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September 15, 2008
Lessons from Ethiopia

Danielle Smith C’09 is an art history major/global health minor and assistant chief of training for Emory EMS.

When I told people I was spending two months of my summer in Ethiopia, the general reaction was, “Why?” I feel Ethiopia, more so than any other African country, has been stigmatized in the U.S. as a place of poverty, suffering and general misery. What I experienced could not have been farther from this stereotype.

While it is true that in my observations at a free ART (antiretroviral therapy) clinic for patients with HIV/AIDS I encountered many heart-wrenching social situations, it would be a horrible injustice to such an amazing country to characterize it only by these negative aspects. I found an atmosphere in Ethiopia of love, kindness and acceptance.

I spent almost the entire two months living in Addis Ababa, a chaotic city in complete opposition to any atmosphere I have previously encountered, but I learned more in two months here about compassion then I have in my entire life spent in the U.S.

While in Ethiopia, I divided my time between entering data for Kenneth Maes, a Ph.D. candidate in the anthropology department here at Emory, and shadowing the physicians at the ALERT (All African Leprosy and Rehabilitation Training Centre) hospital who work in the ART clinics.

The hospital provides free services and medications to the citizens of Addis Ababa, an invaluable service that has resulted in the treatment of thousands of HIV-positive people as well as those suffering from tuberculosis, leprosy and dermatological problems. The availability of these medications to the people of Addis Ababa have drastically improved the living conditions and made it possible to view HIV not as a death sentence, but as a manageable chronic disease.

I found this to be especially true in my time in the pediatric ART clinic. In the two years the clinic has been established, 1,000 patients have received services with only 13 deaths. These remarkable numbers attest to the changing medical conditions in places like Addis Ababa around the world.

However, my time spent there also brought to light the extreme injustices occurring in “underdeveloped” nations. I saw problems caused not by inefficient government, or people unwilling to better their economic situations, but by the structural systems that keep countries like Ethiopia down while countries like the U.S. continue to rise.

For example, one of the first-line drugs used in the ART clinic is Stavudine (or d4T). This particular drug is now used rarely in the U.S. and Europe due to serious side effects including peripheral neuropathy and lipodystrophy, the wasting of fat from a certain area of the body, and its appearance as a “buffalo hump” on another.

The fact that we do not hold Ethiopia and other countries in Africa and Asia to the same standards of care as in the U.S. exemplifies the indifferent attitude our country takes toward places we don’t view as “advancing.”
So much of what I learned while in Ethiopia came from in-depth conversations with the Ethiopian physicians at the clinic and the 26-year-old research assistant with whom I lived. Selam, currently obtaining her master’s in public health at a school in Addis Ababa, became a close friend and confidant. I will continue communication with her, and have spent time visiting her mother, uncle and cousin who live in Atlanta.

I am already making plans to go back to Ethiopia and visit her. She helped me make sense of so many of the things I saw, as much as one can make sense of some of the scenes of horrific poverty and suffering that occur there.

I was able to understand how the U.S. seems to people living their daily lives in a place like Ethiopia, both the misperceptions and the incredibly accurate assessments they make. For example, anyone growing up in the U.S. takes for granted that our family structure and ways of relating to closest kin are the “right way” to do things.

However, Ethiopians are appalled by our treatment of our elders. When I told Selam that it is common to place an elderly parent in a nursing home and visit him or her only on occasion, she was shocked. She explained that would never happen in Ethiopia, because children take care of their parents just as the parents took care of their children for so many years. Maybe this is an area where we could learn a thing or two from the Ethiopian way of life.

I could provide endless examples of ways my views were changed in the time I spent in this amazing country. But my bottom line to most people, when they ask me about my experience, is that the first image when they think of Ethiopia should not be one of a starving child begging on the street.

It should be one of an unbelievably rich culture with a unique and beautiful language, fantastic food, gorgeous mountain ranges, and most of all warm and welcoming people.

While it is crucial not to ignore the many problems that exist in a country like Ethiopia, it is also essential not to let them take center stage.