdens. They hadn’t travelled many miles.

We emptied our basins in the bushes and turned to thank each other. She hugged me happily and pronounced a thousand blessings upon my head. As I watched her painfully limp back inside the church, I felt – well, what I think Jesus intended us to feel after foot-washing.