The author of this article, Hsu Hsiang-ming, and a famous photographer, Wang Chih-hung, went to the northern Ethiopian highland area of Menz and Gishe Awraja in January 1997. They were there to evaluate the three-year medical and health reconstruction program that the Tzu Chi Foundation had set up in cooperation with Medecins du Monde. The two men used camera and pen to document the footprints of love that Taiwan left in Africa.

The temperature in the northern Ethiopian highland in January was rather cool. The eight-month-long dry season (from October to the following May) painted the land a lifeless yellow colour. We were in a jeep hurtling down a bumpy, rocky road. The roar of the engine sliced through the silent highland, and the flying dust behind our car brought some action to this still, expressionless land.

Staring through the dusty window at the long-forgotten highland, I wondered how much tragic history lay buried in this speechless desolation. This was my fourth time to Menz and Gishe Awraja, so nothing was alien to me * the egoistic, stiff-necked mountains, the ravines that fell more than a thousand meters, the wild, rugged land that extended to the sky, and the bumpy roads that shook us upside down. All these aroused the memories that had been sleeping deep in my head.

A Candle in the Wind

For four years, in order to build a basic medical network, provide basic health care, and bring back basic human dignity to poor patients, we worked with Jose Fernandes, who was in charge of the Medicins du Monde project in Ethiopia, to help Ethiopian citizens rebuild their lives.

In those four years, there were many memorable scenes, but there was one in particular that I will never forget.

On the evening of April 16, 1993, Dr. Lin Chien-hsi from the Tzu Chi Hospital and I were at the Mehal Meda Health Centre. While we were discussing how to rebuild the centre, four huge, exhausted, barefoot men appeared. They walked limply into the health centre carrying a stretcher made of tree branches. On the stretcher was a woman suffering from a miscarriage. The sheet covering her was stained in red. One man begged health centre employees to save this woman, saying that they had walked for eight hours to get to this place.

With a gesture of helplessness, the employees said that there were no medical personnel around, so they could not take care of the woman. The feelings of these four men were as chill as the evening wind from the valley. The patient's life, like a candle flickering in the wind, might be extinguished at any minute.

It was fortunate that Dr. Lin was there. With our flashlights and limited medical supplies, we tried to help this woman through her agony. Lying on a cold, broken bed, she battled against death through the long, long night. When sunlight finally appeared, death reluctantly let go of the woman.

Although she had been saved, our minds were rather heavy. We silently pondered the same questions: After we left this place, would the same scene be repeated again? Would it have the same happy ending? How many tragedies would be repeated again and again on this land every day, 365 days a year? And how many people would become part of the soil because they could not survive the eight-hour trip?

A Solid Fortress of Life

This time when I walked into the Mehal Meda Health Centre again, I saw something completely different * new buildings, complete medical equipment, abundant medicine, busy medical personnel in the corridors, people waiting patiently for treatment, and ambulances donated by Tzu Chi parked next to the health centre. All these were telling me that tragedies had become history.

The first medical station that we arrived at after reaching the Menz and Gishe Awraja highland was Mezezo Health Clinic. When I came to this village on a small hill four years ago, it was a rainy day with thick fog. The villagers led us to the only medical station in the village. It was a straw hut that had fallen apart. Dirt walls had collapsed, and there was a stinky odor from the inside of the dark, damp clinic. Bottles of ointments for external injuries were scattered on the shelves, and blood-stained cotton littered the uneven dirt floor. We could hardly believe that this was the medical station for a thousand villagers.

After rebuilding by Tzu Chi and MDM, there stood near the village entrance a brand-new clinic that the villagers were very proud of. Besides the main treatment building, there were also separate buildings for maternity rooms, hospital wards, public washrooms, waste management, water supplies, and dormitories for the clinic staff.

These buildings looked like they had been built with cinder blocks, but they were actually built with rocks. On this deserted highland, around 300 km [186 miles] away from the capital, transportation to the outside world was difficult. Construction materials were in great shortage. Mules were used to bring down odd-shaped rocks from the mountaintop. Then workers chiseled and shaped the rocks until they were smooth and the same size as cinder blocks. When I saw this solid building, I seemed to hear again the echoes of the sounds from the workers striking the rocks. In this wild land secluded from the outside world, it was not easy to build such a modern structure, so we could imagine how hard these workers laboured.

Writing a Happy Ending

Inside the clinic, there were brand-new diagnostic beds, complete medical equipment, bright, clean spaces, drugs on neatly organized shelves, and all sorts of complete, well-managed records. It looked completely different from the old clinic. What really comforted me the most was that there was not only the new hardware, but also the concept of modern medical administration.

From the beginning, we not only emphasized new equipment, we also understood the urgent need to implant concepts of modern medical administration and provide specialized medical and health training. Therefore, along with rebuilding the facilities, we also provided a series of training courses, so that the local medical staff could make the best use of the equipment and maintain it properly. Now, from the clean environmental sanitation to the proper record-keeping, we could tell that this was a medical station with modern administration.

There was a pregnant woman lying quietly on a bed in the delivery room, waiting to welcome the arrival of a new life. From her calm expression, it seemed that she might still have to wait for a long while. But just as we were discussing the operation of the clinic with the local medical staff, the sound of a baby crying loudly suddenly came from the delivery ward. Two medical personnel were busy cutting the umbilical cord and washing the baby. The mother's joyful, satisfied expression showed no trace of exhaustion, and the father was laughing joyfully outside the delivery room.

Wang and I also deeply felt the joy from welcoming this new life, so we followed Chinese tradition and gave the mother red envelopes with money inside, which symbolized a blessing of peace for both the mother and her newborn baby. The mother was quite excited at the blessing from distant Taiwan.

When we walked out of the delivery room, the warm afternoon sun welcomed us. At that moment, we felt really good, not only about the new-born baby, but also about the reconstruction program that had rewritten the close call we witnessed four years ago and given such scenes a happy ending .

A Loving Union

Following a mountain road, the jeep carried us deep into the highland. The event that had just occurred kept turning in my head. Was it a coincidence? Four years ago, four men walked for eight hours to carry a dying woman to us and pour out their despair to us. Now, the smiling mother in the Mezezo Health Centre was embracing a healthy boy. It showed us that the love from Taiwan had born its fruit there.

These two scenes happened on the same highland, but the results were entirely different. The force behind the changes was a union of love that reflected the truth, goodness and beauty of humanity. Because of their humanitarian spirit, the Tzu Chi Foundation from Taiwan and MDM from France stepped out from their national boundaries and worked together for the people of Ethiopia.

Tzu Chi members went to the streets to ask for help for the 347,000 poor Ethiopians living on the highland. They raised funds to offer basic medical protection to the people in that desolate place. MDM, on the other hand, with their specialized medical knowledge and their understanding of Africa, joined with Tzu Chi to work for medical and health reconstruction on the highland. This connection of love has transformed the sadness in Menz and Gishe Awraja.

MAKE THE AGONY LEAVE
Sharing Experience in Giving Aid

Ethiopia to many people is a synonym for "suffering." Whenever this country is mentioned, images of bony people and dead corpses lying everywhere surface in our minds.

The highland is around 300 km [186 mi] north of the Ethiopian capital, Addis Ababa. Because of its highly strategic significance, the highland has been a battleground since ancient times. During the recent civil wars, warlords battled each other here constantly, causing great despair and agony to highland farmers, who were already suffering from poverty. The wars also totally ruined the health system built during the reign of Haile Selassie. When farmers became ill, they could only look to heaven. The best they could have was a shaman chanting incantations to provide psychological comfort . Compounding the misery, this country was severely hit by famine in 1985, and more than 5.8 million refugees were on the verge of starving to death.

In 1993, through the efforts of Liu Chun-yuan, a Taiwanese businessman, and Francis Hickel, a French war photographer, the Tzu Chi Foundation joined hands with Medicins du Monde. They chose the highland areas of Menz and Gishe Awraja, 3,000 to 5,000 meters [10-15 ,000 ft] above sea level in North Shoa, to implement a three-year plan to rebuild the medical network for residents who had been tormented by drought and war.

The three-year plan started on February 15, 1993. It included building two health centres and 14 health clinics, providing medical equipment and medicine, building a clean water supply system, inspecting nutrition for children under five, and training local medical personnel.

Visible Results

In February 1996, the reconstruction plan was completed, and villagers in Menz and Gishe Awraja could receive excellent basic medical treatment in their own villages. This plan not only provided medical assistance, but also spun off many benefits. One benefit especially worth mentioning was the development of clean water supplies.

In the past, women had to carry heavy pottery urns on their heads and walk for more than an hour on mountain roads to get some dirty ground water. Because surface water lacked protection, it was contaminated by livestock and wild animals, so its quality was extremely poor. Fat larvae moved around in the water, and there was an awful odour that could upset anyone's stomach. Nevertheless, villagers depended on such water sources.

In order to provide clean water for the health clinics and the villages, workers first located clean water sources. Then they built large water tanks to protect the resources, and they laid underground water pipes to bring the water to the villages.

Now villagers do not need to travel long distances. They can simply use water taps at supply stations in their villages to receive clean water. The abundant clean water supplies have greatly reduced the risk of contracting diseases and improved the health of the villagers. From the perspective of preventative medicine, developing safe water supplies was more significant than building health clinics.

The health clinics and the water supply systems were still functioning and being administered by the local government and residents one year after the plan workers had left. So we agreed that this had been a successful medical and health reconstruction plan.

The Importance of Community Involvement

Traditionally, international aid work was geared toward one-way material distribution. There was no deep interaction between donors and recipients. If our medical plan were based on providing hardware but not on training local medical personnel, it still would not work. If the plan focused on providing nutrition to malnourished children but disregarded health education for the parents, the children's health problems still could not be solved.

From the beginning, the reconstruction plan promoted by Tzu Chi and MDM put a great deal of emphasis on local communication and involvement. We especially requested local health officials and residents to participate in the whole process of drafting and executing the plan. Only when the residents regarded the plan as a part of the community and a joint effort could they develop a sense of identity with it. At the same time, local involvement helped the community to develop the ability to administer and safeguard the plan.