The cross-cultural component of grief

My dad died Monday morning (July 20) around 3 a.m., ending a five-and-a-half-year battle with ALS, better known as Lou Gehrig’s disease.

I won’t elaborate on the details. They’re not necessary for the content of this post, and they’re too fresh to process, let alone express.

My dad was 51. According to the World Bank, the average life expectancy in the States is around 79 (78.74, to be exact, forgive me for rounding up). In Ethiopia, life expectancy is around 63 (62.97, to be exact).

To an Ethiopian, my dad died old. If we want to look at the age he was diagnosed, 46, and blot out the years he lived sick — the years he couldn’t work, the years where he spent months in and out of hospitals — and, forgive my crass, please, forgive my crass, consider that as his final year of active life, then to an Ethiopian, my dad still died old.

In a country where people are born malnourished, born with bodies fighting to stay alive, diseases that ravish anyone — diseases like typhoid, typhus and malaria, not to mention the swing of acute upper respiratory infections and tuberculosis — thrash the body harder, more mercilessly. Antibiotics flush most of these diseases out of the body, especially if you catch the signs early enough and can find your way to a health post or health center.

You can be sick for a short amount of time, then get better, or you can be sick for a short amount of time and die. You can be chronically weak and snap.

To say living in poverty is fierce and heartbreaking goes without saying.

The aforementioned diseases are preventable. Peace Corps volunteers across all sectors — it’s not just a health volunteer’s priority, although we do focus on teaching and enacting prevention methods more closely than other sectors by the nature of our project framework — spend the duration of service identifying members of the community to train as trainers to keep the flow of knowledge alive, to keep people alive.

Those diseases are preventable, and there is nothing more I want to see than Ethiopians stop dying in the numbers they do from those diseases. Loss brings too much pain, too much shock value and short-term paralysis, things no person should have to experience, let alone repeatedly. They can have better lives because they deserve better lives, and day by day, they’re discovering they have the tools within their own homes to lead those lives.

Ethiopians are not immune to death and the grief that comes attached to loss. Whereas we hide from it, they have a public mourning process. Tents go up outside of the deceased’s home, family members and community members alike notice this visible sign of loss, and they stop to pay their respect. Most towns have a community-based organization designed to help families finance funeral services and burials, and in some circumstances, help keep the family afloat for a short period of time following the death.

Death will happen, here, there and everywhere. We can run from it, or we can know it will happen and stand together as a community to assist each other when the blow comes. Ethiopians do the latter.

It’s that open embrace of a very private, very personal experience, that look of understanding and empathy rather than the loss-of-words look of sympathy that reassures me returning to Ethiopia will be okay.

Why, then, do I feel such hostility to any comments that might suggest he died old?

Culture. Cultural differences. Because while it seems he lived into old age in one part of the world, in the part of the world where I grew up, he didn’t. He died young. He died young and without the opportunity to live his life. (Though I say this, and every single one of his brothers and sisters tells me his greatest joy was his kids. I believe that, but I also believe he got cut off entirely too early.)

Peace Corps envelops itself in cross-cultural activity, it’s the foundation of the organization. It’s rare to have the chance to discuss such a personal, intense part of life while living within another culture, and that’s what I need to remember. Sugarcoating aside, this situation sucks, but it doesn’t mean there’s nothing to learn from it.

The split between the cost of hygiene and the cost of living — what 18 birr can buy you

Personal hygiene is an expensive habit. If you’re a woman, it’s a lot more expensive.

Why? Is it because women like to bathe more frequently, wash their hair, dab their skin in lotions and oils?

Nope. We have periods.

My site is considered a rural town by Peace Corps definitions – a population between 2,000 and 5,000 people. (We’ve got 3,000, if you were curious. Inichiwat ­– let’s play.) By townspeople standards, we like to consider ourselves urban in juxtaposition to neighboring kebeles (neighborhoods) that lack a bus station, police station, health office or health center. (There are perks to living in a woreda – county – capital.)

After last summer’s dirt-to-asphalt road completion, the town has continued to develop its infrastructure. We’ve got a bank coming, more stores are being built along the main road, power patterns are becoming more consistent in when they will be inconsistent.

While these shifts provide pride, they come as a double-edged sword. No longer are health issues specific to town on anyone’s radar – we’re urban. We don’t need help. People here can afford to live – not by Addis Ababa or Hawassa standards, sure, but we’re living.

If you’re employed by a local government office – the health office, the education office, the women and children’s affairs office, as examples – you’re living on 30 birr a day. ($1.50 USD.) If you’re not, cut the price in half. These are the averages, obviously some people do better than 30 birr a day and some do worse.

A half kilo of shinkurt (onions) costs seven birr, as does a half kilo of muz (bananas). A kilo of avocadoes costs nine birr. An orange is one birr.

A cup of bunna is two birr, a cup of shay (tea) costs one birr.

One injera roll is 3.50 birr. One dabo (piece of bread) costs one birr.

A two-liter bottle of water costs 12 birr. A Coke costs 15.

One menstrual pad costs 18 birr. Just one. Not a package. Just one pad.

Eighteen birr.

According to MIT’s Living Wage Calculator, an average American living in Pasco County, Florida (where I grew up) would need to make about $85 USD a day to support herself.

If menstrual pads in Pasco County were as expensive as they are here, that means one pad would cost $51 USD, or 60 percent of a Pasco County resident’s daily income.

Outrageous, yeah?

We can construct all the sex-specific latrines in the world to encourage adolescent girls to stay in school, but the battle begins with being able to afford hygienic practices.

Let’s see what we can do.

Safety in nets — Two months to get a community covered against malaria

Malaria in Ethiopia hides within a list of public-health concerns, reducing its significance to just another disease to curb.

Seventy-five percent of the country is considered at-risk for malaria. The Federal Ministry of Health reports anywhere between 5 million and 10 million cases of recorded malaria each year, and 10 deaths per 100,000 each year stem from malaria.

The country has an epidemic around every five – eight years.

Trainings and pamphlets remind us of the disease’s life cycle and how sleeping under a bed net – especially if you’re pregnant, under 5, or have a weakened immune system – reduces the risk of contracting malaria.

The problem is people aren’t doing it.

People aren’t doing it for a number of reasons – there aren’t nets available (and nets aren’t available because having an elevation of 8,000 feet dampens the belief malaria is a problem, regardless of what health office data indicate), malaria doesn’t eradicate families overnight, and it’s perceived as a poor man’s disease. The last thing you want when you’re trying to develop a town is say, “Hey, we have a problem.” Sleeping under a net calls attention to the fact a disease exists within our presence. It calls attention to something being wrong, something being beyond our control. No one wants to feel powerless.

Just as no one likes to admit a problem exists, no one likes the idea of their kids being susceptible to a problem.

If you’re pregnant, malaria can hide in the body. You’ll never know whether you have malaria because at every antenatal visit you have, you’ll take a malaria test and test negative. (It hides in the placenta.)

It increases the likelihood of mothers developing anemia during pregnancy and spikes the chance of children being born with a low weight, depressing the chance of children beating malnutrition.

That scenario does not have to happen.

Children became the foundation of getting nets distributed across town.

But it took time. It took two months.

Ask any PCV about his/her pet peeves, and most will say something along these lines, “I was telling a friend back home about this one project I’m trying to start, and s/he said, ‘Do you have anything else you’re doing?’” Guys! Friends and family of PCVs everywhere – that line makes us crazy! Our job isn’t a checkmark on a list of items to complete in two years. We can spend weeks planning a meeting only to have it crumble compliments of the morning’s storm. (Do you want to walk 12 kilometers in the rain? Neither do we.)

Telling health office officials nets needed to be distributed wasn’t enough. Highlighting that net distribution would help counter malaria deaths wasn’t enough. As an official asked, “Can you prove it is a problem?”

No. I don’t have to prove it’s a problem. The five-by-five chart on the wall behind you chronicling the top-10 causes of death listing malaria as number 2 did it for me.

Digging through boxes in the office’s storage room won’t do much to generate conversation, either, unless someone walks by and wants to know what the ferenji is doing this time. If you’re lucky, you get a chance to repeat a spiel that fell on deaf ears less than 24 hours ago, and this time, you get the attention of someone who wants to help.

Cue a month of running between health centers and health posts to figure out who has nets, who has distributed them, and who have done neither. Budget time to meet to meet again to schedule a meeting to figure out if people who have nets are using them. Allot time to plan a meeting that outlines net demonstrations and community concerns about using nets. Have the meeting canceled by a daylong storm. Reschedule the meeting, pray for no weather interference.

Then you show up at a women’s development meeting on a Saturday morning. Under the safety of the bus station’s tin-roof waiting area shelter, 40 women meet rain or shine every Wednesday and Saturday at 9 on the dot. They discuss what’s going on within the community and how they can assist.

Before distributing nets to women, health extension workers explained how to hang and clean nets for proper use.

Before distributing nets to women, health extension workers explained how to hang and clean nets for proper use.

Sometimes, health extension workers show up at these meetings, too. They come with a rice bag filled with 50 bed nets to distribute. They demonstrate how to hang the net, why to use it. They take questions. They validate these women and transform them into household leaders. They send them off with the knowledge and means to protect themselves and their families.

We can’t stop mosquitoes from carrying malaria, but we can empower others to keep themselves from getting it.

Peace Corps past, present and future

If the most refreshing part of Chuck’s visit was the discovery that volunteers share the same joys and doubts, the most entertaining part of Genevieve’s visit was watching that journey toward joy and doubt begin.

A rising senior at Lewis and Clark, where she studies sociology, Genevieve’s considering her post-grad options, and Peace Corps is on her list. She spent a few days at site shadowing volunteer life.

Post-visit evaluation: Girl’s a pro.

She arrived on Monday, site’s market day. This town of 3,000 swells to 20,000 as people gather from all over the woreda to sell food and livestock (to the tune of fruits and vegetables, goats and chickens), housing items (like jebennas to make bunna and charcoal stoves), and clothing accessories and to purchase these items, too.

It’s a social affair, women chatting with each other as they carry bags of fruit on their backs en route to the market day road situated in the center of town, or talking with others on the bus if they’re traveling to market. (If you’re walking more than 15 kilometers, you try to catch a bajaj or minibus, both of which operate in full force all day Monday.)

It’s a big day for men, too. Oftentimes, they’re the ones who sell livestock, tied to posts situated outside of bars.

Oh God, this girl came to site on a day where there are drunk men galore.

Indeed. Nor! (Welcome!)

After Genevieve got settled into my room, we stepped outside in the direction of the river, a five-kilometer walk because you have to pass through the town before getting to the outskirts and hitting the bridge that covers the waterway.

Thirteen months into site, there are things I’ve forgotten or become immune to, things that she picked up and things that creeped under her skin.

I don’t know if people have stopped staring at me or if I’ve just written it off, ignoring it because this is my home, too, and absolutely no one gets to strip me of that safety and security. (The shouts that accompany the stares have waned, though. Unless I’m walking along the Wolkite stretch of the road en route to the health posts, no one busts out, “Ferenji!” or “Caramela!” or “(noun here) sichagn!”)

So I’ve either forgotten or adapted, but she noticed it. She noticed curious stares masking the questions, “Why is she here? Who is she? What is she like?”

She felt the unease that accompanies a command for money.

If I’m out and around town’s surrounding kebeles during market day, it’s not uncommon for a child or woman to approach me, hands outstretched and bouncing, mouthing the word, “Money” or its Amharic equivalent, “birr.”

I toss it off with a baka (enough – some volunteers say Excabhier yistilin – God will provide – but that phrase feels trite and I only use it if I’m in a city), careful to avoid eye contact. With Genevieve closer to the woman who was asking, it took a few seconds for me to remember how it feels the first time an elder asks, and then I sandwiched myself between them, telling the woman multiple times, “Please, enough,” before she stopped.

That’s a discomfort the two of us share – I still don’t know how to react when older women ask for money. Writing it off isn’t the same as being unaffected. The first time the call for birr happens, it’s a smack to the system, a reaffirmation that you’re different and can never be the same.

By the second day, Genevieve found her feet. Kids darted toward us, coming to a full stop when they reached us, staring at

Genevieve leading students in an after-school program.

Genevieve leading students in an after-school program.

me, at her, then back at me before coming in for their morning hug. Then they turned to her, and as Genevieve crouched to their height, slid out a “Selam nesh,” and that’s when word spread. “There’s another one!” kids whispered. They approached her with the same curiosity from the day before, this time with arms outstretched.

The part that sold me on her ability to dominate life as a volunteer, if she chooses to take that path, was when she took two cups of Gurage-style coffee sitting in a stranger’s home. One cup is polite, two cups says, “Yeah, I liked it, I appreciate your kindness and sure! I’ll do it again.” (Gurage coffee is coffee spiked with a teaspoon of butter and a sprinkle of salt. Tatchi. [Drink.])

That’s the attitude that breeds satisfaction, that keeps you going on the days when you’re wondering what you’ve done and what will last after you’ve gone. It’s the beginning of the journey.

Life, Death and Faith — What You Find When You Get on a Bus

Few things are more American than the feeling of freedom that stems from sliding our fingers along a steering wheel and pressing a foot to the gas pedal.

We navigate our journeys, mold our expectations as we let ourselves slip into a piece of the world. We can talk to others, we can talk to ourselves, we can talk to God on those miles-long interstate stretches.

The month after graduating from the University of Florida, I did all three when I packed up and drove myself out to California.

I never had a car before and bought the best thing $2,000 could buy (hint: $2,000 will buy you point A to point B, baka.)

Opting for state roads instead of highways whenever possible, that 1999 gold Dodge Intrepid took me through Gulf Breeze (Mississippi), Louisiana’s bayous, all of Texas (geographically, a diverse and beautiful state – as long as you stay ahead of the lightning storms), through New Mexico and Arizona and straight to the Golden Coast.

The 2,000-mile stretch was plenty of time to figure myself out – as I wanted to discover myself. If I didn’t want to stop at a particular exit, I kept going until the tank demanded a refill. If I craved a particular item (sweet tea!), it was at my fingertips. Yeah, these are learning moments, but only in the way that I wanted myself to develop. I met people I otherwise wouldn’t have met, but on my own accord. Our culture is great at that – understanding what we want to understand only when we want to understand. (To be fair, this attitude supersedes borders, regardless of whether we want to admit it.)

After completing that drive, I lost interest in driving. Freeing? Sure. Enjoyable? Yeah. But limiting, and not to mention expensive.

Perhaps Los Angeles isn’t the best city to make such a decision, but it is navigable with public transit. It requires some additional planning and time adjustments, but it can work.

It works, and it’s an opportunity to cross paths, to catch glimpses into others’ lives, to share stories and to discover life beyond ourselves.

Bus by Bus in Ethiopia

Cars cost 300,000 birr (15,000 USD) to purchase and own in Ethiopia. In my site, most families live on 20-30 birr a day (900 birr a month – and rent for a one-room home eats 22 percent of that monthly income). Translated: Most Ethiopians don’t drive cars.

We let public transit carry us to our destinations.

Welcome to a transit town's station. Buses not only file in and out of the station, but also line the streets to fill to capacity before heading to the destination town.

Welcome to a transit town’s station. Buses not only file in and out of the station, but also line the streets to fill to capacity before heading to the destination town.

A quick breakdown on bus travel in Ethiopia:

  • Minibus: Think of a Scooby-Doo style van, minus the quirky collection of detectives, plus 27 people crammed inside, sitting on laps and makeshift benches to reach destinations.
  • Level 1 public bus: An enlarged school bus, packs about 60-75 people.
  • Level 2 public bus: Smaller than a level 1, packs 45-60 people.
  • Selam bus and Sky Bus: Charter buses, with televisions and air conditioning (!) that travel along Ethiopia’s paved roads. This is the most expensive form of road travel.

Turn down the music! Close the window! Are you fine? Where are you go? WARAJ.

In the States, we sit quietly on buses. We stare at our phones, our feet, the street ahead, wait for our stop and yank a yellow cord. Maybe we thank our driver as we hop out – most of the time, we probably don’t.

Some buses don signs mandating silence. Don’t answer your phone, keep conversation to a minimum if you must take that call.

Jesus Christ. How sterile. How boring.

From the start, buses in Ethiopia require conversation.

“Wolkite nesh?” – Are you going to Wolkite?
“Ow.” – Yes.
“Gibi! Gibi!” – Enter! Enter!

If you’re one of the first on the bus and have the option, snag a window seat. Nothing is more valuable than window control. (If you’re not sitting by one to keep it open, you can guarantee it will remain sealed shut unless you really pester the crap out of the person nearest to it, or just reach over and open it yourself.)

Music blares from front-seat speakers. As the driver rolls to a stop to pick up people along the road waving the bus down (not every town has a station, and people will wait along the way for an unfilled bus to pick up extra passengers), people climb on amid a chorus of, Selam nesh? Indet nesh? Selam naw! (Is there peace? How are you? There is peace!)

As people fill in next to you, they’ll greet you according to the time of day, ask where you’re going, if you’re fine. If you’re the ferenji on the bus, the questions expand to, Kwankwa tikoyallash? Gobez, gobez. Etiopia indet naw? Yet nesh? (You know the language? Clever, clever. How is Ethiopia? Where are you going?)

You don’t have to answer every question or engage in conversation the entire ride, but a little bit goes a long way. Ethiopians want to make their friends feel comfortable, and guess what? Everyone here is a friend, a part of an extremely large family. Bait the conversation long enough to satiate curiosity, you’ll be taken care of for an entire ride.

For all the talk, all the love, some people are trying to buy time

Bus prevalence makes it the token mode of transportation for getting to a graduation, a wedding, a baptism. It also becomes the mode of transportation for trying to hold off death as long as possible.

Amid so much conversation, so much affection between strangers, so much joy, sitting near someone taking his final breaths is the ultimate dichotomy.

It happened twice in June.

One Wednesday morning, riding into my hub town to submit a camp budget, a husband and wife sat in the row ahead of me, window wide open and a damp cloth resting across the man’s forehead. His wife kept stroking his head, dabbing away sweat dripping down his face. They were trying to get to Addis as quickly as possible. The driver understood their urgency, not pausing to pick up anyone en route to Wolkite, the zone’s major transit point to catch a bus to the capital.

The couple made it to Addis, only for the husband to die a few days later. No one in town knows what happened, what illness he had. He was fine one day, feverish and faint the next.

A week later, on a bus to the capital for our mid-service medical exam, a friend in a neighboring town and I climbed onto a bus as a woman in our row was having a seizure. I’ve never seen a person seize before, and it’s horrifying. It’s horrifying to see the body lose control. Not knowing how we could help or improve the situation, my friend and I took our seats, not staring at the woman, not wanting to bring attention to her distraught mother and husband.

A little more than halfway to our destination, the woman had a second seizure. Her body went limp, and the mother, tears streaming down her cheeks, quietly removed her daughter’s bracelets as the husband removed her rings. A few times, the mother tried flexing her daughter’s arm, trying to circulate blood flow, trying to hold onto a slim hope that her daughter could still be saved.

A boy a few rows ahead of us and sitting in a makeshift aisle seat turned toward our row when the husband began asking for a phone to borrow so he could call someone, anyone. This kid couldn’t have been more than 7 and he looked back with wide eyes. In a country where death fragments families and everyone knows someone who’s lost a parent at a young age, the look in this boy’s eyes made it clear that when you see it, it’s always hard to swallow.

It’s harder, still, to know what you can do to help.

Discovering Faith’s Influence

Religion dominates Ethiopia. During greetings, it’s common to end with an Exchabier miskel (thanks to God).

Children are born into religion and follow their parents’ faith, whether it’s Islam, Orthodox or Protestant. It’s similar in the States, too, yeah, but also common in the States is the personal decision to say, “I don’t agree with this, I can’t practice what I don’t know I believe.

If those doubts happen here, they’re kept silent and guarded. Among non-religious volunteers, we reach a conclusion that amid so much death and disease, it makes sense to lean on God, to have faith that a higher power can ease the intensity of day-to-day living. Is this the wrong approach? Debatable. Is a Western approach? Yes. Is it arrogant, even? Possibly.

Is it how some of us come to terms with how people live amid such extreme poverty? Yes.

The longer I’m here, the more I revisit religion and faith, the more I look at how the two connect, how they mold societies, how societies mold them. I don’t have any answers, and I don’t expect to have any by the end of service. For what it’s worth, I take it in and try to understand it to the best of my ability.

While drivers barrel toward destinations, Orthodox passengers familiar with the routes know where the churches are, and for the split second that the bus zooms by a church’s general area, passengers pause for a quick prayer.

As the months here continue piling up, the more I see religion accepted as religion. I’ve said before that my landlord is Muslim, yet most of the people who rent on his compound are Orthodox. Religion can be a barrier, but in this town, it’s not. Faith gets respect.

On a bus from Addis down to site last October, two men – one Muslim, one Orthodox – switched seats with each other so the Muslim man could have space to pray.

That’s what you get from public transit, here, there, anywhere. You find faith in humanity.

A town in transition

The dirt road that connects the woreda administration offices to each other, and the piles of stone waiting to solidify the ground as rainy season kicks into full gear.

The dirt road that connects the woreda administration offices to each other, and the piles of stone waiting to solidify the ground as rainy season kicks into full gear.

This time last year, an asphalt road linking east Gurage to west Gurage was under construction. The road, completed in mid-June, runs straight through site.

Within the last five years, site became one of the towns in Gurage Zone to find itself tapping into the power grid. (We’re not talking about a grid system that exists to the extent of New York City, but the formation of one.)

An asphalt road, the literal link for families and friends to (re)connect, became the link for a few other developments moving this town forward. For example…

  • The health center has two ambulances. Two! Laugh at the excitement if you want, but this is huge, especially when the country’s undertaking a campaign to encourage mothers to give birth in health centers and hospitals. Having access to an ambulance to transport a mother during labor means fewer deaths during delivery.
  • Two of the dirt roads jutting off from the main road have two-foot piles of stones spaced every five feet lining them. Cobblestone and asphalt won’t pave these roads (both of which house the woreda’s administration offices), but rain won’t turn this clay roads laced with goat feces into a slip and slide during future rainy seasons one day.
  • The demolition of a centuries-old tree and construction site to expand the health center into a hospital. I whined last October when I saw a group of 10 men hacking away at the tree’s trunk, stupidly assuming the tree would be there for all of service, if not for the town’s entire lifespan. When I asked why we were killing the three, people exclaimed we were going to make the health center a hospital. Sweet. In theory, we’re about to save some lives.
  • WE’RE GETTING A BANK! How rural am I? Most G10s have a bank at site, or within 10 kilometers of site. Those in
    The future Commercial Bank of Ethiopia. It's been under construction for about a year.

    The future Commercial Bank of Ethiopia. It’s been under construction for about a year.

    larger towns have a bank and post office. This place has neither. But not for much longer! We’re moving on up in the world, the G13 moving here in September will never know what life once was.

Words can only say so much. Here are a few photos of site from a year ago to today, highlighting some of the structural changes coming our way. (Will a longer post reflecting on development come later? Undoubtedly. Rainy season provides copious amounts of time for thought.)

A year ago, there was no gate outside of the health office, anyone could stroll in at any point in time. (Convenient when you're an American accustomed to working during lunch.) As of two weeks ago, a gate now halts spending out-of-office hours at the office.

A year ago, there was no gate outside of the health office, anyone could stroll in at any point in time. (Convenient when you’re an American accustomed to working during lunch.) As of two weeks ago, a gate now halts spending out-of-office hours at the office.

Entering the side of town residents refer to as "old town," where town's settlement began about 70 years ago.

Entering the side of town residents refer to as “old town,” where town’s settlement began about 70 years ago.

To the left rests the remains of a centuries-old tree hacked down last October to make space for the health center's expansion into a hospital.

To the left rests the remains of a centuries-old tree hacked down last October to make space for the health center’s expansion into a hospital.