Sharing site in September

G13, the newest group of education volunteers to arrive in Ethiopia, completes pre-service training in mid-September and then proceed onto site to direct teach English to grade 9 and grade 11 students for 24 months.

In line with our post’s design to move to smaller sites, the majority of G13 PCVs found themselves discovering last week at site announcement they would be moving to towns no larger than 5,000 people.

One of those sites was mine.

Welcome to SNNPR, Alice!

Enter Alice.

Born and raised in Kenya, she spent part of her life in Santa Cruz, Calif., before moving back to Kenya to work for an international NGO and joining Peace Corps.

We only spent a few days together (site visit is a four day deal), yet that was enough time to demonstrate age carries no weight in forming friendships.

Oh yeah, and the kids adore her. Winning their hearts is the key to becoming part of the Gurage Zone family. We’re stoked to welcome her just in time for Meskel!

Trying to make your heart meet your mind

It’s easier to write about Dad than it is to talk about Dad.

Part of me doesn’t want to vocalize that he died. Every time I do, my heart clenches a little, my temperature rises, my eyes fill with hot tears. If someone beats me to it and says, “I didn’t know your dad died, I’m so sorry,” as my counterpart did, I can write it off, but the second I’m alone at home, tears spill. (Challenge: Try getting a condolences call right after you’ve applied toothpaste to your toothbrush, then force yourself to choke back tears because you have to brush your teeth. Grief doesn’t care about hygiene.)

It’s hard to hear a reality your heart can’t yet accept as a reality.

Dad began using a speech device in late 2011/early 2012, after ALS stripped him of his voice. He lost use of his arms, hands and fingers in 2011, too, halting any communication we had with each other via text.

(ALS is a neurological disease that stops neurons from delivering messages to the muscles, causing the muscles to atrophy, lending to the disease’s name. His vocal cords stopped working, and he waited until the last possible moment to begin using a speech device, and even then, would still mutter phrases like, “Oh, my God,” because he hated that thing so much. And yeah, he was also stubborn.)

In shorter words, I haven’t been able to communicate with my dad in a traditional sense for a number of years. That complicates and simplifies his death.

For years, unless I was home visiting during school breaks and holidays, someone on the other line – mostly Mom – was holding the phone to his speech device, conversation lagging minutes behind, as his eyes moved across the screen to compose sentences for a mechanized voice to deliver. When I was home, it would be reading his device and piecing together what he was trying to say before he had completed the thought. (I’m not sure if that irritated him – part of me did it to save his energy, but a larger part of me did it because I was his daughter and I got a huge ego stroke from knowing what he wanted. That’s how close we were.)

Half a world away, communication with Dad became more one-sided – e-mails to my aunt, then letters directly to him. It took months after Mom’s death to write letters to Dad because I knew those letters would have no response, no reply, and the last thing I wanted after already losing one parent was feeling like I was writing empty letters. When you know you can’t get a response, that’s how it feels. In some ways, it’s blistering because you know the person on the other end wants to be able to respond.

Our communication had become limited, but it wasn’t done. Maybe the piecemeal approach of losing our ability to communicate prepared me for his death, but did it ease it? Not at all. I still had someone’s laugh to hear, someone to write letters to, someone’s smile to see. I still had someone I could hug.

But that’s gone now, too.

It’s gone and I’ve known for the last five years that it eventually would be. My mind has no problem registering he died because it was going to happen and there was no way of reversing any of his disease. I knew that. I still know it.

Don’t ask my heart to believe it.

Perception and generalization isn’t the small-town reality in Ethiopia

I was angry before returning to Ethiopia.

The same three scenarios raced through my head on repeat.

Agarish indet naw? (How is your country?
Tefash! Lamin? (You’re lost from me! Why?)
America hedkish? (Any item here) sichign! (You went to America? Give me something!)

Those are the horror stories volunteers pass down through the line. I believed the tales, then heard none of them. Not a single one.

I returned to site after 20 days of being away – way too long, I never want to be gone so long again – and people had noticed, but not a single person asked if I had returned with anything to give.

These are the people who beg me to “go play” with other PCVs when I’m at site for too long, fearful their American isn’t getting enough America time. When word spread I had gone back to the States, their eyes glimmered as they asked, “Betasabish indet naw?” and “America konjo naw?” (How is your family? Is America beautiful?) We just finished celebrating Ramadan, and the new year and Meskel are on the rise. Translated: it’s prime family time out here.

I braced myself for the worst, not expecting to get something much calmer and easier on the heart to manage.

As word circulated about Dad, people stopped exclaiming Tefash! and replaced it with Excabier yanorish (God will give you strength and patience). Friends began inviting me to breakfast, to lunch, to dinner, all while reiterating that death is an inescapable part of life, yet despite its inevitability, it’s okay  to be sad. It’s okay to miss what I lost, and it’s also okay to let myself be happy, too, because being happy doesn’t diminish my parents’ memory.

A healthy dose of pragmatism with support. That’s what the sympathy cards lack.

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.