gelbet yellem.

It's still the holiday time in Ethiopia – the coup d'etat of the season is Timket, or Epiphany, falling this weekend. The streets will be thronged with crowds and processions. And holiday season means frequent, lengthy power and water outages... bless the fact that when you turn on a tap and water comes out! The luxury I say! Right now I'm typing this at 8pm in a power outage (Toni and I bought a 100 buck used EEE netbook that has 9 hours of battery before leaving the US for this exact reason!)...  I notice so many things typically drowned out when the electricity is shut off. You see, the Orthodox church here loves, LOVES to project its services by loudspeaker so everyone in a 3 mile radius can hear every chant and prayer and scripture. This is all very well and good, except this LOUD chanting is not for just 30 minutes or an hour – oh no, it drags for full days sometimes, and is typically turned on at night – it comes on around 1am, doesn't stop till about 5 or 6. Prime time to have blaring church services in your ears, no? We were lucky enough this last weekend that they didn't stop for about 40 hours. 40 hours straight! I tell you! And then the local evangelical church likes to compete, and so puts on their loudspeaker too. Rather than chanting, they have a more emphatic preacher 'yelling' his sermons.

Anyway. Tonight the power outage must have extended farther than normal, because there's no church loudspeakers blaring, and all these sounds and smells become more pronounced... the smell of an open-fire coffee ceremony nearby... this is a near daily routine for Ethiopians, the originators of coffee (comes from the Kaffa region – Kaffa...coffee..)... for women it's a key social event, usually around 10am (or 3 Ethiopia time), after all the morning chores are done. They take fresh, green coffee beans (did you know they were green?), roast them in a little pan over hot coals till they turn nice and black. They let everyone in the circle smell them, then after pounding them down and placing them in clay coffee pots, pour water in, let it all boil up, then pour everyone little cups. It's always accompanied by some sort of snack – I can smell the coffee roasting but also that some neighbour of ours is making 'abeba kolo' ('flower corn,' or popcorn :) to go with it... I hear crickets, and rats scattering on our roof... but mostly it's very very quiet....

In other news, Toni leaves for Kenya on Wednesday, and me for Zambia on Sunday. We both have some consultancies in the different countries, and will both be back in 2 weeks. Handy that our times away overlap... but kinda wish it was to the same place.

And in further other news, I've been hired by these people: anthrologica.com ...i.e. a truly truly ideal job for me. I'm going to Zambia on my first assignment, helping a health education organization there (THET is it's name) design a proper monitoring and evaluation strategy for a new DFID grant they've been given, so as to ensure that what they do with this great deal of money is actually effective. I'm thrilled, THRILLED to be hired by the organization, only a bit sad to know I'll be spending time away from Ethiopia. (After Zambia will be a month in Nigeria.) We love it here – power outages, water shortages, rats on the roof, all aside. These things really don't matter in the end – we have much more than we could need, and it's just such a wonderful place to be, I can hardly say enough.

Will write from Zambia – I was last there in 2010 with Toni on our grand Southern Africa World Cup tour – memories! hurrah!

Loves,
jooj.

Zemzem + Injera!

Zemzem is a wonderful woman who lives here in another part of the house with us, and today made a whole heap of injera, the local staple food. They make these big sour pancakes from teff, a grain that only grows in Ethiopia, then put loads of delicious sauces on top that you grab with your hands. It's so so delicious, and super rich in iron so pregnant women in Ethiopia rarely have anemia. (All things come back to maternal health :)

And.. here we go!

Zemzem in our lovely, sunny kitchen - normal stove and special injera stove behind her.

Getting some of the fermented dough...

Spreading it on the injera stove like a crepe...

Cooking!

Putting them in the special big injera basket...

...eh voila!! ahun billou! ameusegenallo Zemzem!

disconnect.

It is New Year’s Day everywhere outside Ethiopia, but just another Tuesday here. The Ethiopian calendar prevails, and they already celebrated the entry to 2006 back in our September. Seeing photos of celebrations from friends and family in Europe and the US is like dreaming – you sort of recognize it, but it doesn’t register with where you are when you ‘wake up.’

Ethiopia is a country of over 80 million people. It’s not in any way some random place, but very much it’s own society, with it’s own character and richness, however ‘separate’ it may seem from all else. But recognizing this ‘disconnect’ becomes increasingly important in understanding that there is no standard way of living, nothing that is universal. While everyone seemed to celebrate the entry to 2013, 80 million people didn’t, but went about their own lives just fine. Life continues within it’s own parameters, regardless of what others are doing elsewhere. To understand this fully is to be empathetic – to see that other ways of being are just as legitimate as your own, and are not merely waiting to be appropriated into your own sense of the way things are. The way things are here is different, and that’s just fine – how critical to look outside ourselves and realize that the world operates on these multiple planes!

I mention this out of frustration when I see an attempt to simply transplant one set of interventions or values from one place to another with no sense of adaptation to local realities. This is the main crux of my PhD thesis, really, and even though I’m working historically, the lessons continue to ring true today. The world of maternal health is particularly divided right now: the US and Europe are swinging towards a push for home birth, whereas 90% of Ethiopian women already give birth at home. The iatrogenic effects of hospitalized birth in the developed world are not to be discounted, but are a drop in the hat compared to the continued morbidity and mortality seen here. Avoidable deaths left and right solely because women give birth without skilled attendants in remote enclaves. To take the advocacy for home birth in the US – where you are a 911 call away from an emergency room – to an Ethiopian context is simply irresponsible. And it frustrates me beyond measure that we are blinded to the luxury that is home birth in a developed country: yes, intervention is the exception rather than the rule in childbirth, but it is still necessary. Where would Katie be, or Dane, if they lived in rural Ethiopia? The best trained doctor or midwife in the world could do nothing for them at home without essential medication. The clinical model in Ethiopia is deeply flawed, there are severe limitations because of poor facilities and failures of health staff, but that doesn’t mean the answer is to revert away from that imperfect clinical model. 

I met with an incredibly energetic young midwife today who is working to strengthen the clinical system through sweeping reform and more concerted training. He was so talented and intelligent, so devoted to improving the system where he could: making clinics more appealing to an Ethiopian context, i.e. allowing women to give birth in any position they choose (mostly squatting), performing the essential coffee ceremony in the clinic immediately after the birth, a key feature women seek when birthing at home. I mean why not? Why not have a birth that embraces Ethiopian values within a clinical setting where misoprostol is at hand? Why can’t foreign birth advocates see that this is exactly the path forward? We can’t expect women to give birth at home when it takes 8 hours to get to the nearest operating theatre or medicine cabinet. If something goes awry – placenta praevia, ruptered uterus, obstructed labour – that woman needs care immediately. You have to be in the vicinity of proper facilities. There is no 911, there is no ambulance. Would you be comfortable in that scenario? Truly? Empathy! Think on it!

Sigh. How’s that as an update for ya? :) I’ll end it there. And despite languishing in 2006 over here, happy 2013 to all you out there! Kisses to everyone, the little ones especially, as ever :)

I will try to post photos soon, since those are way more exciting than these long posts.

Loves,

Jooj.