Fistula survivors gathered with Bonnie Ruder at Terrewode shortly before her departure from Soroti in March. (Photo courtesy of Bonnie Ruder)

Bonnie Ruder, a midwife in Eugene and an Oregon State master’s student in public health and anthropology, had gone to Uganda to learn about a traumatic condition known as obstetric fistula. It arises when labor is prolonged and the constant pressure of the baby on the birth canal causes tissue to die and a hole to open between it and the colon or urethra. Globally, about 2 to 3 million women suffer with the condition and the heartbreaking social isolation it causes. In Uganda alone, about 140,000 women live their days unable to control persistent leakage of urine or fecal matter, and about 1,900 new cases arise there annually. (See Birth Knowledge, an October, 2011, Terra story about Ruder’s research.)

During her time in Uganda, Ruder worked in a regional hospital in the town of Soroti. She interviewed 17 fistula survivors in their homes and in the offices of Terrewode, a nearby women’s health organization. She wanted to know what they had experienced and how they understood the causes of fistula. This summer, she is analyzing the information for her master’s thesis in OSU’s Reproductive Health Lab, but her eventual goal is to assist Terrewode in educating and treating women and reducing the number of new cases.

“It was eye opening,” she says. “I heard their stories about trying to get to a hospital (to give birth), and once they got to the hospital, being ignored for days. They said that the doctors checked on them and just kept saying it wasn’t time. When it finally became ‘time,’ the baby could be dead, and they would rush the women into surgery. The women would be told their baby was dead, that there was nothing the doctor could do, and they would be sent home.”

It was common, Ruder adds, for a woman to be told nothing about what it meant to live with a fistula or how it could be treated. “Sometimes the health-care people would say ‘come back,’ but if she is really poor, how is she supposed to come back? In the meantime, her husband would leave her, and she would be pushed further into poverty to the point where she won’t be able to come back.”

Meanwhile, a potential source of help has been outlawed by the government, she adds. The majority of rural women still give birth at home with the help of a family member or traditional birth attendant. About 60 percent of Uganda’s births occur in this fashion, but in 2010, the government made birth attendants illegal. “They’re really trying to import the Western way of birth without the resources to do it. It doesn’t feel locally appropriate,” she says.

Policy Not Enforced

Fortunately for women who still rely on birth attendants, it’s a cosmetic policy, adds Ruder. Enforcement is nonexistent. Still, what little support birth attendants had received from non-profit organizations has declined, and women have a harder time getting access to attendants’ services.

At the same time, the hospital birthing system is badly overworked. So-called free beds are available, but to use them, patients must bring all their own food and supplies and have a relative or friend bring them any drugs they might need. To get timely help from a doctor or a midwife requires a “tip,” which is usually out of reach of the very poor.

While she was in Soroti, Ruder worked with Terrewode to identify women with fistulas and to get them treated. “If fistula victims can get to town, Terrewode will take them to the hospital and give them all the supplies they need and check on them daily. They’ll tip the doctor to move them up higher on the list of people in line for surgery. And when the surgery is done and women are ready to go home, they also give them bus fare,” says Ruder.

Although she returned to Oregon in March, Ruder continues to assist Terrewode by writing grant proposals. The group is educating a network of women who can promote sound birthing skills and identify fistula sufferers in need of help.

Oregon State’s relationship with Terrewode continued through the efforts of another master’s student in public health, Lauren Baur from Pennsylvania. In July, Baur followed in Ruder’s footsteps and went to Soroti to assist Terrewode. See a video about Baur’s experience below.

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For more information about education abroad opportunities for OSU students, contact the International Degree & Education Abroad (IDEA) office at 541-737-3006.

Villagers work together to transplant rice into the paddy in late spring. (Photo: Jenna Tilt)

The young Chinese laborer was desperate. Like millions of other migrant workers in China’s dash to industrialize, he had left his home and family to work in a factory in the rural interior. Now, environmental officials had closed the zinc smelter in Futian where he worked, and without a job, nearly out of money and separated from his support community, he knocked on the door of the inquisitive American who had been conducting interviews in the village. He asked the foreigner if he could help him with another job or a bus ticket back home. Then he broke down in tears.

“I suspected that he was just looking for money,” writes Bryan Tilt in his 2010 book, The Struggle for Sustainability in Rural China. Tilt, who was a University of Washington graduate student at the time, told the man to come back later and consulted with his landlord, Li Jiejie. She had an extensive family network throughout the region, the arid foothills of southern Sichuan Province. Eventually, Jiejie helped Tilt find the man a job carrying mortar at a construction project. The pay was less than half of what he had made at the smelter.

The laborer’s problems were not unusual. Workers like him, China’s so-called “floating population,” have transformed the Chinese countryside by operating make-shift mines and factories, often living with their families in industrial compounds fouled by coal smoke, polluted water and other wastes. In the 1980s, more than 100 million people moved from agriculture to industry — the largest employment shift ever recorded.

When Tilt, now an Oregon State University anthropologist and a Fulbright scholar, first visited Futian in 2001, it was a poor isolated village of rice farmers. Most residents call themselves Shuitan zu, literally “rice paddy people.”

The local government had built an industrial compound that housed facilities for smelting zinc, washing coal and producing coke for a steel mill in Panzhihua, the region’s largest city. Flush with revenues from the factories, the town had constructed new cement buildings with storefronts and a six-story high-rise office building faced with white tiles to house municipal offices. On a small stream, it erected a dam to produce electricity.

This prosperity came at a price. Acrid coal smoke choked the industrial compound and wafted over homes and farm fields. The stream, a tributary to the Yangtze, ran black with effluents. Children played in slag heaps and other refuse from the factories.

“Piles of coal and ore-slag lay strewn about the factory compound,” writes Tilt. “When it rained, pools of black industrial sludge collected in ruts and potholes in the road and in villagers’ courtyards and gardens.”

Interviews in the Smoke

Tilt had come to Futian to talk with villagers, workers and government officials about their attitudes toward development and pollution. His goal was to reach a deeper understanding about environmental values in China and to learn how people responded to problems and sought redress for damages.

Bryan Tilt interviewed workers in this zinc smelter. It was closed in 2001. (Photo: Bryan Tilt)

For anthropologists, fieldwork means interviews, so Tilt visited people in their homes and offices, scribbling hurried notes in English and Mandarin, which he speaks fluently. (“As an anthropologist, you really can’t understand people except through their language,” he says.) He created questionnaires and asked villagers to fill them out. Enveloped in coal smoke with a handkerchief over his mouth, he interviewed workers in the factory compound.

Although he would have preferred to use a tape recorder to document his discussions, he found quickly that people were reluctant. “People don’t want to talk into tape recorders,” he says. “Recent political history has told them that doing things on the record can be dangerous.”

At times, the conversations were casual and relaxed. Residents honored their guest with refreshments before talking about more serious matters. “In China, you don’t just show up and start doing your work and start pushing your agenda. You eat and you drink. There’s an expectation that you socialize together,” Tilt says. In Futian, Tilt was often served a homemade liquor called bai-jiu, a drink that challenged his palette. “It was like gasoline, only less tasty,” he says.

Conventional wisdom about a society’s attitude toward the environment holds that in the early stages of development, nature takes a back seat to more pressing needs, such as food, warmth and shelter. And yet what Tilt found during his fieldwork was that local farmers and townspeople, most of whom lived in houses with dirt floors and made the equivalent of less than $500 a year, put a high priority on clean air and water.

It wasn’t just a matter of treating nature as sacred. Although traditional Chinese religions (Confucianism, Taoism, Buddhism) regard humans as intimately linked to the environment, farmers told Tilt that pollution reduced their crop yields and made the stream unusable for irrigation and livestock. Other residents complained that the coal smoke and black water made them and their children sick.

“These are people who rely on the land to make a living. If their crops fail, they’re done for. That’s a very pragmatic basis for an environmental value,” says Tilt.

Out of Compliance

In fact, it was pollution of agricultural water that broke the back of Futian’s industrial enterprises. In 2000, a group of farmers appealed to local government and to regional environmental officials to have the factories closed.

Two years later, as the pollution continued to spew from the industrial compound, the farmers took a page from environmental activists in the West and called in the media. A TV reporter used a hidden camera to record the owner of the zinc smelter saying that his factory was too profitable — to himself and to the village — to be closed. A month later, environmental officials issued a written order closing the factories for noncompliance with emissions standards.

During the dry season, farmers carry fodder home for livestock to eat. (Photo: Jenna Tilt)

“It’s often the case that wealth and privilege are a way of buffering yourself against some of those risks,” says Tilt. “These people were on the front lines. They didn’t have those buffers.” To underscore the point, he notes that he and his wife Jenna bought bottled water to drink during their visits to Futian. Most residents did not have that luxury.

“So a lot of what I found ran completely counter to that idea that you need to reach a certain level of economic development before you even care about environmental issues,” he adds. “I think the reason is that these are people who, precisely because of their low socioeconomic position, were directly experiencing the impacts of a local pollution problem.”

In fact, Futian had only recently solved what the Chinese call wenbao wenti, the “warmth and fullness problem,” says Tilt. Many older residents remembered the famine during the Cultural Revolution, when people ate grass from steep, dusty hillsides above the town alongside their livestock (a time some sardonically referred to as “the era of green shit”).

Time for the Opera

Today, they don’t go hungry. They grow more than enough food — rice, vegetables, pork, chicken, beef — to feed themselves and to supply markets downriver in Panzhihua. Satellite TV dishes have even appeared outside some of the ubiquitous mud-walled houses (“I like to watch the Beijing Opera,” one woman told Tilt). In the busy morning market, villagers shop, chat with each other and play mahjong.

Tilt’s interviews show an unexpected divide among people based on where they lived and worked. Whereas many farmers and townspeople objected to the pollution, most factory workers like the young man who had knocked on his door thought that it was harmless or, at worst, easily remedied. They constantly downplayed the health risks, says Tilt. “They had been doing this work for years with no problems. They didn’t worry about it,” he adds.

Nevertheless, a woman who worked in a local health clinic told Tilt that factory workers often came to her complaining of respiratory problems and difficulties breathing. “There is nothing really that we can do for them,” she said.

While closing the factories may have cleared the air in Futian, it also left workers without jobs and the owners deep in debt. Tilt got to know some of the workers and spent his free time with the owner of the zinc smelter, Mr. Zhang, a retired college-educated school teacher who had sunk his life savings into the enterprise. The local government had attracted him to the area with promises of rich natural resources and tax breaks. Now he felt betrayed.

Before he went to China, Tilt considered the factories to be “faceless entities plotting to destroy the environment. They weren’t like that,” he says. “They were people like you and me who were trying to do right by their families. They were trying to make a living. They were doing it under tremendous uncertainty. The political and economic climate in China can change, turn on a dime. If the Party comes out with a new policy and it affects you, you’re out of luck. So there’s a Wild West mentality where, you gotta get what you can get now and move on.”

The factory closures in Futian have been repeated across the country, evidence that environmental protection is being taken more seriously in China. Tilt expects to see continued progress as the government invests in pollution control and alternative energy technologies.

“China is kicking our butts on renewable energy technology,” he says. “It’s because the central government has decided to do that. They have a plan to spend $800 billion on wind, wave, solar and hydroelectric. They are putting a lot of energy, initiative and money behind developing these technologies. And we are sitting around going, ‘Who should take the lead on this?’ Guess what, 10 years from now, they’re going to have all the capacity, and we are not.”

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OSU anthropologists work in Oregon and around the world. Every summer, the Archaeology Field School offers opportunities to literally dig into Pacific Northwest history. See more about faculty research and educational programs in the Department of Anthropology.

At Oregon State University, Ruder is pursuing master’s degrees in medical anthropology and in international public health. In Uganda she will combine these disciplines by studying cultural attitudes toward obstetric fistulas, a medical condition that affects 2 to 3 million women worldwide, mostly in developing countries. Fistulas result in incontinence and social isolation for women if left untreated.

“The roots of the problem are complex,” says Ruder. “Training traditional birth attendants would help. But there are deep cultural traditions at work.”

Fistulas can occur when any unnatural passageway opens up between two organs in the body. During childbirth, especially with girls whose bodies have not fully developed, prolonged pressure by the baby can damage the lining of the birth canal, leading to an opening between the vagina and the urinary tract or the rectum.

In collaboration with Terrewode, a nonprofit organization in Uganda, Ruder will interview birth attendants and fistula sufferers about their understanding of causes and preventive measures. As a member of OSU’s Reproductive Health Laboratory, her ultimate goal is to improve maternal health care for women in developing countries as well as the United States.

Ruder will work in the eastern Ugandan city of Soroti until the end of March, 2012, but it won’t be her first trip to Africa. In 1995, after receiving a bachelor’s degree in political science at the University of Arizona, she volunteered with a nonprofit group in Zimbabwe, the Kunzwana Woman’s Association, working with women on commercial farms and in mining communities. “Living conditions on the farms were terrible and tragic,” she says.

OSU master's student Bonnie Ruder, left, used her midwifery skills with Haitian women after the 2010 earthquake. (Photo courtesy of Bonnie Ruder)

That experience inspired her to move to Oregon and become educated in homebirth as a midwife. In June 2010, following the March earthquake in Haiti, Ruder volunteered for three weeks with Mother Health International in a birth center about two hours from the capital, Port-au-Prince.

“The Haitian women were amazing,” she says. “They were so happy and appreciative of the care.” Many would ride a motorbike from the mountainous countryside to the center to give birth. Because they often had other children at home, they would clutch the newborn in their arms a few hours later as they sped away for the jarring ride home. “It was not our ideal post-partum picture,” says Ruder.

On her way back to Oregon from Haiti, Ruder met Dr. Lewis Wall, a medical anthropologist and obstetrician at Washington University in St. Louis, who established the Worldwide Fistula Fund to serve women in developing countries. While at the university, Ruder also met Alice Emasu, a Ugandan woman and coordinator for Terrewode, an organization in Soroti whose aim is to empower women and support families.

With a $50,000 grant from the The Fistula Foundation, Emasu is addressing some of the cultural factors that lead to childbirth-related fistulas such as poor nutrition, lack of adequate medical care and child marriage. The organization will increase advocacy for treatment, prevention and social integration of fistula patients. Ruder’s ethnographic research will provide a better understanding of how Ugandan women and birth attendants view fistulas.

She explains that from a biomedical perspective, the condition is caused by “obstetrically obstructed labor,” but if local people don’t share that understanding, solutions to the problem may not be effective.

“I’ll ask women who have suffered from the fistula what they think caused it and what they think could prevent it. I’ll also ask those same questions of traditional birth attendants,” says Ruder. With Terrewode, she will evaluate her findings in light of existing approaches to preventing fistulas through education. In the long run, she adds, educating girls and empowering women may be the most effective public health option.

Ruder will travel to Soroti with her husband Eric and two children, Lucas, 8, and Soren, 11. Terrewode is not supporting her work financially, so she is raising funds to help pay for expenses for travel, translation and other activities.

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Ruder interviewed 17 fistula survivors in Soroti and working in the regional hospital. See a June 2012 story about her experience.

A descendant of the King Island community, OSU anthropologist Deanna Kingston leads a team documenting the island's natural and cultural history. (Photo courtesy of Deanna Kingston)

King Island, a two-and-a-half-mile long garrison of rock jutting up out of the Bering Sea, is now uninhabited. But Native Americans lived there for centuries and created a rich culture that still survives among the King Island community on the mainland. Kingston is interviewing native elders from the community as part of a National Science Foundation-funded effort to document the cultural ecology, biogeography and the traditional ecological knowledge of the island.

“All I was looking for was just a list of names,” she told an audience May 2 at Oregon State University’s Center for the Humanities, “but whenever they talked about a particular name they told a story about it.”

An anthropologist, Kingston saw those stories as research questions.

“We’re going with the assumption that if they created folklore about it, that bird must have been important in some way to the people,“ she said. “Why it is important is the question I want to answer.”

Crested and least auklets, King Island (Photo: Kim Nelson)

To help her, Kingston brought in Kim Nelson, an ornithologist with the OSU Department of Fisheries and Wildlife. Nelson was excited because the King Island colonies of auklets, murres and kittiwakes had not been previously studied. “It’s a significant colony,” she said. “It has hundreds of thousands of birds. Nobody has done any research on the island.”

Most of the academic literature concerning the island’s wildlife has to do with the walrus and seals that the islanders hunted. But the stories that Kingston documented showed that the migrating seabirds living on the island from spring to fall also played a large part in the lives of the inhabitants.

Spring brings seabirds and a welcome respite from a diet of marine mammals. King Islands ate both the meat and the eggs of birds. So happy were the islanders to see the first arrival, the snowbird, that stories about them credit the birds with creating people.

Similarly, cormorants, the last birds to leave in the fall, also feature prominently in King Island stories.
Kingston and Nelson documented these stories along with the native bird names and colony place names and created a guide to the birds of King Island.

Kingston is conducting a similar effort on the island’s flora with OSU biologist Jesse Ford. She hopes to include fisheries and marine mammals if funding will allow.

Kim Nelson is co-author of an online book, Guide to the Birds of King Island (Photo courtesy of Kim Nelson)

For Nelson, the experience changed how she will work in the future. Nelson told the audience that involvement with local indigenous peoples will be part of her approach to new study sites from now on. “Ornithologists hunted for Marbled Murrelet nests for a hundred years,” she said. It wasn’t until after they were located in coastal old-growth forests that scientists found artwork by local Indians showing the birds nesting in trees, not the offshore cliffs where ornithologists had been looking.

“They knew,” she said, “but nobody bothered to ask them.”

Finally someone is bothering to ask.

On May 13, 2011, Kingston and Nelson gave a talk on their King Island research at the Traditional Ecological Knowledge in Ecosystem Sustainability Conference at OSU.

Inspired by the university’s upcoming symposium, Song for the Blue Ocean: Science, Art and Ethics (February 18 – 19), “Literature of the Ocean” will “pursue the subject across time as well as through the three-dimensional space of the sea,” says English Assistant Professor Peter Betjemann. Literary readings focus on oceanic zones (littoral, neritic, oceanic) as well as levels within the water column (surface, photic, aphotic) and places where human communities meet the sea (wharves, docks, beaches). The course, ENG 499/582, is being taught winter term.

A joint colloquium in anthropology and zoology will explore the relative strengths, weaknesses and assumptions of the worldviews underlying traditional ecological knowledge (TEK) and Western scientific knowledge (WSK). “Ocean Wisdom: Integrating Traditional and Western Ecological Knowledge of the Pacific,” will focus on the Pacific Ocean and its bordering lands. “Students will compare and contrast the different epistemologies on which TEK and WSK are based via case studies throughout the Pacific region,” says marine ecologist Mark Hixon, who will team teach the class with anthropologist Deanna Kingston. ANTH/Z 499H will be offered spring term.

Deanna Kingston, OSU Dept. of Anthropology (photo taken in 2006)

The official launch of the King Island Place Name website Monday afternoon in the Memorial Union was the culmination of a decade of research led by OSU anthropologist Deanna Kingston, whose ancestors were among the walrus hunters who once populated the now-deserted Alaskan island.

The personal and professional magnitude of the project came to life as the site was projected on a screen before a gathering of colleagues, family members, students and friends. An interactive map of the tiny island in the Bering Sea was dotted with nearly 200 place names that have been collected and documented by researchers working with elder natives who grew up on the island. Audio clips let users hear native speakers pronouncing the words in a dialect of Inupiaq. The site also features a gallery of thousands of photos documenting the plants and birds native to this place where tusked pinnipeds were hunted for centuries on massive ice floes during winter months. The work was supported by the National Science Foundation.

Kinsgton’s mother, son and uncle were on hand to celebrate the site’s unveiling, as were a legion of students and collaborators. Kingston, who wore a jaunty hat in place of the hair she has lost during her battle with breast cancer, choked up when she thanked the people who have worked with her tirelessly to save the linguistic and geographic history of this unique place.

“I told myself I wasn’t going to cry,” Kingston said, smiling sheepishly. “I guess I should just cry and get it over with.”

You can view the website at www.kingislandplacename.com.

Read “The Ice Sages,” a 2007 Terra story about the King Island community and Kingston’s research.

Loren Davis

Along the Oregon coast, in Idaho’s Salmon River canyon and in Baja California, Loren Davis has searched for signs of North America’s earliest inhabitants. His work along the southern Oregon coast has pushed back documented occupation of this area by 1,500 years.

Now, the OSU archaeologist will take a deeper look into the inland and coastal routes used by ancient people to reach the Americas. Davis has been named the executive director of the Keystone Archaeological Research Fund, established through a $1 million gift from Joseph and Ruth Cramer of Denver, Colorado.

The fund will provide research opportunities for students and new equipment for field studies. Davis uses Earth science techniques to identify sites where ancient people could have lived, made stone points or stored food. Recently, his efforts have extended underwater. Last May, he participated in a search for submerged prehistoric sites off the coast of Baja California Sur. He hopes to use similar methods to find early sites off the Oregon coast.

Watch a video of Archeologist Loren Davis at Cape Blanco on the Oregon Coast. Produced for educational use by Joe Cone, Oregon Sea Grant, 2002.

For more information about Loren Davis:

OSU archaeologist to investigate first West Coast humans with $1-million gift, 10-7-08

Ancient Site of Human Activity Found on Oregon Coast, 11-7-02

Support OSU’s archaeological research, contact the OSU Foundation

Euro-American traders and settlers brought Russian, French, Spanish and English to the region we call Oregon, but native people spoke at least 18, possibly more than 25 distinct languages. By 1859, English was becoming dominant, foreshadowing the almost complete loss of native languages and the development of Chinook Jargon (or “Chinuk Wawa”) as a common creole language. Ten of these languages are being revitalized today.

Below, in excerpts from Teaching Oregon Native Languages, OSU anthropologist Joan Gross offers a glimpse of this linguistic heritage. She and co-authors advocate for support of native language instruction “to promote the value of multilingualism in our society and the deep respect for cultural diversity that it brings.”

What became the state of Oregon, an area stretching south from the Columbia Gorge to the Siskiyous, and east from the Pacific over the Coastal Range and Cascades to the High Desert, was a land of many languages, each one encoding information about the land and how to survive on it. The various languages of Oregon belong to language families as different from each other as English is from Arabic: Athabaskan, Salishan, Shastan, Uto-Aztecan, and a number of families that have been roughly grouped into the Penutian phylum (Chinookan, Kalapuyan-Takelman, Sahaptian, Lutuamian, Molallan, Cayusan, Yakonan, Siuslawan, Coosan). Each of these families consisted of several languages, and each language of several spoken dialects. Even within what might be called the same dialect, each village probably had its own subdialect, differing from neighboring villages in the way certain sounds were pronounced and a few vocabulary words…

In addition to the high value placed on learning multiple Native languages, there was still a need for a means of communication in short-term encounters between speakers of different languages. This need was filled by the creation of a trade language that came to be known as Chinook Jargon. By the time Lewis and Clark made their voyage down the Columbia, there is some evidence of a mixed language being spoken, but it most certainly stabilized into a pidgin language during the fur-trading period.

Both natives and Euro-Americans in the Northwest saw the advantage of this easily learned language. Pidgins have a simplified grammatical structure and are much easier to learn than historically rooted languages that have developed all sorts of unsystematic complexities over the years. Languages that bridge communication gaps between speakers of different languages are know as lingua francas. Chinook Jargon quickly became the lingua franca of the Northwest.

The first European nuns who arrived in the Willamette Valley in 1844 to teach the children growing up in this multicultural area used Chinook Jargon with their students. Several Chinook Jargon words drifted into Northwest frontier English. Words like “tyee” (chief), “skookum” (strong), “tillicum” (friend), “wawa” (talk), and “alki” (soon) were used to metaphorically claim identity with the region. An Oregon congressman in the 1880s talked about how General Sheridan and the translator, Nesmith, conversed in Chinook Jargon back in Washington, D.C. (Once, one of their telegrams was intercepted by the Secretary of War who, seeing the incomprehensible words, suspected a plot was afoot.)

Teaching Oregon Native Languages, by Joan Gross, Erin Haynes, David Lewis, Deanna Kingston and Juan Trujillo, published by Oregon State University Press in 2007, can be ordered online.

Note: OSU Press will expand its work in indigenous studies through a $1 million grant to four university presses from the Mellon Foundation. See a January 9, 2009 story in the Chronicle of Higher Education.