Six Months in Sudan (23 page)

The meeting has been organized by Ajak Deng, the man with whom I shared an airport taxi in Geneva, when I was halfway gone, and he was halfway home. He has been sent on behalf of Geneva to further illuminate Abyei’s complex political and social situation and our place in it. Our understanding of the movements, tribal and political, that swirl around us is so rudimentary that we are lost.

The trouble from last week has blown over. The woman who was shot was a civilian as reported. She was killed in a retaliatory attack, the bullet meant for a member of the opposing militia. The night that we sat in the gazebo, eating Paola’s apple pie, was a difficult night for the hospital. We were told the next morning that a militia had occupied the latrines, in anticipation of more wounded, so that they might spring a trap on their enemies. More patients left the hospital, and many refused to use the latrine for days.

Once more soldiers entered the hospital with weapons, and once
more we left it. And then, as Abyei lilted towards a familiar chaos, everything became quiet. No more shooting, no more military intrusions. Perhaps part of it was Marco’s convincing threat that we were an instance away from complete withdrawal. More likely Abyei’s political importance trumped petty militia rivalries and the groups were reined in. The official troops, North and South, were legion, and well resourced. Neither was going to test the other’s considerable mettle over what sounded more and more like drunken quarrels.

We kept the curfew for a few days, and because of it, we had to sleep in the hospital. The day it was my turn, the curfew was lifted and I slept in my tukul.

The hospital has been quiet. Part of it is the waning of the measles epidemic. Though small pockets still smolder in the shifting nomadic populations, the blaze is over. The rest of the decrease in hospital admissions is because of the recent military incursions. Even the market has been hushed. People are holding their breath.

I am not clear whether Ajak’s visit is in response to the recent events, an example of MSF’s quick capacity, or was set into motion with Bev’s departure and debriefing. The mission is still new, and because our interim head of mission is more closely tied to Darfur and has never been to Abyei, clearer insights are welcome throughout this particular MSF thread.

As such, Ajak has been touring the countryside, meeting with the various Dinka chiefs. On his way to Abyei, he spent time in Juba, the capital of the South. His ties to this country are strong, his family name recognized as powerful. His access is complete.

His report to us about Juba did little to illuminate Abyei’s future. The forecast is mixed. Some call for war, saying that the Khartoum government is not to be trusted, that it is not a dialogue in Dinka or Arabic that will bring freedom, but one in bullets. Others are wary but reluctant to let peace slip away after working towards it for so long. He told us something that we already knew: neither side is willing to back down.

“Black and brown,” Tim says, wrinkling his nose and pointing to a pot full of beans.

“You have to take some. It’s not polite,” I say.

“Forget it.”

Ajak is traveling back to Uganda tomorrow, this meeting his final task.

We already know what to expect. Dissatisfaction. When Ajak briefed us before the meeting, he told us this. The community wants us to do more. They are unhappy that we want to focus on the hospital and on secondary care. We either transfer people too much, indicating that our hospital resources are too thin, or we don’t transfer enough, a sign that our transportation options are too few. Some want a helicopter, others an operating room. We heard that many are unhappy being told to go to GOAL for treatment of their non-acute problems.

We struggled with this. No matter how many days in a row we worked, it felt like we were getting further from being accepted. It had surely happened more often, but I can only clearly remember one patient’s approval. I had taken a piece of glass from his foot, and when I apologized for the discomfort it was causing, explaining that local anesthetic in the sole is painful and often ineffective, he shook his head at me and fixed me with a broad smile.

“I am from Darfur. In Darfur, there is no one. No hospitals. No medicines. You are doing a good thing. I am a very lucky man.”

We are not naive. We expect few accolades. The Dinka are a strong people. They have resisted incursions on their soil and on their culture for centuries. Through these last decades, because of the long conflict in Abyei and ascendancy of the NGO as the arbiter of the world’s philanthropic wealth, they have become used to people driving up in Land Cruisers and asking what was needed. We should expect their chiefs to advocate for their people, to ask for as much as they could get even if they might receive a fraction. I would do the same. And after decades of former friends burning down their homes, they will be cautious about trusting new ones.

Tim and I sit down. As soon as we do, others stand up, queue, and begin to heap their plates. The food is similar to what we eat at compound 1, or find in the market. Oil-drenched okra, black beans, ground goat mixed with pasta or potatoes. There is a round piece of
oily white gelatin in the center of the table that survived Tim’s and my pass intact but is being whittled away by the Sudanese guests.

The paramount chief, for his part, has stayed seated and still. His chair is made of large pieces of strong wood that suit his mighty frame and booming voice. Next to him sits Ajak. Ringing the room on rickety chairs are the rest of the attendees. Between the district chiefs and their emissaries, our MOH staff sit across the room from us. When we arrived, Sylvester came over and shook our hands. The vaccine officer, the one with the office at the back of the hospital, didn’t meet our eyes.

The paramount chief brings the meeting to order and everyone sits down. He welcomes us to his house, thanks us for our kind patience in waiting for this important meeting. He throws a meaty arm around Ajak, says he is sad his cousin is leaving so soon, but how good it is that he came.

He starts to make introductions.

“Majak Atem Atem, chief of Gumbial. Arop Atem Deng, chief of Abienton …” Each name leaves me as soon as I hear the next.

“We are each grateful that you have taken the time to come here. We know the hospital is very busy,” he says. “It has been a long time since we have sat together, MSF and us. We hope this is the first of many such meetings.”

Tim shifts uncomfortably beside me. Next to him, Marco smiles at the chief, nods.

“Many people in the community are unhappy with what MSF has done in the hospital ….”

And so it goes. From one person to the next, we are roundly reminded of the things we do not do. As one chief runs out of words, starts to pause, the man to his side starts.

Someone is describing the ire of a patient sent away without treatment, a patient who had some sort of hysterical paralysis that even the local nurses in the hospital called Abyei Syndrome. I interject.

“How many times do you hear from people who come to stay in the hospital? The very sick people?”

The chief dismisses this, shakes his head, and continues on. We slump lower in our chairs. The vaccination officer smirks.

It is an hour later. I glance at the rest of the team. Paola is looking at her feet, Tim leaning forward with his chin in his hands. Marco is trying to remain engaged. Across from him, one of the chiefs who has spoken his piece is leaning his head against the pole behind him, snoring softly.

The paramount chief looks at his watch. He has another meeting. He calls this one to a close. We stand, dejected, dizzy from the contrast between how hard we are working and our perceived performance.

We step out into the bright noon sun. Ajak decides to stay behind. He has more family to see. Tim, Paola, Marco, and I start back to compound 1. The road is rutted from the recent rains, but has dried in the morning heat.

“So?” Paola says to Marco. “What do we do about that?”

He looks puzzled. “What do you mean? Nothing. We do what we are doing. We work in the hospital like before. Until I hear something different from Geneva.”

It is rare that we are this deep in the market at this time of day. Store owners glance up at us. We stop to buy some water. A group of children start to trail us, giggling. We walk on, and as a team, we lighten. That we are misunderstood, that our efforts seem unappreciated, makes the long hours seem even more virtuous.

“Hey, Tim,” I say, pointing at a grass-lined compound and a hanging broken bulb. “Sheeshaashooo …” He laughs.

By the time we pass through the metal gate of compound 1, together, we feel tighter.

11/05: paradise now.

this is the part of the story when the character begins to get tired. when he walks his daily route, one that is so familiar he can do it with his eyes closed, he does it with his eyes closed.

yesterday, on the walk back from the hospital, a monkey loped past me. he cast a brief backward glance, then took a sharp left into the market. he was wearing the most amazing pair of sunglasses.

my morning run has been suspended recently so that i might concentrate more fully on smoking. unfortunately, i woke up over-early this morning, and could find no excuse to avoid it. my usual route, over a flat wide flood plain, has been made impassable by the rains. all that was left was to run along the red road that leaves town, and look over my shoulder for overfull trucks. i took it to its first junction, and turned south. it was very early and i could see a corona form over the fields, much clearer than on other mornings, no refracting dust. in an instant the sun blazed, burned my eyes. people walked from the trees towards abyei over the cracked ground that drained rainwater like a sieve, and their white robes were silhouetted by the sun, morning ghosts.

everyone in our mission smokes furiously. msf. part of the reason is the isolation, the idle minutes. as it has been said in many languages, when you have a cigarette, you always have a friend. the other part is that in the face of all the sickness and early death, one’s health falls from constant focus. you look around at the other passengers, and from all accounts, if it looks like the plane is going down, smoke ’em if you got ’em.

I
AM IN THE LAND CRUISER
, on its plastic back seat. Marco is sitting in the front, Anthony is driving. We are grinding slowly past the tire at the corner, but instead of turning right towards the hospital, we drive straight.

In a few hundred meters, we are somewhere I have never been. We begin to pass half-finished tukuls ringed by a railing of thin sticks. A woman drops a bundle of grass from her head to the ground beside her tukul. It will be used to make a roof, or a fence.

This must be where the new returnees are settling.

We pass the last tukul and bump across an open field. Hundreds of plastic bags, bleached white by the sun, flutter on the rough ground.

“That’s not getting any better!” I shout over the chatter of the car.

“What?” Marco shouts back.

“The plastic! All those bags!”

“I can’t …” He shrugs, smiles.

“Later,” I say, wave my hand. I turn back to the window.

This is my second time in the land that surrounds Abyei. The first time was when I did a mobile clinic a month earlier, to see what it was like. I had been a vocal opponent of mobiles. In my months in the hospital, I had watched the Land Cruiser return at the end of a long day with an exhausted team, and only once or twice had it carried an emergency. I worried that patients who were truly sick might delay attempts to find transport to the hospital if they knew we were coming in a few days. I struggled with the possibility that one day, because of the rain or the fighting or because we had closed the mission, the service would be stopped. Those people may have stayed where they were, farther from Abyei, because we helped them resist the tide of urbanization.

Further, I knew the type of medicine that was practiced. Pills were given based on the patient’s complaint, often in the absence of a physical exam. At my mobile clinic in Cambodia, I found myself sifting through dozens of patients to get to a sick person. On the way, I would dole out pills that would be traded between patients. Two yellow for
one red, my antibiotics for your paracetamol. After a few days, I gave out mostly vitamins.

Last month’s mobile was the same. Queues of women and children, a few men, all mostly healthy. Of the forty or so patients I saw that day, I diagnosed a girl with a possible urinary tract infection, a young boy with a superficial eye infection. To everyone else I gave either paracetamol or vitamins.

Anthony turns onto a wide road, a proper one, and speeds up. The rippled clay rattles my teeth. It is too loud to speak.

We have three sites. We are on our way to the one deepest in the forest. We discovered the population shortly before I arrived, after we received a few cases of hepatitis in the hospital and found that they were from the same area, Bayom. Bev went with the first doctor, the one I had never met, and came across several hundred people, a mixture of soldiers and civilians, all desperately poor, living in the middle of a scrub forest, far from a main road. They had lived closer to Abyei once but, because of the war, had settled here. They had little access to food, less to medicine. It was difficult for them to get to us. We decided to get to them.

I am told that they have a local doctor, someone who has some official training, but we don’t know what type. I am going to meet with him or her. I am going to get the fuck out of Abyei.

Anthony points out the window.

“Bricks!” he shouts.

On the side of the road, stacks of gray clay bricks, formed by hand. They will be fired in a wood kiln and turn red with the heat. The only people who can afford them are NGOs and the government. Local huts are plastered with clay.

The scenery changes back to brown scrub, the land flat and austere. No bricks, no birds, no animals, fast glimpses of an occasional hut. Trees flick by. The sameness is hypnotic. We drive for miles. Flick. Flick. Flick.

The Land Cruiser slows down. To our left, a small dirt track appears, so faint that I would have missed it. We turn. After a short distance,
we see that it will not be passable in the rain. The soil is loamy, and the path dips below the water table in several places. Once the daily rains start, these people will be on an island.