These past two weeks have been full of action, and as share some this with you now I should apologise in advance for the bits of blood and gore. You can avoid this by jumping down to my profile of Aisha, a delightful mother of one of my favourite little patients, or to my inspired ponderings on being a child. Enjoy!
UnpredictabilityHours after I emailed off my last letter home things got pretty hot here. The sporadic shooting accelerated and spread throughout town. A government spokesman later explained to the press that their soldiers had entered one of the IDP (internally displaced persons) camps to retrieve weapons after an alleged assault on one of their officers. I would say much more, except I can’t – but here are a few of my scattered pictures of what I saw.
- Our logistics coordinator presenting up to work to tell in shock of having two dozen bullets become lodged in his mud-brick home. Dozens of other staff from that IDP camp with similar stories and shock and fear.
- Hundreds of defiant IDPs marching through the streets holding banners and sticks aloft shouting out chants of protest. Eventually going home after told in no uncertain terms what would happen if they did not.
- Jeep-loads of reinforcements roaring into town loaded with boys, bullets and big mounted machine guns. Seeing them haunt the town for the next week ‘maintaining order’.
- Bullets in chests, and abdomens, and necks, and legs… Fortunately only two patients that made it to the hospital died. One miracle man had a bullet course right through his neck without destroying any vital structures!
- Feeling the whiz of bullets fly over the hospital and sharing looks of fear, resignation and disbelief with the other patients and staff. Then feeling really uncomfortable realising that if things got worse I would be on a UN helicopter getting out of here – they would not!
Then stranger still, everything just returned to normal. Market day came and went, the roads re-opened, kids rode to school, and we resumed all of our activities (we had closed everything but the hospital). In the days following I would walk to work and look around wondering if I had just dreamed it all. But I slowly realised that everyone here has seen this before. Not always this violent and bloody, but the same forces at work, the same powers and threats and insecurity. And before I knew it things felt like normal again for me too.
As if that was not enough drama for the fortnight, this week finished with a bloody crash too. I was just about to leave the hospital yesterday when the army jeeps started rolling up. Half a dozen jeeps, 13 bloodied bodies. Not war injuries this time, just a damn big motor vehicle accident!
Profiling ‘Aisha’
Aisha Abdallah Adam, 26 year old new mother of baby Heemdan (who is in hospital with pneumonia).
Aisha is a nomadic woman who lives far from Niertiti with her husband and their extended family. She has the striking beauty, shiny dreadlocks, and strong eyes that typify the nomadic women of Darfur, and her lighter coloured skin reveals the ancestry influence of Arabs from the north. Her family depend on their herd of cattle for their livelihood, and their nomadic lifestyle is dictated by finding pasture and water – an increasingly scarce commodity in these parts. This competition for resources underlies the conflict that has existed for decades between rival nomadic clans and between these clans and the settled agriculture based Fur villages.
Every week Aisha travels in to Niertiti for market day. Market day is a big affair in Niertiti, with people coming from miles away to sell their produce in exchange for other necessities. On this day the town becomes its most multicultural, with Arab nomads, Fur villagers, town residents and traders from the larger cities all coming together to exchange goods. Aisha sits with other brightly dressed nomadic women selling the milk and meat from her family’s herd. They are highly valued commodities and Aisha knows that so long as they have healthy cattle her family will survive.
Market day is also the day when Aisha can go to the MSF women’s health centre for her antenatal checkups – a service that has been very readily embraced by her and many other women. However, like many women who live far from Niertiti, her actual delivery was completed at home with the assistance of a traditional birth attendant and a birthing kit from MSF (with soap, a cloth, sterile razor blade and string for cutting and tying the umbilical cord). The availability of pregnancy care and birthing kits have made a big difference to women and their babies here, but we still regularly see the complications from prolonged labour and neonatal conditions like tetanus from the use of dirty knives in cutting the cord.
The reason Aisha sits in hospital now is because her 30 day old baby has pneumonia, which sits alongside diarrhoeal disease as the biggest cause for hospital admission (and death). But today he looks great, and I tickle his tummy while I tell Aisha that he just needs a final dose of antibiotics before she takes him home. Five days in hospital is a big deal for Aisha, as it means five days away from her work and livelihood. So Aisha smiles happily when I give her the news, and her husband and mother beside her share the relief that he is well and they can now go home. Her mother (an older image of Aisha) who jokes that it looks like I want to keep him for myself. I am tempted (-:
Numbers
1 hospital, 60 inpatients, 120 admissions/discharges per week
1 expat doctor (me), 4 Sudanese doctors
1 expat nurse (currently vacant), 14 nurses/nurse assistants
14 births per week, 1 expat midwife (currently vacant), 5 midwife assistants
3 outpatient clinics (including a mobile clinic, and remote clinic)
7 medical assistants, 1800 outpatient consultations per week
1 inpatient feeding centre, 30 kids, 10 admissions/discharges per week
3 outpatient feeding centres, 150 kids, 20 admissions/discharges per week
1 expat Field coordinator, 1 expat Logistician, and a big team of administrative and support staff.
Kids
Every day I walk slowly to work and pass dozens of kids who wave and call out ‘khawadji’ (roughly translated as foreigner). Some of them are filling up water bottles from the bore well, jumping up and down and using all their little weight to pump the handle. Others are playing with marbles on the ground, or arranging sticks into little houses. Some kids race down the dirt road using a forked stick to role the lid of a tin can along the ground. Others are walking or riding to school dressed in neat uniforms and carrying their books protectively under their arms. When they see me they wave energetically or come over to say ‘salaam’ (peace greetings) and shake my hand. Sometimes one child will take my hand and walk along with me (this is followed by a dozen other kids running up to hang off my arms). I am told that the Persian mystic Rumi always made a point of greeting and blessing children, seeing them as particularly sacred. I like this idea. Imagine if every adult greeted every child with the respect and attention that they greet other adults with.
In the hospital one of the best parts of my job is looking after the sick kids and seeing them get well. It is also the hardest part when they don’t get better. So I was excited to find out last week that I have been offered a job at the Royal Children’s Hospital in Melbourne next year. It also made me think what a different life kids here have compared to the kids I will see next year. It will be nice to work in a place that has such a high quality of care – specialist doctors, all the blood tests, X-rays and scans imaginable, no worries about running out of essential medications. But will I also resent the fact that there is so much excess and waste in Australia? I don’t just mean seeing the bloated bellies of malnourished kids here replaced by the bloated bellies of obese young Australians. But also all those little every day excesses in the home, at work, in the hospitals. Those unnecessary things we convince ourselves are ‘needs’.
Children are one of the world’s great reminders of what is valuable and necessary in life. Things like nutritious food, clean water and sanitation, schooling, safety, shelter and time to play and just be kids. There are dozens of reasons why children here may not enjoy these things that most Australian kids take for granted. Conflict, famine, population displacement, child labour, child soldiers, deceased parents, child-headed household, family illness, poverty…
These are all big, complex issues. But they are also all issues that we in the rich ‘west’ can help to relieve (or perpetuate). From the individual level up to the level of international policy, diplomacy and economics, we can all do something. Maybe it is simply donating to MSF or other relief and development organisations. Maybe it is signing a petition to make essential drugs more accessible to low income countries. Maybe it is lobbying for greater awareness and action on the food crisis being exacerbated by international economic stressors. Maybe it is writing to your member of parliament urging stronger action on alleviating poverty among the neighbours of our global village. Maybe it starts by picking one issue to become better informed about.
The west will not be able to ‘fix’ these problems (indeed, the west has done much to cause and perpetuate them through colonial, economic, social and political misadventure). Real change and development is always indigenous. But there is so much more that can be done to empower disadvantaged communities around the world to make this change. So before I step off my soapbox I unashamedly challenge you to find one small thing you can do to contribute before we reach the end of this year.
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