That's the Reason

“Ours is not to reason why..... ” (Alfred Tennyson)

So many of my years overseas have been spent interminably  getting from one   part of a  country to another  especially  those countries in Africa. Africa is a vast continent, the second largest of the seven in the world.  

 
So here I was again in 2011 in  Ethiopia  travelling across country by car. The drive was taking 2 days to get to our destination and of course 2 days to get back. I write this thinking of the return leg of that journey. I was in Ethiopia as usual for work – helping an international organisation do an assessment for the possibility of starting an emergency nutrition programme in the south of Ethiopia  in the zone of Borena.

Moyale town, Borena zone

 It had been sobering talking to the people down there.We passed fields and fields of maize, shrunken and undernourished due to "the wrong sort of rain". Too much rain had fallen earlier in the year destroying the young growth. This was followed   by a period of drought where the the then much needed rain was not present for precious and burgeoning growth of the normally juicy, fat maize cob.  

It was awful seeing the helplessness of these farmers  in Borena  that time in 2011. As if flicking through photos of faces  on my Smartphone, I saw the slightly varying but essentially the same expressions on the faces of the many farmers we interviewed – a confused helpless look as  they told the varying stories of a similar theme – that of livestock dying through lack of water and fodder. The implication of that is like watching your house that you have just bought with a 100% mortgage, debted up to the eyeballs and no house insurance, burn in front  of your eyes. Then the fire men rush up with a bucket of water to try and put it out like the aid agencies trying to help the Ethiopian government deal with this awful drought. One farmer told of how his herd of cows had gone from 60 to 3 in a few months. During that time in Ethiopia, as  in the rest of the Horn of Africa , the rains had  failed which meant the crops failing. Water sources had dried up and people were left without that basic requirement for life – water. And so we stood in many fields of stunted dried up maize, swathes and swathes of fields of abject failure – maize stalks askew in an almost drunken fashion and the corn pods small and underdeveloped just about peeping out of the side of the stem.

Failed maize crops

Like  that example of the burning house these fields represented the failure of the future for the people of Borena. Panic rippled like wind over water on the faces of these Ethiopians as we talked to them. Squinting at us and shielding their eyes from the glaring, relentless sun – they said how they were all waiting to see if the the rains would come later in the year so that  there may be a remote chance they could plant again. If that did not happen.... well at that possibility they said nothing..... only shrugged their hands apart  in a wide helpless gesture. 

I was upset  on that 2 day drive back from Borena to Addis Ababa. Helplesslessness is not a comfortable car companion especially when you are leaving it behind – leaving others to suffer. In addition there was a helpless  waiting of a different sort going on. An old nursing colleague of mine was dying of cancer back in England  as I took that  interminable  drive north back  up  Ethiopia from Borena to  the capital city, Addis Ababa.

Position of Addis Ababa and Borena in Ethiopia

I had not seen  my collaegue  for over 25  years since we were all nursing students. . She married her  first boyfriend a year or so after we qualified and went on to have 4 children.   

 

So I had a lot to think about on that two day drive slumped  in the car  with trees, people, mountains, cattle, donkeys, horses blurring before me as I turned my head, wet eyes and aching full throat away from the gaze of the others in car – thinking of my colleague back in England, dying.

Landscape of Ethiopia en route from Borena to Addis Ababa

I remember that we stopped in a town called Dila where it was pouring with rain – a different story to the arid dryness we had left far behind down south in Borena. We sat in a restaurant and I gazed out at the teeming rain. Across from me, a young couple were sitting opposite each other obviously love struck and feeding each other. 
In Ethiopia it is a custom that you feed the person whom you love or regard very highly. This is in the form of giving what is called in Amharic, a  gursha. A gursha is an act of friendship and love. When eating, a person uses  their hand to strip off a piece of the pancake like bread called injera that is the staple food of much of Ethiopia.. Then some of the stew that is usually given with it  is scooped up with this piece and put into the mouth of the person whom they love or regard highly. The larger the gursha the stronger the friendship or bond. Thus  this practice is common during a meal with friends or family.

"Injera" with various meat and vegetable stews or "wats"

And so the girl in the couple across from me was delicately giving a  gursha to her boyfriend who was beaming with delight. The  gursha was huge and looked enormous in the  small, slender hand of the girl. Her boyfriend had no trouble polishing it  off – his  cheek bulging  like a happy hamster. Their love made them radiant and I envied them their happiness.

Back in the car the driver was playing the range of his CDs over the 2 day journey. He seemed to have a penchant for a particular one song which he played frequently. As we eased ourselves back into the car   this song came on again. It was the one called “Let Your Love Flow” by the Bellamy Brothers which was a hit in 1976. It starts off with :

“There’s a reason for the sunshine sky,

There’s a reason why I’m feeling so high.

Must be the season

When that love light shines all around us”.

The bouncy cheerfulness of the song irritated me with it’s love light, letting your love flow, letting your love shine, birds on the wing, mountain streams,  having reasons and it being the season for all of this etc,etc. I thought to myself rather sullenly that   in fact there did not seem to be a reason for anything – it all seemed a random mess to me. Yet although the song drove me mad,  for some reason there were many times over those two days that I would lean forward and ask  to put that compilation CD on again and fast forward it on to that song . I did not want to admit it but the words and joyfulness, hope and almost breathless appreciation of life imbued in the tune somehow comforted me.

“ Let your love fly.

Like a bird on a wing.

And let your love bind you

To all living things and

Let your love shine”

I had secretly  in child like fashion hoped for a miracle but my nursing colleague did go on to die that summer of 2011 in what was her season of winter and letting go.  I did not go to her funeral as I was still overseas but I knew that  they played the hymn “Amazing Grace” .I read the lyrics and then  read the following verses, again and again as if holding on to a comfort blanket:

“Yes when this flesh and heart shall fail

And mortal life shall cease;

I shall possess, within the veil,

A life of joy and peace

The earth shall soon dissolve like snow

The sun forbear to shine

But God who called me here below

Will be forever mine”

And finally how did Borena and the rest of Ethiopia fair after 2011?  Well at present in 2014, Ethiopia is the darling of the public health world. Ethiopia has been known for it’s food shortages, famines and droughts in the West since the 1970s when the reporter Jonathan Dimbleby revealed the extent of the famine going on in Ethiopia in 1973 and then another famine in 1984/5. This gave the country a massive image problem where Ethiopia was once a byword for malnutrition in Africa. However, Ethiopia, a low income country in the drought prone Horn of Africa has achieved the millenniumdevelopment goal to cut the mortality rate for children under the age of five ahead of the 2015 deadline. Ethiopia has reduced  it’s child deaths by more than two thirds over the past 20 years. In 1990 an estimated 204 children in every 1000 in Ethiopia died before the age of five, just 6 countries had a higher rate.  By 2012 the rate had dropped  to 68, a massive decrease of 67% fall in the under five mortality rate. Government commitment and resources have contributed to Ethiopia’s progress on the issue. According to Dr Peter Salama,  UNICEF country representative for Ethiopia:

“The government has set some very bold and extremely ambitious targets. It has then backed them up with real resources and real commitment sustained over the last 10 years” He then briefly describes the country’s health extension programme :

“The programme put on the government payroll more than 36000 health workers and deployed them to more than 15000 health posts across Ethiopia.... That is the single most important reason why Ethiopia has reduced the under five mortality rate”

Dr Salama said the fact that the health extension programme has been government owned rather than donor led has contributed to it’s success and means that the gains made are sustainable in the long term.

However Ethiopia still has many obstacles to overcome but still it is a heartening public health success story.

Nowadays  we are advised to  focus very much on the moment and be mindful etc. But  in the middle of  a bad moment it can seem as if things will never get better. But they do....... eventually. Events ebb and flow like the seasons and just because we do not know the reason for what happens does not mean there is no reason. 

And so finally back to that irritating Bellamy brothers song:

“And you’ll know what I mean , that’s the season

And you’ll know what I mean, that’s the reason”