Death and Development

The wailing had seemingly stopped when Zena’s brother arrived from Deka.

I had stopped by the funeral with some popcorn for the family and guests. A neighbor told me that the third day of the funeral was appropriate for this kind of action and the snack was greeted with smiles and approval. This is the house of my next door neighbor. They are a great family, an extended family whose relations I don’t quite understand. I buy almost all of my produce from their little store, and we’ve shared meals and coffee several times. This group has the best behaved kids in the area. Fetsum just left for University in Jimma. He is studying pharmacy and was so disappointed he was not chosen for medicine that he has promised to work very hard for the chance to become a Doctor. Then there is Abbiye, the “gobez lij” (smart child) who was one of the brightest kids in his class.

Sadly, I’m at his funeral. He died at the age of 9 from tonsillitis.

The crying is truly brutal, the kind of sound that rocks you to your core. It lasted for three days, with loved ones taking over for crying duty when Zena, the mother, was too tired to cry. Wailers are sometimes even paid to cry on the behalf of the family. Jon and I could hear it from our homes, throughout the day, and lasting well into the night. The first day I went to the funeral she was buried under blankets. Jon looked at me and said, “that’s the saddest room I’ve ever been in.”

On this day, I was outside with several dozen people under the typical green canvas tent. It was quiet until the brother arrived from Deka. He walked down the path slowly, both screaming and crying. Zena greeted him at the doorway and together they called out to “Igzabhiyer” (god). The tone suggesting it was more of a demand ; an answer to the question of why. A few days later, I’m at Bekeles house, a large man with a bushy moustache who seems to have a never ending cold. He is the accountant for the school and I’ve been working with him a lot recently to manage our construction budget. His daughter just died, and she was 22. He is shaking while lying down, but his torso is upright, supported by a few pillows between his back and his house. His right elbow is on his stomach, his head buried in his upheld hand. No one is quite sure of how she died, but it’s believed to be either organ failure or the result of a mishandled abortion.

I excuse myself and head to the school. On the way, I pass Melis, the father of Abbiye. He is solemn, but it is a testament to his character that he is leaving his own funeral  to support his neighbor.I get a call from Mesfin, a man I hold in the highest regard, who has helped me the most with the school project. His wife died 5 months ago from Cancer, diagnosed and on dialysis a little too late. When I arrive at the school, I say hello to Tekelu Radjimu, the second name a nickname indicating how tall he is. (roughly 6’8) He has done an amazing job as the labor organizer at the school. His management is terrific, his flexibility needed and his skills are apparent. The school looks beautiful. Unfortunately the tragedy extends to Tekelu, whose daughter died when a tree he was cutting down fell on her. She was seven. This was 2 months ago, yet Tekelu was working within two weeks. I will never forget his dedication or the empty look in his eyes as he sat with his brothers outside of their home. In the span of a few moments, I’ve crossed paths with friends and neighbors all reeling from the deaths of their loved ones.

This has taken me a while to write because of how hard it was for me to witness and to process. But writing is sometimes my therapy and a way I make sense of the things I’ve seen.  I wonder what I could have done to prevent these tragedies, and what can be done in the future.  I have also thought about these tragedies in the context of Ethiopia and the role of the development community. Recently, I have wrestled a lot with the notion of aide. At the grassroots level, we see how inefficient development work is. Notably I’ve learned that around 70% of development costs are administrative, and that the per diem for some drivers for UNICEF exceeds the salary of some doctors back home. According to one source, The UN per diem for workers in Kampala is 400 dollars per day. Additionally I’ve seen the attitude in which some outsiders perceive Ethiopia, and sadly I can’t claim to be innocent either. It is with pity, and perhaps a self-indulgent desire to help.  To be honest, I’m pretty depressed with the state of giving, the entitlement it can create and the inefficient way in which it’s done.

I think about all of these things as I sit at these funerals. However I know that no amount of money is too much when it comes to global health. There is a monumental gap in the healthcare system between the haves and the have-nots. My neighbor just died of tonsillitis, and I don’t mind if money is occasionally wasted in a global effort to make sure that never happens again. `

I’m depressed and saddened but also inspired. Jon, Chuck and I recently teamed up with doctors from Northwestern and an organization called Peace Care. They taught midwives from throughout the region, using mannequins, and hands on lectures to teach over 70 professionals. Topics ranged from how to treat mothers who have postpartum hemorrhage and how to help a newborn baby breathe. They did an amazing job, and they saved countless lives through their sacrifice. One of the doctors, Adianez, stayed for a few weeks in Bonga hospital. A two year old came in weighing less than 4 pounds, severely malnourished and unable to feed or walk. She took a bus to Chiri to get a feeding tube for the boy and saved its life. The other day, my friend Brett and I watched as the baby, now 14 pounds, took milk from its mother.

So we can only hope that development work operates on a learning curve. I know these discussions are happening across the world. I hope that we can continue to improve the system, to know that smaller is sometimes better and to work to see that money intended to help those in need, goes to those in need. In terms of global health, I’ve come to realize how much work is left to be done. I hope we live in a world where we can see this gap, and to understand that no one should have to bury their child, and no one should die of tonsillitis. No two year-old should weigh four pounds. I have so much respect for those people who fight to bridge this disparity, and to the doctors who came here and saved the lives of local children.  We need more of this in our world, not less. It’s a beautiful concept, perhaps realized by silence. The silence found when we work together to stop the wailing.