Six Months in Sudan

by Dr. James Maskalyk

  “I don’t know, Mohamed. This is pretty nice.”

  We pull into a row of stalls that is Agok’s market, carbon copies of the shops we see in Abyei. Outside of them lean bicycles, their frames wrapped in bright tape, their handlebars draped with flowers.

  Anthony parks in front of a stall and we get out. Seated inside a slanted recubra are three Dinka men, listening intently to a radio.

  “Drink?” Anthony asks.

  “I’ll have a Coca-Cola. Mohamed?”

  “Apple.”

  Anthony goes into the recubra and Mohamed and I sit down on the thick root of a tree. I turn to him.

  “You said the hospital was busy? Measles?”

  “Yes, still many patients.”

  “Any more cases of meningitis?”

  “Maybe one. Lumbar puncture was negative.”

  Anthony returns with our sodas. I fumble in my pocket for some dinars. He waves them away.

  “Thank you, Anthony.”

  He nods, returns to the recubra, and emerges with a three-legged chair. He sits on it, angles his long legs away, puts his chin on his chest, and within seconds, falls asleep. I marvel.

  Five boys, all around ten or twelve years old, emerge from between the stands. As Mohamed and I chat, they slowly circle closer until one bravely sits beside Mohamed. Mohamed puts his hand on the boy’s head and says something in Dinka. He can speak a few words. The boy smiles. The rest of them come closer, emboldened. They start to chatter brightly. Mohamed takes a final swig of his soda, then tosses the bottle across the dusty road. The children scramble for it, the fastest bolting away from the scrum, green plastic bottle in his hand.

  “So, what else in the hospital? How is Mansood and his knee?” I ask.

  “He is getting worse. He won’t walk any more. He has stopped eating.”

  “Did you start him on TB treatment like we talked about?”

  “Yes. Last week. Aweil too.”

  I look away. “Oh yeah. How is she doing?”

  “She smiled the other day.”

  “Really?”

  “Yes. She still is having fevers, but two days ago I was in the TFC, and I saw her laugh.”

  The boys have returned. They are now sitting on the lowest bough of the tree, swinging their legs. I drain the last few drops of my Coke onto the ground and hand my bottle to the youngest. He grins and hands it to the fastest. I take my camera from my satchel, gesture the fastest forward. He’s shy.

  Click.

  A boy, about six years old, in sandals five times too large, comes barreling around the corner of one of the stalls. He is holding, in each hand, the thin ends of two sticks whose tips are brought together through the center of a tin can lid that rolls on the ground before him. He careens past us and around the corner of a recubra.

  “What are you going to do in Khartoum?”

  “Visit my uncles. Eat. Rest. Watch television.”

  “What about look for a wife? Aren’t you supposed to be married by now?”

  “I am still looking.”

  “I think the Dinka mother, the one on the veranda, I think she likes you. Maybe you should take your R&R here and go on some dates. I can chaperone. We can get you some cows. How many do you think you’ll need? Ten?”

  He laughs. “She is very tall. Maybe more than ten.”

  “I can lend you some of mine.”

  Mohamed glances at his watch. “I think we should go back to the airstrip.”

  “Why? What’s the hurry? If we miss it, there’s another in a few days.”

  Mohamed taps Anthony on the leg. He wakes with a start. He jangles the key from his pocket, stands up, and returns the chair to the recubra. We leave the boys swinging their legs from the thick branch.

  We retrace our route. There are a few Land Cruisers at the airstrip now, their passengers waiting inside. We park between two of them. Anthony radios back to Abyei. We sit quietly and scan the sky. Within minutes, the faint buzz of a plane.

  “Well, Mohamed. I hope you get a chance to get some good rest. And that you come back.”

  “I’ll be back. See you soon.” We shake hands.

  The plane loops once, twice, and lands. The engines whine down, and the pilots step from the cockpit. Mohamed moves towards them and queues with the few other passengers. I watch him lean forward over the clipboard the pilot is holding and point at his name. He turns towards us and gives us a thumbs-up. Anthony starts the engine.

  We roll smoothly through Agok. I have my hand out the window, pushing against the hot wind. Anthony offers me a cigarette. I shake my head.

  We are on the red rippled road back to Abyei. We pass a truck coming the other way, its box full of grinning soldiers bent over the cab against the rushing wind. Women carrying buckets on their heads try to flag us down, motioning “slow-slow” by waving their hand towards the ground. We ignore them, and in the sideview mirror, I see their grimaces seconds before they cover their faces from the dirt.

  This is a road I have never been on. In fact, I have seen nothing but Abyei. It seems like it is kilometers between tukuls. I cannot tell where these people are walking from, or to.

  We round a corner, and in the middle of the road is a large log. Two soldiers sit underneath a tree, bored. They glance at me, at our MSF sticker, step lazily out to retrieve the log, and wave us on.

  Scattered huts start to appear. I turn to Anthony.

  “Abyei?”

  “No. Tongsay.”

  I recognize the name. Bev talks about it. It is a town made of SPLA soldiers. The huts become denser. Between them I can see scatters of plastic bags, piles of garbage.

  We pull up to a second military stop, huts on all sides. This time the soldiers do not remove the log from the road. A group of them sits by the side, and as we slow, they stand and come towards us.

  There are ten or so in the group. Two are armed. Anthony reaches towards the HF radio and turns it off. It is better if they think we are not broadcasting.

  They gather at his side of the car. An older man, large, wearing a gray tunic, appears to be their spokesperson. He is familiar. He places one hand on either side of Anthony’s open window and leans in. He smiles at me. Now I recognize him. I met him on my second day, when I refused to transfer the man with the severed radial nerve.

  He and Anthony converse in Dinka. I can’t understand a word. Anthony appears nervous. He is repeating something.

  “Anthony, what’s going on?”

  He doesn’t turn my way, instead waves his hand at me. Be quiet.

  “Anthony. What?”

  He turns. “They want us to take a person to Abyei.”

  “We can’t.”

  “I know. I say.”

  “Who is it?” I ask.

  Anthony points to an old man sitting underneath a piece of thatch tacked up under a tree. The man looks at the ground.

  “They say he is sick.”

  He doesn’t look it.

  “What’s wrong with him?”

  Anthony shrugs.

  “He is dizzy,” says the older man, leaning farther into the cabin. “He walked all day, from Abyei, to visit his daughter here and now he feels sick.”

  “I’m sorry, but we cannot take anyone in our car who does not work for us. It is against our rules. It is for security.”

  “But he is an old man. He is sick.”

  “I can make an exception for an emergency. But only emergencies. All others need to find their own way to the hospital.”

  “You’re the doctor at the hospital, aren’t you?”

  “Yes.”

  “Yet you refuse to help a sick man? What is your job? Is it not to help the sick? How can you call yourself a doctor?” His voice starts to rise.

  More people have come from the huts on either side of the road and are flanking our car.

  “Listen. These are our rules. I can’t break them. I would not ask you to go against yours. Do not ask me to go against mine.”

  “We let you pass
here, time and again, and you will not do us this kindness?” Soldiers now stand both in front of and behind our car.

  Anthony is staring directly at the steering wheel.

  “I’ll tell you what. I will contact my boss, Bev. You know her. I will ask her permission. If she gives it, I will take him. If she does not, I cannot. Anthony? Back up.”

  The car starts, and as we inch backwards, people step away. I turn on the radio.

  “Bev for James. Bev for James.”

  “James, go ahead.”

  “Bev, Anthony and I are in Tongsay and we have been stopped at a roadblock. They want us to transport someone to Abyei. Do you copy?”

  “I copy. Who stopped you? Over.”

  “I don’t know. I never asked his name. They claim the person for transport is sick, but he appears well.”

  “We need to get you out of there. You need to go to the hospital right away. Grenade. One man dead, one boy wounded. Do you copy?”

  “I copy.”

  “Okay. Sit tight. I’m on my way. Over and out.”

  I love that woman. I turn the radio off.

  “Anthony, pull the car ahead again.” We inch forward. “Let the patient come here,” I say, and turn the latch on the door of the Land Cruiser. It swings open. I gesture to the man.

  He comes towards me. His gait looks normal. He draws closer, his eyes wide. He’s nervous. He is within a foot of me now. I reach for his wrist and feel his pulse. It is 80, regular. I open my mouth wide. He does the same. His tongue and gums are shiny and moist. For audience effect, I feel along the front of his neck, the angled sternocleidomastoid, reach behind its muscle belly to feel for swollen lymph nodes. There are none.

  I walk to the back of the Land Cruiser where people are clustered, watching. I address the large man in the tunic, the one who was speaking English.

  “He is okay. No emergency. I think he just needs to rest here for the night. Today was a hot day. He is sick from the heat. Give him clean water. And some bread.”

  “Do you have any medicines?”

  “He doesn’t need any. If he is still sick tomorrow, tell him to ask for me in the hospital. I talked with Bev. No transport. And I need to go. There is a sick boy in the hospital.”

  He steps away from the car, his face stern. Finally, he gestures towards the log and turns away. Two soldiers step forward and remove it. He walks back towards the piece of thatch and doesn’t look back.

  Anthony starts the car and drives away. He looks at me, smiles, shakes his head. I shake mine, and pick up the receiver.

  “Bev for James. Bev for James.”

  “James, go ahead.”

  “Bev, everything is okay. Do you copy?”

  “Affirmative. Where are you?”

  “Past Tongsay. Moving towards Abyei.”

  “I’ll see you in a few minutes. Over and out.”

  Anthony and I drive on in silence as the sun arches towards Sudan’s flat rim. On all sides are brown scrappy acacia trees. I lean my head against the rattling door frame and watch the gravel blur beside our wheels.

  We soon see the plume of Bev’s approaching truck and slow to a stop. She leans out the window.

  “Everything all right?”

  “Yeah, it’s cool. They tried to bully us into taking someone to Abyei. He wasn’t sick. He just didn’t want to walk.”

  “They know better than that. I’m going to go and talk to them.”

  “Give ’em hell. Hey, how did Nyanut make out? Did she use the meds I sent from Khartoum?”

  “Worked fine. She’s grateful.” She drives away.

  We rumble our way to Abyei. We turn down its one red road and pass compound 2. Its guard raises a slow hand. We stop at compound 1’s metal gate.

  I shake my head. “Mustashfa,” I say, and point to the hospital.

  Military compound, howitzer. We park out front and I leave my bags in the back of the Land Cruiser. I walk through the front gate and pass the nursing room.

  Yusuf, one of our nurses, looks up from a fan of patient charts. “Dr. James! Welcome!” he says.

  We shake hands, smile at each other. He leads me to the emergency room. I feel better here than in my hot hut.

  A man is lying on one of the cracked plastic beds, his shirt red with blood. A small pool of it has clotted on the floor. A boy, about eight years old, sits beside him, a bandage around his lower left leg, a red target at its center. He’s staring at me with wide eyes, tears at their corners, and as I come closer, they streak down his cheeks.

  30/03: in the shade.

  i’ve started sleeping outside. it’s better.

  most writing about africa touches on its heat. touches on it, then jumps back with its burnt finger in its mouth. i was determined to avoid the cliché, but today i cannot. today, it is smothering. but at least it’s a dry smothering.

  i woke up this morning, underneath my tree, grateful for my thin sheet. it was dawn. roosters shouted. murmurs of morning voices. i was covered in sand. i could feel its grit in my mouth and underneath my back. a breeze lifted a corner of my mosquito net that had come free.

  the day brightened, this day, the one right now. the wind started to blow warm, and with it, sweat beaded on my neck. after a few minutes of lying and listening, i needed to move. i lifted the mosquito net, shook the dust from my sheets, and bunched them in a ball at the foot of my bed. i walked to the kitchen, to find coffee, to find some bread.

  by 9 a.m., i couldn’t sit in the sun. by 10 i had moved into my tukul. i decided to write before i walked to the hospital on this, my day off. and here i am. it is 10:39 and 104F in the shade. it will climb to almost 120. i am typing with pieces of tissue underneath my wrists because sweat pools on my computer. i have taken my headphones off because it affords me another fraction of uncovered body surface area.

  i will soon leave my tukul and go to the hospital. i will step out into the sun, and touch the top of my head where i have just clipped it on the door frame. my hair will be hot even after these few seconds. i will look down at my scrubs and see dark sweat at my knees. i will walk 480 paces under a cloudless sky, walk it in zigzags, looking for any piece of gray shade, no matter how narrow. fence, lightpost, piece of barbed wire. anything. the last 100 meters is across a dry courtyard, and the wind will sweep across it, gusting heat into the hospital.

  i will move through the different wards, each hanging with their different smell of sickness, the hot drafts stilled by the walls. mothers in the tfc will fan their babies, and the man in the back room—i can’t decide what is wrong with him, why he is wasting away—he will lie on his back and stare at the ceiling. of the 51 patients, i will see the sickest ones. i will go back, sometime in the afternoon, through the courtyard and its hot wind, down the road, then left, and enter compound 1. i will go into the kitchen and drink a liter of warm water from the fridge that was just unplugged. i will leave because i can’t stand the heat. i will walk to the shower and turn it on. the water will flow from the pipe, and, warmed by the white sun, it will be almost too hot to bear. i will stand in the doorway and towel my hair, and by that time, the rest of me will be dry. i will return to my tukul, take the thermometer that is hanging by my plastic desk, and take a photograph of it. i will then post it here.

  you feel the heat like a real thing, something you must push against when you open a door. at times, you can’t tell where your body stops and the air begins. in other places i’ve been, the heat seems like it comes mostly from the top. here it comes from all sides. you step outside, and it presses firmly on the back of your neck, scolding you. you pass the metal gate, and the reflection hits you like a punch. you bend to pick up a vaccine box left in the sun, and touch the metal handles and get burned. all sides.

  that is my final word on the heat. my tissues are soaked through. sorry for the digression but i hope the telling will be an exorcism. perhaps with it i will be able to stop thinking of the white shock of diving into icy mountain streams, or sitting on a surfboard at sun
set swinging up and down with the swells, or the clear silence before the snowboard lands ten feet below on a cushion of dry snow that stings your face in a million tiny points.

  MANUT’S LEG IS SHATTERED. The story goes that he found the grenade, and his drunk uncle started fooling with it, pulled the pin.

  Bang.

  When I assessed the uncle, he had a hole through his stomach. His body lay in the baking-hot emergency tent for two days, much to the horror of the mothers in the nearby feeding center. We have no morgue, and Abyei has no discernible system for dealing with dead bodies. Bev sent our community liaison to talk to Abyei’s paramount chief, and the body was soon removed.

  Now the boy is lying in a bed in one of the dark rooms, his mother on a mat on the floor beside him. Her forehead is scarred with hundreds of arching dots. I am looking at his chart. No fever. The discharge from his wound seems clear. No infection so far.

  I push down on Manut’s lower eyelid. His conjunctiva is pale. I’m not sure how much blood he has lost since the injury. We took him to the operating room the other day and picked out as much shrapnel as we could. I couldn’t tell if his leg was completely shattered. Some of his tibia was splintered, but there seemed to be a thick column that was intact. I needed to open it again.

  “Can you tell Ismael we need to check his hemoglobin?”

  I write it on the bottom of the chart, and then hand it to the nurse behind me. She nods and writes it down on a ledger pad, then bunches the chart with the thirty others I have given her so far.