The Elephant Cloud


The Elephant Cloud header image 1

The Street Boys

April 19th, 2010 by · Africa, Ethiopia

jirata, lalise, and damekaMark Twain delights us with the wonders of boyhood. Skinned knees and bare feet, wild with imagination and thirst for adventure. Jirata, Dameka, and Lalise would fit brilliantly into these pages. I can see these three scamps racing the red clay roads to the staduim on Saturday mornings to watch futbol, striking taekwondo poses, and nabbing mangoes along the way. Later, they’d hang out by the foosball tables on the side of the tarmac, a road that cuts thru Gimbie on it’s way to Addis Ababa or Sudan, depending on your direction. It was by these tables on my walks home that they adopted me, taking turns teaching and quizzing me on Amharic, or Oromifa. I could never tell which was which.

lalise, taekwondo is big in ethiopia and free to watchThese boys are like all little boys and they’ll steal your heart and take your hand. Except they have no hands to guide them, they are on their own. These are the street boys, living together as a family, sleeping under trucks and in doorways, begging or charming their dinners from the townspeople and restaurants.

One little urchin with lazy eyes and a peaceful smile followed us into a restaurant for dinner. We were with our friend Mark and by the time we washed and sat down, David was sitting right beside us, beaming. I thought he was with you, oh, I thought he was with you. He sat patient, a perfect little gentleman and the clever little guy won us over. When the communal plate of injera came we bought him a soda and feasted. After the meal, clutching his prized soda, he rocked with lightness of laughter as Darlene mimicked an exploding belly.

I had already been working with the street boys for a couple weeks when we came upon Jirata, exhausted and sitting on the curb, in front of his favorite mango stand. I saw his tiny figure rise and turn to us with his signature stare, bloodshot eyes, and exhausted posture. Darlene, who’d never met him, recognized him instantly from my photos. His anticipation was overwhelming and his tiny hand found mine. I knelt to bump shoulders, as is the ethiopian greeting, and took the whole of his filth, from head to toe, into a warm embrace. I have never seen dirtier children.

Everyone had been looking for him, the boys told us he was sick and skipping school. Only nine years old, he’s HIV positive and both parents have been taken by the disease. He has no one looking after him aside from his best friends, who during previous hospital stays held vigil by his side.

No words were exchanged and his grip tightened and we walked to the hospital. This attracted attention. Ethiopians are not accustomed to foreigners embracing filthy street kids, let alone walking off with them. He could barely eat and he was so dehydrated his lips were sore. He managed half a banana and held a mango for later. He was admitted to the hospital.

The next morning, I set out to visit him. A little girl living on the hospital grounds knew where his bed was and brought me into the ward to see him. I had drawn a little cartoon on a makeshift card, but when we arrived, his bed was empty. The nurse said he woke, pulled out his IV, and left.

my team, my teachers

A few days earlier, I happened upon a crowd gathered on the curb not far from the hospital. Two of the boys were in the middle so I pushed my way in and found another boy lying on the ground. I’d never seen him before, but he was wearing one of the yellow t-shirts that were given to a handful of the boys six months earlier. One man spoke broken english so I grabbed Moti by the shoulder and pulled him over to relay the story. The man translated, but would never have considered asking Moti himself. The crowd dispersed but the boys remained together, I know they would not have left him alone. I picked him up and carried him to the hospital. Half way he insisted on walking, though he had to hold me with all his might, his strength all but gone. In the emergency room I found a nurse and they laid him down to rest. I learned later that he was epileptic and had had a seizure. He was discharged that afternoon and I never saw him again. The Children’s Medical Fund paid the bill.

Today, Jirata and four other boys are living in a small rented house in Gimbie. A program called the Street Boys pays for the accommodation. A sister project, The Ark, offers economic opportunity for unwed mothers and employed one of them to live in the house and watch the boys.

I created the following video about the Children’s Medical Fund, which provides health care for children in need under the age of eighteen, including the Street Boys.



Finding Jinsse

April 18th, 2010 by · Africa, Ethiopia

where is tarikeIn order to do anything in Africa, you have to take full control. Then, as you’re just about to take full control you are boldly reminded that this is Africa. You have no control.

I had an assignment from the States to follow up on two hospital patients and document their progress in photographs. Jinsse and Tarike, two women admitted in February and now home with their families. Binyam, a young Ethiopian working tirelessly with the hospitals community outreach programs instructed me to find their fathers names and the kebeles in which they lived.

I started with the hospital registers and quickly learned that in juggling english, amharic, and oromifa, no one spells a name the same way twice. Translating from amharic script, vowels are often doubled in an attempt to spell things phonetically for the ferengi. One name is spelled differently on each incarnation of the register, patient charts, lab cards, and prescriptions. Sometimes the name includes the fathers name, sometimes it doesn’t. No one keeps their cards, so a new one is made each time. If someone asks you to find someone by the name Jinsse, you might be looking for Jisse, Jinsse, or Jinsee and chances are the people wont know her name, only her fathers.

In the end, it was the nursing students who remembered the patients and I closed the useless register. Jinsse was too far, a three hours walk and no vehicles would make it. Finding Jinsse would be impossible. Tarike, on the other hand, was close, just one kebele over. You can practically see her house from here.

Africa lulls you into an acceptance of waiting. You actually believe things could be straight forward, that it will come together, as planned. Never, never, never fall for this. Let me assure you it is most certainly will not. Africa reveals itself slowly. Rushing one thing will inevitably complicate something else.

In the two weeks we spent living in the hospital compound we accomplished a lot. Darlene was exhausted at the end of each day seeing patients and I was accruing video for my projects. But those accomplishments came with the price of waiting. Time, patience, trust and a lot of faith are complicit with unwritten schedules, vague complications, cultural under-communication, and over ambitious goodwill. There is a refusal to admit defeat and you rely on motorcycles that almost work but might need a part. When you are in Africa and you’re on a tight schedule, you miss a lot, because Africa rewards the patient traveler. However, if you surrender to Africa, you suddenly find yourself as I did, on my last day and still waiting. It was Friday morning and our flight would leave on Saturday just after midnight. We were an eight hour drive from the airport.

In the end, it was cold hard cash that broke the wait. I hired a truck and invited Monica to join me and disperse shoes to the village children through one of her many outreach programs. We’d drive thru Tarike’s village, do a meet and greet, and then head over the hills and deliver shoes to children in the vicinity of Jinsse’s village and hope we might find someone that knows her family.

I may have bought off the wait, but Africa was firm in it’s resolve. Tarike was not on the way. We couldn’t see her house, the village officers were not available to help us, and the bribes we’d have to pay did not inspire confidence. We’d need to see the village officers, but not today. It would be impossible for her to live in the village and the officers not know about it, I was assured. Deflated, I was now forced into a decision. Would we stay another day? I would have to give up our seats in the land cruiser and instead take local transport to Addis, making the trip ten hours, instead of the eight.

shoesThe shoe project went much better. We bumped along weathered dirt tracks rising over farmland hills and thru the heart of village life. We parked by a lone tree and unloaded two duffels of shoes while children ran across fields as word spread. Binyam fitted shoes to young girls offering their toes, their dresses worn and dirty, their waists wrapped in ropes which bound them to a future of heavy loads they would carry to support their families. But it was a beautiful afternoon full of goodwill and cheer. In fact, the goodwill was so overwhelming that one man, whose daughters were fitted with free, brand new shoes, was so pleased he charged only a small fee to lead us to Jinsse.

After two weeks of hearing how far she was, how impossible to find, how remote, we actually found her standing on the side of the road in front of a relatives house. She practically had a sign over her head. I was so pleased with accomplishing the impossible that I decided we’d stay and find Tarike. I would give up our seats on the land cruiser and set out with Binyam, first thing in the morning.

kitfoBy noon the next day the motorbike still wouldn’t start and I spent the morning waiting. I was getting nervous and hungry, and Binyam was feeling pressure, so I took him out for kitfo, grabbing a sparkplug en route. Kitfo, is raw meat with a hot green chili paste eaten on injera. Ethiopians are mad for it and it cheered him up considerably. I had my kitfo fried up to be on the safe side. I bought him a hen on the way home, a good egg-layer.

The spark plug didn’t solve the problem. He worked thru the afternoon, it was three o’clock and no one at Air Egypt or Ethiopia Airlines would answer the well-published phone numbers on the world wide web. Changing our flights was out of the question, the search would end at sundown and I began to believe if I waited one more day, our luck would change. But that was impossible. Not Africa impossible, but real impossible.

Unable to delay my departure, defeated, we decide to walk to her village. As we passed the Adventist Church, we notice an unused motorbike parked out front. With a little fast talking and the mandatory African waiting period, we procured the bike. Tarike was once again, right next door. I could almost see her smile.

The race was on and skidding into the kebele we greeted the village officers. Tarike? Never heard of her. What?! Maybe you should try the next village over. My heart sank but the bike bounced along and we called out the village name as villagers pointed us in one direction or another.

The road split several times and we took the wrong fork with each division. The day was coming to an end and we eventually ran into a group of Hararbe’s, muslims who had been airlifted from the Somali side of the country to the Sudanese side and set up in a makeshift village camp, like refugees. They only spoke arabic and so we could no longer communicate. We turned around, defeated and bumped our way back toward Gimbie in silence. And then, out in those hills in the earliest hours of dusk, Africa relented and we came across a group of women returning to their village on foot. Yes, said one, Tarike is my neighbor.

Tarike cannot walk. Whatever she suffers, the womans own daughter suffers the same. Two months ago, the village carried Tarike to the hospital for care, and she was admitted, but nothing could be done for her. She is now home, an hours walk from where our bike idled. The bike would not make it, a bridge was out. It was late in the day. I looked at all the faces around me. Hardened by the earth, each carried a heavy load wearing battered shoes and beautifully patterned, but stained and filthy dresses. The future of the girls I saw yesterday.

Tarike would have to stay where she was, they would not carry her again, unless they believed in the treatments she would receive. This was their story, but like the spelling of names, no two stories in Africa are the same.

Binyam looked at me. He would return tomorrow, he was also stung from being so close but not having found her. He would make the hike and get her picture. No, I shook my head. In the middle of that forest, surrounded by the villagers faces looking at me, what was I really going to do? I could almost read it in their faces. Why was I there for Tarike, was this ferengi on the back of a motorbike really going to help?

I had nothing to offer these women but I felt Africa wrap a brotherly arm around me as if proud for bringing me here. There was no doubt that I would be shown more if I stayed longer, but this is what I would see for now. Knowing I had a rocky ride home to survive, we turned the bike and headed out, white knuckles on the gear rack. Africa always surprises when you surrender to it and what you are seeking is not the reward you eventually find.

As for our return to Addis, I received a call late in the evening. Minivan seats were available for us. We just needed to meet a boy named Howie at 4:30 in the morning under a street lamp across from the bus station. This did not impress Darlene and our ten hour, twenty hour ride to Addis is a whole other story that will need to wait.

Inspired by the travels of Joni Kabana and Philippa Ribbink and their collaboration in travel photography and developing world medicine.



When Antibiotics Aren’t Enough

April 12th, 2010 by · Africa, Ethiopia

gimbie-6207Loaded with drugs, dental tools, used reading glasses and medical supplies, the Land Cruiser sat idle as ten Ethiopians, Americans and a Britt wedged their bodies into the vehicle, vying for cramped space.

We were headed an hour west into remote Ethiopia, close to Sudan’s border, where an under-stocked, dilapidated clinic waited our arrival.

Satellite clinics within this mission based hospital cover over 100 miles of deforested valleys and hills, reaching areas forgotten by governmental planning. Desolate regions far from public transport and markets, people so poor that second-hand clothes and shoes remain unattainable. Many are barefoot, carrying heavy loads of wood or water to their distant villages.

village church

The red dusted window played like a foreign film sans subtitles as Islamic holy men herded zebu humped long-horned cattle and sheep with matted, twisted tails slowly through rows of thatched huts supporting coptic religious crosses.
Fields of seasoned mangoes and avocados fell heavy from trees into villagers hands where they lined the dirt tracks selling fruit, charcoal and sugar cane.

A narrowed path turns into a village where a lone yellow acacia tree towers in the dry heat, its lower branches gone, a telling of fate as firewood is sparse and nothing goes unused. Children race to the car, pointing and howling, ‘ferengi,’(white foreigner) as we unfurl ourselves into the new surroundings, our clinic for the next several days.

A little girl, perhaps five, with crazy hair and a makeshift dress races between my legs, shrieking. She grabs my hand and slaps it into hers, triumphant. We eye each other curiously, making faces, slowing our pace to the clinic.

Towering above these children, I notice their heads, or in this case, compared with Tanzania, the lack of fungus on their scalp. It has changed, how I look and interact with the environment.

Past her smile, I notice palms that are peeling and skin on her extremities cracked, her fingers clubbed with deep nail ridges. A little boy running to catch us has a swollen belly with a protruding umbilicus, his reddish hair is sparse and brittle. We pass women squatting over charcoal, large goiters protruding under scarves. While malnutrition and deficiencies are evident throughout Ethiopia, so is the panacea. But the abundant wheat, fruit and vegetables grown as cash crops don’t find their way into the local diet. There are no government subsidiaries for vitamin or iodine supplementation.

Patients arrived early, miles away they came in droves, sick children and elderly in tow. Emanual, my interpreter of twenty-three, shouted for our first patient. An anxious young husband, wife at his side, an infant nursing under the head scarf, I had yet to sit down, no chance to organize my stethoscope, paperwork, they spoke hurriedly as he deciphered this Oromifa dialect. Weaving a tale of night sweats, lesions and infections, he finally motions his wife to uncover the child- feverish eyes look over her breast as a rotting odor engulfs my senses.
A moment of panic struck, what was I doing here in Ethiopia? Hours away from a hospital and people too poor to travel any distance were asking for help. I found myself struggling, wondering how I could help this family, one among hundreds waiting outside the broken blue door?

Experience builds confidence, until one day you reach Africa and everything changes. What we learned from medical books and mentors in the western world suddenly means very little. His face covered with small, irregular raised bumps, many secondarily infected with impetigo gave way to to large bulbous abscess draining from the neck and back of his head. Tight curls atop his head matted with virescent pus.
Lifting his weak body, she moved his small head aside and pointed to a clustering of new pimples on her arm. I had no idea what this strange mix of lesions could be, nor the illness taking over his body.

I had to get this boy to a hospital, IV antibiotics, fluids started. Without proper treatment, he would die. Urgently, I made my way through the crowded clinic looking for Shumate, my new colleague, an Ethiopian nurse with years of clinic medicine in the rural villages. I urged her to come quickly and see the boy. While distress covered my face with desperation and fraught, she glowing, entered like an angel, touching the child and his parents, quietly asking questions, a sense of calm.

She turns to me and in soothing English, explains what it could be- autoimmune, HIV, end-stage Syphilis, TB, fungus, bacterial… She agrees the child is septic and perhaps he will die. Pragmatically she continues, “There is nothing the family can do to change this, they can’t afford to get to a hospital and they can’t afford treatment, and we can’t help everyone because many children die in Ethiopia, that is the way.”

I sit back down, defeated.

Holding back tears, I watch as she takes over the grim situation, gently picking up the child encouraging the family, offering everything we have brought to help- injectable Penicillin, antibiotics, Tylenol, she offers a prayer, her smile holding strong, reassuring the family that life is a cycle, they are calmed by her efforts.

Her steady hand to my shaken heart, she leans forward, wisdom trickling from her soul, “You must help those whom you can and help those whom you can’t, you must offer hope, this is Ethiopia, that’s all there is to it.”
Those who could afford hospital visits had done so months ago, these are the remaining few from an impoverished country of 80 million, with nothing left.
I look around and see for the first time the raw humanity around me, hope riding on the shoulders of sickness, poverty and malnutrition. Seated upon wooden benches, soothing one another’s discomfort all waiting to be seen: malnutrition, whooping cough, lost pregnancies, deformities, infections, burns, epilepsy, AIDS, prolapsed uterus, scrotal hydrocele and the list goes on. Simple vaccines, surgery and proper treatment could treat most of the conditions, but funds, resources and education are lacking.

We are all they have, and once a month this organization offers them assistance with medical supplies, comfort and hope to those who are the poorest of the poor.

The boy and his mother were treated with our meager supplies and then the father, not wanting to take up resources as more sick families arrived, bundled up his family and began the long walk home to his village.

I remain conflicted about the roles and funds of NGOs, International Aide and Medical Organizations in the third world. I am still struggling with the many poor and critically ill patients who received our palliative care, but were unable to obtain further treatment or hospital admission.

Who am I to judge and in a world of such prosperity, why do so many still suffer?




April 10th, 2010 by · Africa, Ethiopia

In a land where water can be scarce or remote and is always heavy to carry, hygiene is not always the first consideration. In a land where the body is pushed to exhaustion simply to put food on the table, shoes aren’t necessarily in the budget. Education can be a luxury and even then teachers might not be available. This is a film about taking nothing for granted.

This is the first of two videos I was tasked with making and the imagery contains pictures of terribly disfigured feet due to an ailment called podoconiosis. If you do not like medical imagery, consider this before watching the video or viewing the gallery. The video was made to support the work of Gimbie Adventist Hospital in Ethiopia and I would especially like to thank Monica Barlow, who among many other things, is the compassionate narrator.



Tomb Raiders of the Lost Cairo

March 30th, 2010 by · Africa, Egypt

Filmed on location in Egypt, 2010.
Some people tour the tombs with a guide, some people go without a guide and some people hire the right girls to get the job done.