beauty saloon.

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

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.


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...."

"'am...ah do....." says a stylist crouching behind the washing sink.


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.


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


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


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.