Concern

Back in Kombolche at the Concern offices, we wait a short while for our man to finish a meeting. The wait provides an opportunity to look around the compound. It is fully self contained with service bays for the small fleet of vehicles used by the operation. These range from four wheel drive Land Cruisers (anything less is ineffective in this terrain – there is only one main road north and one going east. Neither are sealed. Apart from these two, there are tracks like the one we went up to Girar Amba. Cars simply wouldn’t make it. Concern also has a couple of larger trucks, one of which I photographed a few days ago because its ‘no firearms’ sign caught my interest.


I have heard some aid organizations criticized for having large expensive offices in smart city centre premises. I have no idea if Concern does this is its home country (Ireland) but certainly not here. The offices are a collection of portakabins, small but perfectly adequate, lined up next to some small basic single story buildings that house the itinerant employees and volunteers.

We meet two of them for the second time and end up in the guest house for tea and biccies. Orla, a lovely friendly Irish woman married to an Ethiopian doctor is a nutritionist travelling to rural areas to treat malnutrition, particularly in children. The program she tells us about involves a new peanut based food product that is easy to produce within the continent, has high nutritional value and is widely used as part of a reasonably recently established food and basic healthcare package.

She has just been up in the extreme highlands where poverty and its associated problems are endemic. The children are tiny, partly because of the effects of altitude and partly to malnutrition. She tells us its freezing up there, and that the program she runs has significant but limited success because women won’t travel the distance they have to to reach the program headquarters on as frequent a basis as is recommended. Fortnightly is recommended, monthly is what they will do.

People from countries that are smaller or better served by transport might find it hard to imagine the distances involved. Seeing people walking everywhere as I have on this trip I begin to get the sense of this. Kids walking to and from school, people carrying water containers and various goods in directions where the nearest village is twenty minutes away by car hint at the reality of this.

I recall the first day we arrived and took two old men from the bridge where we stopped and took old Cunningham family friends met with by chance into Degan. A distance of about 10kms which presumably they would otherwise have walked. I have not seen many minibuses or any buses at all on the route between Kombolche and Degan, so if there are any, they must run infrequently. This travel is on main roads. Getting up to Girar Amba, which is still a relatively well established route is a harder story, and going beyond that to the highland terrain Orla has just described must be on a level with some of the serious tramping that some hardy people choose to do for pleasure where I live.


It strikes me while searching the collection for pictures of men of the age we picked up that my photographs reflect the age demographic for a country where the average life expectancy is well below 60 and the percent of the population over this age is tiny. There are clearly some who defy and raise the average, wiry old men who may be much younger than they look.

The advice that our man is now free to see us leads to what turns out to be a small set back. After agreeing to be the mediator and our decision to change the terms of the MoU to include this consideration, Ato Endalamaw advises us that he can’t sign the MoU, that we will have to see the Head of Concern for Ethiopia when we return to Addis to ask him to endorse it. As well as a matter of protocol, he recommends we seek advice on transfer of funds and legal and administrative matters regarding purchase, donation and duty free import of the vehicle. Although there is a little disappointment at finding another hurdle to cross, it makes perfect sense and we are assured of an appointment with the CEO in the capital. The meeting is valuable and informative as it happens, and we leave Concern in no doubt at all that it will work out.

On our last trip back through Kombolche, I stick the video camera out the window to capture the dirt road, the container like shops, people walking, the bridge over the river that doubles as the local car wash and all related sounds. Its all fairly well imprinted in my memory but telling the story to others will be easier without the need for recourse to words.

The last stop

In a way it’s a good thing that everything is done with time enough but none to spare as there is little time to think of having to say goodbye. All the last minute things are in the pipeline now and its only in the van on the way back to Kombolche that there is a moment for reflection on what we have come to and are about to leave. Maybe it feels different for the family who have been coming here on and off for the past 40 years and frequently for the last five or so. As the first timer in the group it still feels sad to come, stay such a short while and leave again with little more than a few small but worthwhile gifts and a promise of more to come.

I wondered when I was first offered the chance of coming if I could be of more use ‘on the ground’ as in back in NZ doing fund raising and promotional activities. Now I know there is nothing like experience to make sure motivation doesn’t flag and it was well worthwhile on many fronts making the effort to come. There is something about having branched out from the straight line of things that should be done – responsibilities, obligations, habits – most related to work and although I know how important this is, sometimes its good to remember its not the be and end all.

The promise we leave with is big – about NZ$50,000 or UK20,000 worth. A brand new 4 wheel drive ambulance to get those women in childbirth to hospital and save their lives. But at this point we don’t know those numbers. The visit to Toyota Moenco in Addis has yet to happen three days and many more events down the line.


The last stop in Degan apart from Ron’s quick roadside consultation on an elderly man with curable eye disease is at the Health Centre. This is a closer inspection than the cursory glance on previous days. A chance to shoot some video and to be talked through the shopping list they give us, on request – to take away and fill. Medical books, equipment, money for furniture… running water isn’t even high on the wish list as it is not the most immediate need. They have managed without it for quite some time and it’s a big ask.



Watching people sitting outside waiting for appointments, the coughing penetrates, the body language is part of an easy diagnosis of general ill health and specific problems. The environment is uplifting thiogh, there is hope here and help that wasn’t available a few years before. The staff are increasingly well qualified though that currently adds up to a grand total of the Director who is a former military doctor (probably not much maternity care experience then), the interned environmental health graduate who will be gone as soon as he is able and a qualified clinical nurse who would like to study further and qualify in midwifery but can’t afford to and some semi-skilled assistants. Its not a cast of thousands or Nobel prize winners, but it is what they have got and do a great job with considering.


On the equipment front things are not so rosy. Before getting into the realms of actual medical equipment, there are beds with no mattresses, old worn out beds in the labour room that just don’t look appealing. No water birth facilities here! Few drugs or necessary tools to deal with complications.


One of the gifts Ron and Maria have brought is a great addition to the inventory – a vacuum extractor – don’t ask – use your imagination on what that might be used for in a labour ward.

Another really useful gift for the clinic is money. A reasonably substantial amount at that – gleaned from savings, donations and other bits and pieces that Maria has squirreled away. All of it gratefully received and graciously accepted. The straightforward attitude to this is refreshing. Its easy to ask if x, y, or z would be useful and if not, they will tell you. No cultural complications like accepting because it is impolite to refuse. Good to know exactly where we stand.


And where we stand we can see potential – lots of it – its just needs a few resources, which hopefully we can help to provide. With business completed we take our leave. Not quite as simply and dispassionately as my words make it sound. Some things are beyond my ability to describe. The incentive to get us moving is a date back in Kombolche with the final person to sign the MOU – Ato Endalamaw, the local Head of Concern who has agreed to mediate the agreement in case of any dispute. The experience and reputation of him personally and of his organization locally make this an ideal arrangement. At the moment it’s another hurdle we have to jump over. Well worthwhile but challenging still.

On the way back to Kombolche I remember to shoot some video footage of the gorgeous surroundings on the 20 km trip and the quarry, which deserves an entry all of its own. People young and old, small and grown, breaking rocks for building projects entirely by hand. That deserves and entry of its own so more on it later.

Degan High School (at last)

The first stop in Degan today is the High School – made it at last! I am not sure if some or all of the reason for the repeated delay in delivering the goods here earlier in the week is the absence of the principle. He has just returned from Addis where he graduated with a degree – in Physics if I recall correctly.


I’d love to know more about this – if he had to manage study at a distance without the mod cons that others take for granted for online learning, at the same time as running a school with 1500 students and very limited resources.

Like the primary school, this one runs two shifts a day to accommodate the large number of students who come to study here from the surrounding kebeles (districts). Unlike the primary, this school has just begun using distance education technology referred to locally as ‘plasma screen’. This involves lessons beamed out by satellite from major centres to rural schools. The technology and the teaching method are new and yet to have teething problems ironed out it seems. However, it works at a basic level and that is quite amazing given the primitive state of most of the technology that is visible in these environs. I am confident that it will be made to work well in the hands of these capable and resourceful people in the not too distant future.


Education is clearly a community priority and when I talk to students, they have strongly stated requests for modernization of the school, curriculum related textbooks, resources and more classrooms and teachers to allow them to study up to grade 11 – the final year of secondary education. For the past two years, the additional classrooms and teachers have been respectively built and hired just in time to allow the top year of students to continue. Funds for further expansion have run out two years short of the target. The only option for those wishing to continue is to leave home to complete their studies in another town. Needless to say this is expensive and beyond the means of many poor families, leaving many willing but unable. Driving in and out of Kombolche, it is clear that some students walk a long way to school. From Degan to the nearest high school the distance makes this impossible.

A conversation with the principal reveals similar requests, mainly more resources and teachers to allow the school to manage increasing student numbers and valid aspirations. What the students have told me is well rehearsed as they recently completed a project focused on their Millenium Goals.

The new millennium started in Ethiopia on September 11th 2007 by the calendar observed by much of the world. Just over a month before our arrival. I got a distinct feeling that the students aspirations were much more than just the product of a recent exercise. They appeared to be very well informed about standards in the rest of the world and just how limiting the situation in their own country and region is by comparison. Informed though not at all resigned or accepting. Driven is perhaps more appropriate a term. The questions they posed were tough ones. Basically they wanted to know why we had come, how standards we saw in Degan compared to where we come from and what power I / we have to help drive the development they see as so essential in their home town. The best I could offer was information that we are a small organization with little power and few resources, but that the little that DESTA and its ancestors have contributed in the past has helped a lot in bringing them to where they are now. I don’t try to explain the starfish poem and wonder later if I should as story telling seems to be a recognized for of communication.


The Deputy Principle has organized a group of the highest-grade students to talk to me (video clip to follow shortly).


I did my best to explain to him what I wanted – i.e. to have the students tell their own story. I had an idea that I might work with them over the course of a week or even a few days, get them to script, shoot and edit their own story using the video and digital cameras and the donated laptop. It has taken so long to actually get to the point of having this discussion that the idea is now impossible. It is challenging enough to try to explain the concept to someone who has never used a video camera and maybe never taken a photograph either. Now I am here with a strict limit of less than an hour to leave enough time to complete business at the Health Centre then return to Kombolche to catch Ato Endalamaw at the Concern Office. He has agreed to act as Mediator in case of any dispute between parties to the Ambulance Management MoU. The document has been changed accordingly and now he has to sign it also. I have become accustomed to the pace and don’t have a problem with it, though I would have loved to spend more with the students, who are obviously bright, passionate and ready to challenge.

So in that hour I have to show a group of teachers how to use the donated laptop, talk to the students, make a courtesy call with the others, to the recently constructed British Airways sponsored library. The sign on the walls will be photographed to take back to BA Community relations.



Next (a final) stop at Degan Health Centre.

Thursday 4th October – The final day in Degan / Kombolche

At one point it was suggested that we might have completed business and be ready to travel back to Addis today – a day early. Not sure where the idea came from but there is not a chance. The MoU is getting very close but is not signed off yet. The donations for Degan High School are still in my possession, and some final gifts for the Health Centre have yet to be handed over. I have a sense that there is a reason for everything happening in the way and at the speed it does. I also have a sense that there is neither any point nor any need to try and explain this. Geldof’s words about ‘direct engagement with life’ echo in my memory and seem to explain everything at a fundamental level. So begins another busy day.

The first stop for the morning is at the Regional Health Authority offices in Kombolche. The MoU terms are finalized and we have a printed copy in our possession. Despite the complete failure of other attempts to use what little technology we find on offer in this remotely connected part of the world, that part has worked perfectly. The Degan Community leader, Shemeles and Health Centre Director Eshetu are scheduled to meet us there at 10am. Local representatives and higher authorities spoken to on the phone at the very time they factor into our plans should be, and are already there awaiting our arrival. It has been a long road to reach this point, but I have confidence that the terms of the agreement are not only acceptable but also defined by, and entirely relevant to the paries concerned. The Woreda (regional) Health Authority is accepting responsibility for running costs, driver appointment, salary and ensuring long term sustainability of the ambulance service. The Health Centre is assured that the vehicle will be dedicated for use as an ambulance service under their direction. The Community acknowledges its role in managing the service, as well as the benefits it will undoubtedly provide.

Sheik Alam (top right) is the one in this company who hasn’t been involved in earlier discussions. He is a senior official and a key person in acceptance and implementation of the deal. Sam’s smile reflects my own sense of joy and relief, when, at a certain point in the discussion to explain the terms and the purpose of the agreement, he picks up a pen and starts signing the document. I am not sure what the protocol is but this seems to be a signal that its ok for others to sign also and six copies of the document get passed around the table for signing and stamping - a most satisfying culmination to the discussions of the past few days. This may seem over played when the focus of the discussion has been on a group of overseas donors promising to gift a brand new and not inexpensive vehicle for the use of the local community. However, its important for us to know that long term sustainability of the service is in the picture, that responsibility for this rests in local hands and that accountability factors are nailed down.

In a context where little private transport is available for any purpose, and four wheel drive necessary for much of the terrain, it would be easy to see the pressure of other demands being put on the organization owning such a vehicle. The advice from long established and locally experienced contacts that we are keen to follow and the family’s understanding of local culture is that making the gift publicly, visibly and on very specific terms will exclude the possibility of anyone trying to over rule the agreement. In a country where anyone can go above the head of anyone else to lodge a genuine complaint and be guaranteed a fair hearing, we are confident that the backing and signed agreement from all these stakeholders will serve the purpose well. Thanks to the intimate local knowledge gained through years of local experience and friendships, without which this deal would not have been possible. It is no wonder that sometimes the road to sustainable development through international aid is paved with misread good intentions.


So we have our prize - or so we believe - head back to Tekle's to pick up the rest of the team and drive on out to Degan.

Make a brief stop on the way to grab some pics of this rather unusual site - a rusting Russian tank long since abandoned in a ditch at the side of a road. We are not the only ones gawping at it. I guess there is a story to be told, but no time or opportunity for us to learn what it is.

Perhaps another time - the same goes for a visit to Degan or Bati markets, to the ancient rock hewn temples at Lalibela and other sights that attract a growing number of the more adventurous type of tourists. The visit to Degan High School is finally getting closer to reality though! Today could be the day - in fact it has to be!

Next!...Degan Health Centre

Feels like another day
On what feels like the fourth day we have lived through today, but is really just a very busy Wednesday in northern Ethiopia, we move on from our lunch date - feeling totally spoiled - to further discussions at the Health Centre. This is the top priority for the visit – a fact that can easily be forgotten with the time devoted to schools and individuals all seeming to be of equal and critical importance.

The slightly frantic recently widowed man sheltering his tiny baby from the impartial glare of the sun under a black umbrella both haunts and reminds of this purpose – i.e. to negotiate an MoU with all interested parties to ensure that the ambulance our fund raising efforts will provide will be used solely for transporting emergency cases to the health centre or to hospital. We also want agreement that this vehicle will be maintained, a driver hired, running costs borne by the Woreda Health Authority and funds put aside for replacement after the 7 year expected working life of the suitably converted long wheel base Toyota Land Cruiser. (Toyota is clearly the supplier of choice in this country).


A lot can happen in that timeframe. Hopefully the entire area will be better resourced and serviced seven years down the track. If the rate of development in the capital is anything to go by this should be a realistic hope.

The health centre is looking great. Knowing from earlier DESTA video edits that there was nothing of the kind here two years ago makes it look even better and the future brighter.


Bigger aid organizations than ours have been at work here as the USAID logo bears witness. If I recall correctly, the Swedish Government was involved as well. But not knowing the terms of their donation, its hard to anticipate whether or not its safe to expect to come back in another year and find the furniture and equipment in place to make the tidy new buildings fully functional. There are beds (old and new) with no mattresses, rooms with no furniture, not a lot of equipment and no running water supply.



The young environmental health graduate ‘exiled’ here from Addis for a two year internship reckons the next project should be to install a water tank to provide a constant supply to the centre. Not a lot to ask really, and the visible evidence of not having this amenity is appalling to unfamiliar eyes. The sight of a woman sitting under a tree doing the centre’s washing ‘traditional style’ in a large bowl of water looks like a beautiful painting but confirms its a good idea for more than one reason.

The pity is, this bright and well educated young man who knows what better standards look like is only here for the two years ‘posting’ required of Health Sector graduates, then he’ll be off to where those standards already exist - in Ethiopia or elsewhere - rather than sticking around to lobby for them to come to Degan.


He is not from here originally and has no long-term commitment to the community. Local kids who do have ties here have to travel (literally and metaphorically) a hard and expensive road to get to university for the education that could drive this kind of development. Can you see the problem? It will be revisited with more detail when we finally get to the high school for the so far daily rescheduled visit. A few children from the original Degan Mission School founded by Ron and Maria have already travelled this road and come back as the officials we are dealing with now.

Some have travelled and not come back but still maintain ties with their home area one way or another. One we are in contact with heads administration in the highly prized and contested Nile Basin area - water is more valuable than oil in some situations. Another has made a successful career and lives in the western USA. Loyalty reigns though, and he maintains contact from a distance - even taking the trouble to call Sam to express support and wish him well with the latest stage of the project in Degan. Communication may not be as technologically advanced here as it is in some places but it's every bit as effective if not more so. Clearly the news of our presence in Degan has reached him on another continent within days of our unannounced arrival. Not everyone has, or can seize this kind of opportunity though, and it may be a long time coming to some.

For the moment though, we consider immediate problems and what it is possible to do with our small team and limited resources. Like the poem about a man walking along a beach littered with grounded starfish and putting the ones he passes back in the water – saying 'I made a difference to that one', we are able to help some, if not every one, and do believe that matters.

The discussion is around the MoU and how negotiations will proceed from here. Its already Wednesday so things need to start coming together. The upshot of this discussion is that Shemeles, the elected community leader (seated below) and Eshetu, the health centre director will travel back with us to the Concern office in Kombolche to discuss any revisions to the draft of the MoU that Ato Andalamo’s assistant recommends. They will then return to Degan for sundown (they have been fasting all day remember) and come back again in the morning to the Woreda Health Authority offices to meet with the other signatories, Sheik Alam and the authority’s representative for final sign off.


The discussion is productive and some changes are approved. Turns out to be a good thing the donated laptop is still with us at this stage as the changes can be made on the spot and the final version of the document printed off. It all takes longer than expected though, sundown arrives and the guys are starving. The driver drops them at the terrace café where we stopped for morning tea on the first day before driving the rest of us back to Tekle’s. He will return to pick them up and drive them back to Degan. Sense his annoyance at the need to work late and after dark. As it turns out, the café has no food so all they get is cakes. I can only hope there was some dinner left for them when they got home to Degan!

Back at the hotel a visitor is waiting. A lady that has known Ron and Maria since she was 16 and lives locally in a leper’s community. We tried to visit her earlier in the day but she and her fellow residents were at a religious festival that is happening a bus ride away. They are beggars and donations are good around such events because looking after the poor is part of the belief system. There are emotional scenes as she knew Maria was taken ill last year and that it could have been fatal. She has an adopted daughter – her own two children died in tragic circumstances. The girl is beautiful and the soft toy brought as a gift for her instantly becomes an extra appendage and spreads a stunning smile across her face.



Eventually we gather for dinner. The limited options on the menu that might be criticized in other circumstances are perused without complaint. The salads are excellent and more than enough to add to the rich traditional dishes served from the village kitchens. The restaurant is busy again with a new batch of tourists passing through.

The sight of them reminds me of a moment of stark contrast that came into the frame today. A convoy of four dust coloured Land Cruisers drove at fair speed through Degan while we stood with a group of people - as is typical where there is little traffic - gathered in the street. The blaring horns sounded aggressive and large modern vehicles full of European tourists looked like a gash in the landscape.

I can’t stay awake for the final activity – which would be Wednesday / day 7 by the previous counting standard – and leave the Cunningham clan discussing the small donations that will be left for individuals and families. This is always done discretely after they leave to avoid making a public show of who is in difficult circumstances, though the community generally seem to know this anyway as they help as far as they can. There is a long list, including widows, elderly, sick and destitute people. Its is gratifying to think that such small and available gifts can make a positive difference to their lives. A couple of examples - the temporarily destitute family with two young children who had to leave their land so the mother can undergo a six month course of treatment for TB at the Degan Health Centre. NZ$60 paid their rent for the remaining four months, left a reasonable contribution for food and some second hand clothes for the kids. A similar amount covered minor eye surgery for an elderly man to remain independent for a few more years.