[dehai-news] Shaebia.org: Shaebia.orgInterview with Prof. Astier Almedom

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From: Berhane Habtemariam (Berhane.Habtemariam@gmx.de)
Date: Mon Jan 12 2009 - 11:02:14 EST

Interview with Prof. Astier Almedom
Efrem Habtetsion, Jan 12, 2009


Q:Tell us a little about yourself.

My name is Astier Mesghenna Almedom. I was born and brought up in Asmara. I
went to England for higher education and studied at Oxford University as an
undergraduate in human sciences, a multidisciplinary field of study that
covers everything about humans. I studied anthropology, sociology, human
ecology, evolutionary biology, population genetics, linguistics, demography,
and quantitative methods. I then decided to specialize in anthropology -
biological anthropology - for my doctoral research on 'infant feeding,
health and growth.' And my field of study was in Addis Ababa, Ethiopia.

Q:Why exactly Addis Ababa?

Astier: At that time my father was in Addis in internal exile. First he was
a political prisoner at the Expo prison in Asmara and then he was
transferred to Alem Bekagn in Addis Ababa. After he was released, he was
confined to the city for 13 years. At that time (the late 1980s) I was a
graduate student and my first interest was to study how the Eritrean refuges
in the Sudan were managing to cope. However, it was decided that it would
not be safe and proper for me to use my grant from Oxford University in the
insecure environment of conflict and displacement, so I took up my second
option, which was to go to Ethiopia. Ethiopia was not safe either, but I
tried and I was


allowed to stay inside the city of Addis Ababa because my passport said that
I was born in Asmara, and Eritreans were not allowed to conduct research in
the rural areas of southern Ethiopia such as Sidama, a place I was
interested in.

Q:How did you do with your research then?

It was huge risk to take in 1987/88. It was the first time that Ethiopia's
leader, Colonel Menghestu publicly acknowledged the war in the North with
the EPLF and TPLF. Before that time, he had referred to both Eritrean and
Tigrayan liberation struggles as trouble caused by "a handful of bandits". I
recall that the slogan 'hulum neger wede tor gnbar' (everything to the war
frontlines) was constantly repeated and large numbers of young people (below
the age of 35) were conscripted, forcibly recruited to contribute to the war
efforts. Anyway, inspite of the dangers, I still managed to conduct my
fieldwork in low-income households within the Kolfe district of the City.

Q:What were your findings then?

One of my findings was that many of the mothers who participated in my
research were reporting 'yemenfes chenqet, or 'oppression of the soul.' When
I asked why, the reasons they gave included the absence of either a husband
or brother or older son who had been conscripted, sent to the North and
didn't send any news and never came back. They had constant worry and lack
of interest in the day-to-day demands of life. My analysis showed that those
mothers who were reported with oppression of the soul, had children who
suffered more and more infections like diarrhea and other diseases linked to
poor hygiene - those mothers were demoralized. I later published those
findings as part of my analysis of the relationship between mother's morale
and infant health (Almedom, 1995).

When I submitted my thesis in March 1991, I had no idea that everything in
Ethiopia and Eritrea and Tigre would change so dramatically within two
months. By May 1991, everything had changed - Eritrea and Tigre were
liberated along with the rest of Ethiopia as Manghestu fled the country.
Eritrea became independent. When I defended my thesis in July (1991) a few
months after submitting, my examiners asked, "Now that the Menghestu's
regime is gone, do you think these mothers will recover from oppression of
the soul?" My answer was guarded because I expected that the change of
government would probably help in general terms, because the mothers had
told me clearly that the causes of oppression of the soul were social and
political. The solutions had to be social and political. But of course, if
the missing relatives never came back, they would still be in the same state
of oppression of the soul. I was careful not to speculate that this state of
loss of morale might be "depression" as I am not a clinical practitioner.

Q:Tell me more about your professional background.

About a year after I took my doctorate from Oxford and I started working in
London at the London School of Hygiene Tropical Medicine (University of
London) in 1992. I was working with the Environmental Health Program where
our multidisciplinary team focused on identifying and preventing diseases
related to unsafe water, sanitation, and hygiene practices.

I published a practical book on how to use participatory research methods to
engage people in investigation and analysis of water and sanitation-related
hygiene practices; and to help engineers and others understand and take into
account people's attitudes, beliefs and practices on hygiene when designing
and implementing programs. Traditionally, engineers tended to look just at
the installation of "pumps and pipes". Now, it is common to integrate the
social and cultural determinants of the design and use of water supply and
sanitation facilities.

UNICEF (New York) funded the translation of my book from English to Spanish
and French in 1998, and many other agencies and Universities have been using
it since. More recently, an Arabic translation was released by the United
Nations Standing Committee on Nutrition (2006) and it is also used as a
textbook in one of our courses at Tufts University within the
interdisciplinary graduate program called "Water, Systems, and Society". I
usually give guest lectures in the course, which is taught jointly with the
Masters in Public Health (MPH) Program and is called "Biology of Water and

Q:Have you carried out research or related activities in Eritrea?

Yes, indeed. Soon after the book I just mentioned was published, we had a
regional "training of trainers" workshop on hygiene evaluation in Asmara in
August 1997. The workshop was organized jointly by UNICEF and the Ministry
of Health. It was a regional workshop for southern and eastern Africa and we
had participants/trainers from Zambia, Zimbabwe, Kenya, Tanzania, and
Ethiopia. That was my first big workshop as a trainer of trainers in
Eritrea, and it was immediately followed by a hygiene evaluation study in
three different locations: one in Tsaeda-Christian, a semi-urban area, the
second one in Embeyto, an example of a rural setting, and the third was
Dekemhare, a town. The idea was for my Eritrean colleagues from the Water
Resources Department, Ministry of Health and UNICEF to replicate the study
in all the six Zobas.

Q:Regarding your occupation.

In 1999, I worked in senior management of the National Health Service (NHS)
in London. While I was there, I was invited to apply for a job at Tufts
University in Boston and that was when I decided to return to the topic of
mothers' morale and mental well-being. I focused on disaster settings and I
soon realized that there are two different sets of questions: those that
people ask in a community and those that professionals ask concerning the
mental health of those who survive disasters.


Fortunately, I had the freedom and capacity to allow my study participants
to define the questions. Eritrea is a natural place for me to conduct
research. When we left it open for people to identify the questions that
needed to be addressed, going around all the six zones and meeting with
mothers of young children, they were telling me that it was not the trauma
of war and displacement that they wanted to talk about. They had already
passed that stage, survived it, and have coped reasonably well. What they
really wanted to talk about was about how strong they were and how they have
been managing to keep their children, families and communities well, against
all odds. It was then that my interest in resilience became more clearly
defined. I started looking at it seriously with my team of researchers in
collaboration with the Ministry of Health through the Primary Health Care
Division. Colleagues in the Ministry of Education Curriculum Department, and
the National Union of Eritrean Women also contributed to my study.

Q:But what is the definition of resilience?

Resilience a multidimensional construct that I have defined as the capacity
of individuals, families, communities, systems and institutions to
anticipate, withstand and/or judiciously engage with catastrophic events
and/or experiences; actively making meaning with the goal of maintaining
normal functions without fundamental loss of identity. Resilience is also
widely understood and used among natural scientists as a basis for
sustainability of ecosystems - the interlinked social and ecological
systems. I shall be talking more about this at the public seminar tomorrow.

Q:What was the basic fact that you found about resilience in Eritrea?

What we found was that Eritrea is a good place to study resilience because
historically it had survived against all odds. Almost all the powerful
countries of the world had written it off as non-viable after going to great
lengths to destroy its national integrity. The people of Eritrea became more
resourceful, more self-reliant and the communities grew more and more
socially cohesive.

Social cohesion is an Eritrean feature, certainly more evident in Eritrea
than any other country that I have visited. What we found interesting while
using the "sense of coherence" scale was that Eritrean mothers managed and
comprehended very well the difficult circumstances they were in. Above all,
they reported that it was meaningful for them to focus on surviving

Historically, when we look at Eritrea's struggle for independence, the armed
struggle was always motivating people with hope especially in the annual
meeting such as the Bologna Festivals. People would say 'Neameta ab Asmara,'
'next year in Asmara.' There was a real sense of hope and goal-oriented
determination to make huge sacrifices to achieve that end. So, everyone was
inspired to do as much as possible in order to achieve the goal of

Q:How would you compare this social cohesion to other societies you visited?

Some of the other societies I have looked at don't have anything at all that
makes it meaningful for them to maintain social cohesion and survive. For
example, I was in Afghanistan in 1995 and at that time al Mujahidin were
just leaving and the Taliban were coming in. The people we visited in
Displaced People Camps were not at all able to see any meaning or any reason
for the constant violence. They expressed abject hopelessness. So, I noted
that unlike Eritreans, Afghan mothers had absolutely no sense of
meaningfulness of what was going on. So, meaningfulness, I think, is the
critical sub-scale of the sense of coherence scale. We used the sense of
coherence scale in all nine languages of Eritrea.

Q:Which were the areas you selected?

We selected Adi Keshi, Denden and Hamboka, three camps of Internally
Displaced Peoples, which we later clustered together for the purposes of
data analysis; we had Gelalo, Kelbech and Shelshela from the pastoralist
communities. And urban settings like Asmara, Eden (Elabered), Ghindae and
Gogne were also included. The latter were not displaced at all. We saw, on
the sense of coherence scale, that the people who were used to being
displaced scored more or less the same as the people who were not displaced,
but those who were sedentary agriculturalists and displaced by the border
conflict with Ethiopia (1998-2000) scored less. We concluded that
displacement is a real challenge to people's resilience.

Q:What was the mothers' reaction?

It was difficult for them to stay in the camps for extended periods of time.
When we conducted this study in 2003 and 2004, children born after
displacement were growing up in the camps. People associate themselves with
their birth place, and often derive their identity from the place.
Meaningful links are made between people and places as we all identify
ourselves with the place we call home. It is therefore a real challenge to
be displaced, and not know when you might be able to return home. Children
born in camps don't know any other home. Now, of course, I am pleased to
note that those mothers and their families have been able to return home for
the most part, and some have been resettled elsewhere - everyone has
returned to their farming livelihoods. Adi-Keshi and other camps were only
temporary places of shelter and transition.

The other thing we found in Adi Keshi Camp was the way the displacement
happened was highly organized. People were evacuated systematically. The
local administrators were there. So, mothers who knew and were known to
their own home village administrators were not as distressed as they might
have been if they had been disconnected from their communities and local
administrators. The Camp was fully equipped with tents, latrines, water
reservoirs, a school, a church, and mobile clinics. When we first visited, I
was struck by the vibrant and safe atmosphere of the camp with a weekly
market and all kinds of cultural activities in full swing. In our published
reports, you will find it documented that organized and caring humanitarian
interventions such as those enjoyed by the residents of Adi-Keshi camp can
promote resilience and reduce vulnerability. Disorganized and careless
humanitarian action can by the same token do more harm than good. So,
Eritrean humanitarian assistance has much to contribute to the international
community by way of example of good practice.

Q:How do you see the role of our government in coordinating humanitarian

The Eritrean government's insistence on coordinating efforts of all
humanitarian aid agencies is one that I fully support. Most NGOs are
non-governmental by definition; they are not really encouraged to coordinate
their efforts on the ground even if they are willing and motivated to do so.
There are many failing governments in Africa and other continents. A growing
number of donors also understand the problems associated with lack of
coordination, but they also demand accountability that related to different
agendas and specific missions. So, the fact that the Eritrean government is
committed to supporting coordinated efforts may present a challenge to the
agencies whose donors have specific missions. Those on the receiving end,
including the mothers I have been listening to, would rather have
coordinated social support of which humanitarian assistance is one form.
They should not have to make sense of so many different agencies
interventions that target them in their times of need. Uncoordinated and
disorganized humanitarian aid can inadvertently undermine community

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