Six Months in Sudan (22 page)

We evacuated all MSF staff from the hospital. It was Marco’s only card to play, to withdraw activities. If such impositions continue, we close the mission. They lose the free care for their soldiers and their families, and gain the ill will of a community.

In Germany, during our pre-departure training, we were reminded that the nature of conflict has changed. Wars no longer take their greatest toll on combatants, but on civilians. This means that our proximity to the fighting is necessarily greater. As war spreads its wide grasp, it erodes the space in which we work.

Once, being a humanitarian carried with it a certain privilege: if
you declared yourself one, you were not a target, not even on the battlefield. The red crosses and MSF logos no longer provide as much protection. Some don’t see them, and to others, they look like bull’s-eyes, a sign of wealth, of resources. Someone told me that in Darfur, Land Cruisers get jacked at a rate of around one per day. A month or two ago we got an email that cited a report claiming Sudanese Armed Forces had painted some of their planes white, like the UN, and were using them to transport supplies, possibly weapons, to Darfur. The distinctions were becoming blurred.

We were increasingly seen as part of the conflict, a potential pawn in a larger political game. With one swift stroke, one could drive help away from an enemy, or more likely, from civilian countrymen who might be supporting them.

The problem is, once this humanitarian space falls away, it cannot be rebuilt. The newer wars will have no memory of it. Those whose only protection is this invisible margin of safety will be left defenseless. It is why we keep our distance from anyone with guns, even the UN, why we cringe when we see soldiers delivering food, or hear the phrase “militarizing humanitarian corridors.”

The space is not only for us. One of the reasons the worn red road between the compound and hospital is safe at night is that if it were not, we would leave. The hospital, once full of armed soldiers, was a place where people could feel safe because if someone refused to check their grenade at the door, we evacuated. We demand the space, and with it comes air for everyone.

We left the hospital. When the soldiers did too, with the body, we returned. Well, two of our nurses did. A skeleton shift. At the suggestion of the UN, Abyei is under curfew. No unnecessary movements until the situation declares itself. Both nurses will sleep in the hospital. I will try to handle things over the radio as much as possible, and go to the hospital for life-threatening cases only. Others will wait until morning.

From what we can glean, the fighting is between opposing militia. Both armies, the South and the North, find it more politically convenient to use groups of armed civilians to do unofficial fighting to make a point or to raise uncertainty without declaring war. They choose groups
with whom they have ethnic or historical allegiances, or to whom they can make promises of power, and arm them. What better way, for instance, to defer a census, or a referendum, than to claim a place too “unsafe” for it? Meanwhile, the oil wells keep humming.

It is unclear whether the recent spate of violence is a symptom of something larger. We knew tensions were high, heard that troops were mobilizing on both sides. Each week, Marco meets with the UN to discuss security, but at the most recent, no escalation was predicted.

If this is not a symptom, it could be a spark, a shard of glass. Like peace, sometimes war only needs a little piece to become real. If more fighting happens between these two groups, their mentors might show their allegiances. Or as in previous geneses of war here, a rebel group proves itself dangerous, and hornets fly from Khartoum.

These are our thoughts as we sit in the gazebo in the center of our compound, watching the season’s first torrential downpour. The rains to this point have been heavy but short. This one is unrelenting. The compound is mud, puddles connected by small rivers.

We are all here. Marco, Paola, David, me. Tim is away on his R&R. I miss Antonia. Paola does too. She helped us laugh.

Paola stands up and runs to the kitchen. On our last trip to Muglad for gas, she got the driver to buy apples. This afternoon she volunteered to bake a pie. We are all grateful for something to anticipate besides war.

“So. If things get hectic, gunfire-wise, where do we go?” I ask. “The kitchen?”

“No,” David answers. “The walls are too thin. Not safe. The bricks are very poor clay. Look.” He leans over and breaks a small piece from the gazebo’s wall.

We look at our security area, bags of dirt between Tim’s tukul and mine. They had burst in the sun, and with the rain they are now mostly mud.

“I think Tim’s tukul is best,” David says. “We have the kitchen to one side, your tukul to the other, some protection from the bags of dirt. We would still be vulnerable on two sides, more or less.” He looks at Marco, who says nothing, only shrugs.

Marco has been quiet for most of the day. I think the gravity of his position is becoming more real. As the situation threatens to worsen, we turn to him. He can turn to the acting head of mission in Khartoum, but the man has never visited Abyei before and will likely only support Marco’s assessment.

We too are grounded in this place more firmly than before. This is, in essence, what we signed up for, to be in the middle. We are where we wanted to be.

The rain thunders on the roof overtop of us. Paola comes back.

“Not quite ready,” she says, smiling.

I think about my thoughts. They meander, unhurried. Things are calm. The possibility of escalation still seems unlikely and, at the least, beyond our control. If something happens, we will rely on the UN for air evac, or leave by ground in our Land Cruisers, towards the North.

“Hey, what do we do about David? He can’t go through the North. No visa,” I ask.

Marco is silent. He has thought about it, but doesn’t want to talk.

“We can put him on a donkey,” I say.

“Yeah, we can give them rubber boots,” Paola says. “Two for David, four for the donkey.”

“And some BP-5.”

“And an injection to make him strong.”

David begins to intone one of his stories about Darfur, about how chaotic and dangerous it was, how much more so than here. We all find the story unhelpful. Paola leaves to go check on the pie. Marco asks me for the insect repellent. The plastic sheeting that David and I hung along the walls of the gazebo flutters, and the metal pole at its bottom swings away from the wall and into it again, clanging viciously.

Clang … clang … clang.

A guard runs through the rain, hugging a handset close to his body. He hands it to me.

“Hospital,” he says. Marco and David are watching.

“Hospital, go ahead.”

“Dr. James. We have another body. Gunshot. Over.”

Uh-oh. “Um. Hospital, is it a soldier?”

“Negative. A civilian.”

“What are the vital signs?”

“The patient is dead. Brought by police. Over.”

There is no reason to go to the hospital. Marco takes the handset from me and tells the nurse to send the guard to find Sylvester. He can inspect the body.

Marco gives the handset to the guard. There is no way to tell what has happened. Not until the morning. No movements. Can’t talk on the radio.

Paola returns with the pie. “Sorry, but there was no butter. Only flour. I tried to use some yeast, but I think it died from the heat.” She looks disappointed.

After months of beans and fried goat, we are thrilled. She starts to cut it into pieces.

“Wait!” David and I run through the rain to get our cameras.

We sit together, under the tin roof, quietly eating apple pie, and strain our ears above the din of the rain to listen for gunshots. It’s impossible. A mere 460 paces away, a dead body sits on the veranda, and our thoughts are there too, wondering if this is the beginning of what everyone in Abyei is waiting for.

05/05: the problem of the dead body.

i have been told that some years, in this season, a thin cloud appears on the horizon of an otherwise clear day. it approaches quickly with the wind and, minutes later, locusts cover crops, cars, tukuls, lie floundering in puddles. as i type this, one is doing a stop-motion crawl across my tukul floor. skitter-pause … skitter-pause … skitter.

last night i had a fever and lay in bed, sweating, plastered to my sheets. as i was drifting in and out i heard, above the usual noise, wailing. a chorus of cries from the hospital. another dead body. another throng of people at the gate and more, running from town.

we have been having problems with dead bodies recently. not because of their alarming number; this is something the abyei hospital is accustomed to. others.

where to put them? we replaced the dusty room at the back of the hospital, a makeshift morgue, with a pharmacy. now when someone arrives at the hospital ten minutes too late, we flounder for space. in the emergency room? occasionally. it does little to instill live patients with confidence in the hospital, or in my skills in emergency medicine. in the tent beside the tfc? once. the man with the grenade hole in his stomach. when the roof of the tfc crashed in from all the rain the women refused to move their children into the tent. haunted. on the ground, in the back? too wet. in the room at the front? nope, full … measles patient. in the pharmacy? over my …

dead body problems. when someone is sick in a village, they don’t come to the hospital straight away. there is no road. transport is too expensive. often the family calls a traditional healer, and they spend their carefully collected money, likely saved for this exact contingency, for treatments that do not work. the patient worsens. there is no
choice but to spend what money they have left to hire a donkey, or a car, and bring the patient to abyei. they don’t have enough, so they sell their only goat, or a piece of their land, to their neighbors. they use the money to get the patient to the hospital, ten minutes too late.

they are grieving, and penniless. there is nowhere to put the body, nor for them to sleep. pleading, they ask for our help to take the body to the graveyard. they are heartbroken. we say no.

it is an impossible decision. we could easily take one of our cars, the pickup for instance, and offer the family some relief from a cruel day. but we don’t. we cannot be a hospital and a hearse service. nor when someone knocks on our compound door, his eyes as big as moons, and says “my wife, she is delivering at home, but the baby is stuck, can you take her to the hospital,” can we be an ambulance service. no, we say, you need to find a way, and quietly close the gate.

these are impossible decisions because their wisdom is easy to see, but they are contrary to one’s spirit. once we start transferring bodies to the graveyard, the hospital becomes their destination. once we become an ambulance service, our resources become taxed, and we may go to destinations that are not secure. further, each time we are a band-aid, we simply cover the problem, and delay the slow work towards a tenable, permanent solution. but when a family comes kilometers over broken roads, carrying their dying daughter, and they arrive ten minutes too late, when you tell them that no, you cannot help them bury her though you have the means, the knowledge that you are being wise is poor comfort.

you want to drive each patient where they need to go until you run out of gas, use every last dose of rabies vaccine for the small chance the dog was infected and the child dies foaming, to give the starving family money even if it will only feed them for a day, drip all of the blood into this patient, the human (someone’s father, brother, son, best friend) bleeding in front of you even though it means there might be
none for the next ten, but today you have it, and today is his lucky day, and tomorrow you will worry about tomorrow.

but we don’t. we are measured, and careful. it is what tomorrow’s patients expect of us and the tomorrows stretch towards forever, and today is nearly done.

T
IM IS SITTING BESIDE ME
on a low chair. I look at him, and gesture towards the pots full of food on the table to our right. It is 11 a.m. and our Sudanese hosts are waiting for us to eat. This is early for us to take lunch, and late for their breakfast.

We rise to our feet and head towards the table. Paola does the same. Marco sits.

Lining the rest of the large, sturdy recubra are Abyei’s nine Dinka chiefs. Some of them have a small entourage, and all are eyeing the groaning table hungrily. This is the paramount chief’s recubra. He is the most powerful man in the Dinka tribal system in Abyei, the one who resolves disputes the local prefects cannot, and the food is made by his chef. One can assume that if there is to be a reversal in our opinion of Abyei’s regional cuisine, this is where it will happen.

It is customary within this tribal system to solve disputes in a public forum. We are here to allow for the airing of grievances about our project. The word we have received, through our local staff and community contacts, is that there are many. This is an attempt to establish a dialogue, to improve our standing with the people we are here to serve.