The 2018 Homacho team; Bob Eager, Matt Daughenbaugh, Don Koppes, and Nancy McLaughlin. Jim Schilling and Darryl Mozena provided transportation to the bus terminal in Rockford.

The 2018 Homacho team; Bob Eager, Matt Daughenbaugh, Don Koppes, and Nancy McLaughlin. Jim Schilling and Darryl Mozena provided transportation to the bus terminal in Rockford.

The scene at the AirCanada check-in counter at O’Hare Airport, Chicago.

The scene at the AirCanada check-in counter at O’Hare Airport, Chicago.

And, we’re off - Dubuque, Iowa - Chicago, Illinois

We began our long journey to the village at Don’s house with with 23 full-size suitcases packed with shoes, clothes, seeds, and school supplies for the village. It took a little while to figure out how to remove some of the seats in the van so we could fit all the suitcases. But once we did, we loaded up and were on our way to Rockford to catch the bus to O’Hare Airport.

When we arrived at O’Hare, the AirCanada ticketing team was very curious as to why just four people were traveling with so much luggage. Don explained that we were on a mission trip to Ethiopia and that the contents of the luggage would be distributed free to anyone who needed it in the village once we arrived. When he learned the purpose of the trip, the desk supervisor at AirCanada expedited the check-in process for us and waived fifty percent of the fees for the luggage. Normally, passengers are allowed two pieces of checked luggage for free, anything more is charged at $200 per piece for up to 50 pounds each. We had calculated that this cargo would cost approximately $3,000 to transport to the village, but because the ticketing supervisor was sympathetic to our cause, we were only charged $1,500.

Later, as we were sitting at the gate waiting for our flight, we began receiving notices via an AirCanada iPhone app that our first flight was significantly delayed. Within a few minutes, it was clear that we would miss our connecting flight from Toronto to Frankfurt, Germany, and we would have to try to make another connection once we finally arrived in Canada. Just as we were realizing the headaches we’d have to deal with in Toronto, the same desk supervisor who greeted us at check-in appeared at our gate with four new boarding passes for a flight that was leaving for Toronto in just fifteen minutes. He had been watching out for us because he was touched by our story and believed in our mission. He took the initiative to do what he could to make sure we had a great start to our trip. We couldn’t believe our luck and are truly grateful to him and AirCanada for their kindness and generosity.

Our bus driver, Abush, on the road from Addis to Hossana.

Our bus driver, Abush, on the road from Addis to Hossana.

The “welcome committee” in Homacho. Everyone here helped us unload the bus, including the 23 suitcases full of shoes and clothes for the village.

The “welcome committee” in Homacho. Everyone here helped us unload the bus, including the 23 suitcases full of shoes and clothes for the village.

The journey to homacho - Addis, Hossana, and Homacho, Ethiopia

We arrived in Addis at about one in the morning local time. After nearly two hours of wrangling suitcases at baggage claim and working through customs, we emerged from the airport into the crisp morning air. Argaw had gone over a week ahead to help prepare for the trip and he met us at the airport with his brother Tessema and his son, Abush who would drive the bus that would take us to the village. We checked in to a hotel in Addis to rest up for the long drive the following day.

Although we had already traveled nearly 24 hours including flight and layover time, it would take us another nine hours to travel from Addis to Homacho. It is not far, only about 150 miles or so but the roads are not in the best of shape. Where there is pavement, we had to slow down to avoid large potholes, livestock, and people. On dirt roads that resemble the surface of Mars, we were only able to go about 20 miles per hour.

When we finally arrived at Argaw’s family home, we were enthusiastically greeted by family and random villagers who were very curious about the people on the bus. The bus parked outside the gate of the house and when we got off, we were surrounded by a sea of smiling faces. A number of young boys from the neighborhood had followed the bus through the village and eagerly helped us unload all of our suitcases and supplies. We felt instantly at home.

Every time we wandered through the village, we acquired an entourage of children eager to hold our hands and walk with us. It was one of the most memorable and endearing parts of our trip.

Every time we wandered through the village, we acquired an entourage of children eager to hold our hands and walk with us. It was one of the most memorable and endearing parts of our trip.

Women stand around the mill waiting for their grain to be processed into usable flour.

Women stand around the mill waiting for their grain to be processed into usable flour.

exploring the village - Homacho, Ethiopia

Monday was our first opportunity to really get out and explore the village. As we walked through the gate from the house to the road, there were a few children outside waiting for us and eager to tag along for a walk. They each grabbed one of our hands and off we set off together toward the center of town.

Our first stop was the village mill where women bring their teff or wheat to be ground into usable flour. Teff is a fine grain, about the size of a poppy seed, that comes in a variety of colors, from white to dark brown. It is used to make the traditional fermented bread, injera. Injera is flat, with the consistency of a pancake but with the taste of a rich sourdough. Ethiopians have injera at every meal and use it as a utensil for their meat, vegetables and sauces. Stepping into the mill was like stepping back in time. In one corner, a woman was on the floor sifting wheat. On the other side of the room, women stood near an ancient looking machine waiting for their grain to be turned into flour they could use to feed their families.

Toward the center of town, we came across two water tanks that Friends of Homacho built after the development of our first spring. The tanks are a few years old, yet still very functional, though in need of some minor repair. We wanted to assess the condition of the tanks and get estimates on what repairs might cost. For those of us who had never been to the village before, the water tanks were the first tangible sign of the great work Friends of Homacho has done in the village over the last ten years. The funds raised by our tiny organization actually built these stone tanks that supply water to hundreds of people throughout the village.  

Next, we visited the high school. It was rumored that the school had WiFi, so we went there hoping to be able to retrieve some emails or send some texts home to family to let them know we arrived in the village safely. We had all looked into international mobile service and had come up with different answers. One plan had indicated that calls and texts were possible throughout the country, but another map showed no coverage whatsoever. As it turns out, our iPhones became nothing more than fancy cameras unless we had access to WiFi. Argaw is friends with one of the school officials, so when we arrived on campus, he asked if we could have the WiFi password. Unfortunately, he informed us that WiFi was not currently available because the school was unable to pay the bill.

When we emerged from the high school, our entourage was still waiting for us, and had grown to over forty kids.

 
A classroom at the Fule school. In addition to providing concrete floors for nine rooms, Friends of Homacho will purchase new blackboards for each classroom.

A classroom at the Fule school. In addition to providing concrete floors for nine rooms, Friends of Homacho will purchase new blackboards for each classroom.

Students, teachers, community leaders, and representatives from Friends of Homacho gather for an all-school assembly under a tree in the middle of the school yard.

Students, teachers, community leaders, and representatives from Friends of Homacho gather for an all-school assembly under a tree in the middle of the school yard.

our visit to fule school - Fule, Ethiopia

On Tuesday, we visited the Fule school. We had been in contact with the school principal previously about installing concrete floors, but we needed to get some final measurements and confirm the total number of rooms that needed to be completed. So we set out in the van from Homacho and arrived in Fule about 45 minutes later. When the van pulled up, we were astonished to see that the entire school had turned out to greet us with song and dance.

After touring the classrooms, we met with the students and teachers under a large tree in the middle of the school grounds. Representatives from the school spoke, expressing their enthusiastic appreciation to Friends of Homacho for agreeing to provide concrete floors in all the classrooms. Don was then invited to speak and through a translator said how grateful he was for the amazing welcome the children provided. He also promised that, in addition to providing concrete floors, we would also provide new blackboards for all the classrooms. His comments were met by applause from students and teachers alike. The last speaker at the assembly was one of the town elders from Fule. An older gentleman, he stood slowly and speaking through an interpreter said, “We were close to death, but because you have come, we feel like we have risen from the dead.”

Later that evening, in a further display of their gratitude, the principal of the Fule school, the leader of the PTA and a teacher showed up at Argaw’s family home in Homacho where we were staying. They brought a two-gallon bucket of fresh honey, just harvested from a hive, and passed it around the room for everyone to share.

Click on the video below to see the greeting we received from the children at Fule.

A hut on the trail to the new Hadera spring.

A hut on the trail to the new Hadera spring.

Don Koppes pictured in front of the Hadera spring. Construction will begin in January and it should be completed by April 2019. Water from this spring will serve the poorest section of Homacho.

Don Koppes pictured in front of the Hadera spring. Construction will begin in January and it should be completed by April 2019. Water from this spring will serve the poorest section of Homacho.

hiking to the new hadera spring - Rural Homacho, Ethiopia

Since 2011, Friends of Homacho has helped the village develop three springs. In the last year, representatives from the Homacho water department identified a new spring in a remote area known as Hadera. They contacted Friends of Homacho and asked if we would be interested in helping to develop this spring in order to bring more water into the village.

We agreed to investigate further, but on one condition - this spring had to bring water to the poorest part of the village. There was some contention on this point from business leaders in Homacho. We heard that there was a small group of local restaurant owners who wanted to develop this spring just to increase water pressure to their businesses so they could add a second story to their buildings.

Don remained firm in our negotiations. Friends of Homacho is working in the village to help those most in need, not help relatively wealthy business owners expand their businesses. In the end, the water department conceded, and the agreement was drawn up specifically to deliver water from the Hadera spring to the poorest part of the village.

We drove through the hills of rural Homacho for about 45 minutes before we arrived at the trail that leads to the spring. The landscape in this area is absolutely picturesque. There is a mixture of rolling wheat and teff fields combined with green vegetation. The fields were dotted with farmers harvesting wheat by hand with scythes as they have done for centuries. Along the trail, we passed a number of small thatched huts, some with laundry hanging outside on a line to dry.

We hiked almost two miles over rugged terrain before we heard the sound of water rushing in the distance. Standing next to it, the spring is not that big. You can just see a babbling waterfall partially hidden by lush green foliage. But the water collected here will mean a big difference in the lives of many people in the village.

We estimated that the the development of this spring will require nearly four and a half miles of pipe to deliver water directly into Homacho. This project will provide a water station at the elementary school, five other water stations strategically placed in the village, and a new water tank near the old farmers’ market in the center of town. Before we left to come back home, we deposited sufficient funds with our contacts in Homacho so that construction on this spring could begin immediately.

Random villagers along the dirt road to Gofora help push our van up the hill toward the town square.

Random villagers along the dirt road to Gofora help push our van up the hill toward the town square.

The first picture I took of the two boys who started the photo session at Gofora.

The first picture I took of the two boys who started the photo session at Gofora.

Visit to Gofora

We visited the Gofora school on our way back from Fule. Friends of Homacho provided concrete floors here in 2017 and we wanted to stop by and see how things were going. When we arrived, we discovered that school was out for the day, likely because of a funeral that occurred earlier in the day in the tiny village. Walking around the school, it was clear that this was one of the poorer schools that we have worked with. Many of the schools we had seen on this trip had finished exterior walls that were painted. But the exterior walls of the Gofora school were just exposed mud and timber, and many of the walls had large gaping holes.

When we walked back to the road and loaded up in the van - it wouldn’t start. Now, back home, a problem like a car not starting is not that big of a deal. You can easily whip out your cell phone, call a friend to help, or finally use your AAA membership. In rural Ethiopia however, it’s a bit more of a challenge. Our driver, Debeba, accessed the engine under the driver’s seat and tried his best to get it to start but, there was absolutely nothing happening. The engine was dead.

As we sat there stranded, many of the locals walking by on the dirt road stopped and looked curiously at the van and at us. At one point, a young farmer had to navigate his herd of cows past the broken-down van on his way back home. We had passed a kind of town square just up the road about a quarter of a mile when we drove down to the school. So we decided it would be best to push the van off the road and see what we could do to fix it where we had more room.

This instance was just one example out of many that I witnessed throughout our time in Ethiopia of the overwhelming kindness and generosity of the people there. Everyone is willing to help. Random strangers passing by on the dirt road joined in to push the van up the road. There was a sense from the locals that this is just what we do. When people need help, no matter who they are, we help.

When we got to the town square, I walked over to the side of the road, sat on an old tree stump and began to write in my journal. I’m not mechanically inclined at home and I was even less so here in the middle of a rural African village, so I thought it best to leave that up to the local experts. As I was writing, I noticed that there was a small thatch-roofed hut behind me and thought it would make an ideal backdrop for a selfie. So I grabbed my phone, and took the shot.

Across the road, two young boys saw me snap that selfie. They laughed, waved, and began posing together. I assumed that they wanted me to take their picture, so I did. They ran over to me to see their picture, and giggled at what they saw. Then I took their picture again and showed it to them. They laughed again. In a matter of minutes, I was completely surrounded on all sides by local villagers curious about what I was doing, and eager to have their picture taken as well. So I sat there, for the better part of an hour, snapping random photos of anyone who came over, and showing them their portrait.

Their reactions to their pictures were fantastic. Some were embarrassed, others giggled nervously, but nearly everyone laughed and smiled at what they saw. It was clear that they were having fun playing the picture game. I’m convinced I could have sat there all day long and snapped photos over and over again because they were having so much fun with it. And so was I.

It was one of those rare occasions in life where you’re able to connect with someone on a completely different plane. Without words or language, there on the side of a dirt road in the middle of rural Ethiopia, we all made an instant human connection by just by snapping a picture and laughing together. Their personalities were projected in their smiles, their kindness was reflected in their eyes, and a sense of joy echoed in their laughter.

When Argaw yelled over to let me know that they had started the van, I did feel a slight sense of relief that we didn’t have to ride on the back of a motorcycle or walk ten miles back to the village. But mostly, I was sad that the photo booth game had to come to an end. I took a few last pictures, high-fived everyone, and jumped back into the van for the ride back to Homacho. The pictures are great, but this is one memory I’ll carry in my heart for a lifetime.

Below are a few select pictures from the Gofora photo booth. In the first picture,
you can see the van in the background and people running over to gather around me.

The gate outside the clinic in Homacho.

The gate outside the clinic in Homacho.

The intensive care unit at the Nigist Eleni Mohammed Memorial Hospital in Hosanna, Ethiopia.

The intensive care unit at the Nigist Eleni Mohammed Memorial Hospital in Hosanna, Ethiopia.

a visit to the clinic in Homacho and a hospital in Hosanna, Ethiopia

We often take our access to health care in this country for granted. Our cabinets are filled with bottles of pills for every little ache or malady. There is a Walgreens on every other corner and urgent care centers are open around the clock to treat our inconvenient sniffles at times most convenient to our busy schedules. In our worst hours, first responders speed to our rescue, whether at home or by the side of the road, and have the ability to whisk us away in a waiting helicopter to some of the finest health care institutions in the country if necessary. It’s not like that in Ethiopia. And traveling in this emerging third-world country, you quickly come to realize just how good we have it.

In May of 2017, Friends of Homacho sponsored our first medical mission to the village. Our medical team worked at the clinic with local doctors for two days. While we were there, we bought an expensive antibiotic for the clinic as well as a battery-operated otoscope and fetal Doppler monitor. In addition to working at the clinic, our medical team also examined and diagnosed people who came to where we were staying because they could not afford the clinic registration fee. We treated them as best we could, and in many cases, provided our own personal money for these patients to go to the clinic or the nearest city for medical help.

It was during this first medical visit that we discovered vitamin A deficiency is a serious public health problem in Ethiopia. Vitamin A deficiency is the leading cause of preventable blindness in children worldwide. Many children become blind every year because of a lack of vitamin A and half of these children die within a year of losing their sight. According to UNICEF and the World Health Organization, periodic, high-dose vitamin A supplementation is a proven, low-cost intervention to prevent childhood blindness and reduce illnesses such as diarrhea. Preparing for our trip in December 2018, we decided we could do something about this.

In addition to shoes, clothes and school supplies, the twenty-three suitcases also contained 30,000 doses of vitamin A donated by Mercy Family Pharmacy. For some reason, vitamin A is difficult to acquire in Ethiopia. In the week before our departure, we learned that the Ethiopian government recently cracked down on medicines being brought into the country because they discovered that many of those shipments, claiming to be lifesaving medicines or supplements, are just sugar pills. We were prepared to present evidence to customs upon arrival in the country that our pills were genuine, but as it turned out, we didn’t have to.

Homacho Clinic

When we met Daniel, the new CEO of the Homacho clinic, he had only been on the job for about two weeks. He heard from the previous administration that we were there last year, treated patients and donated some items, so he was willing to take the time to meet with us, and tour us around the facility, although we stopped by unannounced.

Daniel first took us into the pediatric ward. There were two children being treated here, both in opposite corners of the room being comforted by parents with concerned looks on their faces. There were no sheets on the beds, just a mattress with a white plastic cover. The walls were decorated with colorful murals depicting children holding hands or playing soccer.

The first thing that struck us was the standard of cleanliness. We are so used to hospitals being squeaky-clean and sterile environments, complete with a unique “hospital smell” that is somehow frightening and comforting at the same time. Here though, the standards aren’t as stringent. Dust is everywhere in Ethiopia, there is just no escaping it. The roads here are not paved so the smallest activity on the roads during the dry season sends plumes of red dust into the air that ends up coating everything. The white tiles of the floor had a coating of dust so thick that you could see shoe prints. Nothing in this room, or any area of the clinic for that matter, would have passed a white glove test.

Next, Daniel took us to an area behind the hospital where all of the clinic laundry is done by hand at a concrete station, similar to those we have built throughout the village. Representatives at the clinic in Homacho have asked us for two years to purchase a washer and dryer for their facility, and Daniel repeated that request. It certainly makes sense for a clinic facility to have a modern automatic laundry facility, but we remain concerned that there simply wouldn’t be enough water pressure to operate even the most basic washing machine.

From there we went to the labor and delivery rooms of the clinic where they deliver about 150 babies per month. Daniel showed us an ultrasound machine that was donated to the clinic that they hoped they could upgrade soon because of poor picture quality. We also asked about their access to vitamin A and their protocol for administering the supplement to expectant mothers. A nurse said that they did have some vitamin A and went to the pharmacy to get some. She brought back a single bottle of low-dose vitamin A, manufactured in Canada that had expired in July 2018.

Wrapping up the tour outside the clinic, we asked Daniel what was on his wish list. First and foremost was an automatic washer and dryer. Then, the clinic has about twenty beds total in the facility, and they don’t have an adequate supply of linens for each. Currently, they are only able to change the sheets on the beds about three times per week, or as absolutely necessary. They would like to have a sufficient supply of sheets, pillow cases, blankets and patient gowns for them to change out at least once per day. We made arrangements with Daniel to drop off the supply of vitamin A at the clinic before we left the country, and walked through the clinic gates toward the center of the village.

The emergency department at the Homacho clinic.

The emergency department at the Homacho clinic.

The outside pavilion at the clinic where patients check-in and wait to be seen by a doctor.

The outside pavilion at the clinic where patients check-in and wait to be seen by a doctor.

Daniel talks to Don about the need for a washer and dryer. Daniel is leaning on the laundry station where all the clinic laundry is done by hand.

Daniel talks to Don about the need for a washer and dryer. Daniel is leaning on the laundry station where all the clinic laundry is done by hand.

Patient beds in the pediatric ward in the clinic at Homacho.

Patient beds in the pediatric ward in the clinic at Homacho.

Hosanna Hospital

Later that week, we journeyed back to Hosanna to visit the largest public health facility in the city, Nigist Eleni Mohammed Memorial Hospital. Again, we popped in unannounced, and with the help of a mutual contact, we were introduced to Paulose, the chief medical officer and  Shanko, the CEO, who coincidentally, grew up in Homacho. They were both very gracious and took the time to tell us a little bit about the hospital before taking us on a tour.

The hospital was established in 1984 in response to a growing public need for health care in the area. It was originally funded by the government as well as private funds raised from the general public. They see about 165,000 outpatients per year and treat about 12,000 inpatients. A staggering 6,500 babies born in this hospital every year. To offer some perspective, Hosanna is similar in size to metropolitan Dubuque, Iowa, between 60,000 to 75,000 people. In 2018, only 1,500 babies were born in Dubuque, at both hospitals, combined.

Because there are so many babies born here, moms are required to be out of the labor and delivery ward within two hours of giving birth. When Sahnko said this, I thought he made a mistake, so I asked him to clarify. No, I had heard him correctly. If there are no significant complications, the mother and baby are discharged from the ward within just two hours following the birth of the baby. If they need further rest, or need to arrange for transportation, they are allowed to stay in a pavilion located in the courtyard of the hospital where they can relax and watch television until they are able find their way home.

Although the hospital in Hosanna was bigger and had more access to resources, the conditions here were much worse than the conditions at the clinic back in the village. The building itself is crumbling. Outside, the walls are covered with wooden scaffolding in what looked like an attempt to repair some of the stucco exterior. Inside, the stairs leading to patient floors were cracked making it difficult even for us to get up and down without tripping.

When we arrived on the patient floors, it was obvious that the hospital is clearly not equipped to handle this many patients. There were so many patients on the medical ward that they did not have enough beds to accommodate everyone. Patients were lying on mattresses in the hallway, and we had to step over them to make our way through.

The tour continued outside where Shanko showed us a concrete shell of a building that will eventually be the new home of the emergency department. The current emergency room consists of just four beds in a tiny space that is so cramped, they have placed a bed behind the reception desk to treat patients. Shanko explained that while the new building is within three or four months of being completed, they have no budget to furnish the building once it is complete - no money for beds, equipment, or even the staff it will require to open the unit.

We ended the tour outside the outpatient unit near where a young man with pins in his leg, sat alone on a gurney placed on the ground, apparently waiting for someone to take him into therapy. We asked Shanko and Paulose what some of their greatest needs were and they said finding the resources to complete the emergency room was perhaps most important at this time. Additionally, they have ongoing needs for basic supplies like, drapes to separate patient beds, gowns for patients to wear and gloves for nurses and doctors to wear when they are treating patients.

Seeing the conditions in the hospital we decided that we had enough vitamin A to supply both the clinic in Homacho and the hospital in Hosanna. We let Shanko and Paulose know that we would stop by the hospital on our way back to Addis and drop off the supplements for their patients.  We exchanged email addresses and will endeavor to stay in contact with them to see how we might be able to help them in the future.

I think of them often, the faces of the patients and caregivers we encountered at both facilities; the mom who was having her first ultrasound when we walked through the room, the young boy in the pediatric ward who offered me the biggest smile from his hospital bed, the patients resting on mattresses on the floor in the hallway, and a caring nurse who sat on the edge of a bed holding an elderly person’s hand. Despite incredible challenges, patients and caregivers get by in Ethiopia as best they can with the resources they have. The problem is, they just don’t have enough.

A bed in the intensive care unit of the Hosanna hospital.

A bed in the intensive care unit of the Hosanna hospital.

The OR schedule was posted just outside the surgical unit. There were four procedures scheduled that day; bladder stone procedure, dermoid tumor biopsy, right femoral hernia, and a prostate procedure.

The OR schedule was posted just outside the surgical unit. There were four procedures scheduled that day; bladder stone procedure, dermoid tumor biopsy, right femoral hernia, and a prostate procedure.

Patients were lined along the hallways on mattresses because there were no beds in the wards.

Patients were lined along the hallways on mattresses because there were no beds in the wards.

IMG_3286.jpeg
One of the busy pediatric wards. The young man in the bed to the left smiled at us and was well enough to get out of bed and follow us for a bit.

One of the busy pediatric wards. The young man in the bed to the left smiled at us and was well enough to get out of bed and follow us for a bit.

The pavilion in the courtyard of the hospital where new mothers wait to recover before going home.

The pavilion in the courtyard of the hospital where new mothers wait to recover before going home.

A young man waits outside the outpatient services area of the hospital. Notice the pins in his right leg.

A young man waits outside the outpatient services area of the hospital. Notice the pins in his right leg.

The new emergency department building should be completed by April 2019, but the hospital does have the funds to furnish it with medical equipment.

The new emergency department building should be completed by April 2019, but the hospital does have the funds to furnish it with medical equipment.