A Valuable Rip-Off

Eager to get back to our work in Bahir Dar, we opted to fly back on Tuesday evening instead of taking another 12+ hour bus road on “the most dangerous roads in the world.” (According to some health source, this designation goes to Ethiopia, likely due to the mountainous terrain coupled with fast risky drivers and seemingly-oblivious pedestrians and livestock.) At the airport in Addis, we were advised during a friendly conversation with a guard that the restaurant in the parking lot would be much cheaper than going inside the airport building if we wanted a quick bite to eat before our flight. The menu was written only in Amharic, but as I scanned it, I noticed that it was very reasonably priced and no one item was above about 15 birr. We asked our waiter for suggestions and tried them—a plain egg sandwich, a burger, a coke and macchiato. Ryan commented as we finished, “This bill has got to be less than 50 birr or else they’re ripping us off.” To our surprise, not only was it above 50, it was 73 birr!! We reluctantly paid, thinking that perhaps the egg sandwich and burger were just not listed on the original menu. We questioned him, “Sentino burger?” “30.” “Sentino egg sandwich?” “25.” “Sentino coca?” “10.” “Sentino macchiato?” “8 birr.” The coca and macchiato were rip-offs. Even at the most expensive restaurants, macchiatos are 3 or 4, cocas are usually 5. Frustration! As we passed the guard again, he asked, “How was it?” I replied, “Good, but expensive!” His eyebrows shot up. “Really?” We mentioned the prices that the waiter quoted for the menu items and guard remarked, “Oh, he cheated you.” I began to be hopeful that some justice might be done. After all, the guard had a gun. I implored the guard to help us get to the bottom of the issue. It really wasn’t the money; rather, it was the principle of the Ethiopian way of charging more than double for taxis and food if you are a foreigner. The guard called our waiter over, asking him the prices. The waiter looked at his feet, sheepishly saying, “Macchiato 4, coca 5..” The guard turned to us, “So, he cheated you about 20 birr. How shall he repay you?” I looked at the guard, who genuinely looked sad. I said, “Give the guard and his 2 friends here all macchiatos for starters.” The guard responded, “And what about him… will you invite [the waiter] to join us? He is sorry.” We nodded in agreement. The waiter returned to get some birr to make up the rest of the difference. As he walked away, the guard commented, “He doesn’t earn a good monthly salary. He thought you were from Europe and just tourists.” The waiter came back to hand us 4 birr. I stuck it back in his pocket and said, “You take this, just please don’t do it again. Be fair.” We walked away, thinking about the guards getting their macchiatos, about the waiter perhaps learning a lesson about not cheating people or alternatively happy that he got away with it this time, and about us learning that people cheat us regularly because they likely aren’t paid well and tourists provide crucial income when they don’t question prices. In the end, I believe the guard was the cleverest. He pacified our desire to have someone on our side helping bring a cheater to some retribution and also kept peace with the waiter by including him in the macchiato party and by allowing him to still cheat us by more than 10 birr (He had actually charged more than 30 birr extra). The whole concept of Ethiopians’ acceptability of double standards in prices just because of the color of one’s skin still irks me, but at least the circumstances of one individual waiter brought the issue into better focus for me.


Back to work

Our detour to Addis had turned out about as good as one could hope as far as time away goes. We were back to work on Wednesday morning. Melissa and I were at the Fistula Hospital for 6 surgeries in the morning. Mid-afternoon, we took part in a party celebrating the hiring of a local Ethiopian surgeon full-time at the Fistula Hospital. They had a coffee ceremony, popcorn, and their “special occasion” bread (usually reserved for weddings and funerals). We went on a mini-safari after the party with a visiting surgeon. We pretended we were on a big hunt, ducking under coffee trees, over fences, traversing the fields near the lake filled with ibis, cows, horses, sheep, goats, storks and other random birds until we came near the edge of the lake where there were very large footprints in the mud. We all came to the conclusion that these had to be hippo footprints. Cool!

Thursday Melissa and I were in the government hospital operating room all day. A visiting plastic surgeon (from Addis) performed a few cleft lip/palate surgeries as well as a facial reconstruction, the general surgeon we were with did an open gallbladder surgery, an above-the-knee amputation, and removal of a goiter, and the ob/gyn’s occasionally interrupted the surgery schedule for c-sections for obstructed labor. After lunch, I was taken aback when one of the students approached me at brought up the subject of the situation I’d experienced near the beginning of my time regarding the drunken doctor. “You know, this happens sometimes,” the student commented, “and you should just forget it. You should not charge him. Then other people will think you are cruel. You should just forget it so there is nothing between you and him.” I was shocked. First, I did not know why he would tell me this unless what I had done was somehow unacceptable in their culture. Second, this meant that at the least, most of the students had heard about the incident. For me, though, I did not regret how I had handled the situation, regardless of “culture.” I explained, “I did not spread this, and I am not talking with anyone else at the hospital except I did tell his boss. I was uncomfortable in the situation, what he did was not good for the professions of doctors. Unless someone speaks up about it, it may continue to be accepted behavior.” I took a deep breath. “But, I do not have anything against him now and I am not charging him legally or anything. This was just between him, his boss, and me. If he was in trouble with his boss, maybe this will help him realize he needs to be careful about his behavior.” The conversation left me emotionally exhausted, but I was at peace with how I had handled the situation and hoped that whole ordeal could be finished.


The scare

What did we do before cell phones? We had to follow-through on plans to meet together and we had to make careful plans, both of which were off-target on Thursday night. With 4 of us now to coordinate schedules and only 1 house key and 1 cell phone, we have to communicate a lot before we leave the house in the morning. I ended up coming home alone to find no one. I knew Melissa and Austin were going on a date, and Ryan and I (I thought) would meet at home before going to eat out with someone from the church that night. I sat on the porch, reading and waiting for Ryan to get home on his bicycle from soccer practice. I finished an entire book, walked around, and I even walked to the street and asked random passersby to use their cell phone to call Ryan. No answer. After 2 hours, it was dark, and I was panicking. Tears streamed down a tired face as I thought about Ryan biking in a country with the “most dangerous roads in the world” and about how just 2 weeks earlier Berhanu (our landlord) had found out about his brother’s wife dying in a car accident from police who finally answered their incessant calls to her mobile phone.
Two and a half hours after I had come home, I was desperate. Even the guard who speaks no English was talking in Amharic to me like he was sorry for me. I asked him through gestures to come with me outside the gate again (in the dark this time) so that I could call Ryan again from a hitchhiked phone. Berhanu met us in his vehicle at the road, unexpectedly bringing us some water and bread on his way to visit family near our house. “What’s wrong?” he asked me. I told him my predicament and he offered me his phone. I called and Ryan answered! I was relieved, but confused. “Where are you?!” He had been waiting at the restaurant with the person from church, not wanting to leave in case I eventually showed up and running all of our conversations that day through his brain to figure out where I might have gone. He didn’t answer the first time because the phone was out of minutes and Austin and Melissa actually had borrowed the phone for awhile so that they could make a few important calls. In the end, no harm was done, but we are even more careful now to communicate and to check in when we can.


Blessed

Due to our unanticipated travel to Addis, our finances, our willingness to put ourselves at the mercy of more people who would hassle us and try to rip us off, our desire to stay over the weekend for Ryan’s soccer practices and church, and even our head colds, we decided not to join Melissa, Austin, and 2 others who were going to Gondor and the Simian Mountains to hike Friday-Sunday. Instead, I headed back to the hospital to see how many babies I could deliver. Jackpot! It was a holiday on Friday so it was only 3 midwives and me in the maternity ward. Miraculously, not a single baby died, and not a single mother had a tear during the deliveries. I delivered my first breech (butt first) and my first with an umbilical cord wrapped around her neck with minimal complications. I had never even seen a breech delivery much less be the one to do the delivery! Almost all will go to c-section in the US. I remembered to allow the baby to come out most of the way before touching it. Then, when I had the baby’s body in my hands, I froze for a second. What do I do now? How do I get the head out? There was no doctor around. I thought back to my “Intro to Global Health” course where we had been taught emergency obstetrics in limited-resource settings and even practiced on models. Confidence roared back and I gently coaxed the baby’s arm out. I began reaching to put my fingers in the baby’s mouth and over his cheekbones to flex the head when the mother helped me by giving a solid push and soon the baby was wriggling free in my arms. “Konjo lej!” Beautiful child. “Gibberish gibberish,” said the mother. The midwife translated, “She says ‘Thank you for your good care.’” I couldn’t help but smile big.

The midwives talked about our day during the downtime. “You are so lucky!” they exclaimed. Considering some of my other days here, I knew why they made that statement. I said, “Yes, we are blessed today.” They asked, “Did you pray this morning?” I nodded in affirmation. “You must have prayed a lot, because you are so blessed today!” I agreed, but I cautioned them. “Do you remember the story of Job in the bible? Do you remember when he said, ‘I am despairing of hope…’ and his life had just been basically ruined by the death of his children, the pillage of his livestock, and the sores which had come upon his body? Do you remember? He said right after that, ‘As for me, I know my Redeemer lives!’ So even though we say we are blessed for having this good day, we need to remember that even on our bad days when the babies are dying and there are complications that we are still blessed. Like Job said, ‘The Lord gives and the Lord takes away. Blessed be the Name of the Lord.’” I grinned. “But I agree: this is a blessed day!”


Clowning around

Saturday we both decided to be pathetic together. Our voices were raspy and slightly hoarse, a head-cold gone bad from our time in Addis. We both were coughing and hawking up lougies in the morning. I commented that Ryan had an unusually low voice, to which he replied, “bow-chika-bow-wow” or however you spell that. This is the first time in our marriage that we have been sick at the same time. (And yes, we are having a competition to see whose immune system will win first, and I think I’m ahead.) Obviously, the cold is more annoying than actually activity-prohibiting. We did our last load of laundry (for this trip) in the bathtub with bar soap and good ole elbow grease. Then, Ryan suggested we walk down the Nile River towards a palace of Haile Sallasie, one of Ethiopia’s former kings (and one of the kings nearly idolized by the Rastafarian sects). I was being my normal self and rushing at the beginning, knowing that if we didn’t hurry, we wouldn’t have time to go to a performance that night. Ryan patiently said, “We don’t need to conquer this. I just wanted to go on a walk with you.” Oh. Right. I could take a lesson from the Ethiopians who say, “We have no lack of time. We have a lack of money, but there is no lack of time.” So we slowed down, explored a monument to Martyrs during the time of the communist regime, walked through someone’s garden, took random rocky paths down to the Nile—stepping aside to let the cows with the horns walk by of course—to stumble upon Ethiopians bathing (oops), finally walking down a path with two shepherds (both about the age of 9) to a place where we could stop and just relax among the papyrus with the cool breeze off the river rushing by.

After returning to the city, we met our American friends (from the Clinton Health Foundation, CHF) to go to “the circus.” Apparently, the group Jokers Without Borders, was in town! It’s a clown group which travels internationally to lift spirits, release tension, and improve morale just as the group Doctors Without Borders travels to give emergency healthcare internationally. The Saturday market was crowded! No place was found to perform among the hundreds of people squatting next to their piles of tomatoes, potatoes, spices, mangos, etc, etc, etc. We headed to another location, then another before finally finding them in the city park near the lake. What a treat!! They wore black and white striped jumpsuits; their faces were not painted nor did they have wigs. They juggled, they fell down, they rode unicycles even with kids from the audience on their shoulders, they made music with random “instruments” (ping pong paddles, seed pods, xylophone, clappers) for almost a whole hour! One of my favorite acts was when the girl joker/clown balanced on what was essentially a loose thick rope tied between two trees, a slack rope. Then, she got on a unicycle on that slack rope, and then she balanced on all of that while juggling pins in the air. It was amazing. Secondly, I nearly died laughing when they brought a girl out of the crowd and one of the man jokers stood far away from her and pointed, “You, you you you!” Then, getting down on a knee, he said nasally, “I love you!” just like many of the local people do to us foreigners from a distance. The joker then balanced a long-stemmed rose on his nose and walked over to her. I went to the hotel in which they are staying today to ask if they might come to the hospital on Monday. They seemed excited about that possibility, and I am very excited that the patients and families might have a cheery day tomorrow!

In church this morning, I was struck by some of the kids in attendance. One less than 1 yr old looked around with big brown eyes, taking in the worship time from her perch over her mom’s shoulders. Kids danced in the aisles. One child, while breastfeeding, was clapping along with the songs. (They breastfeed longer here than in the US.) It was a stark contrast to the less than 1.5 yr old child sitting with his mother on the sidewalk who was guided by his mother to turn his tiny palm up for money when someone walked by. I am not speaking to their social status; I am speaking of how each is learning methods of behavior at a young age. Children seem to mimic actions that they see until they are old enough to judge for themselves. The next generation is being molded by the current behavior of their parents and the community at large. It takes a village to raise a child. What kind of village are we being for the next generation and for our kids?
After church, we went swimming! The Papyrus Hotel is one of two safe areas to swim in Bahir Dar (obviously not the lake!) Although you could not see the bottom, it seemed clean enough. It was a darker blue than normal and likely not chlorinated. It was refreshing but really cold! I had an informal diving contest with an Ethiopian. I let him win (although he would have beaten me eventually). The diving board was covered in a slick vinyl, so I opted not to run on it. Secondly, the board was made of two pieces and they were not firmly attached, making the end of the board very unsteady when I shifted my weight. We swam with Charlie and Dee, our CHF friends and unofficial mentors, and their 8 yr old adopted (from Ethiopia) daughter Memar. Memar has only swam three times, but she is pretty athletic and a daredevil. While walking away from the clowns yesterday, Memar was picking on Ryan and Charlie, so Charlie and Dee encouraged Ryan to carry Memar like a sack of potatoes. Memar started running, but she was no match for Ryan. He crouched down and weaved stealthily around several other people walking along the sidewalk before snatching her up and holding her, yelling, upside down over his shoulder. It was quite a scene, probably, if one had assumed that the Ethiopian child was not related to the 4 white forenji’s walking along. We got a kick out of one young man. “Is she your daughter?” he asked Dee. “Yes she is!” The man looked thoughtful. “But she does not have the same look as you.” Dee replied, incredulously, “Oh really? She looks the same to me!” holding her white arm next to Memar’s beautiful dark skin. We had a good laugh. Since Memar as declared that she wants to be a doctor someday, Dee asked me if Memar could come to the hospital this week just to see what I do. I think it will be great to have a 9 year old tag along, although I am hesitant to bring her to the maternity ward. Maybe we’ll just look at the newly born babies and skip the whole birthing part. It can be traumatic to see a birth under anesthetic much less a totally natural birth and women’s vocal response to that.

Melissa and Austin came back safely from the Simian Mountains tonight. We went to the Ghion Hotel for dinner, talking about our weekends. They thoroughly enjoyed themselves, talking about how it was comparable to the Grand Canyon, about the multitudes of baboons which they took pictures of, and of their hike to the second-highest peak in Ethiopia. I was a little jealous, but looking back on our relationships-filled weekend, I don’t regret our decision to stay. Ryan’s favorite part of the night was that there was a soccer game being shown while we ate dinner outside on a big white sheet big screen! There were at least 30 people eating and watching the game, and a monkey even joined the scene scampering up and down the trees around us just to make it interesting. Just clowning around!