Anatomy of a Mud House

This is a very belated post of an event that happened in April, but I wanted to put it up, as it will be something most Westerner’s don’t know about. When I arrived here a 18 months ago, many people thought I would be living in a mud house with a thatched roof. Well, I do live in a mud house with a tin roof, which is very normal for Addis Ababa. But it is a “civilized” mud house with finished walls and floors, unlike the mud houses in which most of our beneficiaries live.

Well, I found out more about mud houses on April Fool’s Day at 2 am, when my living room ceiling came crashing down from a running faucet upstairs that had run long enough to cause problems. It was not an April Fool’s joke. Fortunately, I didn’t lose anything of value.

I’ve documented the process in photos, as it has been quite interesting. It took more than 6 weeks to complete. Fortunately, I was provided with temporary quarters upstairs while the repairs were made.

Wet mud gone

First, the wet mud was pulled off the wall and taken out to the backyard. The lathe underneath needed to dry. The mud is put into a pile and covered with straw and allowed to “cure”. The straw is mixed in every couple of days.

Mud Curing

Wooden Lathe

After about a week, the mud was put into wheelbarrows and brought back to my house and literally “thrown” back onto the lathe. Then it is smoothed, just like plaster and left to dry. During the drying process, it smelled like a barnyard– because there is more than dirt and straw in the mud!

Cured Mud

Ermia throwing mud onto ceiling

Then, the mold came. It took weeks for the mud to dry. They used a charcoal burner one day, but smoked everyone out upstairs. So we just waited…and waited…and waited. Gypsum was put on the wall to pull out the moisture– and more mold grew on that! I sent photos of the mold to my friend Derek, who is a microbiologist, and he told me it is not the toxic kind of mold! Last week an electric heater was put in for a day.

Mold on Mud

Mold on Gypsum

Finally, the mud was deemed dry enough to paint, so the walls and ceilings were painted in the living room and kitchen, the varnish was redone on the floors. So, another adventure in Addis!

Weusene Update

Here’s a quick update on Weusene. We went to Alert Hospital on the other side of town last Monday, only to find that the doctor was at Black Lion Hospital! So back we came–that’ll teach me to call before I go!

He felt that she needed 15 more days of treatment, which will make a total of 45 days. There is no known benefit for going beyond 45 days. She wanted to know if there was any other way to get the medicine, other than shots, but alas, there is not. She has been her usual sweet, brave self in coming in every day to get 2 painful shots.

On our way back to the office after the appointment, we stopped at the souk (shop) to buy eggs and lentils for her. When I asked her if there was anything else she would like, she pointed to the bag of nail polish hanging overhead. So she is now the proud owner of some extremely bright red nail polish!

We go back to the doctor the first week in October to find out the next step. There may be the possibility of another treatment, which is pills, if she is not completely well from the current treatment. The number of people who can get the pills is limited, so we shall see what they decide.

Meanwhile, after her shots each day, I am teaching her the Amharic alphabet. My Amharic isn’t very good, but I do know the alphabet and can read it, so I’m a baby step ahead of her.

Melkam Addis Amet or Happy New Year 2003 September 2010 Update

Greetings from wet and muddy Addis Ababa, where we hope the rain will stop by the end of the month. I’m writing this on September 11th, which is Ethiopian New Year. The Julian calendar is still in effect here, so I get to relive 2003!

The last few months have been incredibly busy with medical teams back to back to back from mid-June to mid-August. We saw a lot of patients, gave out a lot of medicine, did lots of counseling with patients and saw spiritual fruit with some people making decisions for Christ. Many thanks to Medical Campus Outreach from Augusta, GA, Highland Park Presbyterian Church from Dallas, Cedar Springs Presbyterian Church from Knoxville, and Covenant Presbyterian Church from Nashville. It was great to get reacquainted with some old friends and meet some new ones. One particular patient from our June medical team has kept me busy and challenged medically. This is her story.

Weusene is a 12 year old girl from down-country (outside of Addis), who was sent to a distant relative here at least a year ago in order to get medical treatment for a rash involving her cheeks, nose and mouth which she had had for at least 2 years prior to coming here. She was sent by the Kebele (local government office) to one of our outreach clinics in June.

I didn’t see her initially, but was asked to follow her after the team left, because they had put her on Prednisone, which needed to be tapered. Normally, we don’t follow patients we pick up at our outreach clinics, but this was a special exception. We had an “iffy” diagnosis of mucocutaneous leishmaniasis, which Teddy, our project manager made. So, between the end of July and early August, I was treating her for bacterial infection and tapering the Prednisone. At the beginning of August, we had a pediatric infectious disease specialist from Vanderbilt, who came with a medical team from Nashville. I sent him a picture of her face ahead of time and he was pretty convinced that this was mucocutaneous leishmaniasis. And what is mucocutaneous leishmaniasis? Well, it is a disease caused by the bite of a sand fly which affects the skin and mucus membranes (lips, nose, inside of mouth). There is also a visceral type which infects the liver and spleen and can be quickly fatal.

So how does one find treatment for this disease???? In the US, the drugs can only be gotten through the CDC in Atlanta. So I talked with a pharmacist here, who referred me to another pharmacist, who referred me to Médecins Sans Frontières Holland (Doctors Without Borders.) They are one of the few groups in the world that actually treats this disease (other than the US military). So Teddy, Weusene and I went off to their office in order to find out what the possibilities were for treatment. Initially, we were going to send her north to Gondar, where an MSF representative would meet her and her older sister, and take her to their treatment site on the Sudan border.

That was the plan, until their doctor in Gondar told them there was treatment available in Addis, at the Black Lion Hospital, which is essentially in the neighborhood of our main office. So they made us an appointment at Black Lion and off we went. We were taken to the Leishmaniasis Lab, where a swab was taken of Weusene’s mouth and told we needed to go to Alert Hospital where a biopsy would be done. So we got in Teddy’s car and went to Alert, where we met an Ethiopian dermatologist, an Ethiopian PhD student in Microbiology and a PhD researcher from Switzerland/London, who were all lovely. They took a biopsy of her face (ouch) and told me that this was classic mucocutaneous leishmaniasis, though they might not be able to see the parasite in the biopsy. There were no Dermatology beds available at Alert and no way to treat her at Black Lion, so they asked if I would treat her. After being significantly invested in this little girl, I couldn’t say no, and Teddy agreed. Then we all, including the two researchers, piled back into Teddy’s car and went back to Black Lion to get the medicine.

The treatment is with a drug called sodium stibogluconate, which is Antimony, a heavy metal–remember this from Chemistry?? Neither did I!!! It can be given by IV or intramuscular injection and is given daily for 30 days. It is a very painful injection, regardless of the route of administration. And because of the volume of medicine to be injected into muscle, it needs to be given in 2 injections.

Weusene has faithfully come to all her appointments, both before and since we started the treatment. She is very brave, considering that she knows that she is going to get 2 very painful injections everyday. After about a week, she had a lot of swelling in her face, which is a local reaction to the drug. However, at about two weeks, we started to see improvement in the swelling and the ulcerations on her lower lip started to heal. September 15th will be the last day of treatment. We go back to see the team at Alert Hospital on Sept. 20th, to see if she is really done or will need additional treatment.

So what happens to her after the treatment is done? That’s the question I’ve been asking myself. If she goes back home, she will likely become someone’s houseworker and never get an education (she’s functionally illiterate as it is) or be married at 15 or 16. If she is to stay in Addis, she will need financial support, as the distant relative she lives with has told us several times she needs to send Weusene back home because she can’t afford to feed another person, so I’ve been helping them with food each week. I’ve been praying about whether or not to support her here in Addis so she can go to school and have a future that is more promising than she might have otherwise. Teddy and I will need to talk with her, once a decision is made about her treatment to find out what she would like.

I’m going to Namibia from September 14-18 to attend the Africa Palliative Care Conference. Palliative/hospice care has long been an interest of mine and we are expecting that sometime in the not too distant future, we will need to start doing more palliative/hospice type care in our project, as less funding is available for AIDS drugs, first line treatment fails and second line treatment becomes less available. Another nurse from SIM, our partner mission here, is going with me.

Once back from Namibia, it will be a busy time until October 15th when I leave for a 3½ week trip to the US. I’m looking forward to seeing many friends, family and supporters. It will be a busy time there, as I squeeze in doctor’s appointments, visits with friends in MD, visits to NH and MA, shopping for things I can’t get here and a few days in Chattanooga at the Mission to the World Global Missions Conference.

Again, many thanks to you all for your faithful prayers, financial support, care packages, emails, snail mails, and Facebook messages. Here are some more prayer and praise items.

Praise:

  • Good summer medical teams
  • A new Amharic language tutor, who is excellent
  • Progress in Weusene’s treatment

Prayer:

  • Safe and productive time in Namibia
  • Preparations for trip to US
  • Income generating sewing project with ladies in our project
  • Continued financial support to be able to be here another 2 years.
  • Complete healing for Weusene and how to help her in the future

When It Rains, It (almost) Snows

Sweeping

A couple of Saturdays ago we had the fiercest wind and rain storm that we’ve had since I’ve been here. About 5pm the wind suddenly picked up, the rain came pouring down and was blown against the building, coming through cracks in windows, blowing out some windows and causing a tree to fall on someone’s Land Cruiser. After we all secured things in our apartments, we were out with brooms and dust pans, trying to get rid of the very slippery hail that came down. It really looked like snow on the ground and I asked if anyone had a snow shovel–they thought I was crazy. We had fun working together and cleaning up.

Hail on the steps

More hail

Hail at the bottom of the downspout

I’ve been reading the book “What’s So Amazing About Grace?” by Philip Yancey. In the next to the last chapter he writes this about the church:

“If the world despises a notorious sinner, the church will love her.

If the world cuts off aid to the poor and the suffering, the church will offer food and healing.

If the world oppresses, the church will raise up the oppressed.

If the world shames a social outcast, the church will proclaim God’s reconciling love.

If the world seeks profit and self-fulfillment, the church seeks sacrifice and service.

If the world demands retribution, the church dispenses grace.

If the world splinters into factions, the church joins together in unity.

If the world destroys its enemies, the church loves them.” p. 262

Update from Addis Ababa, June 2010

Greetings from rainy Addis Ababa. Rainy season has started–though it could be said that it never stopped when it should have last September! We had an amazing hail storm a couple weeks ago; the ground was covered with hail stones and the noise on the tin roof was deafening! As promised in my March update, I’m going to introduce you to my Ethiopian colleagues in this update. I thought I had pictures of all of them, but I don’t. And when I copied this from Word, the pictures didn’t copy, will have to work on that later.

Teddy Alemayheu is the Project Manager. He is a nurse and a social worker, and is now studying project management. He is an amazing person, extremely gifted in connecting with people. Many of our beneficiaries consider him to be their children’s “father” when they feel their kids need some male influence. He is my go-to person for difficult situations and we have a great working relationship.

Danny Abebe and Betty Tsedeke are the assistant project managers. Danny is responsible for the office in Bole. Danny was my translator on my first trip here 5 years ago, so he has had a special place in my heart. Betty is a social worker and finished her Master’s degree in Social Work last year. She works primarily in the Lideta office and helps me deal with difficult situations.

Achiso, Abebe and Desalegn are the nurses in the project. They keep track of the beneficiaries, teach classes on adherence and compliance to HIV medications, make home visits, fill prescriptions and treat minor illnesses. They keep me up to date on sick beneficiaries and we make home visits together. They are all in school to obtain their bachelor’s degree in nursing.

A’elef, Hawie, Tigist, are our community mobilization officers. They work closely with our women’s support groups, leading Bible studies and teaching the women to support each other through good times and bad. They also help to coordinate our monthly support distribution when all the beneficiaries show up to get rent money, soap, cooking oil and teff (the staple grain used to make injerra, the flat bread eaten here daily.)

Gizaw Meles coordinates all of our visiting medical teams, which is a huge job, especially this summer. He works closely with the Mission to the World office in Atlanta, getting all the professional information on the participants, gets them credentialed here, arranges transportation, accommodations, food and daily schedules, finances, and answers myriad questions. He is theologically trained and leads our Community Bible Study in each of the project offices.

Tsegaye works with the children and youth program and arranges for school uniforms and school fees for our 500 school aged children who are in many, many different schools. He also monitors report cards and works with our child sponsorship program and the men’s support group in Lideta.

Sammy Temesgen is a lab technician, who helps with lab work when we have visiting medical teams. He also makes home visits, helps to coordinate repairs on beneficiary homes and will soon be working with a TB case finding project.

Girma is our office manager in Lideta. He helps Bev with the finances, does payroll, and multiple other things everyday, like running the generator when we don’t have power.

Abeba, Bizaheyu, and Asnakech are our Expert Patients in the Lideta office. They are beneficiaries who have been trained to be peer counselors, because they were found to be managing their own health exceptionally well. They are each responsible for the all beneficiaries in a specific neighborhood and are our eyes and ears in the community. They know who is sick and needs a home visit, will go to the hospital or medical appointments with other beneficiaries to help advocate for them. They are great encouragements in my attempts to speak Amharic.

Genet and Bayoush are our cleaner and shopkeeper in Lideta. Genet keeps our office clean and makes us tea twice a day. Bayoush keeps all project donations except medications, organized and inventoried

So, since the last update, I completed language school in mid-April. I’m nowhere close to proficient in Amharic, but I work at it every day and understand and speak a bit more as the days go by. I try to study at lunch time several days a week.

Just after finishing language school, I went to South Africa for a week for a Mission to the World Eastern and Southern Africa retreat. We were in the Cape Town area, which was absolutely beautiful–ocean, beaches, vineyards.

I’ve been back to work full time since May. It is good to be back doing what I came here to do. I’ve been updating the charts in Lideta, making home visits, seeing beneficiaries in all the offices, occasionally attending community bible study in Lideta when the medical schedule allows, visiting hospitalized beneficiaries and coordinating the TB case finding project, which will be launched by the time you get this. And I’ve been busy preparing for our visiting medical teams coming during rainy season.

Outside of work, I’m keeping plenty busy, but space doesn’t allow me to elaborate much. I’m part of an Inter-Mission prayer meeting that meets weekly with missionaries from several different Christian mission agencies here in Ethiopia. I was part of a Bible Study Fellowship pilot class for 4 months which will resume in the fall. And my “2 year project” knitting a sweater is moving along quite well. I might even finish it in less time. Most of the time, it’s great for relaxing and unwinding.

Praise and Prayer items:

  • Good relationships with my work colleagues.
  • Faithful financial supporters that allow me to be here, doing what I love.
  • Good terminal evaluation by the government of our last 3 year agreement. Pray that the submission of our new 3 year agreement would be viewed favorably.
  • Two healthy babies have been born, with several more due soon.
  • Renewed work permit for Andy and Bev Warren–it was touch and go for a few days.
  • That our TB active case finding project would be useful to our project and government.
  • Back-to-back medical teams from mid-June to mid-August–that I and my teammates would rest in God’s strength and not our own during these busy times.
  • That our 3 summer interns, Kyle, Lindsay and Sarah would enjoy their work with the children and youth of the project and deepen their walk with Christ.
  • Sick beneficiaries, particularly two children with AIDS and TB.
  • A trip to the US from mid-October to early November, that plans for seeing family and friends would start to come together.

Thanks, as always, for your encouraging emails, letters, prayers and packages. It means a lot to have my “home team” behind me. I’m looking forward to seeing many of you when I’m home in the fall.

A Light Goes Out in Sandtown

When I read my email on Thursday evening, I was surprised to read that my friend, Allan Tibbels had died. Allan was the founder and co-executive director of Sandtown Habitat for Humanity in the Sandtown-Winchester neighborhood of West Baltimore, a place I called my “second neighborhood” in Baltimore City. It was my privilege to work with Sandtown Habitat, renovating vacant shells of buildings that would become affordable homes for people. My church renovated six houses and I worked on all of them and several others. I also worked with Allan on the board of the New Song Family Health Center.

Allan was a person who, as a quadriplegic, could have sat home and collected disability. But instead, he chose to make a difference in a poor urban area of Baltimore City, into which he and his family moved in the late 1980’s. He was a well known sight in Sandtown, buzzing around in his electric wheelchair. He was a mentor to many, raised some Sandtown kids as his own sons, always living out the Gospel in whatever he did.

Anyone who has known Allen has been enriched by his passion, his faith, his caring for those less fortunate than him, his desire to bring the kingdom of God and true shalom to his neighborhood. He died with his boots on and those will be hard boots to fill. But he has left a legacy to those of us who were privileged to know and love him and we rejoice that he has been freed from the physical constraints of his body in the presence of Jesus.

 

Caleb’s Birthday

Caleb is the 3 year old son of my teammates, Michael and Emily Treadwell. He turned 3 on April 9th. A couple days later, we had a party at Desta Mender (Joy Village), a working farm and Midwifery College of the Addis Ababa Fistula Hospital (http://www.fistulafoundation.org/hospital/history/). They have a café there, which is open on the weekends and a favorite place to go after church for Sunday lunch. There is plenty of grassy space for kids to run around, animals to watch and pet, and nice, clean air.

Caleb in his new sweater vest

Caleb and Ruthie

Horses

Cake!

South Africa

In mid-April, our Mission to the World team went to Cape Town, South Africa for an East and Southern Africa retreat. It was a wonderfully refreshing week. Being April in the southern hemisphere, autumn was on the way. We were in a valley west of Cape Town where there are many vineyards. It was great to see the ocean again. We were like kids at Disneyland when we got to the Johannesburg airport–there was a Subway sandwich shop, a real bookstore, toilet paper in the rest rooms, and Coke Zero in 1 liter plastic bottles! Needless to say, we found ourselves in a developed country. Oh, and we could use our credit cards and ATM cards–the swiping actually worked. Here are some photos of the beauty of the area.

Hermanus Valley

Indian Ocean

Cape Town

Cape Town Table Mountain

Orphan Holiday Celebrations

Easter, Betselot and me

We care for about 43 orphans in our project–that is, kids for whom both parents are deceased. They are referred to as “double” orphans, because losing one parent here can have you called an orphan. So on major Ethiopian holidays, such as Christmas, New Year’s (in September) and Easter, we have a party for the orphans. For Ethiopian New Year, we had a program at the main office and then took them to lunch at a local restaurant. For Christmas, we had a party at the office, told the Christmas story and decorated Christmas cookies and ate pizza. For Easter, we went to our Bole office, where one of our beneficiaries cooked Ethiopian food for them. We told the Easter story of Christ’s death and resurrection and they drew pictures to illustrate it. The older girls had fun taking pictures with my camera at Easter, but these pictures are from 3 celebrations.

New Year’s, Brian and friends

Christmas, Hirut and Nathanael

Easter, Betty and Kendi

Firkerte being a kid!