It Started With A Coup in Addis Ababa
How Matthew Kane ’78 and Ann Markes ’79 Fell in Love with Africa
“Yes, I was caught in Addis Ababa for the coup,” says Matthew Kane ’78 describing his introduction to the African continent when, in 1977, the Ethiopian Airways flight to Nairobi boarded by 24 students heading to St. Lawrence University’s Kenya Program was extended to a three-day layover in the capital city.
“I thought that I was one of the lucky ones to explore, even slightly, a different country,” recalls Kane. “The fact that all the borders to the outside world were closed did not phase me. We were free to travel during the day and only had to be back to our hotel in time for the 6 p.m. curfew.” Kane and a few others were able to check out the city market and Wenchi Crater Lake on the outskirts of Addis Ababa before boarding a flight to Nairobi three days later when the borders opened up.
Perhaps witnessing a coup was the first story Kane shared in spring 1978, when Peter French, associate professor of government and director of the Kenya Program, first introduced him to his future wife, Ann Markes ’79, who had participated in the Kenya Program as a sophomore the year before. Markes and Kane were both pre-med students at St. Lawrence making the Kenya Program an unusual diversion from the rigor of the curriculum. However, once in Kenya, both were able to intern at urban and rural medical facilities observing doctors and nurses’ clinical expertise often despite the limited resources.
“Like many students who went to Kenya,” says Kane, “the program changed the course of our lives. Sharing our mutual love for Kenya, we both strongly felt that we wanted to return.”
In spring 1982, they did just that, finding a way to work for three months in Nairobi at Kenyatta National Hospital and Tumutumu Hospital near the base of Mt. Kenya while studying medicine at the University of Buffalo. They made another trip to Kenya in 1985 in between residency training to live and work at Tumutumu Hospital, this time for a year, hosting two Kenya Program students interning at the hospital during their stay.
“That year in Kenya changed my whole approach toward my career,” says Markes. “I found residency very challenging—long hours, no sleep. By spending a year, really working as a physician with minimal resources, it forced me to hone my clinical skills, do the work to understand a patient’s history, and really rely on my hands and my ears. There are all these other senses to examine a patient to determine what’s going on. We did have some X-ray capabilities, and we had some minimal laboratory testing, but really it was our clinical skills that were well-developed during that year.”
The couple took a prolonged break from international volunteer opportunities while they worked in the U.S. and raised three children. Once the children grew old enough, Markes and Kane resumed volunteer work abroad.
“We took our children to St. Lucia where we worked at a hospital and have been to Haiti on multiple occasions volunteering our services, both before and after the terrible earthquake in 2010,” says Markes, who has also done work with Interplast, an international plastic surgery group, in Vietnam and China.
Since 2010, however, the couple has narrowed their volunteer work to Northern Uganda, specifically with the Acholi community in a region that has been devastated by more than 20 years of civil war ending in 2006. The armed conflict resulted in incredible atrocities including the abduction of many children, displacement of entire populations, and destruction of the cultural, economic, and medical infrastructure. Through a project called STEP-UP (Sustain, Train, Educate, Promote–Uganda Project) started by Markes, Kane, and Josh Miller, professor of social work at Smith College and specialist in post-traumatic healing, Markes and Kane have re-engaged with providing medical support in Africa.
“STEP-UP has become our passion,” says Kane. “Using a trainer-of-trainers model, we are helping the local government-employed medical community teach their colleagues critical skills and knowledge in the area of maternal-child health.” The mission of STEP-UP supports the health and psychosocial well-being of families through collaborative medical and psychosocial capacity building. It is a partnership based on shared respect, planning, and decision making, between U.S.-trained medical professionals and social workers and Ugandan practitioners and community leaders who bring their social, cultural, and indigenous knowledge and wisdom to solution-based programming.
The couple’s medical expertise is being shared with skilled local midwives, clinical officers, nurses, and nursing assistants to reduce maternal and infant mortality specifically using trainings developed by the World Health Organization.
“After we leave, they continue training another 120 healthcare workers in their region,” explains Markes. “Beyond that, we have developed an additional model based on the recommendations of one of our Ugandan colleagues to expand that training to the village health teams and the former traditional birth assistants who are no longer able to do deliveries, but still function in a very important role within their villages.” The trainings can be the difference between life and death.
“They are able to tell the difference between a pregnant mother who might just be a little uncomfortable versus a pregnant mother who may be on the verge of death,” says Markes. “Sometimes that distinction is not so easy to make if you don’t really know the signs.”
“We also bring a psychosocial team with us, who are really targeting the residual effects of the war,” she says. “Because if you think about it, the young adults in the community, now the fathers and the mothers of the children, were the children traumatized by this lengthy conflict.” This trauma and disruption are manifesting now in high rates of suicide, alcoholism, and domestic violence not seen prior to the war.
The COVID-19 pandemic has meant that Kane and Markes have not been back to Uganda since February 2020, but they continue to be in close contact with their Ugandan colleagues when possible, providing financial support for PPE and training on COVID prevention, as well as confronting rampant misinformation about COVID and sustaining the work of government health workers, village health teams, and community leaders.
“We’re now at a different junction,” says Markes, who notes that Northern Ugandan immunization rates are still very low, and there are numerous technological, political, and social challenges to overcome. Despite those hurdles, Kane and Markes are planning to return to Uganda in January 2023 with a full medical and psychosocial team.
“Since we’re both retired, we can start to expand what we’ve done,” says Markes. Both understand that Uganda has a long history of political turmoil, and there is no such thing as perfect conditions when considering their return. “However,” Kane adds, “the commitment of our Ugandan colleagues to their community, while committed to our comfort and safety, always draws us back.”