2006 JIGJIGA, ETHIOPIE

2006 Jijiga, Ethiopie

VOSH Southeast mission to Jigjiga, Ethiopie, Avril, 2006
By SuEllen Brauer, Mission Biographer

The Vision Team:

Charles Covington, mission leader, is a native Virginian but now lives in Lake Mary, FL. He has 2 daughters, a son, et 7 grandchildren; they live in Sanford, FL, Brookline, MA, and Brandon, FL. Before retiring, Charlie worked as a postal inspector for the U. S. Postal Inspection Service and auditor for AAA. He is a member of Silver Springs Lions Club, secretary/treasurer of VOSH International, a director of VOSH Southeast, and a member of Lake Mary Elder Affairs Commission. Charlie has led missions to Croatia, Bulgaria (2), Hungry, République Dominicaine (2), Pérou, Paraguay (3) and Vietnam and also participated in missions to Brazil, Romania, Ukraine, Mexique, and Peru. He is one of three Floridian Lions Club members who were involved in the charter of VOSH-Southeast in 1996.

John Spencer, clinic director, is an optometrist from St. Paul, MN. John is currently practicing in West St Paul MN in a multi-specialty group setting. He and his wife Marguerite have six children. This is John’s 6th VOSH mission. He likes to read and travel; he and his family love the water and particularly enjoy Lake Superior. John a développé une philosophie "pas de soucis", evolving from his two years teaching at the University of Auckland, Nouvelle-Zélande.

Irma North is an optometrist and had a solo contact lens practice in Chicago for 54 years. She has two daughters; one lives in Texas and one lives in Washington. She moved to the state of Washington to be close to her daughter and family. She thinks this is her 38th mission; she started participating in missions in 1977. Irma says VOSH keeps her alert.

Anup K Deol graduated from Illinois College of Optometry in 1991, did a residency at the VA Hospital in Huntington West Virginia, has owned her own practice since 1994, and is a solo practitioner. She has done previous VOSH missions to India (which she led), Russia, Nicaragua, Honduras, Samoa, and Mexico. She and John Knutsen, another member of the vision team, will be married this summer. On the mission they met Yusuf, an orphan, and are very interested in adopting him, if possible.

Anwi Ngando is from Limbe, Cameroon in West Africa and is a third year student at Illinois College of Optometry. Anwi enjoys traveling, is fluent in English and French, and speaks some Spanish. She said participating in this VOSH mission has been an inspirational, self-fulfilling, and memorable experience for her. Someday, she plans on leading a VOSH mission to her hometown in Cameroon.

Joseph Pruitt is a student at the Illinois College of Optometry and is due to graduate in May 2007. Joe is from Chino, CA and has been interested in becoming an optometrist since the age of 7 when he had his first eye exam. He is unsure exactly where he wants to practice, but he is sure it will be a career filled with more mission work.

Cerella Wade is finishing her 3rd year at the Illinois College of Optometry. In New Orleans she graduated from Ursuline Academy and from Xavier University. This summer, Cerella begins her rotation with her first stop in Long Island, New York. She is still evaluating where she will practice following graduation next year. Cerella has always been drawn to social causes; this mission was Cerella’s first missionary work; the experience she gained in Ethiopia has helped her perform clinical practice at an improved level.

Maggie Arkinstall, the sole representative from the United Kingdom, is a newcomer to such a voluntary mission, but planning more following retirement in 2007. She is currently working in the construction industry in the Midlands. Maggie has lived in Peru, Jordan, Saudi Arabia and Malaysia because of various civil engineering projects, as well as Canada and Australia in her younger day! She still has a long wish list of countries and cultures to experience.

SuEllen Brauer, mission biographer, lives in Decatur, IL and is the doting aunt to 12 nieces and nephews. She is a retired mathematics teacher and is presently working part time as a math consultant to the Decatur Area Technical Academy. She enjoys doing all kinds of needle arts, reading, and traveling. This is SuEllen’s 6th VOSH mission; she has done other VOSH missions in Honduras (3), Paraguay and Peru.

Alan Carpenter retired from Travelers Ins. June 1, 2005 after 42 years then married Rebecca, a 5th grade teacher; between them they have 3 grown children and 3 grandchildren. Although he has done other missions in foreign countries (Afrique, China, Costa Rica, République Dominicaine, Cuba, and Brazil) this is his second VOSH mission; his first VOSH mission was to Paraguay.

John Knutsen was born and raised in Washington State, he has a Bachelor of Science degree in finance, and he is a real estate investor in the northwest part of the United States. John said VOSH Southeast mission to Ethiopia was his first VOSH experience and his first venture to one of the poorest countries in the world. He described it as an amazing experience that every person should get to do at least once.

Laura (Duchess) DeMent, mission photographer, is a nurse practitioner. For 30 years she worked in school-based clinics; the last 20 years were with special education ED/BD children aged 6 - 21. She has a son, two daughters, et 3 grandchildren. Laura has traveled all over the world; this is her first VOSH mission, but she has done other volunteer work including medical missions in Guatemala, Honduras and Native American reservations. She also taught English in Russia.

Judy Johnson says this, her 3rd VOSH mission, was a reprieve from working with her two brothers in preparing their parents’ home for sale. She’s a Minnesotan with four sons, seven grandchildren, keen interests in people, their cultures, travel and teaching English to immigrants and refugees. Other VOSH missions were to Peru and Paraguay. A family safari in Tanzania is planned for July with a son and two granddaughters.

Caryl (Cookie) Mikrut and her husband Louie have 5 grown children and 7 grandchildren. Cookie is a retired elementary school teacher; when I asked her how long she had taught she said it seemed like 500 years. She describes herself as a volunteer junkie, her motto is “have bag, will travel”. She has done VOSH missions in Hungary, Croatia, Bulgaria, Pérou, Honduras, Bosnia Herzegovina, Mexique, Nicaragua, and Vietnam.

Cliff Morris, Jr. lives in Orlando, FL; he and his wife Angela have 8 children and 7 grandchildren. Cliff is a retired mathematics professor and dean from Valencia Community College, Orlando, Floride. After a November 2000 People to People trip to Cape Town, Johannesburg, and Pretoria, South Africa, he began in 2002 teaching mathematics annually in Mitchell’s Plain at Portland High School (usually in March). He has been involved with VOSH missions to Brazil, Pérou (2), Romania, Paraguay, and Hungary.

Iva Prosser is a widow; she was an army wife for 25 years; she has 2 sons, 2 daughters, et 13 grandchildren. She was born in Florida and presently lives in Florida but has lived in Germany, Korea, and Alaska. She is a licensed Optician and has owned her own business. She has been struck by lightning, is a cancer survivor, and has a pilot’s license for a single engine plane.

Stanley Mataichi Sagara, a resident of Washington DC who was raised on the Yakima Indian Reservation in WA, is an US Armed Forces veteran (506 Parachute Infantry Regiment (PIR) 101st Abn Div, et 508 PIR 82nd Abn Div). After retirement he served in the Office of Special Investigations, US Air Force, was Office Manager for the Chief Seattle Council, Boy Scouts of America, and served as a Criminal Investigator for the Office of Naval Intelligence. He joined the Lions Club in 1984, started collecting eyeglasses, and has participated in 23 missions to various parts of the world, including Nicaragua (4), Honduras (2), Mexique (2), Guatemala (2), Paraguay (3), Ukraine (2), Russia, Bulgaria, India, Viet Nam, Cambodia, and Thailand. He has a son, a daughter, and two grandsons.

Joseph Scheinkoenig is originally from Milwaukee but recently moved to Land O’ Lakes, Floride. He was a chemical engineer in the field of Seawater Desalination, served as president of St. John’s Northwestern Military Academy, and served 38 years of active and reserve service in the U. S. Army. This is his first VOSH mission. but he has been on other eye care missions to St. Vincent, Mexique, and Costa Rica.

Joseph Wade is employed at Bell South in Louisiana where he is a software developer; he is an engineer by profession. Joe is also a colonel in the Army Reserves. Joe ended a six-month deployment as an Army Communications Officer with FEMA in Baton Rouge, LA. He helped FEMA to rebuild the communications infrastructure throughout LA following Hurricanes Katrina and Rita. This was his first VOSH experience. He and Rena are the parents of Cerella and Jamille; Jamille is an Accounting major at Florida A & M University in Tallahassee.

Maurenia (Rena) Wade is an Accountant at Dominion Exploration in Houston, Texas. Rena makes her home in New Orleans but following her company’s move to Houston, is temporarily in Houston and displaced due to Hurricane Katrina. Rena is also a colonel in the Army Reserves and will retire in October. During a year long deployment in Kuwait there were few opportunities to spend time with family, Rena enjoyed her VOSH experience as a chance to spend time with Cerella and also perform a voluntary service.

Our Host and Guide

Our host and guide while we were in Ethiopia was Rashid Bede, a tall Ethiopian man with a ready smile who wanted to give back to his hometown of Jigjiga, a city of about 250,000 people in the eastern part of Ethiopia. Rashid is a college graduate, a medical lab technician and works with Dr. John Spencer in Minnesota. When he told me his story, he started the story with his paternal granddad, who was born in Kabribayah (a city in Ethiopia near the Somalia border) and became clan leader of that area. At that time Haile Salassie was the ruler of Ethiopia, and the children of clan leaders had many opportunities for education. Rashid’s dad graduated from the Addis Ababa University in political science and went on to get his masters in Germany. He came back to be governor of the state Harar Regional (at that time there 14 states but now Ethiopia is divided into 9 ethnic states and 2 administrations, one of which is Addis Ababa, the capital of Ethiopia). Rashid’s dad was killed in the 1977 war between Ethiopia and Somalia; the war was a dispute over land. Rashid, who was 4 ou 5 at the time, said his father was shot, but they don’t know by whom.
Rashid’s family is Muslim. His father had two wives; Rashid has six brothers and sisters and seven half-brothers and half-sisters. When his father died, Rashid’s grandfather took eight of his grandchildren-Rashid included- to Somalia on foot. The rest of Rashid’s family remained in Ethiopia. Rashid graduated from high school in Somalia at the age of fifteen.
En 1990, a civil war in Somalia caused many to flee to Kenya. En 1992 Rashid, now in Kenya as a refugee, was granted official US refugee status and flown to Atlanta, Georgia. He went through an ESL program (English as a Second Language), and by December had moved to Minnesota where he attended St. Paul Technical College, graduating in 1999 as a medical lab technician.
Rashid’s employment as a “lab tech” carried him to West St Paul and Allina Medical Clinic, where he met and befriended John Spencer OD (Rashid is everybody’s friend!). Conversations led to intense planning of FL-VOSH’s endeavor to Jigjiga, Ethiopia under the guidance of Charlie Covington.
Rashid was married in May 2005 via “semi-arrangement” with the help of Rashid’s mother. One year out, husband and wife manifest much happiness.

Ethiopian Volunteers

The success of any VOSH mission depends on the vision team, the host, and the volunteers of the country. The first volunteer that comes to mind is Dr. Ahmed; he is well respected in Ethiopia, is a doctor of dermatology, head of the State Health Bureau of Jigjiga and works with the Minister of Health of Ethiopia. Charlie (mission leader), John (clinic director), and Rashid all spoke very highly of him; they said he was instrumental in getting our glasses out of customs and contributed to the overall success of our mission.
A group of volunteers that we could not do without are the interpreters. On some missions some of the vision team may speak the language; in Ethiopia there are 9 official languages and countless dialects; not surprisingly, none of the vision team spoke any of the Ethiopian languages. The stated literacy rate in Ethiopia is 44% for males and 33% for females; finding Ethiopians comfortable with the English language was difficult. This was the first time most of the interpreters had spoken English with those from America or the UK; our accents were most definitely an issue. At times the interpreter could not understand the specific dialect of Ethiopian and had to get another interpreter to translate.
Additionally, there were many others who helped and supported us: the drivers, the cooks, security, the people who did our laundry, etc

The Mission

We left Washington Dulles about 9 h; it was a 16-hour flight to Addis Ababa, Ethiopia with an hour on the ground in Rome. We arrived in Addis Ababa about 9 h (Ethiopian time). Getting the glasses through customs is always a worry; so, when they told us they would collect our luggage while we waited in the VIP lounge, we took that to be a good sign, but they took the glasses to customs. There was a $2,000 import tax assessed on the glasses; this was based on the stated value of the glasses. We were informed that we needed a fax from the Minister of Finance to give us a waiver; he was not in his office at 10:00 pm on a Friday night but his deputy was. This tax is relatively new, and the Ethiopian Embassy had not informed us about it; but, apparently we were supposed to have gotten a waiver before we left home. While on a previous mission, Charlie had recalled the glasses had been left in customs overnight unattended and had “disappeared” by morning. Given this, Charlie decided it was best that John and Rashid spend the night with the glasses; the remainder of the team was taken to the hotel.

The negotiation team to get the glasses out of customs was Charlie, John, Rashid and Dr. Ahmed. The deputy Minister of Finance asked us to have a letter faxed from the Jigjiga State Finance minister, which we did the next morning and brought it to customs. Customs said we needed another letter from the “Head of State”; the wheels of bureaucracy grind slowly! While this took place, the rest of the vision team was at the hotel waiting for some word of what was going on. Finally at 2pm, the Head of Airport Customs said the first letter was enough documentation and ordered the glasses released. It was unclear if he had decided we had jumped through enough hoops, or was impressed (John says perhaps fed up) with our persistence. Charlie said when the glasses were released, the negotiating group didn’t waste any time getting the glasses loaded in the van before someone changed their mind.

The original clinical itinerary called for: a bus ride to Jigjiga the day after arriving in Addis Ababa; three days of clinic at one site; a free day; two more days of clinic at another site; and back to Addis Ababa for about three days recuperating and R&R. But with the extra day on the front end in Addis Ababa, the group decided to forfeit our free day and work five consecutive days of clinic.

Most of the airports in Ethiopia do not have paved runways; Addis Ababa Airport has paved runways; Jigjiga Airport does not. If the runways are not paved, take off and landing is not a given especially during stretches of inclement weather…like rain! Since we would be shouldering a rainy season, it was decided to travel by bus. The provided transportation included a bus for most of the team (with luggage tied on top) and four Land Rovers for the glasses, the luggage, and seats for few of the team. (It is hard to believe how much room is needed to transport the glasses. Charlie had rented a big van to drive the glasses, with Alan, from Florida to Washington Dulles; with their luggage and the glasses there was absolutely no extra room in the van.)

Before leaving the states, we had been assured that the trip from Addis Ababa to Jigjiga by bus would take 9-11 hours. While waiting around at Addis Ababa Airport trying to get the glasses out of customs, Charlie and Rashid had been able to make arrangements for the team to travel the first day to Nazret, two hours closer to Jigjiga. The next morning we left Nazret at 7 suis; et, being two hours closer to Jigjiga, we were expecting another 7-9 hours on the bus. The good news was that the roads were paved all the way to Harar; the last 1/4 of the way, about the last 4 hours, there were washboard type bumps. There was plenty of bad news, including poor bathroom facilities and no suitable lunch stop, but about 9 h (that is 14 hours on the bus) we could see the lights of Jigjiga and we had a flat tire. Hotel Bede kept the lights on and had dinner waiting for us. The bus ride back to Nazret at the end of the mission and to Addis Ababa the day after that is a similar tale of long hours and poor facilities, but this tale includes driving through flood waters to reach a low bridge to cross a river, waiting an hour because of “frozen” brakes, and having a driver with questionable night vision skills.

The first site for the clinic was in the health center of the city of Kabribayah. This is primarily a Somali-Muslim area, very much like Jigjiga 30km to its west. Kabribayah has about 50,000 inhabitants and within its confines there is a refugee camp of people who fled the 1990 Somalia civil war. I was told the city now has a middle school and a high school, and the young people have a chance for education; however the website ies.edu.org/projects/Ethiopia painted a different picture.

“Basic services in this region are rare, and this includes opportunities for basic education. Schools, well-trained teachers, and instructional materials are severely lacking. Qur’anic schools are fairly numerous throughout the area, but their curricula consist primarily in studies of the Qur’an, while their teaching method is usually rote memorization. Even within the existing Qur’anic schools, fewer opportunities exist for girls than for boys. As a result, less than ten percent of the children attend formal schools; and only about one-third of those attending are girls.”

The health center is “staffed” by one doctor and primarily functions as a “maternity ward” of sorts, a TB clinic, and an internal medicine clinic. The health center itself had about 10 rooms surrounding a courtyard with covered walkways; all rooms had concrete floors. This layout enabled us to start at one end with registration, continue around with visual acuity, do the Retinomax, see the doctors in a semi-darkened room, and wind up with dispensing and fitting of the glasses in an open area, with an adjoining secure room for our glasses.

The first morning in Jigjiga we left the hotel at 7am, drove an hour to Kabribayah, set up the clinic and started the patient flow at 11:30 suis. This means we arrived at the site, looked the site over and decided how to set up the clinic, unloaded all of our equipment and glasses and solved all of the tactical problems in 3 and a half hours.

The second site was in the “eye clinic” section of Karamardha Hospital, the State hospital of the Somalia Region in Jigjiga, a 10-minute ride from the hotel. The clinic was staffed by an ophthalmologist, surgery support personnel, technical assistants, and two additional doctors. Several of the team was invited to observe two or three of the eye surgeries; the skill of the ophthalmologist, amidst the dodgy conditions, was most impressive.

We didn’t have as much room for our clinic here as we did at the health center in Kabribayah, the quarters being tighter and less direct; therefore lines didn’t flow as well. That disjointedness, along with the veranda-type setting could have been a precursor to chaos and security issues, but all worked hard ensuring a relatively smooth process. It was at the Karamardha Hospital registration area where chaos did temporarily erupt, but this was abated nicely by Maggie and some duly motivated military personnel.

The hospital itself is State-run with most treatment and “services” being free to the patients. However, basic ancillary services such as lab testing are not often available; resource to medicinal treatment is rare, (and medical prescriptions, if able to be filled, are done so at a cost directly to the patient).

Clinic Director John Spencer shares his thoughts:

“Clinically, the Ethiopia mission involved a unique patient population, avec une maladie oculaire "classique" qui pointe malheureusement trop souvent le bout de son nez. Oral and topical antibiotics were helpful, yet only a handful of the many needing assistance were seen and able to benefit. We did in fact see close to 2,700 patients (credit the hard work of the FL-VOSH and Ethiopian volunteers), however the need for primary eye care is ongoing and seemingly endless; so much more can be and should be done.”

When you see so much need, it becomes difficult to focus on things you can do. Anup did bring to our attention 4 jeunes enfants. She writes:

“This was one of the most needed missions I have done. I could not believe the amount of ocular disease that we encountered, especially trachoma (What we need to do is help with their water supply). Also the other thing that touched me was the four little patients that had tumors in their eyes, and we collected money to send them to Addis Ababa for enucleation of their eyes to try and save their lives.”

Ethiopia has National Health Care; at no charge to the families, surgery is available in Addis Ababa. However even with National Health Care, families are financially responsible for getting the children to Addis Ababa and for the room and board for the family while in Addis Ababa; very few families, if any, can afford to do this. As Anup stated, the vision team took up a collection of $600 to be used by the families for these purposes. The money was left with Dr. Ahmed; who followed up, arranging the surgeries and monetary logistics for the families.

I asked Charlie how this mission compared with other missions and to comment on the security issues.

“Twelve years of participating in and leading missions to most every region of the world could not prepare me or my colleagues for what we witnessed and experienced in the Somali refugee camps on the border of Somalia and in Jigjiga. In Jigjiga, a teaming city of several hundred-thousand, it was readily apparent that the need for just about any kind of service was almost overwhelming. We began our mission in a Somali refugee camp about 30 km outside Jigjiga on the Somalia border. Thousands of patients lined up for the clinic. The number of patients that were blind, had cataracts and glaucoma numbered in the hundreds, many with very advanced stages of the diseases. Fortunately, there was a Cuban educated Ophthalmologist assigned from the State Minister of Health to perform surgeries but he too was soon overwhelmed with the number of referrals. After the first day, security became an issue as people pushed, shoved and fought with each other to gain entry to the clinic. The police and military had to be called in to restore order. The last two days, the clinic was held in the city of Jigjiga. Similar experiences were encountered at the second clinic site with a large population of glaucoma and cataract patients. Security was a nagging problem there as well.

During our stay, we had the pleasant surprise of seeing U. S. Army personnel living in our hotel. Captain Hale, the Commander of the Unit, told me that his group was there to help build the infrastructure in Jigjiga by doing such things as digging wells, building storm drainage, etc. Captain Hale said that it is the military’s program of helping people in regions where they might be adversely influenced by terrorist insurgent elements.

In closing, I would urge other Chapters to organize missions to this region of the world as the need is truly great.”

One of the good things about riding the bus is being truly able to observe the inner-workings of central and eastern Ethiopia. We drove through the Great Rift Valley and did see small fields, but most of the eastern country-side revealed rocks and “high-desert” aridness. Most of the field machinery seemed to be made up of either longhorn-type cows pulling a homemade wooden one shear plow, or the apparent landowner himself pulling the plow.

Dwellings (non Addis Ababa) varied greatly with the only consistency being that they were “primitive”. Types viewed included: huts with thatched roots; huts with camel dung plastered sides; corrugated tin houses; and small buildings made of concrete blocks. Near the first site of the clinic the houses were very colorful, looking like haystacks covered with material (tarps, plastic, cardboard, etc) to keep out the elements if possible; a repeated sign for me of Ethiopians are resourceful with what is available. Nothing is wasted.

There were varied modes of transportation. Few private cars were seen. We saw many buses and mini vans; most which had luggage tied to the top. There were blue and white taxis for transportation within the city and blue and white vans for transportation between cities. The transportation of goods was mainly done by trucks, small burros and camels; the occasional horse and cart utilized for small loads in the country and rural villages.

I know I was in truly in Africa, but I was nonetheless surprised to actually see wild animals. We didn’t see the “safari-type” lions and elephants. But we did come across herds of wild camels and baboons; in the evenings hyenas were seen and heard!

Experiencing different cultures is one of the joys, and sometimes frustrations, of travel. VOSH missions work closely with the people allowing us to experience cultural differences in a more “human” way than we would if we were typical tourists. Cultural experience can rely on economic conditions, religious beliefs, and even weather. Par exemple, with the warm weather most hotels do not find the need to heat the water; cold showers were one cultural difference I would rather have not experienced. Laundry was done by hand and hung outside to dry. Our hosts graciously offered to do our personal laundry but suggested we give it to them on a dry day.
The difference in time and perception of time was certainly apparent. The sun rises and sets at about the same time every day (approximately 6am to 6pm). We non-Ethiopian visitors were much accustomed to being punctual; our Ethiopian hosts appeared less in a hurry. Breakfast was indeed in the morning and dinner was indeed in the evening. Transportation did indeed arrive. However, the specific times for those desired events were variable.

One morning on the way to the clinic site Charlie asked Rashid to talk about culture; Rashid said our culture is “don’t ask, don’t tell”. Another time Rashid had said “they will tell you what they think you want to hear”. We also noticed that the patients keep asking until they get what they want, (which, I am told, is common most VOSHer’s experiences) For example, if they didn’t get eye drops from the doctor the patients would ask for them in dispensing and if they didn’t get them in dispensing they would ask for them in fitting.

Dress or costume is also a cultural difference. Ethiopia is approximately 40% Muslim (in fact eastern Ethiopia is almost predominantly a Muslim culture). The women of the Somali State of Ethiopia keep their heads covered with scarves, some bound quite tightly, making glasses adjustment perhaps the ultimate cultural experience. Several women had Henna tattoos on their hands; a vegetable dyed tattoo that lasts several weeks. Their hands may also be decorated with very graceful designs or flowers; it is attractive and gives the hand a very graceful look.

When we talk of cultural experiences, food usually comes to mind. The first clinical day lunch can be defined as “culture shock”, (I have no hesitancy speaking for the entire group on this). We were given a hearty plate of noodles cooked with onions, pommes de terre, a little seasoning, and pieces of lamb. We looked around for the silverware … hmm, la plupart des gens de la campagne n'utilisent pas d'argenterie, nous nous sommes donc ajustés et avons mangé à la manière éthiopienne - avec nos mains. (I do admit, since I always travel with a spoon and a tin cup, the second day I had my spoon in my pocket; et, when they handed me a plate of rice and meat, I was ready!)

Breakfast at the Hotel Bede usually consisted of scrambled eggs or omelets and toast; sometimes there were butter and peach preserves on the table. For dinner there was: rice, noodles, and spaghetti without sauce (at least two and sometimes all three would be served at each dinner); some sort of meat cut up in little pieces and cooked with some seasoning (Rashid said it was beef or goat); and French bread. There was also the typical Ethiopian bread called injera. It is sort of gray, spongy bread reminiscent of a pancake; one travel book described it as “moist and slightly pliant” and says to “tear off a coaster-sized piece and use it to pinch up two or three bits of stew”. Sometimes there would be other dishes such as a beet and potato salad or something that we thought was made of mashed split peas or lentils. Usually there was no desert, but we did have canned fruit and a tapioca-type pudding one evening. For every meal there was always plenty of hot coffee, hot water for tea, and bottled Coke, Fanta, and water.

I had a chat with Rashid and asked him to tell me about his country. He said Ethiopia is a large country with a population of 70 million, very friendly people; it is a rich country with lots of minerals and gold. Unemployment is very high in Ethiopia. I asked about security within the country, and he said there is the army and there is the police; while the army is seems very powerful; the police are local and cannot discipline the people. Families take care of their own, for there is no welfare system as we know it. When I asked what people do to make a living, he answered that Ethiopians are farmers (most of the land is owned by individuals ) or storeowners; the rest of the working people work for the government. Rashid’s mother, for example, started out by bringing some stuffs from Somalia and Dijibouti to sell in a small store. She saved her money for bigger things, and now she has Hotel Bede, as well as a construction company that builds houses, gas stations and drills wells for water. Mrs. Bede generously donated room and board in her hotel for the members of the vision team.

There are two rainy seasons in Ethiopia; the good season of rain runs from March to June; the fall rain runs from September through the first half of October. Being there in April, it was no surprise that it rained several days. In the area of Jigjiga there is no grass; if we looked at the hillside and saw green, it was the green of shrub bushes, not the green of grass. So when it rained in Jigjiga, it became muddy, really muddy.

I remember reading of deforestation, overgrazing, and soil erosion being significant problems of Ethiopia. I imagine most recall pictures of starving Ethiopian people and the 1984 song “We Are the World” that was used to raise money for Ethiopia (“We are the world, we are the children. We are the ones who make a brighter day so let’s start giving …”). With all of the rain and recollections of droughts and famine in Ethiopia, I asked Rashid about that; he said there still drought and famine southeast Ethiopia and that the UN, the USA, and the World Food program are actively involved in famine-relief in that area.

During our last night in Jigjiga, the mayor and other dignitaries treated us to a special dinner with entertainment and presents. The dinner consisted of our usual rice, noodles, spaghetti and pieces of meat (beef and goat), breads (French and the Ethiopian Injera), and the usual beverages. In addition there was: one dish of hard cooked eggs in an oily red pepper sauce; salad with cabbage, beets, tomatoes and sliced hard eggs; and cold cooked beets with potatoes. There was also more meat (chicken and lamb…we think) and fruit and tapioca-type pudding for desert.

The entertainment consisted of a troupe of eight Somali dancers and a singer accompanied by drums and keyboard. The men wore white shirts and white wrap around skirts. The women had on white dresses with tiered skirts, white head covering, colored sashes, and colored aprons. One of the dances was entitled “Celebration of the Rain”. Another dance had something to do with “fighting for a woman” that involved spears and other various accessories. The evening closed with the mayor giving each of us a piece of the national costume as a present. Each of the VOSH women received a shawl type garment that was to be worn over the head (although several of us wore them as shawls in Addis Ababa). Each VOSH male received a brightly printed garment to be worn as a traditional skirt.

Our R and R included a couple of days in Addis Ababa. As we can all testify, this is an important part of the mission; it provides a necessary respite from the long days under adverse conditions, much like that cup of coffee and conversation at the end of a good dinner.

The first afternoon and the next morning of R&R in Addis Ababa, we were on our own. Some went shopping at the Mercato (some went shopping twice at the Mercato), Africa’s biggest market, and bought treasures for themselves or folks back home; some caught up on sleep, email and/or reading. Laura and I hired a taxi for a couple of hours to tour Addis Ababa; I wanted to see places a bus cannot go; we particularly wanted to see the churches. Our taxi driver obliged and took us to three. We also wanted to see the differences that big city life offers city versus our “country life” experience in Jigjiga. We saw regular type stores and businesses, tall apartment buildings with balconies, evidence that people lived there just like they do in other big cities, and lots of construction sites. I ended up with more hopeful feeling of Ethiopia after this tour.

As a group on day two of R&R, we went to the National Museum of Ethiopia and saw Lucy, the most famous feature of this museum. Donald Johanson and Tom Gray found Lucy’s remains on November 24, 1974 and Lucy is dated to be just less than 3.8 million years old. The way Lucy got her name, according to the Arizona State University website, is that there was much celebrating the night of November 24, 1974 with the Beatles song “Lucy in the Sky With Diamonds” being played over and over. At some point during this night, someone, no one remembers who, started calling her Lucy and the name stuck.

The meals during the R and R part of the mission always seem particularly special. Before I left for Ethiopia friends had told me about Ristorante Castelli, saying it was supposed to be the best Italian restaurant in the world, (corroborated by Sir Bob Geldorf, the force behind “We Are the World”). I was skeptical, but passed the word along to Charlie. The first day back in Addis Ababa we made reservations, and we can attest to the fact that Castelli’s is wonderful. The restaurant was opened in 1948 by an Italian soldier, Francesco Castelli, who had come to Africa in the late 1930’s as part of Mussolini’s occupying army; et, when it was time to go home, he decided to stay and open a restaurant. His widow Rosa stills runs it with her brother Carlo.

Our meal started out with a cold anti-pasto salad buffet followed by three mains dishes served family style; these included the house specialties of Spaghetti allo zaffarano piccante (spaghetti with a spicy mix of turmeric and saffron), Linguine alla Costantion (linguine made with a secret sauce named after a regular customer), and to-die-for pasta with Gorgonzola. The décor is charming, laden with wooden floors and paneling. It is said that anyone who ate at Castelli’s in 1955 would find the place virtually unchanged.

The next night, our last night in Ethiopia, was also special. Rashid arranged for us to eat at a typical Ethiopian restaurant whose décor reminded me of the “Big Houses” in safari movies. It was rustic with rattan furniture. The wall decorated with pictures made out of seeds. Again we had musical entertainment of singing and dancing. The meal was served around a rattan coffee table while we were seated in comfortable rattan chairs. Before the meal, we were brought warm water in pitchers with a bowl to wash our hands followed by a towel for drying. We could order whatever beverage we wanted to drink, but the meal was served family style on big rattan platters. There were small bowls of varied spicy foods to be eaten with injera. After the meal, pitchers of warm water were brought around again to wash our hands.

Missions to third world countries are tough yet rewarding and fulfilling. I asked Joe, one of three third-year optometry students on the mission, to share his thoughts:

“I always expected Ethiopia was going to be a country inhabited by a significant amount of “have-nots”. That is one of the staple definitions when one tries to define a third world country. Unfortunately, even with that being said, I could never have been prepared to deal with what I encountered. I expected to see the “have-nots” and I saw the “have-nothings”. I expected to help the visually impaired and ended up just hoping I comforted the blind. I went on the trip expecting a little break from my monotonous life and returned with exceeding joy for every mundane aspect now knowing first hand what my life is like.”

This was a good mission. We saw so much poverty that it would have been easy to focus on what we could not do instead of what we did do. We saw 2, 628 patients in 5 journées. Each patient saw an optometrist. We dispensed and fitted many pairs of glasses; but, unfortunately, we couldn’t help about 20% of the patients because they already had advanced disease. When I think about all of those we couldn’t help, I try to remember a particular five year old boy; I try to remember the smile on his face when we put glasses on him and for the first time he could see the pictures on the wall; I try to remember the hope that I felt that he, and countless others, will have a better life because we were there.

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