Quitting Soccer

By Surafel K Gebreselassie

The day started like every Saturday. I had the usual bread and a cup of hot tea. Just before I left the house mama pulled me over and told me not to go anywhere that day.

“I had a bad dream,” she said. “I want you to pound the coffee,” she continued.

Rahel, my younger sister, had roasted the coffee beans. I took over hurriedly and started pounding it. It came to me what mama said. We were afraid of mama’s dreams. Her dreams always came true. I pounded the coffee enough to get to fine powder, just how mama wanted her coffee ground. She wouldn’t want it very fined. That wouldn’t bring out the oil.  She came over the back alley where I was dumping the powder on a cup. She bent over and mumbled again, loud enough for me to hear.

“Please stay at home, I had a bad dream,” she said it again. I still remember the worried looks on her face.  When I remind her these days she bounces back in time and just reflects on the challenges of that era.

“I knew that you were not listening to me,” she told me one day.

I still remember the shock on her face when I came home later that afternoon with a broken right arm.

As soon as I finished pounding the coffee I run away to the soccer field to the dismay of her. It wasn’t that I was a good player but I remember being lucky in front of goals. There was always somebody from the neighborhood who would show up to see how we played soccer. I remember how people reacted when I slalomed through several defenders and the goal keeper but ended up shooting the ball wide.

‘You could have done it earlier, why waste all the trickery to miss the ball,’ I remember some angry spectators shouting their frustration.

With a flailing broken arm and supported by friends, I managed to get home after stopping by a local pharmacy for a couple of Indian made acetaminophen pills and a cup of cold water. I was thirsty. Tears, sweat and mud had disfigured what was left of me. Mama was frustrated, angry and yet crying at the same time. Soon the two bed room ranch was full. People took turns to look at my arm. She said my father would kill me. He was gone for the day. When he was back, he was resigned to the facts.  They didn’t trust the medical system and decided to take me to a local bone setter who placed a cast and advised me to take pain killers except that the pain never went away and my wrist bone was not right from the look of it. I wasn’t able to bend it.  Confusion set in the family. Grandmother intervened and suggested another bone setter who used to live in the outskirts of Addis. After a long bus drive we managed to get there. I was scared. Four people had to hold me tight until this bone setter broke my bone again to align it in place.  It was the worst pain of my life.  Mom wasn’t there because she didn’t want to see me cry. I was briefly unconscious. It was also a moment of change. The way I see things started to change. I became a quite person. I learned how to write with my left hand. Grandma would bring me consolation, some grapes from the same garden that she fiercely protected. I missed school for 2 months.  I stayed at home alone for most days.  Our rented ranch had 2 small bed rooms, a living room, a kitchen and a latrine.  In front of us there were three town houses each with a living room and a bed room.  Each town house had a detached kitchen. It’s unthinkable now how many families lived in that complex. Mr Ahmed and his wife, Aisha, along with their son and two daughters were in the right farthest corner.  They had a black and white TV before any one of us so all the kids would beg to get in to watch soccer games. That is where I saw the magic of Maradona.  After I broke my arm I got permission to watch other shows broadcast in the only government owned Ethiopian TV. I had to leave before the end of the shows on many occasions. It was simply too late for them to stay up beyond 10 pm. I also remember the days I enjoyed some of the best pastry during the fasting holy month of Ramadan.  Mr Gebre and his wife, Roman with their son and three daughters used to live in the middle house. The living room had a bunker bed to accommodate everyone. A nephew would join them from Awasa, the southern province of the country. Known for keeping house maids on their toes, Roman had a heavy presence in the compound. It wasn’t always easy to communicate with her. I was afraid of her although over the years she loosened up. We envied them because of their old automobile, a Chevrolet.  I was a little older than both the boys but occasionally played soccer together.  The house farther left was shared by two families each essentially living in a room. The front part, what would have been the living room, was owned by Kiristos and his wife Mulu and their four sons and three daughters. They didn’t have a separate kitchen and often cook on the verenda with their section covered and separated from the rest of the complex.  I used to put on my arm sling and sit on the veranda. After everyone leaves to work or school,  Mulu would stay behind making stew with its sweet aroma feeling the compound.  A stew of  chickpeas. When I talk to the children after so many years we wonder how they managed to live in that one room.  Mr Kiristos was rumored even then to have had lots of money. I was very fond of him. They would have bought TV if they had space to put it on.  In the later years the boys would come to our place to watch soccer. I remember one day when the younger boy farted just before Platini took a penalty. On the back room lived Mr Argaw and Almaz along with their three daughters, two of whom slept in the kitchen. In between our ranch and theirs was a common area, about ten feet wide excluding the veranda space. At both ends of the common area lie two poles with two or three ropes tethered to hang wet clothes.  Just next to our verenda there was a sewage line that drained the rain water. All the water would drain to it because of the sloppy nature of the land escape. The water and all the sewage then curves right by our bed room and drain further down another 10 feet before it joins another shanty compound just to the right of us. I always felt that our family got the worst of it.  My father’s wheezes often signaled the beginning of winter.  All the families in the compound shared a tap water source. We took turns to fill our plastic pails.  The kids even bathed there in a hot summer day. Arguments would break out during heavy winter season between the neighborhoods on more than few occasions.  The path of the sewage is the main contention point. A woman with an evil eye lived in the neighborhood immediately next to our compound along with others. Their wall and back windows faced us.  We didn’t know how many bedroom she had as no one dared to look through the window. If the woman opened her window, we all would run to take cover, site a verse from the bible to shield us from her evil eye.

When I  finally made it to school, I realized how much I had changed. My classmates were all ahead of me. It felt like a life time. I no more wanted to be the soccer player I so much adored. Conquering pain became my destiny. I wanted to be a doctor. I didn’t know how to proceed except to take it one at a time. The first thing was to quit soccer. So I did. It would take Ethiopia thirty one years before qualify for the continental cup. I made the right choice.

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Tenayistilign tips: Kidney stone

  • Kidney stones are formed inside the kidney (of mineral and acid salts that stick together).
  • There are four major types of kidney stones : calcium, uric acid, struvite ( infection) and cystine
  • About 70% of kidney stones are made of calcium compounds mainly calcium oxalate
  • Too much oxalate ( a compound found in some foods) in the urine is a risk for kidney stone formation
  • Common foods in Ethiopian diet rich in oxalate : Gomen ( spinach), Sikuar Dinich ( sweet patato), Lewuz ( nuts),  chekolata ( chocolate)
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Tsion

By Surafel K Gebreselassie

My father would have liked me to be a lawyer or a teacher like himself; but as I grew taller than my friends, he was more worried about military service. During the last few years of Hailemariam’s dictatorship, a family’s nightmare was to see their sons rounded up on the open, thrown on military convoys and in to training camps and the front, where the unwinnable war was raging.  I remember those days after the high school leaving exam sitting on the veranda for long hours contemplating the future ahead of me, a bleak future eclipsed by my own ambition but inhibited by the realities of the time. I wish I knew then where I would be today, I would have taken it easy. My mother noticed my worries about passing the test and would on occasions sit with me on the veranda. Because of increasing bandit attacks and accidents on the only train service in Ethiopia, she had stopped going to Harar to fetch goods for sale in Addis before I was a senior in high school. Most were used clothes from the West. On occasions that it didn’t sell, I and my other siblings would share them. I remember the T shirts, the fight to fit them in.

We grew up worrying about two things. We thought our father would die any minute when he had one of those asthma attacks, waiting until the last gasp of air before I escort him to the local medicine man to get an injection of epinephrine. Then his heart would pound fast before he gets relief. He would hold me for a minute. Then we would walk back home as the rest of the family waits in prayers.  When I think about it now it was ridiculous to wait but he always thought that medicine was not a cure only a remedy and perhaps that he thought he would save some money.

We also grew up worrying that mom may not make it back from her Harar trip. I still remember how it felt to hear the wails of the train several blocks away in the quite Addis night. It’s during those days that my father and I would walk to pick her. One day, casually, he bought me a cup of tea from the vendors at the train station and said something that I never would forget. That we are poor and that the only way forward was to be good in school. It stuck with me. I was scared. I used to play soccer often than I should have; that was what the kids in Sengatera did any way. We played soccer before going to school, after school and during weekends. We wanted to win against the rich kids in the other neighbor hoods who wore famous jerseys from Italian and British clubs. They had real leather soccer balls. If we couldn’t win we would drag them in to the dirt field and enjoy as these kids would look like us for ninety minutes with their parents complaining on the side lines. One day on a play off soccer match, the referee called a penalty against us. Our soccer club used to be called Mexico City. We all lived close to the Mexico square in Addis Ababa. That was also the time when Mexico hosted the world cup. We liked their green jerseys, and most of us got shirts close to any combination of green, so Mexico City. It was a big match. We had the best goalie. We called him Amoraw ( Eagle). Many people had showed up from Sengatera, as they always do for a soccer match. They started cursing loud. It worked. Amoraw saved the penalty. We rushed, hug him but we hug both Amoraw and the ball. The referee called for a repeat penalty. Curses don’ work twice.

***

A pair of new trousers, few 32 page note books including one squared  for math , and blue ink pens marked the beginning of a seventh grade.  Beyenemerid was an elementary and junior high school that operated on two shifts and was only a walking distance away from home and from the closest soccer field. I started at Beyenemerid when I was 8 or 9. That would have been a year after we moved from Keffa, the birth place of coffee in South West Ethiopia. I spend a year at a neighboring elementary school trying to get used to the city life. Beyenemerid wasn’t far either so it wasn’t hard on my parents. I progressed adequately to seventh grade but distracted by soccer and the social fabric we were at; we had to stay with our grandparents often sleeping on the floor until we rented a two bedroom cluster home from the government. That took several years of lobbying. The best thing was to be a child at the time and not worry about it although that was not true for every child in Africa. Some had to work and feed the whole family. Some had to take arms. That was also a time I appreciated the mercy of God. My little sister was badly inflicted by measles. She was yellow and febrile. She made it.

One Tuesday afternoon I was late. The math teacher had noticed. I went to school direct from the soccer field with dried sweat on my face. He called me out to solve an algebra question.  I hesitated. He asked for a volunteer. There she was, Tsion, who walked with measured steps towards the black board to rescue me. Her petit face was of lightly roasted coffee beans, the original beans that I grew up with in Keffa, she wore a black and white flower dress and a black sandal. Her hair was treaded in two rows and left hanging by her side. She would push it backwards as she worked her way on to the question.  In the middle of it she seemed lost in the question itself but regained her confidence back and smiled as the whole class clapped. Our eyes met as she walked back to her seat.

 I run home at the end of class. I run through the two way traffic, in between cars. I ran first to grandpa’s place.  I was afraid to go straight home, I thought everyone would know my little secrete. Grandma thought I stopped by to sneak on the grapes. I was sweating.

‘Are you ok?’

 It was that season of the year where the garden grapes were ripe. The birds would gather to work on the grape trees. It’s a fight to save some for sale and some for us. The birds knew when grandma was at home or away, they knew when she was mad or when she was happy, they knew when one of her friends, Ayelech,  was at the house visiting because grandma would take time with her best friend talking all the gossips in the neighborhoods. They knew of her cataract so they won’t fly away unless she is too close or fly to the mango trees of a neighbor two house away and fly back in the moment she closes the door.  They never get caught and we always took the blame only for the birds to laught at us.

Grandpa was seating in his wheelchair by the main door listening to his old radio; always listening to the war in Beirut. He was taken by the conflict that he would switch from channel to channel for the same story. He had the advantage of speaking several languages including French. He made use of it. He would translate stories to English and Amharic for a living only to spend it on the lottery.

Bonjour, I said.

 ‘That’s too late for the time,’ he pointed out. I was trying to please him. He told me to pull a chair and sit next to him.

‘It’s your father,’ he said, ‘I could teach you French well’.

He was right. My father wanted me to focus on school. He knew well ahead that a few French and Italian in a furiously independent Ethiopia would not translate in to bread. Grandpa was mild in his take of life. He was also forgiving. He lost a leg to the Italian occupation of Ethiopia but never grudges against many of his Italian friends who were as old and stop by to visit him; rather cherished his contribution to his motherland. And then the story would go on about the battle of Adwa where Ethiopia thwarted colonialism by defeating Italian troops in 1896, an epic moment in the life of any African or of African descent. Soon after I forgot about Tsion, collected my books and left grandpa’s place memorizing a new word that I learned from him. I rushed to the door before it would escape me.

Bonne nuit, I said and run in the dark night.

***

The math teacher announced official competition between all the seventh grade classes in Junior High. Two students would be selected from each class. A soccer fan, he structured it as a tournament. The representative students would be quizzed in front of the whole class. There was quarter and semifinals and finally the winners of each shift would compete to win the math student of the year award. Tsion automatically qualified to represent our class. We had to fight for the remaining spot. I still remember the geometry question he paused one day. I pulled all the courage to go out in front of the class. I wasn’t worried much about the open rubber shoe I had or the torn trouser on the side. I wanted to shine. I wanted Tsion to notice me. I wanted to impress her. It was the most important day of my life. A day I made the biggest decision against all odds. I stood up for myself. I shredded fear. I went out and solved the equation. I was awaked by the thunderous clap of the whole class. I didn’t realize that I was staring at Tsion. She was laughing. I looked reflexively at myself. Through the gaping hole she was looking at my ass.  I turned to her, she looked down. I jumped to my sit. I never looked back again. The teacher resumed his lessons for the remainder of class. At the end he called me and gave me a hand written note to give to my parents.

‘Don’t unfold it,” he said. My mother was not happy after she read the note. She started cursing the teacher.  She was loud. Mama’s friends who showed up when they saw her agitated started cursing the teacher too.

“That is none of his business,” Askale added.

“His kids are the worst dressed,” Mulu followed. Some suggested that I move to another school after the end of the school year.

My father was rather quite. He pulled the closet open, picked up a piece of gray fabric, beckoned me and headed to the door. I didn’t realize until we got to the tailor shops few blocks down that I was getting a brand new custom made trouser. Readymade clothes were very expensive in socialist Ethiopia at the time.

Tuesday October 23, 1984, while the world was learning from BBC news TV reports about the looming famine in Ethiopia, with a new trouser and a matching used T shirt I joined Tsion in the math competition at Beyenemerid junior. We later won our first competition on October 31st; even the news of the assassination of Indira Gandhi didn’t dampen our excitement.

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Papa

By Surafel K Gebreselassie

He walked in the pathology sign out room, flushed with excitement. I have never seen him so excited since I joined his lab to appreciate some renal pathology.

‘There are many dense deposits on electron microscopy along the tubular basement membrane,’ he mumbled as we all focused on the microscopy in front of us.

The whole tubules were taken up by inflammatory cells.

There were many eosinophils (that I could easily identify), lymphocytes and plasma cells.

The tubular architecture was almost destroyed with relatively intact glomerulus.

 I have never seen anything like this!

The sign out room had one microscope but six people can look at the specimen magnified however many times with one person, often Papa, driving the show.

We moved on to the next case.

The glomerulus looked all right until we stumbled on the edge of the specimen with a focal segmental sclerosis. I picked that one and felt good about it but Papa was not excited.

‘Wait a minute, do you see the protein resorption droplets?’ he paused and continued, ‘there are more of those,’ and then we stumbled on a glomerulus with atrophic tubules all around it.

 ‘That glomerulus looked ok but would die out eventually,’ he said with authority. The tiny blood vessels or capillaries didn’t look normal. They had, ‘double contours’, as Papa would call them. They have formed membranes all around them.

‘Look at this vessel, how old is the patient?’

‘Thirty seven, he is black,’ the fellow replied instantly. That was my age. That was me, I thought.

‘The vessels look eighty; there is a lot of scaring,’ he continued, ‘probably untreated hypertension.’

‘On and off the emergency room, this time admitted with severe headache and blood pressure of 230 by 120 millimeter of mercury. His creatinine was 8 and he is now on dialysis. ’ The fellow filled the gap.

The kidney was done.

 I could tell by the look at Papa, a sad look, a resigned feeling.

They all called him Papa. He was a father figure in the pathology department. He has written several research papers, book chapters and books. He travelled all over the world to give magnificent lectures about the structure of the kidney as seen under a microscopy. He knew his stuff. He lived inside these small clusters of tiny blood vessels called glomerulus and its complex structure that filters the blood, and perhaps napped in the draining tubes or tubules as they are called in Latin.

 Across the hall from the pathology department, in the basement of the old hospital building,

I emptied my bladder.

I paused at the dark yellow urine,

It never occurred to me how hard the many glomeruli, their tubules, vessels and nerve endings had to work along with the many hormones and signaling molecules to make that urine,

That we rush to flush off!

v   

We bounced back and forth every five minutes. Before I knew it time was up and I found myself taking exit from the free way. There was no time to introduce each other. Every one of us shouted our names as we approached the narrow alleys. Something must have happened in a split second. Why some of us had to leave the free way was a mystery. The alley was large enough for me, my partner Chloride, friends such Magnesium, Potassium and Calcium.  I envied their names.

 Why didn’t they name me Magnesium?

Several others have made it too. I remember seeing Phosphorous from distance. We were on the same plate at one point. A lot more friends were left behind. Albumin was crying but couldn’t fit the tiny alley. Losing some of the weight may have helped. Those left behind, I was told, made it to the rest of the crowd by boat.

There were many train stations. I had to carry Phosphorous, Glucose, Amino acid and some other friends who begged me on to the train. My beautiful Chloride is always with me. Potassium didn’t need help. He is always gentle, dressed up and no one touches him. They say he could stop the heart or drive it crazy if he wants. Just before the train left I saw Bicarbonate having a date with Hydrogen, and then they disappeared. Their children carbon dioxide and water are on a private jet. Chloride noticed that Magnesium was nowhere to be seen so we left the station and moved on, down the hill and up the mountain. Potassium was there waiting with a kite. There was no extra seat for a guy other than me. Magnesium was on his feet any way along with his friend Calcium, chatting and praising vitamin D. Calcium was frustrated about the news of his clone and how Parathyroid is being confused these days. They could have waited or moved to the next station and have their own kite as people of their tribe had done for generations.

 I don’t trust Magnesium, I don’t know much about him.

We wanted to check it out any way and moved to the next station,

But there was no room for Potassium.

Before we knew it we are at the last stop where there was a lot of chaos. It was wet. Word came that there was no hope beyond that.

 I had just enough for me to rent a bike. With tears in her cheeks, I left Chloride behind and crossed the bridge. She would try to walk across however slowly. Potassium was resigned to his fate thinking of missed opportunities all along.

A full bladder woke me up. I rushed to dump it again.

It was foggy outside, a rainy day in Boston.

I headed to the lab, to learn from the master.

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An Unforgettable Experience in Malaria Country

By Surafel K Gebreselassie, M.D

They lowered the stretcher down on to the mud floor in front of the clinic, a rapidly made stretcher of sheep skin tethered on its corners to wooden holders. Four muscular hands of farmers carried him for over several miles. Behind them stood a woman holding her two little boys, their face crisscrossed with dried up tear. A five and seven year old, I would guess.

A grueling medical school was finally over. Or so it felt after six years. Ties in place, shirts tucked in, their creases military crisp, we lined up to board the campus bus to our new destination with palpable determination and innocence to impress and make a difference to a community we belong to. We were assigned to work at the Asendabo health center, some 280 km south west of Addis Ababa. The team comprised of two interns, graduating nurses, pharmacists, laboratory technologists and environmental health students. It was part of the community oriented philosophy of Jimma University School of Medicine. Logistics was arranged and paid for by the school.

We arrived at mid-day. The city was hard hit by a malaria epidemic. There was no time to rest. The health center’s few inpatient beds were full. After a brief introduction by the medical director, one of only two physicians for a city of over 100,000, and a quick fixture of lunch, we went straight to work. Two registered nurses toil the day working as nurse practitioners. Our presence was immediately welcomed. Both nurses haven’t had a vacation in over a year. They took this opportunity to travel and visit their families in the north. We divided work almost immediately. I took the inpatient service. The health center’s only car was broken. There was no alternate transportation for those who need referral to tertiary care service provided at JimmaHospital.

A middle aged man with liver failure blotted with fluids; a teenage girl who just gave birth to twins, her husband furious for not having boys as if the sex of the kids were not determined by his own sex chromosomes; an elderly woman and her two teenage girls with malaria. It was almost sun set when we finished evaluating each patient adjusting medication when I heard footsteps coming closer. I turned around and saw fear and despair on a beautiful face. I gasped for air as though my aorta was dissecting. Her two boys were clinging to her blouse. The younger boy is fighting with flies on a piece of sugar cane trying to squeeze the juice out first. She didn’t need to explain. I rushed to the man on the stretcher.

The horse ride to the villages was fun. Time flew by quickly. The malaria epidemic abated finally with no winners but with promise to fight it out again next season. It was mid-week when we picked up our last assignment; to vaccinate the kids against polio. We set out to vaccinate as many kids as we possibly could. We headed to the villages on horseback, on a bike and alternately on foot, mesmerized by the amazing beauty of the landscape. However, I could not get past the thought of why, we, as a nation were choking with such despair. There was no time to dwell on the past so I kept on moving. A couple of hours later we reached our destination. People were waiting for us en mass. Word was out that we were coming with candies. Everyone wanted one, grand pa, mom, dad, the kids, literally everyone. It wasn’t my idea but it worked any way. At the end of the day we were led to a beautiful grass house, one of a kind in the village. We were treated with delicious food and drinks. The honey wine in particular was great. Slowly things started to make sense. A man in his forty’s, his wife and two boys stood up to say thank you. I looked at them straight in the eye. How did I forget the ordeal of the first few days, the trials and tribulations of helping a family, the slow recovery? When I saw them with their full house, with their cattle, their horses, their farm, their friends and relatives, I panicked at the thought of the unthinkable. I thought about the people who didn’t make it. I thought about those who would die next season of malaria and the fight that awaits the next group of doctors.

We packed our vaccination kit and headed back to our place. I saw the young boy running towards me to give me what was left of the sugar cane. I gave him the last candy that I saved for myself. With that, I left this beautiful region and its kind inhabitants with a bitter sweet feeling.

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