It was raining and I was muddy and exhausted. A few feet away my home beckoned to me but my mind was wandering. I walked past the Grays house, thinking about Paul Gray in the hospital in Addis Abba and wondering what strange illness he had that would spike fevers to 103 for over seven days. Was it malaria, typhoid or relapsing fever or some other unnamed dreaded disease? Walking on I looked across to Dr’s. Ruth and Mogus’ house. Just last week she noticed that her beloved nanny was losing weight. Hepatitis B was the culprit. Only today, my gardener, Tilahun, had left work early with headache, nausea and fever. Previously he had been diagnosed with malaria and typhoid. Was it back again? And then earlier in the week Mark had come home from the hospital wiped out after doing an extremely difficult case on one of our nurses. When he opened her up, it appeared that this young nurse was full of ovarian cancer. It was seeded all throughout her abdomen with large tumors in the ovaries and fallopian tubes. But on further inspection he discovered that this pseudo cancer was in fact a terrible case of peritoneal tuberculosis. As I neared my house I noticed a wild dog lurking behind Dr. Ruth’s house. Rabies is a huge problem here and currently our hospital fence has large holes big enough to allow this tall dog to wander among our houses unchecked. So during this brief walk home in the pouring rain I did a quick reality check. We are not invincible. Daily we see illnesses that in the states would be confined to a quarantine ward in the hospital. We interact with our patients, friends and strangers daily: hugging, praying, eating, laughing, riding in taxis, worshipping together and inviting them into our homes. The nurse with TB had been in my home the previous Saturday for a Bible study. I’m not complaining, I love this country and the people and know that I am called to be here in this place at this time. It was just a brief reality check…that we are vulnerable to some particularly deadly diseases and we must be careful.
The birthday party for Lydia Gray was over and still there was no sign of Mark. Lydia’s dad had also missed her 2nd birthday party and came in just at the tail end to watch as she opened presents from her grandparents. “Have you seen Mark?” I asked Paul. “Yes,” he responded. “He’s still in the OR. He has a bad baby.” With those words my heart sunk. It is what Mark dreads the most. Trained as an obstetrician in the states, he was always able to refer those cases to the pediatrician. Now the responsibility fell on his shoulders and it was heavy. I made a thermos of hot tea and grabbed some cookies and bread and headed for the OR. It was already 5:30 and he had been there since 1.
The usually bustling OR was eerily quiet except for the persistent beep of the ventilator machine. I found him sitting on a stool next to the sick baby. He and his new resident from Rwanda were the only ones in the room. The bed where the mother had had her emergency C-section was washed clean; the only sign remaining of the traumatic delivery was her sick baby lying on a table wrapped in green surgical drapes with an oxygen tube running down her mouth. The baby was blue and lifeless. The steady beep of the ventilator told me that she wasn’t getting enough oxygen. Our OR ventilator machines are different than the ones in the states. They are equipped with their own oxygen supply. Mark patiently pumped the green leather bag giving the life sustaining oxygen to the baby. “She has a steady heartbeat, “ he said, “but she just can’t breathe on her own.” “I can’t just let her die, she has a heartbeat.” “I have to try.” He took a sip of hot tea and offered some to Dr. Ron. Ron declined but took the bread. He hadn’t eaten all day. The baby’s stats continued to drop as I stood over her and watched her chest rise and fall with the oxygen. Later the on call night nurse anesthetist came in and reinserted her oxygen tube. The baby’s stats began to rise dramatically. 50, 60, 70, 75, 80, 82, 85, 90. She was getting 90 percent oxygen now and she began to pink up. It was quite remarkable to see the dramatic change. But she never moved a muscle, not even a slight finger flicker. I laid my hands on her chest and prayed for her. Mark left me to watch the machine and he went to find some nurses to cover the shifts. He couldn’t move the baby to the ICU because the ventilator machine in the OR was the best one in the hospital.
One of our nurses watching the baby.
The nurses made a plan and we headed to the ICU to check on the mother. The grandmother was hovering closely to her very sick daughter who had lost a lot of blood. Her case was all too familiar. It was her first baby. She had been in labor in the countryside and pushing for two days. Mark asked the grandmother if she would like to see her new grandchild. She smiled, bowed her head in acquiescence and followed him to the OR. She was a tiny woman, dressed in a long flowing skirt with her head and shoulders draped in the traditional white Ethiopian shawl. Even though she spoke no Amharic her body language needed no translator. When she saw her little granddaughter, she lifted her hands in praise and worshiped. As tears swelled in our eyes…did she really know how sick her granddaughter was…we hugged each other and cried, two grandmothers worlds apart culturally, but united in the love of a grandchild as only grandmothers can be. I wish this story had a dramatic happy ending, but it doesn’t. The baby died Monday morning.
Mark doing an ultrasound on a patient in the outpatient clinic. He does his ultrasounds in a small clinic just inside the maternity ward. This patient came in with her brother,who translated, and her husband. She has five children and Mark discovered a possible tumor in her uterus. Her husband was consulted and he and his wife opted for a hysterectomy because they did not want anymore children.
The final result of the surgery. One large uterine fibroid on the right and one large ovarian dermoid cyst on the left.
A few weeks ago I followed Mark around to take some pictures and see what his life is really like at the hospital. He was super busy on this day, running between the outpatient clinic and juggling the surgery schedule. The following are a few pictures of my morning spent with Mark. Even as he was doing this ultrasound his cell phone was ringing telling him to come to surgery. His patience under stress always impresses me…he has been this way ever since I have known him. He just calmly asked the surgical crew to wait for him and he would be there in a few minutes and then proceeded to do the ultrasound and interview the patient and listen to her husband and her brother as he translated the discussion from Wolaittina into Amharina and then into English. As he left the examining room, the hallway was lined with patients waiting to consult with him. He walked to surgery, where the patient was already anesthetized with a spinal anesthetic and within five minutes began operating. Amazingly, I watched from the sidelines and didn’t get queezy at all. The same cannot be said for my daughter Sara, who became quite light headed and elected to leave the surgery after about 10 minutes.
- Mark and chief resident, Dr. Teddy, are removing a large fibroid from the patient’s uterus and also removing an ovary with large dermoid cyst.
Looking at the surgery from another angle.
Events have a way of bringing out energy that we never knew we were capable of. When we learned that the COSECSA organization was coming to Soddo Christian Hospital to do an inspection with the anticipation of credentialing our hospital for our resident’s surgical certification, we pulled out all stops. In pulling out the stops I must give most of the credit to our cleaners, repairmen and gardeners. They worked exceptionally hard. COSECSA is the acronym for College of Surgeons of East, Central and Southern Africa. By credentialing our residents, it would allow them to practice medicine in any African country where COSECSA was the credentialing body. This was huge.
There is nothing like a goal to get one motivated. One month before the physicians were due to arrive; the hospital began to spruce up. Bafa, our painter, painted all the trim of the hospital a rich dark brown. Philemon, our head repairman, took out the old IV tubing that was used for fencing and replaced it with new silver chains. As Mark did a C-section one night, he could hear the repairman hanging a new door in surgery. Later he returned to OB and the painters were painting the hallway at 10:00 at night! We have a new outpatient registration building that was recently completed, but it still needed a little tweaking. It got tweaked. The lights on the front gate of the hospital had never been put in place…they magically appeared just before COSECSA arrived. My part was the grounds. We have been tirelessly working on condensing the hospital gardens into manageable sections, instead of the large overgrown areas that we once had. We have bought and planted thousands of red and green tiny landscaping plants and painstakingly laid them out in various designs along the long hospital walkways.
Mogus planting rows of red and green plants
But the one thing we have not been able to tackle is the grass. We have acres of grass at the hospital that just doesn’t get cut. Without a lawnmower, our grass is cut blade by blade with a sickle. I can design and plant gardens, but if the grass is long and shaggy, the hospital will always look unkempt. Three days before COSECSA was due to arrive, we brought in all the missionary home gardeners, all of our extra repairmen and the three hospital gardeners to cut the grass. In the pouring rain we weeded the gardens on the main drive into the hospital, planted more flowers and cut all of the grass on the main thoroughfare into the hospital.
The after effects of working in the mud and rain.
Dego, our head gardener with the new lawn mower
A power mower would have cut this grass in two hours. It took our hand laborers three days, but it looked lovely.The representatives from COSECSA were impressed with our hospital and gave us a favorable review. We hope that we will receive a five year certification. So much credit goes to our awesome hospital staff. On Thursday of last week we threw them a popcorn and pop party to say thank you.
Some of the gardeners enjoying their drinks
Becka Gray and I popped mounds and mounds of popcorn and set up a table on the hospital grounds where we served all of the workers. It was a fun time saying thank you and… showing off our new push lawnmower!
Sara, my daughter and Rosie (short term administration helper) at the popcorn table.
In Michigan and other Midwestern states, a high school graduation tradition is slowing winding down. By July, most of the graduation ceremonies and fabulous open houses laden with meatballs, potato salad and barbeque are over but in Ethiopia they are still in full swing. School was officially over several weeks ago but graduation ceremonies continue. It’s not uncommon to see little children dressed out in black graduation robes and caps holding bouquets of roses as they proudly exit the school with their parents. Yesterday as Mark and I took a walk in the neighborhood groups of children held their precious diploma in their hands indicating they had passed to the next grade. Smiles and congratulations were heard throughout the neighborhood. Last weekend we were invited to the graduation open house of Kidist, our language teacher Paulo’s wife. Kidist graduated from Arba Minch University with a degree in elementary teaching with an emphasis in Amharic. In some ways the open house was very similar to a Michigan open house. Gifts of money are valued and appreciated and food is a key part of the celebration. With rainy season in full swing, Paulos rented a large military tent and set up benches inside for comfort.
Open House Tent
Loud upbeat Ethiopian music greeted us from a CD player with extra-large amplifiers. We took lots of pictures of Kidist in her graduation gown but that is where the similarity ended.
Kidist with her diploma
As foreigners we were treated to very special Ethiopian celebration food inside their mud brick home. Doro Wet is a chicken dish made with the basic Ethiopian ingredients of onions, tomatoes, garlic, oil, butter and beri beri spice. What makes Doro Wet different than other Ethiopian dishes is the extra spices that are added like cardamom, cinnamon, and nutmeg. You scoop up the delicious sauce with handfuls of fresh baked injera. After enjoying the meal sitting around the coffee table in the living room, we went out to the tent where an enthusiastic singer was entertaining the crowd with his guitar and songs. Later a very energetic preacher gave a lengthy sermon about heaven. As we picked our way back home over dirt ‘roads’ pitted with potholes and tortuous ditches gauged out by the heavy rains, we could hear the ominous thunder rumbling in the distant hills and were glad that Paulos had erected the tent for their celebration.
Abebe entered my life on my first day of ESL class. There were 10 students but Abebe caught my eye. His English was above average and his interaction with the class excellent. But there was something else about him…he seemed sad. After class I walked him outside and asked if there was anything wrong. He quietly told me that there was but he would tell me at another time. The next time we met for class he was there again. He walked with me up the long compound drive and told me part of his story. He was an orphan, his parents dying when he was quite young. He had been living with his father’s brother and his wife, but the aunt did not like him and was always criticizing him and beating him for any infraction. He couldn’t take it anymore and fled the home to live with some school friends. He needed some work to help with his expenses. Since we were in a new house and it needed a lot of outside attention, I hired Abebe to come and help me out. Little did I know that in the process of working with me, he would steal my heart.
Abebe planting ground cover
Part of Abebe’s story is way too familiar to me. My father was also an orphan. Both of his parents died during the 1917 influenza epidemic that killed an estimated 30 million people around the world. He and his sister were split up between aunts and uncles. He was taken by an uncle, a farmer in Missouri , who needed extra male help on the farm. My father was cruelly beaten by the uncle who expected him to be more of a slave worker than beloved orphaned nephew. He was able to finish grade 7 in school before he eventually ran away from his uncle and the farm. He only really talked in detail about it once to me, but his story seared my heart. Now here came Abebe… bright, kind, orphaned and in need of a family to love him.
My heart and Marks are huge for teenagers who need a safe place and someone to love on them. While I was in the states, he spent a lot of time with Mark, planting a garden and even playing a game of Scrabble with him. Abebe loves Jesus and often teaches small children in Saturday “Sunday” school. He prays deep prayers. He is a thinker and is sometimes way ahead of me and the other workers when it comes to ideas about designing gardens and pathways. He recently finished his 9th grade studies. I asked him if he was the first in his class, knowing how bright he is. He very humbly said, “No unfortunately, I am not the first.” “I am the third.” Well, third is pretty good in a class of 2000 students! In the fall we hope to get him into a private high school where he can finish grade 10 before moving on to the high school classes at the government school. We are seriously working on sustainable ways to make a difference in this very sweet boy’s life.
Texas was way too hot for this Michigan girl, but hanging out with my two kids, Betsy and David and my precious grandson was worth the heat. Jack David is now two months old and responding to people and hugs.
Jack and me
The plan was for me to take over in the home after Betsy’s mother Jill came back to Michigan. Betsy had two more weeks of school to finish and then home for the summer to be a full time mom. Each day Jack and I got up when Betsy and David left for the day. We went for early morning walks before the Texas heat simmered up to 100 degrees. Betsy left enough breast milk in the freezer and I kept busy making bottles, singing to Jack and preparing dinner. On the last day of school Betsy left class and keeled over with pain in her abdomen. By that night she was vomiting and the next afternoon we took her to an outpatient clinic and then on to the ER where they diagnosed gallstones in her duct and gallbladder. She was in so much pain. She was finally admitted to the hospital on Saturday morning and had two surgeries, one on Sunday morning to remove the stones from her duct and then on Monday to remove the sick gallbladder. She came home from the hospital on Tuesday morning before I had to fly out at 5:00 that afternoon. I definitely had more Jack David time than I anticipated, but was so very thankful that I could be with them during this unscheduled health crisis.
David, Jack David and me
Before the hospitalization they took me to Rosa’s to meet their small group…David pastors a Spanish speaking church at Antioch. Their friends in the church are so warm and friendly and just made me feel so welcome. Saturday morning we went out to an Anabaptist community where we ate breakfast in their lovely restaurant and then toured all of the buildings where they make textiles, grind flour and create beautiful furniture.
David, Betsy and Jack David
David and I took two trips to HEB, their upscale supermarket where I thoroughly enjoyed checking out all the new foods and ice cream labels. Yum. I think David would have bought me every ice cream that my heart fancied. We settled for some yummy Blue Bell peanut butter crunch and my favorite, Ben and Jerry’s Pistachio Pistachio.
The rest of my trip has been lovely catching up with my friends and family here in Michigan. By next weekend, I should be back with my loving husband!
With Mother’s Day fast approaching and no children around to celebrate with, we decided, along with Jackie and Duane Anderson, to make a getaway from Soddo and combine several errands into a mini retreat. The planned departure was Thursday morning. We were packed and ready to leave when Duane came to the door at 7:00 A.M. to inform us that we could not leave until Friday. The Ministry of Education, at the last minute, had decided to come to Soddo to inspect the hospital in regards to the PAACS residency program. Our administrator, Desalyn, wanted Duane here. That worked out OK for us for I had lots to do here.
The rains have begun and it is planting season. I have taken on the rather daunting task of working in the hospital flower beds and helping to direct our talented gardener, Degu and his new assistant Mogus. I say the task is daunting, because the gardeners have created so many flower beds, along each walkway and each building that they cannot possibly keep up with the maintenance. The beds have continued to get larger and larger with fewer flowers and more weeds. My goal is to tighten the beds so that we can maintain them and sustain them in the long dusty dry season. With that in mind, I wanted Degu, our gardener to accompany me to Addis to pick out plants for the hospital.
Our first destination was Addis Abba where Jackie and Duane wanted to purchase new furniture for their house. Jackie and I have this lovely unusual relationship. We both like the same things…books, colors, ideas, baskets, flowers, food, tea, exercise. I’ve never met anyone so much like me. They really liked our comfortable furniture and wanted something like it. We arrived in Addis about 5:00 on Friday afternoon and went straight to the furniture store. They shopped the store and ended up purchasing the identical furniture for several hundred dollars less…it was on sale! We shopped for staples at a nice grocery store and later ate out at a delicious Chinese restaurant run by a great Ethiopian chef. The next morning, Duane had lots of meetings and Jackie, Mark and I took off to get our errands done. Our hospital driver, Goucho and Degu, hired an Isuzu truck to carry the furniture and meet us at our final destination, Debra Zeit to purchase flowers for the hospital
We chose Debra Zeit for two reasons, the most important being they sold many flowers along the roadside and we would be able to purchase plants for the hospital flower beds. The second reason was that there were beautiful crater lakes with several nice hotels.
I love to garden; in fact, you could say it is one of my passions. Walking along the two mile stretch of flowers, shrubs and trees was a taste of heaven. The plants were healthy and cheap! For instance, I purchased 40 good sized hedge plants for .50 each. Geraniums were the same and palm trees were only $3.00. Degu and I shopped and shopped and he carefully chose healthy plants for the hospital. We sent him back to Soddo with the Isuzu truck and we went to our hotel.
It wasn’t quite the hotel we were expecting but the owner, a kind and chatty former nurse from Belgium welcomed us. We settled into two mud huts with grass roofs overlooking the lovely Lake Babagayo, a volcanic crater lake.
Lake Babagayo
The furnishings were rather primitive, but we did have electricity and hot water. We had a pleasant dinner sitting outside, enjoying the peace and quiet of the still lake.
Our African lodge in Debra Zeit
The peace and quiet, however, were short lived. In the night a pack of dogs and hyenas began a barking howling war that lasted several hours. At 4:00 A.M. the Orthodox Church turned on their loud speakers and we felt like we were right inside the church listening to the chanting in the ancient Geze language. By 5:00 the road outside our room was bustling with truck traffic. We thought about looking for another hotel but wondered how Jackie and Duane would feel. But the first thing they said in the morning was, “Let’s look for another place. We have no electricity or hot water and the bed is like sleeping on the floor.” It actually was. It was a mud bed with a thin mattress over the top. Ours was much more comfortable. So
Our mud hut hotel room
after a small breakfast we walked along the lake looking for another hotel. Eventually we found a lovely resort that was empty for Sunday night. It was right across the lake from our previous hotel. When we ordered lunch we discovered that the cook and hostess were Americans. She assured me that he would make me a real American hamburger and he did. So we spent our Mother’s Day relaxing in a beautiful Western style resort overlooking the water where I enjoyed my first tub bath since coming to Ethiopia! Unfortunately, the Internet didn’t work, so we had no contact with our children on Mother’s Day. That was a disappointment but the compensation was a delicious candlelight meal on the water prepared by an excellent American chef.
Breakfast at our hotel overlooking Lake Babagayo
Monday morning we left early to return to Addis and finish our shopping. But first, Jackie and I had to take one last look at the flowers. I decided to purchase a few more plants for the hospital (few meaning about 40!) and more for our house, including three rose bushes. We packed the shrubs on top of the van along with our suitcases and arranged the rest of the flowers inside the van. We headed to Addis where we had too many errands to accomplish by 2:00. We dropped Duane off for another meeting and headed into town to shop. As we headed into a round about the police flagged us down. Our driver got out of the car where the policeman chastised him for having plants inside the van! He gave him a ticket of 160 birr and kept his driver’s license. This meant that we had to pay the ticket and then drive back to the police officer to prove to him that we had paid the ticket so that Gaucho could get his driver’s license back! Two precious hours later we turned in the receipt and drove away with the plants still inside the van!
Justifiably, Goucho was edgy about the plants so after we finished our shopping for perishables, we repacked the van and loaded the remaining shrubs and plants on top. I put my foot down, however, with the roses. I showed Goucho that I would place my sweatshirt over the top of the plants to hide their existence, but I would not put the roses on top of the van to blow in the wind for 5 hours! We arrived back in Soddo about 8:00 Monday night, tired but also exhilarated to have so many new plants to work with.
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