Thursday, October 25, 2007

Wolaita, Ethiopia: 10/25/07

Ruth and I are sitting in her kitchen enjoying the music Shelley sent to us. There is so much to share about today that I don’t think it is possible to get it all said. We stayed up late, late last night talking about everything, then got up early to drive 1.5 hours with Dr. Mary to a Wolaittan village called Gadalla, where she practices medicine every other Thursday. It is like a county seat, but for a smaller area.

On the drive in, we saw a donkey cart carrying a pallet with a sick woman on it. Children chased us yelling “Mary, Mary.” When we arrived, we found the sick lined up outside the clinic. The first ones on homemade stretchers and the others sitting or standing in line. We handed out cards to those in line, which guaranteed they would be seen. Those who were late must return in two weeks. People traveled for hours and even days to get to the clinic.

The government buildings are constructed primarily of mud mixed with dried grass and are quite dark inside. I had to use my flash, which gives the photos a look that is not really accurate.

We set up in an empty room that is the clinic. Someone brought in a bench, two chairs and a small table, which later in the day became the pharmacy. We left all but one window closed to protect the medicines and food we brought, and make a place to get away from the people for a break once during the day.

Patients were seen outside by Dr. Ruth, who made notes on scraps of paper until the paper ran out, then used her hand. They really need packs of post-its or small pads of paper to write prescriptions on. Helping her was Sebastian, a German medical student and two boy translators, who are in a school Mary runs where they learn English. Also helping was a man that I suspect Dr. Mary hired because he is older and has trouble finding work. He carried the scale, and acted as sort of a guard; sometimes chasing people back with a switch he made from a corn stalk.

I took photos while holding the baby, but I will get to that later.

Cases that needed a second opinion were sent over to Dr. Mary and her young translator in the clinic. Dr. Mary speaks Wolaittan, and it appeared the boy would clarify, or translate into Amharic when needed. Dr. Mary saw these patients, organized medicines and handed out food to those in her food program.

Next to this place was another small building that serves as a school. The children bring small stools or sit on the dirt. There is a chalkboard with the English alphabet on it. Wolaitan language uses the same letters we do, but the vowels are pronounced like they are in Spanish. When we arrived, sixty or so children were crammed into the room, doing lessons by chanting. I think the noise made it difficult for Mary, so it was good when they finished. Dr. Ruth also had challenges hearing the people outside because there were so many people gathering and talking around her. She often had to ask people to be quiet. Each time, some people would take it upon themselves to police the others. Men would smack the women, talking or not, who would in turn slap the kids. Five minutes later it would be noisy again. Relentless flies buzzing, kids playing on the donkey carts, cattle munching the banana leaves behind the clinic and donkeys yelling at each created a distinctly soundscape unlike any I’ve heard in South Carolina.

I’m trying to think of words to describe the problems we saw, but the words like “heart-wrenching” have been so overused, they don’t touch what we all felt. Here are some snippets of the conversations.

Ruth, “how often does he get to eat meat?”
“once, maybe twice a year.”
“any papayas or mangos, or vegetables?”
“no, just corn or bread or fake banana”
“well, with his condition, he needs some vitamins or he will go blind. Is it possible for him to buy some fruits and eat them on a regular basis?”

Ruth, “how long has she looked like this?”
This was about a woman who looked like she was nine months pregnant with twins.
“Ten months. She had a baby, but no blood came, then she swelled up like this.”
“The baby was born and looked normal?”
“did the baby live?”
“I will get a can, will you see if you can get her to urinate in it?”
Six people carry her stretcher behind the clinic and come back with the can.

There is no privacy. People gather all around the person being examined and watch everything. Maybe this is good as they may learn some methods of healing and prevention. One woman pulled her shirt aside to show me her breast. Most of it was gone and the remainder looked as if it had been horribly burned and blistered. At first glance Mary said cancer, then they made more observations and diagnosed her with localized TB in the breast.

Diagnoses in the field must be made without lab work, by observation and conferring with each other and medical books. Sometimes the people need to go to the hospital. If the case is dire, and Ruth refers them, they can be seen using the benevolent fund.

Ruth, “she needs surgery for this hernia, do you have bus money to get her to Soddo Christian Hospital?”
“okay, well, she can wear a scarf tied tightly around it, then, when the pain gets very bad, which may take some time, you must try and find a way for her to come have surgery.”

To a girl, who for over one year had one eye horribly swollen and protruding from her face, “I will give you this card, and you go to the hospital with it, and they will see you.”

One boy we took home with us. He is ten, and had trouble breathing. He was bone thin and the skin sucked in and out of his lower ribs when he wheezed.
Ruth, “how long has he been breathing like this?”
“two years now”
“and what color is his spit?”
“it comes out with pus and is yellow.”
One look at his father’s ragged clothing and lack of shoes and I can see why they put off the trek to the doctor. I wonder what it cost them to not work for a day? I saw not one of the patients or family members eat or drink all day. They decided it was TB, confirmed on an x-ray even I could read when we got home to the hospital. Sweet boy was scared. I think he had never seen a “city” before. He liked my camera, though. We bought him a soda and gave him shoes and a shirt and will check on him again tomorrow. He is on oxygen and has an IV. I can’t imagine what he is feeling.

Dr. Ruth and Dr. Mary are amazing people. Dr. Ruth is in her element in this situation. Each person she meets must feel they are the most valuable person on earth when she talks with them in her sweet voice. Though outwardly calm, I can see her mental gears running hyper speed while she diagnoses, then tries to figure out what her patients have the means to do that will help. I saw her do this in the Dominican Republic, dispensing orders like these for diabetes, “if you can, you must try to drink three glasses of pure water each day,” and, “if I give you shoes, will you keep them on always and protect your toes?”

Mary’s love for the people is more evident in the many things she thinks to do to help them. She spends so much of her own money, I don’t know how she manages. One of the many things she does is make up vitamin packs. Each day’s dose is wrapped in a triangle of newsprint. The pack contains a malaria preventative, folic acid and vitamin b. She started just with the women, and found that men also really thrived on the folic acid/b combination.

She also had large milk cans filled with homemade Bisquick that she distributes to families that are malnourished. It can be mixed with water and baked traditionally to make nutritious bread and contains protein powder, and milk solids along with other vitamin enriched flours.

Today was the first time Sebastian had seen rural medicine in an area of extreme poverty. I felt for him. He is young, and I’m sure what he saw today will stay with him for a lifetime. He was very tired when we got home – I think emotionally. He did a wonderful job, too. In Germany, he was able to attend med school for around $800 a semester because it is governmentally subsidized (and, interestingly, there are no entrance exams), and he will have a job after taking this time off to do this work. His girlfriend is in Ghana working in an orphanage while he is here. She contracted a bad strain of malaria her first week and used up all her malaria meds treating it, so he is worried about her.

After they finished seeing all the patients, the people lined up to get their medicines at the makeshift pharmacy. Dr. Mary charges them a very small fee, which I think is a good idea because it maintains the value of her service.

Saturday, October 20, 2007

My friend in Ethiopia's newsletter

This is the doctor I'm going to stay with in Ethiopia. We met there in January of 06, and since then she visited me once here - we drove to Washington and NYC for a three day whirlwind tour, and we met in the Dominican Republic for a week, too. She is an amazing woman. I don't have all the photos, unfortunately.

Ruth's Report

Newsletter 2 June 2007

Early in the morning of the 19th of May, I arrived at Bole Airport, Addis Abeba. After a stay with friends, Co and Marja Tollenaar, who are also serving through Witte Velden Foundation, I traveled to Soddo on the 30th of May. Thanks to Co and Marja, my time in Addis was very productive. I managed to arrange the necessary practicalities as registration at the Dutch Embassy, an Ethiopian driving license, an internet connection and shopping.

Soddo is situated in the Great Rift Valley, a 6.5 hours drive south of Addis Abeba. Soddo is said to have 70.000 inhabitants. I live on the hospital compound at the edge of town. From the veranda there is a view to distant lake Abaya.

I have by now got used to power cuts and water shortage, Kebede (a boy who works in the compound and does the shopping), the guards who greet me and switch on the lights at night, the sound of crickets, the market place with mud, cows and goats and little children calling "ferenchiâ". That means white one. My neighbours and I are the only whites around.

With medical students from washington and neigbour.

Arrival in Ethiopia
Soddo Christian Hospital

Caused by the increasing inflation the number of poor people is on the rise. The local wheat is called tef, which is used to prepare the local staple injera. A kilo of tef now costs 5 Birr (50 eurocents). An average family needs 40 kilos of tef a month. That is 200 Birr per month for food only. The average income is 320 Birr.

Soddo Christian Hospital
I'e been working in the hospital for a couple of weeks now. The hospital has an operation section with four Ethiopian assistant-doctors, two Ethiopian surgeons and an American medical director. Then there is the clinic, first aid, children and internal section which is run by three Ethiopian doctors. I'm the fourth doctor and also work in the clinic, first aid, children and internal section. An Ethiopian doctor and me are heading this part of the hospital.

There is a room available for me to see patients. Fortunately a translator was found to assist me, because sometimes patients speak a language that none here can understand. Apart from Amharic (the national language) there are ten other languages.

Many diseases are poverty and hygiene related. There is malaria, tuberculosis, vitamine deficiencies, malnutrition, intestine and eye infections and HIV.

On of the things I am going to pay attention to is the children's section.

We have nine beds, which are however rarely occupied.

Sometimes small babies are discharged too early. This week professor Glenn Geelhoed and 15 medical students from Washington University visited, and he advised me on this issue.

Malaria in Gadalla.

One day a week I go to see patients together with Mary, a doctor specialized in tropical diseases. She has been working in Soddo for 11 years. The clinic is in Gadalla, west of Soddo. Part of the road is tarmac, but rest is in such poor condition that it takes 1.5 - 2 hours to cover 50 km. The rainy season is setting in and we had already postponed our visit for one day because of heavy rains. The road can become impassable.

At the clinic the patients are waiting. There was a little boy, last in line, with eyes showing yellow (caused by malaria), sick, barefoot in mud like many others, torn trousers and no shirt. I gave him recipe for medicin. When I came back he was standing against the wall, crying. I asked him what was the matter and he opened his hand, showing two wrinkled notes of 1 Birr. He couldn't afford the medicine, costing 6 Birr (60 eurocents)! it was so sad. We gave him food, clothes and the medicine.

Heading back the road appeared to be so slippery that the Toyota four wheel drive was skidding even in low gear. Because the area is part of the Rift Valley, it is not level. For the first time I was a little bit scared.

Prayer issues:
I thank God for:
financial means, the help and friendship of Co and Marja;
safety and protection, also on the road;
support in many ways from the church in Winterswijk, my home Baptist's community in Arnhem Zuid, family and friends.
Please pray for:
the new day clinic 2.5 hours drive north-east of Soddo. Most of this area is Islamic. Mary had been asked for this clinic before. We hope to pay our first visit on June 25th;
wisdom and understanding for the hospital staff and me.
the women's bible study group which I've been asked to carry on with;
safety and protection.

Psalm 18: 31 For who is God except the LORD? And who is a rock besides our God?-

Soddo Christian Hospital,
Po Box 305, Soddo Wolaitta, Africa
Voor giften:
Stg Witte Velden,
Postgiro 1485137
ovv Ruth Droppers
Thuisfront: Esther Droppers,
Ruth Droppers Serving in Health Care in Ethiopia Voor giften:
Isaiah 55:5 because of the LORD your God,
the Holy One of Israel

Ruth’s Report

Newsletter 3 – September 2007

Often during lunch and supper hours there were no employees.

Sometimes it happened that the emergency department nurse slept during the night in a different room. Which meant that at that time there was no emergency care for the patient.

I try to understand the background of the culture.

It touches me every time how late patients come in to the hospital. To travel 140 miles with a broken arm or 2 days on a donkey with a delivery is no exception.

The disease is prolonged at that stage and the patients are very sick. We also see the damaging effect of the treatment of the local witch doctors.

It happens often that family has no money to pay a whole treatment. The hospital therefore has a benevolent fund. In the committee who checks the requests sits also a Ethopian head nurse and pastor. For me, I see that I have no insite in it, cause how can I distinguish between very poor and a little bit more poor.

The hospital- Soddo Christian Hospital

In the past period we were able to improve the care on the pediatric- and medical ward. Nurses now lay clean sheets on the beds before the doctors round. They measure bloodpressures and write down the temperature as well the used medicines on the chart. As you can see in the pictures below the family members take care for their sick relative. They are in the hospital during the day and the night.

Every day we see in the clinic around 60 patients.

Last month one the general doctors left the team because he started his surgical training. We hope that next month there will be replacement.

Every week we have our own medical meeting in which we talk about diseases.

Together with the other head physician we stressed the importance of a laboratory and rontgen department which are open 24/7 and it seems that it really is working now.

There is 1 doctor to 35.000 people in Ethiopia. In the Netherlands there is 1 doctor to 305 people. They say that Ethiopia has 2000 general doctors. 1000 general doctors work in the bigger cities. Soddo is not a big city.

At the clinic pediatric ward with Korean people and neighbours

Care for twins

In the week when the second newsletter went out, I went with Mary, an American tropical specialist, to the clinic. A mother came walking in to the clinic with her malnourished twins. Their names where Amanuel and Abanezer . They were 2 months old and weight only 2,5 kg. After the delivery the mother was to weak and the babies where given away to family members, with as result that when they returned, the mother had no breastmilk any more. In that area were no wetnurses: mothers who want to breastfeed a second child. There is no clean water. There is no babyfood and when it would be there it would be to expensive. Mary had no place for shelter. What to do? We could not let them die¦.. I decided to take them in with the agreement that they would go back to the parents when they were strong enough. Very soon I had the first necessary baby materials through neighbours, family and friends. And I got help from a short-term American student Ariel who lived a month in my house and helped. And the help of Almaz, an older Ethiopian woman who took care of them from Monday till Friday from 8 am-6pm. In the beginning they lay together in a plastic washing tub and we fed them almost continuously. It the weeks after that grew and started to laugh.

Now three weeks ago, when they weighed 5 kg, they went back to their parents. For me it was nog easy cause I grew attached to them.

We gave the parents baby food, clothes, bottles and dipers and money for the bus to come back to Soddo and get babyfood every week.

Despite this support the parents told us repeatly that they could not take care of the babies; the father has no income and there are also two other children in the family. Recently a son of them passed away.

The parents have decided to give them up for adoption. The twins are now in an orphanage and they are doing good.

The twins at arrival and in week 7
manuel en Abanezer bij aankomst, 3 weken 7 weken

Matthew 25:35

For I was hungry and you gave me food, I was thirsty and you gave me something to drink, I was a stranger and you welcomed me, I was naked and you gave me clothing.

I would like to thank family and friends for the materials and emails you sent. Often they came at exactly the right moment. I try to answer as quick as possible, but sometimes it can take a while.

I thank the Lord God for:

Safety and protection.
The sent babymaterials trough friends and family.
A work- and Residence permit; the womens Biblestudy group.
Rest in busy times.
Prayer I aks for:

The coming time when I, together with and olders short-term couple, will be alone on the compound. The neighbours and the medical director are for a short period in the States and South-Africa.
The hospital, when we think of expanding the clinic and pharmacy, because the current building is getting to crowded.

If you wish to help Ruth and her work, you can send her a donation (a check from an American bank is fine, there is just no tax deduction here:
Stichting Witte Velden te Hilversum
Postbanknumber 1485137
IBAN: NL 41 PSTB 0001 4851 37
mention her name: for Ruth Droppers

Email of the foundation is:
Email of contact person in Netherlands:

Monday, October 15, 2007

preparing to go

David and I always complain about leaving.
We despise the insanity of trying to get all our work done,
clients happy,
house ready,
bags packed,
lists checked,
forgotten items overnighted,
contact info sheets drawn up . . . and these are the items under the first 100 on my list! Monday, Ethiopia. Three weeks this time. The longest I've left Alden, and I have to say I'm concerned about his reaction to it. I hope I can email often. Connection speeds, or lack thereof, make Skyping a joke.

Right now I should be sleeping, but I'm downloading the audio book, "a thousand splendid suns." I want to listen to it on the trip home if I can figure out how to make this ipod thing Rod gave me work. It will save me space. I have another book, "oracle bones" that I've been saving. It will last me to Ethiopia, then I can give it to Dr. Ruth. I also have a few devotional books, and a couple kids books and a trade mag if I can fit them in.

The carryons are the hardest - I must include everything to make the shoot happen in the likely event that luggage won't arrive. Camera, back up camera. Lenses - long, wide, medium, memory cards - I ordered more today, hope they make it in time - tape stock, video camera(s), mics, cables, chargers for all gear, extra long life batteries, flash for camera, extra AA batteries, fan to run with 220 converter so I don't fry chargers, computer with power supply, blank disks, change of clothing, reading material, medicines, toothbrush. Wear the shoes I can go into the bush with, even though they are annoying in security. Full size pillow. Well hidden crisp $20 bills. Water bottle - empty so I won't be suspected of carrying waterborne explosives. Sunglasses. locks and steel cable, large scarf to use as hood and protection against nasty airline seat or as blanket if flight is delayed. change of socks. Passport. Blow up 3/4 camping air matt. travel alarm clock. I once spent 8 hours sleeping in Curacao while my friends fidgeted in their uncomfortable seats. They made fun of me, lying on my camping mattress covered with my scarf - but I was sleeping and I didn't care - my alarm was set, I could relax. Wish it was that easy at home with kids!

My trips through security are a nightmare. I pity the people behind me. Video camera? yes, at least one. Computer, yes. shoes, yes. bag of liquids? yes. search? yes. Do my carry ons weigh 45 pounds each? yes.

Sunday, October 14, 2007

Lovely Zion

Zion was the flower girl in a wedding today for Camille, the college student who used to baby sit her a lot. She did really well going down the aisle and for a few minutes up front. I was proud of her, and she looked very elegant in her Ethiopian clothes.

It was a lovely service and I thought it was very cute that Camille's dad scribbled this line on his hand "her mother and I"

Thursday, October 04, 2007

SC Heart Gallery

I shot photos for the SC Heart Gallery the other day, and tonight I worked on them in Photoshop. I'm done, and I can't seem to stop crying. It is a wonderful idea, taking photos of children who want to be in a family. As the photographers, we try to capture the essense of the child in a single black and white photo. The hope is that someone will see the photo in one of the Heart Center galleries or on line and will be able to imagine that child in his or her life.

There were 44 kids at the shoot. Forty-four local children who wanted to have a mommy and/or daddy enough that they risked spending the day with perfect strangers, smiling brightly and posing in hopes that eventually someone would pick them.

I wonder what they thought about on the ride over to the photo shoot. And, that night in bed before sleeping? Did they imagine a couple looking at their photo and saying to themselves, "oh, that boy is for us! He looks so smart and caring and I bet he would enjoy camping with us, too." Or, did they try to forget the possible meaning of the day and concentrate on something else?

This was not the first time for most of the children. I photographed a boy of thirteen, a girl who is fourteen, a boy around twelve and two young (and very energetic) boys. The two eldest stole my heart. What chances do they have of being adopted at this time in their lives?

I looked up an older child on line on the SC waiting child list and sent in an inquiry. How hard is it to adopt an older child? The response I got was curt - unbelievable, really, when you consider what is at stake. Some following up on my part revealed that it is not difficult to adopt locally, and it is next to free when compared with international adoption. And, the child has medical insurance even after she or he is adopted and often there is a monthly stipend to help the family afford another child - all the way through college. You can even foster first, to make sure the child fits within your family.

It seems doable. I will have to find out more. The thought of those precious kids I met going on their first date, learning to drive, picking a major in college, dealing with a mean boss - all without a mom or dad - it just rips me apart.

Wednesday, October 03, 2007

Photos in the Fair

David won something. We don't know what it is. David is cautioning me, "Maybe you should wait and see what I won. Maybe I got the "what rednecks think this is art" award!
I don't care. I'm proud of him.

Monday, October 01, 2007

I don't have to update

Because my friend Laura talked about our weekend on her blog. Cool.