Six Months in Sudan

by Dr. James Maskalyk

  days find weeks again. soon we realize we have an opportunity to make a lurching step towards a better tb program, or a bigger feeding center, or having a borehole finally dug. what we don’t have is much time. we become frantic again, and as the end draws nearer, we wish it were further away. but it isn’t. and here comes someone else, full of nervous energy, and a new world rolls over him.

  for the time being, for me, my respite is that half hour of silence before the generator starts. the sun is still down, and the roosters newly up. we leave our tukuls, walk quietly past one another, whisper “morning … morning.” we go to the kitchen and boil some water, grab a piece of warm bread, and sit on the brick wall of our communal gazebo and look at the sky. for a few minutes, the world seems to stretch wide, much wider than the grass walls of compound 1. for a minute, we are who we are.

  WE ARE SITTING TOGETHER, the Abyei team. All of us. Bev, Paola, Jean, Tim, and me. The measles team is meeting with itself, in one of their emergency tents. The Ministry of Health has asked us to finish our campaign. They want to begin one of their own.

  It is rare for the five of us to be together like this. Since I arrived, we have been pulled in so many different directions, and because of it, pulled apart, not together. Difficult in a place like this where it is already easy to feel alone.

  “Pass the ful,” Paola says.

  “I can’t believe you eat that stuff,” Jean says, giving Paola the pot of black and brown beans.

  “I like it,” she says.

  “It makes me want to die.”

  “A piece of bread, too.”

  Paola is leaving soon. So am I. She is going on her R&R. She has planned it for months. I’m off to Ethiopia.

  “So, Paola, when do you leave again?”

  “Two days.” The edges of her mouth start to curve up.

  I know the answer, but ask because the thought of it makes her happy.

  Questions about time are common talk. At least to me.

  When are you taking your R&R?

  When did you arrive again?

  When are you finished?

  When do I go home?

  Will I get to a time when I don’t want to?

  When?

  “Bev, when do you leave?” I ask.

  “Not sure. Soon. Beginning of April. Couple weeks.”

  “What are you going to do when you get home?”

  “Can’t think about it. Still two weeks.”

  She’s tired. Measles has taken a toll on her. I’ve asked her a few times if she is okay. She says she is. I’ve stopped asking. We don’t talk about how we are doing, except to say we’re tired.

  I am reminded of visiting an HIV project in Zambia a few years before. I asked a first-mission nurse, disheartened midway through her nine-month mission, what she found most difficult about the job.

  “No feedback.”

  This work is not what one does if he is interested in being told that he is doing the right thing. We are expected to know. The work is not easy, not for anyone, and it never ends. If you keep on looking over your shoulder, waiting for a pat on the back, you’ve missed the point. It’s not about you. If you are expecting it to be, better you stay at home. Still, at the end of a long day, it is an easy thing to miss. My blog is good for that. I’m lucky.

  “What about you, Jean?”

  “Same as Bev. Couple of weeks. Paola will be the oldest one in the mission, hey, Paola?”

  “I guess,” she says, frowning.

  “And after she’s gone, it will be you and Tim. The pros.”

  “Yeah, right.”

  We finish our food, and stack the plates on top of one another. None of us are compelled to find the tasks we left behind before lunch. I grab the plates, walk them to the kitchen, and set them beside the sink. Our cook looks up grumpily. I ask her to make us coffee. It makes her no happier.

  Everyone has moved to our makeshift couch. The wind blows hot through the gazebo.

  “How are things in the hospital?” Bev asks.

  “All right,” I answer.

  “How many patients now?”

  “Seventy or so.”

  “Is Mohamed going to be able to handle them all while you’re away?”

  “Hope so.”

  I don’t want to talk about it. Everyone is quiet. Tim takes a cigarette from Bev’s pack.

  “How’s the girl doing, the orphan?” Bev asks.

  “Still sick. One of the nurses found a mother in the TFC to take care of her. At least for now.”

  “What’s wrong with her?”

  “Don’t know. Treated her for everything.” She’s heartbroken, that’s the problem.

  I don’t want to talk about her either. I’m thinking about Ethiopia.

  The coffee arrives. We each drink our glasses, linger for a minute, then, one at a time, go our separate ways.

  (breath)

  20/03: lucy.

  i arrived in addis ababa late last friday night. my flight was delayed because of a sandstorm in khartoum so thick that it blocked the sun from the sky, and for several hours, our plane.

  i shared a taxi to the hotel with a colleague from mozambique who was also attending the tb workshop. it is a strange but certain phenomenon that when you identify a stranger as someone who works for msf, you welcome them into your fold of friends. perhaps family might be more apt. you may not get along, nor agree, but there is a common ground and with it, some forgiveness. at least you know that the person wearing the msf shirt who stole the last cold pepsi has been through a metafilter, that they could be working somewhere else, somewhere easier, closer to their friends and family for a hell of a lot more money. so, you curse them under your breath, grab the warm fanta, and sit back down.

  though i landed in africa more than a month ago, i didn’t feel like i had arrived until i found myself crammed into an ethiopian minibus with 15 other people. it was so full i had to lean over a row of passengers and brace myself on the back of the driver’s seat. the cross hanging from his rearview mirror swung left, then right, as he angled his way through a thick mix of cars, goats, and pedestrians to pick up more people, reggae music bumping from under his seat. it is no wonder that the largest single cause of premature morbidity for expatriates is road traffic accidents. i am sure the same is true for goats.

  yesterday i visited the ethiopian anthropological museum. ethiopia’s rift valley is one of the richest sites in the world for fossils. thirty years ago or so, they excavated a nearly complete skeleton of one of our oldest bipedal ancestors, lucy. she is 3.2 million years old. her bones lie in the basement of the museum here in addis. there is an older fossil somewhere, an even grayer relative of ours, but i don’t think the skeleton was as complete as lucy’s, and at the least it isn’t just down the road from my hotel.

  so there she was, a pile of old bones. 3,200,000 years ago, she walked in the mountains i can see from my window. there’s no way to know how many children she had, nor what type of food she liked best, nor how she died. nor if she had a ringing laugh, or was afraid of the dark. we can tell that she walked, and that her brain wasn’t much smaller than ours. she represented an important advance. once she was an adult, she walked on two legs for her entire life. some scientists suspect that it allowed her to search the savannah for prey or enemies. others believe it was a step towards being able to throw and catch a frisbee, the most perfect manifestation of human ability.

  the environment applies somewhat different pressures to us now. rather than responding to it, we change it to suit us. we don’t grow more fingers, we build tools. i wonder how we evolve now that instead of standing on our hind legs, we can see our enemies on google earth.

  part of the process, effect or side effect, seems to be an increased recognition of a shared human condition. it began, perhaps, with the printing press, then the first morse signal, from there to radio and television, and has been most completely manifest with the world wide web. the perspective it offers more properly places us in the
world. in that way, the internet is not an infinite series of portals, it is a mirror in which we can see ourselves reflected more perfectly than ever before, an iteration in the development of a collective consciousness.

  lucy can be forgiven for not caring about what lay on the other side of the mountain. she could not have known. one hopes that if she had, she would have made the walk. i do not think that is a naive hope. i am sitting in a room with 32 people from 22 countries who have been pushed towards common ground like we were pushed onto our hind legs a few million years ago. there is room enough for more, for all of us.

  “HELLO?”

  “Hey. It’s James. Can you hear me?”

  “Hello?”

  “Sarah, it’s James. From Sudan.”

  “Oh! Hello! Wow. How are you?”

  “I’m all right. What about you?”

  “Wow. Good. It’s good to hear your voice. You sound really close. Where are you?”

  “Khartoum. Just got in from Addis yesterday. I’m on Skype.”

  “How was it?”

  “Really good. Fun. I made a good friend, from Morocco. We dubbed ourselves the Addis Ababa exploratory team. We were out every night, checking out the city.”

  “And?”

  “Cool. Our last night we went to this crazy club. I think it’s one of Africa’s largest. At 4 a.m., the dance floor was still heaving. It was good.”

  “That sounds like what you needed.”

  “Definitely.”

  “When are you going back to Abyei?”

  “Day after tomorrow, I think. Got my visa in Addis. It was a gong show. It took, like, three days. The Sudanese sorely overestimated my desire to return to their country. I went to the embassy and stood in lineup after lineup. Every time I asked if I was in the right one, they pointed to another. At one point I was in a line where people were being weighed. I thought I was going to be eaten or something.”

  “That’s funny.”

  “Yeah, it was weird. Anyway, it worked out. Turns out the guy behind the visa counter was from Abyei, so he sorted me. Finally. And I’m Abyei bound.”

  “How do you feel about that?”

  “All right.”

  “Really? … James?”

  “Yeah, no, not really. I’m not super-psyched about it.”

  “Yeah, you don’t sound like you are.”

  “It hasn’t been a very good time. I mean, I know it’s not about good times, but it’s harder than I thought it was going to be. It’s like … I can’t get away, you know? Not even in my sleep.”

  “You suck at sleeping.”

  “Yeah, I totally suck. But it’s like … a kid dies or whatever, and you’re like, ‘Hmm, what should I do now? I guess I’ll just wait around for the next one.’”

  “Oh baby.”

  “Yeah. Whatever. It’s cool.”

  “Doesn’t sound like it.”

  “It’s okay. Sorry. Didn’t mean to harsh you out. It’s worse to look forward to than it is to experience. Just a tough day today, I guess. I think it’s why they don’t let you go home on your R&R, ’cause there’s always this feeling when you’re going back to the field.”

  “You’re not harshing me out. I don’t hear from you much. Just through your blog, like everyone. So it’s good. I miss you. If you need to talk, you can call me any time.”

  “Thanks. Sorry.”

  “Don’t be an idiot. Maybe if you’re miserable, you shouldn’t go back.”

  “No. I’ll figure it out. Anyway, Sarah, what’s up with you?”

  “The usual. Wintertime here. Spring is happening soon. February was brutal like always. Work is kinda slow right now, but that’s okay. The boys are throwing a party soon.”

  “I thought everyone agreed not to have any fun until I got back.”

  “Oh yeah. I forgot. I’ll tell them to cancel it.”

  “They don’t have to cancel it. They can still throw it, but maybe no music or something. Everyone can just mope around, think about orphans or starvation.”

  “I’ll suggest it.”

  “Okay. I should go. Office is closing. Thanks for listening.”

  “Any time, James. Really.”

  26/03: sand.

  the speaker above me clicked on.

  “ladies and gentlemen, we have started our descent towards khartoum. we ask you to ensure that your seats and table trays are returned to their upright position and that your luggage is stowed in the overhead bins or safely under the seat in front of you. the weather in khartoum is … um … blowing sand. the temperature is 90 degrees fahrenheit. local time is 1:50 a.m.”

  i was once again in the land of blowing sand.

  right now i am sitting in the msf office, five minutes away from the guest house where i stay, just past the garbage mound, and down the road. there is a small desk near the entrance. it is surrounded by boxes of drugs and equipment destined for the field, but there is just room enough for me. i can hear the squeal of the hf radio as it picks up signals from abyei or darfur. i wonder what they are saying.

  on our last night in addis, some of us went dancing. there were about ten of us who became fast friends. we shared a similar enthusiasm for what we were learning, but also about what there was to learn about addis. after the long days, we discovered yemeni restaurants, king melenik’s old castle, got lost in africa’s biggest market, found traditional music, little holes in the wall just down the road.

  the last thing we found was the dance floor late on saturday night. i was surrounded by people i had come to know, respect, and like. every hour our number would dwindle as someone left for the hotel to pack for rural ethiopia, or mozambique, or geneva. i was talking with my friend maria, an argentinian doctor who had last seen me throwing my backpack on top of a crowded bus in zimbabwe the day i finished with msf last. she said she often wondered what happened to me.

  “james, answer me something. this life, where you get to meet people and know them, and become friends, and then in a few days or a few weeks, either they leave or you do … we say ‘well, that’s msf,’ but i don’t know. is it worth it?”

  i am not sure, i said. i think so. maybe having your heart broken like that is what keeps it open.

  now maria is back in buenos aires. mohammed ali (the great) is in mozambique. anthony in uganda. all blown like sand.

  i am looking at the departure and arrivals board. on it names, destinations, and dates are scrawled in felt pen. mine is there.

  James KRT → AB 28/03/07

  but there are others.

  my field coordinator is leaving in two weeks, and there may be someone to relieve her. our logistician is leaving at the same time, but as of yet, there is no one to take his place. in khartoum, there are similar problems. we have been without a medical coordinator for several weeks. i saw our logistical coordinator in ethiopia and he told me he resigned. our head of mission wants to be gone by the middle of april. no news on his replacement. when i left from abyei, i shared the plane with one of the two sudanese medical technicians that work in the hospital and who, with mohamed and me, make up our four person medical team. i learned today she is not returning to the project.

  i will send word from abyei. love the spring for me.

  CHAPTER II

  THE PLANE RUMBLES TO A STOP and a cloud of dust envelops it, then swirls away.

  “Welcome to Agok,” the pilot says as he opens the door. Two of us clamber down.

  Planes no longer fly into Abyei. The runway is too full of donkeys and bricks. This is as close as they come now, forty-five minutes and three military checkstops away.

  I step out onto the cracked ground. The sun presses down and a hot wind pushes past. I look around. Ah. There’s our Land Cruiser. And the driver, Anthony. I wave. Here we go.

  “Hello, Doctor,” he shouts, an Arabic purr on the last r. “Welcome home.”

  The pilot deposits my bag into the dust. The other passenger, with whom I had not exchanged a single word, is already driving away in
a UN vehicle. I walk to the Land Cruiser and shake Anthony’s hand.

  “Sir Anthony. Good to see you.”

  I open the rear door. A man is sleeping on one of the benches, his forearm over his eyes. At the creak of the door, he sits up, blinking sleepily.

  “Mohamed? What are you doing here? I thought you were on your R&R already. Or did you stay because you missed me too much?”

  “I missed you, man. Too-too much,” he says. He shuffles forward and we shake hands, bent underneath the truck’s metal chassis, grinning at each other. “The hospital is very busy so I delayed for a few days. Bev asked me to.”

  “She’s on her way to Khartoum, right?”

  “No. She delayed too.”

  “How is she?”

  “Very tired.”

  “And everyone else?”

  “Everyone is okay.”

  “Good. So, you’re leaving today?”

  “Yes. My plane is at three.”

  “Let’s go find a Coke or something. I’ll wait with you. And if the plane doesn’t come, you can just take your R&R here, in Agok.”

  “If the plane does not come, I will walk to Khartoum.”

  I close the back door and jump into the passenger seat. “Anthony, take us to Agok’s fanciest restaurant.”

  He looks at me, key paused in the ignition.

  “Coca-Cola. Let’s get some Coca-Cola.”

  The airstrip is deserted, and we rumble down its center. I don’t mention the ruts we are deepening. We turn off at its end, and widely spaced tukuls begin to appear, some deep in the scrub between hills, others closer to the road. We pass a group of children walking side by side, laughing. A man with a hoe angled on his shoulder waves.

  My time in Addis has helped me see Abyei more clearly. People I met talked about their projects in Uganda or Mozambique. Weddings, local girlfriends, weekend trips. In the five or six weeks I have been in Abyei, I couldn’t tell you one particular thing about the place, one custom, one habit of its people. It has been closed to me, or me to it. This is partly because of my tendency to retreat when I need respite, but it’s more than that. Every gathering is a military one, every second person you pass at night a soldier. People are building their tukuls, working all day, and in the hospital, I see the poorest, the ones with no mosquito nets, or no access to clean water. Not only does our language seem irreconcilable, so do our worlds.