Ethiopia’s
UNSEEN
a project of THE UNIVERSITY OF NEBRASKA–LINCOLN’S COLLEGE OF JOURNALISM AND MASS COMMUNICATIONS
Saving
SISAY
Seven-year-old Ethiopian boy fights scoliosis story by FAIZ SIDDIQUI photos by ANDREW DICKINSON
My friends hate me. No one wants to play with me. SISAY | scoliosis patient
I
t’s a late-spring morning in Ethiopia’s bustling capital as a dozen kids flock to the courtyard of their open-air school. Someone scoops up a crushed water bottle and suddenly a frenzied soccer game erupts before the bell rings. On the balcony above, a shy 7-year-old boy pokes his head through the arms of a rusty guard railing. The tiny third-grader, with puffy cheeks and missing front teeth, stares down as classmates twice his size furiously skitter the makeshift
plastic ball across the asphalt. Sisay Gudeta rises on his tiptoes, clenching the blue metal bars for a better view. His face is an expressionless mask amid the screams and early-morning laughter of his frolicking classmates. For a long time, his bulbous brown eyes fixate on the courtyard, on the game he loves more than anything. He’d be down there with them if he weren’t so worried about being pushed around. He desperately wants to run like his friends, to be free and fearless – just like them. He
says such things all the time. For his mother, it’s a constant struggle, a constant challenge to try to explain the pyramid-shaped hump bulging beneath his green cotton sweater. The bump on his spine that he was born with. The one that gets bigger and bigger each year. The one they cannot afford to fix. The one that could one day kill him. “My friends hate me,” he tells her one day after school. “No one wants to play with me.”
Sisay attends Tesfakokob primary school in Addis Ababa, Ethiopia. SAVING SISAY | 2
Twelve spine patients, who all recently returned from surgeries in Ghana sponsored by Hodes’ organization, pose for a picture for the doctor in front of the back wall of The Cure Hospital.
New York native operates Ethiopian spine clinic, saves thousands
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n a gated compound on the other side of Addis Ababa, a clean-shaven New Yorker sifts through a sheaf of X-rays and medical documents, quietly sipping his afternoon cup of tea. He wears a plaid button-down with rolled up sleeves, round metal frames sliding down the bridge of his nose. To his Ethiopian assistants, he is “Dr. Rick.” To his American office staff, he is simply “Rick.” But to those who hobble into his clinic on afternoons like this, those in desperate need of life-saving spinal reconstructions,
Richard M. Hodes, M.D., is something else. He’s their last hope. Hodes, 61, operates the only known spine clinic in this city of 3.4 million, the capital of a country where the ailing and destitute are largely forgotten. Even at a mere 5-foot-3, 127 pounds, he’s bigger than most of his patients. But he wasn’t always sure he would study medicine. Hodes graduated in 1975 from Vermont’s Middlebury College with a degree in geography. At the time, he wasn’t really interested in a job, so he painted houses and hitchhiked to
California. Eventually, he traveled to Bangladesh and South India. “In Asia, I saw lots of very sick and deformed people, and decided that this is how I could use my medical skills,” said Hodes, who soon enrolled at the University of Rochester School of Medicine. He received his medical degree in 1982, then began an internal medicine residency at Johns Hopkins University. After completing the residency, he embarked on a journey that would dramatically alter the trajectory of his life.
SAVING SISAY | 3
Sisay and a fellow spine patient take a minute to stare at a passerby in the trees while waiting for their appointment at The Cure Hospital.
A man of strong Jewish faith, Hodes ventured to Ethiopia during the mid-1980s famine that led to hundreds of thousands of deaths, a horrific tragedy that thrust the country into the global spotlight. For the last two decades, he’s lived in Addis, evaluating patients whose spines, he says, are among the worst in the world. “We’re sort of setting world records here,” says Hodes, who serves as Ethiopia’s medical director for the American
Jewish Joint Distribution Committee. People in this landlocked nation, in the northeast corner of a sprawling continent, are expected to die about 16 years earlier than Americans, according to the World Health Organization. And for citizens who, on average, live on less than $1,200 annually, a $20,000 spinal reconstruction is a hopeless proposition. But these hump-backed children have a friend in Hodes. He has provided free medical
evaluations for 1,700 of them, while legally adopting five Ethiopian children himself. Helping victims of severe scoliosis and other illnesses long thought to be eradicated – spinal tuberculosis and polio – has long since become his life’s work. But there’s a hitch: He cannot help everyone. In a sense, he has to select those who will live. And those who will not. In a sense, he has to play God.
SAVING SISAY | 4
‘Everything is temporary’
W
hen Sisay peels off his shirt, ribs visibly appear just beneath the skin. And there it is: a soccer-ball-sized bump protruding from his back. His mother admits that sometimes, when she sees the hump, she gasps. The 42-year-old mother hasn’t told her son about the severity of his condition, and Sisay himself is a bit shocked when he sees photographs of his back. But he knows there’s an issue. Otherwise, why would he be – at 7 – just a shade over 3 feet tall? “When he puts his clothes on, he feels bad because people can see his back,” the mother says. “If he goes to the field to play ball, they will not let him play because they think he is sick.” He is. For tens of thousands in Ethiopia, scoliosis twists spines to a life-threatening degree. Doctors there believe that similar conditions – a result of malnutrition, a shortage of specialists, and a lack of early medical screenings – exist in many poor countries. But they also say the condition seems to be more acute in Ethiopia.
TOP: Sisay stands alone outside his home as night sets on their neighborhood MIDDLE: Sisay is washed in a small green bucket by his mother, Abonesh at their home. He receives this washing twice a week. BOTTOM: Sisay approaches the main gate of The Cure Hospital on Shiro Meda.
SAVING SISAY | 5
In the US, for example, doctors routinely recommend back braces for any children with spinal curves greater than 25 degrees. Doctors often rely on surgery to correct spinal curves of greater than 45 degrees, according to the National Institutes of Health. Scoliosis has curved Sisay’s spine 120 degrees, unheard of outside the developing world. For this reason, he shares a common trait with many victims of congenital spine diseases in his country: a hood-shaped hump protrudes from his back, leaving
his upper body constricted and underdeveloped on top of thin, stilt-like legs. If he doesn’t receive treatment, doctors say he’ll continue life with the lung capacity of a 7-year-old until the condition kills him, as early as age 14. “He is such a beautiful child,” says the grandmother, Dangale. She sits in a corner rocking chair, knitting a white dress to sell at the nearby Merkato for less than a dollar. It will take three weeks to finish. “After he got sick, I just felt like crying. I asked God what I did to do this to him,” the grandmother says.
TOP: Sisay wipes his eyes as chalk dust falls off the blackboard in his first grade classroom. He is often called to the board to do exercises and he is third in his class of 39. BOTTOM LEFT: A student at the school stares at Sisay as they walk home through their neighborhood after classes ended on. Sisay gets stared at and made fun of because of his condition. BOTTOM RIGHT: Sisay watches as other school children play before the start of classes. He can’t keep up in activities that require jumping or running, and doesn’t like being pushed around, so he usually doesn’t participate.
SAVING SISAY | 6
Sisay sits next to his mother, Abonesh Teka, in their home.
The mother, who earns a dollar a day picking up trash on city streets, once carried her son up a 10,500-foot peak overlooking the city, believing that if no one else could, surely God would save her child. There, on Entoto Mountain, is where a mother journeyed to the most sacred site in the Ethiopian Orthodox tradition. At the summit, the mother cradled the sick child in her twig-like arms, bathing him in holy water. Later that day, they returned to
their tin-roof shack that lies in a back alley, in a densely populated neighborhood. The home is where the boy watches “Tom & Jerry” on a rickety television set with two channels. He almost broke it once, trying to push a DVD of music videos he’d gotten from a neighbor into the screen. There was no slot for it. “I don’t touch it,” he says of the television. “If I touch it, it will break. And if it breaks, I will not be happy.” In their tin-roofed shack, a ray
of light shines through a small hole in the plank door. Another shaft splashes their yellow cement walls from a ceiling skylight. On the wall a wooden placard reads: “Hulum Yalfal” -- “Everything is temporary.” One day after school, the boy tells his mother: “Take me to the hospital so I can run like my friends.” For years, she has tried to do exactly that. But it was always the same – the doctor said there was nothing they could do. But soon, she will try again.
Sisay hits a balloon toward his sister Tigut as they play together in their home. SAVING SISAY | 8
Hodes relies on faith to discern how to treat scoliosis patients
O
Sisay, center, leans on his mother as they both wait for their names to be called at the clinic. They arrived at the clinic at 7:15 a.m. and they weren’t seen until 1:30 p.m. 60 patients were at the clinic on this day.
n this late-May afternoon, Dr. Hodes is catching up after a threeweek fundraising trip to America, where he stopped at Brandeis University to deliver the school’s commencement speech. To subsidize the spinal surgical costs, he tours the United States a few months every year, raising the money to pay for each operation. Over the years, he has raised several million himself, primarily via speeches to groups of private donors through-
out the Northeast United States. But he hopes to one day open a spine center in Ethiopia that handles cases as extreme as the ones he routinely sees. He estimates the project will cost between $10 million and $20 million. Now, he’s face-first in a pile of immigration papers, medical histories and fresh scans of his patients’ backs. On his X-rays, spinal curves of 120 and 240 degrees tend to look like roller-coaster tracks or musical instruments.
One day, a boy visited Hodes’ clinic with an almost serpentine curvature in his back, going “down, then up, then down again.” Hodes recalled his initial shock at learning the extent of Ethiopia’s spinal diseases. It’s common to see kids with warped backs hobbling up and down the road, or begging on street corners. Sometimes, healers in rural villages near the northern border try to flatten patients’ backs by pressing smoldering rocks to their skin. SAVING SISAY | 9
“Even in the United States, with our very crazy health system, you can still manage to get spine surgery and correct it at a decent point,” he says. “I always thought the worst thing would be 180-degrees – so that’s like a pancake folded on top of each other. But in fact, there’s a kid who has 240-degree scoliosis. His spine is like a saxophone.” His surgical candidates are sent to Ghana, where Dr. Oheneba Boachie-Adjei, an orthopedic surgeon, leads the nonprofit Foundation of Orthopedics and Complex Spine in Accra, that country’s capital. The two doctors have teamed up to provide 300 surgeries over the years.
“If you leave these kids alone, you won’t see them as teenagers,” says Boachie-Adjei, Chief Emeritus of the Scoliosis Service at the Hospital for Special Surgery in New York. The surgical treatment typically consists of several procedures – an initial one to help straighten the spine, another that stretches it to promote normal growth, and a final one that surgically rebuilds the spine into a normal configuration. Hodes knows he can’t heal everyone. So he tries to focus his resources on young patients with promise. Ideally, they’re younger than 25 and doing well in school. Ideally, someone like Sisay – a 7-year-old who’s
third in his class and dreams one day of being a pilot. “I have criteria for this, but it’s very tough knowing that so many lives are in my hands,” he says. “I say a prayer asking God to help me in my work before sitting down to analyze these records.” For Hodes, faith is the only way to come to grips with reality. After months of evaluating patients, diagnosing conditions, and reviewing X-rays, he has a decision to make: Of the 270 new patients this year, he can only arrange surgery for 60. Today in his office, a diminutive 7-year-old boy’s scan prompted him to say: “We need to intervene.”
In a crowded doctor’s office, Rick Hodes takes a photo of Sisay as the two meet for the first time at Hodes’ clinic in The Cure Hospital. Hodes photographs all of his patients because he says x-rays don’t always show the human behind it, and also don’t always portray the severity of the problem. He currently monitors over 1,000 spine patients and spends $600,000 a year of fundraised money on sending patients to Ghana, Canada, Germany and other places for life-saving surgeries.
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Journey to healing Godeta sits in the lap of his mother, Abonesh, as they take a public minibus to the clinic at Cure Hospital on Shiro Meda.
T
hey awake in the pre-dawn hours of a chilly morning. Inside the home, Sisay slips his arms into a black, toddler-sized suit jacket held by his mother. He’s careful not to wake his sister, who sleeps on the floor below. At 6:10 a.m., he jumps up and starts toward the door. “Hold on,” his mother says, kneeling beside her daughter to say they’re leaving. Outside, blue and white minibuses await in the Abonet Traffic Circle, about three blocks away. The mother pulls her son into the
crowded cabin of the first van. She digs $1.50 birr (about eight cents) out of her pocket for bus fare. Meanwhile, Sisay begins taking in the sights: “Lion! “Dog!“ “Machina!” The boy doesn’t mind the bumpy ride. He rarely gets to leave the neighborhood. And then, for a brief moment amid the confusion of a larger, busier bus stop, they become confused. The mother doesn’t know which bus to take next. She and her boy can’t risk boarding the wrong one. Didn’t she almost scream when she first heard of a doctor who offers spinal exams, and possibly life-saving surgery – all
for free? But now she’s in a panic. Finally, a driver points them in the right direction. Sisay steps on board the second bus with a packet of shortbread cookies in hand – breakfast he bought at the food stand nearby. This time, the driver wants double the fare. In the middle of a crowded street, Abonesh forks over the money. She knows how many parents, desperately seeking care for their children, will be waiting outside the clinic on this chilly morning. She has no choice. SAVING SISAY | 11
I
‘Are you the man who’s going to fix my back?’
nside his bedroom, Hodes naps. He arrived back home around 3 a.m. following a three-week fundraising tour along the U.S. East Coast. On this morning, he wakes early. His assistants already have warned him that dozens of new patients will be waiting at the clinic – 2.9 miles away. By 7:15 a.m., mother and son are walking through the hospital’s tall blue gates. They’re the second family to arrive. For a moment, the stress is gone. For Hodes, it’s only beginning. He won’t arrive for several hours, but the 60 patients have begun pouring in. A man whose lifeless, twig-like left arm was broken and never treated 24 years ago, when a horse stepped on it. An uncle and nephew who drove 15 hours to have the 16-year-old’s massive knee tumor examined. A 24-year-old whose mangled spine leaves him unable to walk. They’re all waiting for one
doctor, hoping the man in the white coat with a buzzcut and wireframes can work a miracle. From his home, he slides into a private car. At 10:15 a.m. the car stops and his assistants climb out. Sixty patients wait in the parking lot. *** He knows all about the boy. He’s seen the pictures. Heard from his volunteers how witty the kid can be. The waist-high 7-year-old spots the doctor in the parking lot. He begins walking toward him. Their eyes meet. Then, the boy stops. He stands in front of the doctor, silent, looking up. The doctor leans down to eye-level. “What’s your name?” he asks. “Sisay Gudeta,” the boy responds. “Are you the man who’s going to fix my back?”
Editor’s note: Dr. Hodes approved Sisay for corrective spine surgery. He received the initial treatment in Ghana shortly thereafter, growing 2.5 inches in a month. In March, he returned to Ghana, where doctors attached metal rods to his spine to promote normal growth. The surgery was successful, and Sisay, who is learning English, is now on track to lead a normal life. Around puberty, Sisay will very likely undergo a final surgery to correct the curve in his spine.
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Craving
TRADITION the uncertain future of Ethiopia’s coffee industry photos by ALLISON HESS
Left: Webelem Merne talks with customers in her coffee shop on the outskirts of Addis Ababa. Middle: Merne pours coffee from a jebena, a traditional Ethiopian clay coffee pot. Right: Coffee beans roast on a small tray of coals sitting feet above the ground.
Ethiopians proudly claim the origins of coffee for themselves. According to legend, the first man ever to taste the drink that has now become Ethiopia’s biggest export was a goatherd named Kaldi. After noticing his goats’ energetic state after eating berries off a nearby bush, he brought them to an Islamic monk, who opposed their use and tossed the berries into a fire. After an enticing scent emerged from the fire, Kaldi and the monk removed the berries and brewed the world’s first cup of coffee. But much has changed in the world of Ethiopian coffee since Kaldi’s first cup. In Ethiopia, coffee is an integral part of an individual’s day. But it’s also a massive
industry — and one that often has difficulty sustaining itself. The tremendous amount of coffee that Ethiopians consume, logically, should mean success for the $3 billion industry. However, with high demand for coffee around the world and unpredictable price fluxuations, independent coffee shop owners like Webelem Merne (left) often get lost in the process. Merne herself struggles to break even and pay rent each month, selling between 50 and 60 Birr (about $2.50-$3) worth of coffee each day at the small coffee shop she runs out of her home. The curtain behind her is the only thing that separates her business from her private life at home. CRAVING TRADITION | 2
Ethiopia exports about 3 million bags a year to roughly 50 different countries.
50 million Ethiopians directly
or indirectly depend on coffee for their living.
Ethiopians consume 50 percent of the coffee they produce as a country. Ethiopia is the largest coffee-producing country in Africa, and fifth largest in the world.
The $3 billion industry is highly susceptible to exploitation on the global market. A pound of coffee sells for about 40 birr, or 2 dollars in the United States. Source: Structure and Performance of Ethiopia’s Coffee Sector, June 2014 and the International Coffee Organization CRAVING TRADITION | 3
Left: Ethiopian women leave the Oromia Coffee Farmers Cooperative Union (OCFCU) warehouse for a lunch break. The warehouse operates 24 hours a day, with workers sorting good the coffee beans from the bad.
Top Right: OCFCU workers sift through coffee beans in preparation for exportation. The cooperative union was founded 15 years ago and represented just 34 cooperatives. Today, it represents more than 230.
Bottom Right: The OCFCU was foudned to assist small-scale farmers in getting a fair price for their coffee beans in the Ethiopian coffee market. It fosters fair trade and economically sound relationships between traders, producers and consumers.
CRAVING TRADITION | 4
Above: OCFCU workers load burlap bags of sold coffee beans onto a truck to be delivered and exported.
Above: Women sit in the Merkato of Addis Ababa, sorting through piles of unroasted coffee beans. The Merkato is Africa’s largest open-air market, covering multiple square miles of Ethiopia’s capital city. It employs an estimated 13,000 workers, and is home to many small shops.
Above: A man meanders through the narrow opening between the coffee bean dealers in the Merkato of Addis Ababa. CRAVING TRADITION | 6
Dagme Chomen completes the cupping process in the OCFCU’s on-site cupping lab. Cupping is a process that determines the quality of the coffee.
Different types of coffee sit in OCFCU’s cupping lab while workers take notes on its taste and aroma. It decides what class of coffee it will receive.
CRAVING TRADITION | 7
[Coffee] is something that makes me very happy. I want it more than food. I am addicted to it. WEBELEM MERNE coffee shop owner
Autism’s
RESTRAINTS Muluneh Getachew spends a lot of his time restrained by the wrist with a long piece of soft blue material. Getachew is autistic and was brought to the Macedonia homeless shelter in Addis Ababa, Ethiopia a year and a half ago. He is restrained because his condition causes him to be in constant movement and the homeless shelter does not have the resources to provide someone to supervise him at all times. story and photos by ADAM PRIBIL AUTISM’S RESTRAINTS | 1
A growing
PROBLEM Muluneh Getachew, 10, suffers from a severe form of autism. Getachew lives at the Macedonia homeless shelter in Addis Ababa, Ethiopia and has never received treatment for his autism. Getachew rarely cries but when he does,
Getachew’s problems will be further enhanced as he grows and they are not able to easily restrain him. ZEMI YENUS President of the Joy Center for Autism his caretakers can be baffled as to the reason. Eleni Gebrelyesus who was caring for him at this time said, “I don’t know sometimes why he cries, some days he cries more.”
AUTISM’S RESTRAINTS | 2
HOPE
Finding
T
he Macedonia homeless shelter is home to 170 elderly, mentally ill, and terminally ill individuals. Muluneh’s autism makes him dependent on the same types of care as these individuals. Caretakers must feed, bathe and change Muluneh’s diapers. However, Zemi Yenus of the Joy Center for Autism believes therapy can assist him. “Within a year of therapy he would be able to do these basic functions on his own,” Yenus said. Eleni Gebrelyesus is one of the primary caretakers of Muluneh, at the Macedonia homeless shelter. Caring for an autistic child requires incredible patience, something Gebrelyesus has experience with. “When I was a child, my parents had too many children so I was sent to live at a monastery, it’s here I took care of elderly who couldn’t care for themselves,” Gebrelyesus said. Proper treatment for Getachew’s autism would cost about $150 a month. At Macedonia, that $150 feeds, shelters and clothes five people.
AUTISM’S RESTRAINTS | 3
A lonely
FUTURE
Muluneh is restrained to a bed at the Macedonia homeless shelter. Muluneh’s autism can lead to emotional outbursts, requiring him to be constantly supervised, but at the resource strapped shelter, he is restrained with a piece of soft rope when there is not a caretaker available to watch him. As Muluneh grows, his restraints will have to become stronger in order to keep him and those around him safe. AUTISM’S RESTRAINTS | 4
In his own
WORLD Muluneh spends the day at the Lion Park Zoo. Muluneh would rather feel his way around in the bushes than give any attention to the animal exhibitions. “Autistic children are in their own world and what we do here is to try and bring them into our world,” said Zemi Yenus, president of the Joy Center for Autism.
AUTISM’S RESTRAINTS | 5
Moving
FORWARD A
fter photographer Adam Pribil’s trip to Ethiopia, a fundraiser called, “Finding Muluneh,” was set up to raise money for treatment of Muluneh’s condition. Pribil and Alyson Osterbuhr put together the fundraiser, and as of Aug. 2014 it has raised $2,293 toward treatment for Getachew. This amount will cover his enrollment at the Joy Center for Autism as well as transportation costs for 10 months. The fundraiser is currently trying to reach a new goal of $5,520 that would ensure treatment for Getachew for two additional years. Donations can be made at www.youcaring.com/muluneh.
AUTISM’S RESTRAINTS | 6
Believing without
SEEING
Being blind and independent in Addis Ababa
story and photos by STACIE HECKER
BELIEVING WITHOUT SEEING | 1
People discriminated against me because I’m visually impaired. They don’t want to treat you like a full person. FATE TILAM
BELIEVING WITHOUT SEEING | 2
A thin-framed woman with thin-framed sunglasses lounged on a mattress tossed into the corner of the dilapidated concrete one-room house. Her cheekbones were gingerly touched with the sunlight peering over the top of the tin fence surrounding the house. The water droplets from her bath in a bucket moments ago were back-lit from the same sunlight. She was a beautiful woman, but she would never know just how beautiful she was. “People discriminated against me because I’m visually impaired. They don’t want to treat you like a full person. Generally, they kill your future hopes. That’s why I really don’t want to go back to where I was born,” Fate Tilam said. Fate is a 27-year-old blind woman living in Addis Ababa. She lives with her roommate, Fiker, who is also blind, and Fiker’s two children. Because they live in Addis Ababa, their home is expensive and costs the equivalent of 34 USD per month. Fate became blind at age seven, shortly after she and several of her classmates contracted smallpox. Out of 12 children, she was the only survivor. Fate works at Addis Raey Primary School where she teaches Amharic and civics to sighted students. She is also the school counselor, so students feel very close to her; but otherwise treat her like every other teacher. Fate says this is unlike her own experiences in school. Fate likes to spend her free time at the blind association – a compound where blind people gather to make friends. The real appeal of the blind association is for the people to have a place where no one will judge them. With about 42 USD coming in per month from her job as a teacher, Fate usually doesn’t have any money to spare. On special occasions, however, she likes to get her hair done. One of Fate’s great loves is singing. Fate was selected last year in the first rounds to participate in Ethiopian Idol. Fate was voted off in the second round. The judges said she hadn’t practiced enough. “You have to believe that you can learn, work and do activities just like others who can see. We feel bad when people say, ‘Look at those blind people.’ We can only teach them to change their attitude toward us. I accept everything as it is and move forward.”
Fate reads off of a braille document in order to teach Amharic and civics to her students at Addis Raey Primary School.
Fate is also a school counselor and has a solid, close relationship with students who treat her like any other teacher.
Daily activities can prove to be more difficult and lonesome for the blind in Ethiopia. Fate walks home alone in the streets of her town.
Fate and Fiker together at the blind association.
Fate competes on the first season of Ethiopian Idol; she was voted off during the second round.
BELIEVING WITHOUT SEEING | 3
Despite her small income as a school teacher and having bills to pay, Fate still finds the time and money to pamper herself with trips to the salon. “Blind people know everything we do for beauty,” Fate said. “I know myself best of all and how to look beautiful.”
There are 1.2 million in Ethiopia
blind people and
2.8 million with
(There were 94.1 million people in Ethiopia in 2013.)
Ethiopia has one of the highest rates of blindness in the
world.
impaired vision.
90%
of the blindness is either curable or preventable. BELIEVING WITHOUT SEEING | 4
I accept everything as it is and
move forward. Fate Tilam
CHILD
Behind the veil Yemikir and Tigiste sit alone in the back of their husbands’ home, while their husbands and their family dance and celebrate in front of them. It is Amharic tradition for the brides to remain quiet, shy, and partially covered.
BRIDES story and photos by BRIANNA SOUKUP
T
he brides sit on the dark green tarp in the middle of the village and wait. They wait for four days. They wait without family and friends. They wait because they are not allowed inside their husbands’ homes. Yemikir Alelegan is 9 and Tigiste Amlaku is 12, or at least that is what they think. Neither of the brides knows exactly how old she is. On the fourth day, groomsmen carry the brides from underneath the makeshift tent. The groomsmen put the girls on their backs and hood them with black shawls. It is the first time they are allowed to leave the tent. The village men chant and dance around them as they are carried to their grooms’ house. Yemikir and Tigiste keep their heads down and never say a word. Tigiste will return to her parents’ village after the 10-day wedding ceremony. After a two-month visit, Tigiste will live with her husband because at age 12 she is considered old enough to be a wife and mother. Yemikir, who is 9, will return home for a few years before beginning her life with her new husband. BEHIND THE VEIL | 1
Yemikir and Tigiste sit under the tarp outside in their husbands’ village. The brides have to eat, sleep, and live in the tent for days until they are brought into their husbands’ homes. Tigiste and Yemikir are marrying two brothers, but the two brides are not related. They both come from different villages in the area and the marriage was arranged by the brides’ parents and the grooms’ family.
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Two young brides, Tigiste Amlaku, 12, and Yemikir Alelegan, 9, are carried into their new husbands’ home by their groomsmen in May 2013. Carrying the brides into their husbands’ homes is one part of a ten day long wedding ceremony. Tigiste and Yemikir live in the rural Amhara region in Northern Ethiopia. Early marriage, although illegal in Ethiopia, is still heavily practiced in the rural areas of the country.
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Tigiste and Yemikir leave their husbands’ village after the 10 day long cermony is over. Tigiste will come back in a month, but Yemikir, since she is only 9 years old, will come back to the village when she is old enough. This age is determined by the groom’s family. The bride, or the bride’s family, usually have no say in the matter.
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Yemikir and her new husband stand outside of his house while Tigiste is pulled away by her husband.
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band beat her and her uncles came and took her away.
Melashiw is 14 years old and lives in the rural Amhara region of Northern Ethiopia. Melashiw is now in her second marriage. Her first marriage ended because her husband beat her and her uncles came and took her away.
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Melashiw’s husband, Shambell, left, watches her cook injera over an open flame outside of their house. After Melashiw’s first marriage ended she with her sister and her sister’s husband. Melashiw eventually married Shambell because her sister’s husband wanted her too. Melashiw said that she didn’t want to get married again and would have rather gone back to school.
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The backyard of Melashiw and Shambell’s home in the Amhara region of Ethiopia.
BEHIND THE VEIL | 8
Melashiw looks out of her door while she weaves her straw baskets. One of her daily activities that she enjoys. She doesn’t know what her future will hold. She doesn’t know if her family will let her stay with Shambell. Like many young brides in the Amhara region all she can do is hope for the best.
BEHIND THE VEIL | 9
HOPE
FOR RAHEL New HIV medication allows a 14-year-old orphan to have dreams for her future photos by SHELBY WOLFE
Rahel Nunu stands in front of a painting she made on one of the walls inside AHOPE orphanage.
Rahel loves to express herself through art. She draws a portrait of herself, copying a picture that was taken when she was 4 years old, one year before she was brought to AHOPE.
AHOPE, Ethiopia is the last orphanage in Addis Ababa solely for HIV-positive children. The walls of the compound are both a safe haven from discrimination and a barrier from normal lives as members of the community. Rahel Nunu is one of the oldest children, she has no hope for adoption and often worries about her future outside of AHOPE, but she also believes she can live independently. “I lived this life and I know it. I want to try life outside the orphanage.
I want to live in a family setting with a father and a mother at home as a regular family,” Rahel said. There was no medication available until 2005. AHOPE’s main objective revolved around survival and providing the children a comfortable place to live until they die. Now, with daily adherence, the antiretroviral medication allows the children to live healthy lives. But the medication also causes side affects such as nausea, drowsiness, headaches, and skin rashes.
I want to be somebody honored and respected, I want to be an artist and help people and I know I will get a reward for helping people. RAHEL HOPE FOR RAHEL | 2
Rahel laughs with a staff member at AHOPE compound. Rahel has breakfast with her sisters inside the living area of the AHOPE compound.
Outside the AHOPE compound for HIV orphans. Rahel watches her AHOPE siblings play a game of basketball while sitting on the front porch of the home.
Rahel sits alone while eating breakfast while the other children are already at school. She had to stay home because of side effects from the HIV medication.
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Rahel takes her HIV medication.
HIV IN ETHIOPIA Women are three times as likely to be infected as men in Ethiopia
HIV positive population by age and gender males 14 females 14 and younger and younger 9.8% 9.7%
males 15 and older 28.8% females 15 and older 51.7%
ETHIOPIA HAS ONE OF THE LARGEST POPULATION OF ORPHANS IN THE WORLD
13% of children are missing one or both parents
This represents an estimated 4.6 million children – more than 800,000 of whom were orphaned by HIV/AIDS Rahel on the bus that took her and her AHOPE sisters to field day at the Worldwide Orphans Complex. | Rahel swings outsite the AHOPE compound. | Rahel laughs with two of her AHOPE sisters on the front porch of the AHOPE compound living area.
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I lived this life and I know it. I want to try life outside the orphanage. I want to live in a family setting with a father and a mother at home as a regular family. RAHEL
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HEALING WITH FAITH Ethiopia’s impoverished trust in God and traditional healers
story and photos by CARA WILWERDING
Much of Tekle’s life revolves around religion. Every Sunday, he walks to his church to sing and pray. He even has a special room in his house dedicated to prayer and meditation. Tekle Gebriel is cloaked in white. He drapes himself in a crisp shawl with colorful diamonds lining the edge, eases on shiny white dress shoes and pulls a cream-colored stocking cap over his head. He carries a tall staff inscribed with Stars of David. It’s 7 a.m. Sunday in Addis Ababa, Ethiopia.
Walking up a dusty cobblestone road, Gebriel begins his weekly trek to Eguzuabguer Ab Orthodox Christian Church. Homeless men, women and children line the roadside. Unlike many churchgoers who walk the same path, Gebriel engages these people. He stops and gives
each person one Ethiopian birr, about a nickle. “Half of them are blind, so they can’t see,” said Gebriel, a traditional healer. “Second, those whose hands or legs are paralyzed can’t work. Giving to them is the ultimate justification after death, and it is a must to help or give.” HEALING WITH FAITH | 2
With help from family and employees, Tekle grows plants to produce medicines, ointments and salves in his backyard. Like everything else in his life, this process is also a relgious one.
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The Eguzuabguer Ab Orthodox Christian Church in Addis Ababa that Tekle attends.
“I ask God to bless the medicines when they are being produced and given. So when these medicines are produced it is with faith.”
Tekle Gabriel believes in God and the power of traditional, non-western medicine. He believes he can cure even the most serious diseases. Tekle’s patients believe in him, too.
He walks to his church every week, giving money to the blind and homeless along the way.
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Waiting for a
CURE
Western oncologists told Abeba Meaza a complete cure is not possible, especially without chemotherapy or surgery. But that does not shake her faith. “What one cannot do, God can do,” Meaza said. “If they are doctors or specialists or if they go to the moon or the sun, nothing happens without God.”
She unfolded the crumpled, yellow sheet of notebook paper, and a pressed passionfruit flower fluttered onto her lap. Abeba. It means “flower” in Amharic. Sitting in a waiting room with baby blue walls, cream-colored benches and an open metal door that lets in the occasional fly, we exchange hugs, laughs and goodbyes. The room smells like antiseptic wipes. Crisp raindrops patter on the crumbling concrete outside. This was the last time I would see Abeba Meaza, a 60-year-old breast cancer patient living in Addis Ababa, Ethiopia. She’d fought with the disease for four years, but breast cancer didn’t scare her. Abeba saw a cure in her future. After experimentation with both, she’s now using traditional and herbal remedies rather than chemotherapy and surgery. Retrieving another gift from inside the folded notebook paper, Abeba kissed a navy blue crucifix before making the sign of the cross. A smile spanned across her face, as it did every time she talked about God. “Everyone can tell me that I will die, but I believe in God and I will survive,” Abeba said. “Human beings can’t determine my life. I don’t worry about that.”
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Shining moments
THE FEKAT CIRCUS MORGAN SPIEHS
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Birhanu Taddese juggles during a rehearsal at the Fekat Circus compound in Addis Ababa, Ethiopia. "Here and outside is different. I can talk to people. I can do whatever I want. I can eat, sleep well," Taddese said. Birhanu Taddese is a 21 year-old Fekat Circus performer in Ethiopia’s capitol, Addis Ababa. According to its members, the Fekat Circus is a circus for social change. It is a place for runaway children to find hope. The circus trains neighborhood children and visits the nearby hospital to entertain patients in the pediatric ward. Most of the performers were street children or orphans before finding the circus. “Previously, I used to live with my dad and we didn’t get along very well. He used to hit me a lot,”
Taddese said. After Taddese ran away from his broken home he spent his childhood as a runaway. He lived in the streets with a non-government organization and was hosted by a juvenile detention center all before age 13. Taddese also struggled emotionally. Standing about 4 feet and 2 inches tall, Taddese lives with dwarfism. So as a boy who struggled to speak and was physically different, Taddese had no self-confidence. Taddese started training when he was 14. The Fekat Circus wel-
comed Taddese when he was 19 and has been with them for 2 years. According to Dereje Dange, the leader of the Fekat Circus, Taddese is a different person than when he first came to them. Dange said that at first, it was really hard for Taddese to have a conversation because he could only make sounds and no words. Dange took him under his wing and worked on his confidence by showing Taddese how to use his height as an advantage. Through all their work, Dange found that Taddese was exceptionally good at entertaining children.
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I used to live with my dad and we didn’t get along very well. He used to hit me a lot. BIRHANU TADDESE
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The main
ROUTINE Birhanu Taddese lifts weights at the Fekat Circus compound. Lifting weights is a part of his morning routine. Taddese lives at the circus with the other 11 performers. Even more men sleep in compound depending on the night. Birhanu usually wakes up before the other members.
At the beginning nature gave me something but at the circus they gave me training. TADDASSE
Birhanu Taddese applies clown make up before working at the local pediatric ward at the Black Lion Hospital. Taddese is doctor clown so he can "make the kids smile and feel well." Taddese feels he better connects with the children than the other performers because of his size. Members of the Fekat Circus also read to the children and give them supplies to color. They work in the pediatric ward hoping to give the hospital a more child friendly atmosphere.
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Birhanu Taddese helps Sadko Ade during children’s training. Children’s trainings are held every week night at the compound. Taddese helps with trainings as well as works as a “doctor clown” with other circus performers at the local hospital’s pediatric ward. Taddese became interested in circus arts when there were circus trainings at a non-governmental organization he was living at. Many of the younger children at the compound now look to Taddase as a role model in their training.
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“When I first came here I did not talk. I would just sit quietly,” Taddese said. “Dereje is the one who came up to me and told me I need to get up and work. That is when I realized what he is saying is for my own sake.” Dange and Abebe Fenta started the Fekat Circus in 2004. Like Taddese, they grew up in the streets of Addis Ababa and wanted to give circus trainings to other disadvantaged children. The Fekat Circus now has eight performers taking part in the shows around the city. Their acts are not like those westerners probably picture. There are no animals or fire, ringmasters or big top. They use their bodies to flip and make human pyramids and climb what they call Chinese polls. The performers use props such as balls and boxes to juggle, rings to jump through and boards and wheels to balance on. Fekat Circus performers practice almost every day, morning through the afternoon. They entertain patients in the pediatric ward of Black Lion hospital and perform a show for the community about once a month. On weeknights some members train more than 50 low-income neighborhood kids. Currently, the men of the Fekat Circus are on tour in Europe. Even though there are only 8 performers, up to 14 people sleep in the circus compound each night. The guard, Derina lost his leg when he was 14. He has since received support from his circus brothers and was finally able to get a prosthetic leg. A former performer left the circus to go to school and the Fekat members helped pay his tuition. Brothers and friends can all find a place to sleep at the circus. “We are one family. We work together, sleep together, enjoy together,” Girma said. “The others are not my friends. They’re my brothers.” The men don’t plan to stay in Fekat forever. Dange wants a farm with cows in the country, Girma wants to return home and find his family and Taddese wants to start his own circus for children that don’t have the opportunity now. Fekat means “blossoming” in Amharic. It has given the men a chance to grow and find a life of purpose.
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We are one family. We work together, sleep together, enjoy together. The others are not my friends.They are
my brothers. -Biranhu Taddase
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