everyone has a collection of their favorite
travelling malapropisms. beauty saloons are mine. they
abound here in addis, and in other places in africa. when i see
the sign, i can't help but think of a dusty beauty saloon in
arizona. the swinging doors burst open. people look up from
washing hair and peek from underneath hair dryers.
"must be the wind." someone says.
just
then you here the tack....tack.....tack of high heels on a parquet
floor. a middle aged woman with a beehive hairdo and wearing a
pancho turns the corner, a curling iron hanging
dangling loosely from her right hand, the business
hand. everyone is silent, watching. the only sound is
the drone of an upright hair dryer. she fixes it with a steely
glare and it whines off.
"i don't suppose anyone here knows anything about a straightenin' hair...."
"umm....ma'am...ah do....." says a stylist crouching behind the washing sink.
people
breathe a sigh of relief, the dryer goes back on, and
the beehive woman collapses into an old barber chair, dusty
and relieved.
arrived to ethiopia yesterday. have
successfully avoided any beauty saloon trouble. the weather is
mercifully cool. i needed some time to regroup from abyei, and
will find some. i am grateful.
i am not sure who
noticed, but the picture of a girl i spoke of, one who was abandoned at
the hospital dehydrated and motherless, was taken down. my
colleagues at MSF communications called my attention to it, and rightly
so. after posting it, i felt uneasy, and looked to take it down
myself, but was unable to access the web. luckily they were one
step ahead, and removed it until they could discuss it on monday.
it
is probably better down. on matters like this, it is better
to err so far on the side of caution, that the chance of harm is
zero. when i speak of patients, i am careful to make them
unidentifiable. when i send pictures, i spend considerable
amount of time discussing possible consequences with each
family. i try to make them understand that others will
see their pictures, and one day might recognize them. of course that
will likely never happen. few of you will go to sudan, fewer still to
abyei, fewer still cross
paths with anyone here. it remains my duty to
explain it as best i
can. when i travelled africa last time, with a photographer, we
were exhaustive with our consent forms because our subjects were people
with HIV, and the stigma towards the illness is
strong. no matter how well we did, it
is likely that they never fully appreciated their right to
refuse. a similar criticism is often levelled at clinical
studies in developing countries. we speak in our language, from
an insoluble position of power.
i have been meditating on the the picture before it was
brought to my attention. both because it made me
uneasy, but so too to better understand my reasons for posting
it. it was obvious that this one patient had been occupying my
thoughts. she typified a problem that i did not have the tools to
address. i can't properly explain why it was her when there
are five children a week whose positions are as
tenuous. the best i can come up with is that when there are
so many battles, one can choose only a few to fight
completely.
so, i chose this one, or it chose me. when i saw
her at first, she was so dehydrated, and so, so thirsty. she
simply needed to be offered water. in canada (sorry...i
know i promised), if i had such evidence she was being neglected, i
would make a phone call, and she would be taken somewhere safe within
the hour. but there are no similar options here. no
orphanages, and people are so poor they can't afford another hungry
mouth. as someone for whom the family/kids
scenario is not even a faint "ping" on my radar, i thought long and
hard about trying to care for her. i don't think i can.
so, a friend asked for her picture, and i took it without asking
because there was noone to ask. a small sin, but one better
corrected. by putting a face to the story, it made her more
real. afterward, someone kindly offered, through my blog, to try
and adopt her.
what a generous thing. i don't imagine it is
possible. i think it more wise to work towards a more
sustainable solution. to use it as an opportunity to inform
myself better of how similar situations are handled in the community,
and if there aren't any methods, to formalize some with the community
leaders.
these are difficult decisions. you do not want this
young girl to get lost in a larger shuffle towards something as vague
as "sustainable solutions". you want her to
be cared for as well as possible. do you win this small
battle (i.e. pay someone to care for her) and wait to
wage the longer war, or accept that in the early part of the
campaign there may be a human cost?
it is a common dilemma in this type of work. i
remember first facing it in rural cambodia when
i examined a man who most certainly had appendicitis. i
had a landcruiser, and could take him to the hospital, even pay for his
operation. but i was leaving in a month, and there was noone
behind me. what then? would people stand by the side of the
road, hoping to wave me down like they did this time, and be farther
from a correct answer to the problem? i thought they would.
better to inform them of the seriousness of the illness, the need for
surgery, and point them in the right direction.
i compromised a bit. i gave him enough money for transportation,
and a good, long dose of antibiotics in case he decided to keep the
money. he did, and survived the appendicits without
surgery. i saw him two weeks later in the fields.
then, as now, i was uncertain. it is easy to imagine that in
the longer run, it is better to solve the larger problem to spare more
lives in the future, what does the future matter to a man who needs
urgent surgery for appendicits, or a small girl as her mouth
grows dry?
it deserves some more time. i will think more on it. maybe at the beauty saloon.
