Village Clinic

Mobile Clinic – Profiling ‘Aladeen’ – Parties

I am half way through my mission here in Darfur. I have learnt so much about Darfur, the world and about myself. I have had the opportunity to work with amazing people who, in the face of gross injustice and abuse, refuse to be passive victims and instead find the strength to work for a better future. Today I would like to take to on a journey to our mobile clinic and introduce you to a few more Darfur locals.

Thur Clinic
It is 8:30am and the morning sun has risen from behind the Jebbel Marra mountains to cast an orange glow across the country. Today is my weekly visit to Thur, about 30 minutes drive to the southeast, where MSF runs a clinic three times a week. As I walk into the office to pick up the money and travel documents my driver calls out a cheery ‘salaam’ while polishing the windows of our Landcruiser. Joined by my translator and a medical assistant we load the car with boxes of Plumpy Nut (a peanut-based nutrition supplement), a cold-box full of vaccines, sterile equipment for the dressing room and various other medical bits and pieces. In Thur we will meet the local team who do the actual day to day running of the clinic and are already very well set up.

As we leave Niertiti we check in with the local police and wait while our travel documents are scrutinised (even short day trips like this requires authorisation in advance). I look around to see lots of bored young men in khakis lounging around with rifles slung over their shoulders. We get waved through and start bumping along the road to Thur. In the midst of such tight security I love the drive to Thur as it is the only regular chance I get to leave Niertiti and see some of the beautiful Darfur countryside. Today we pass a herd of camels which cross the road in a cloud of dust. A young nomad boy is perched high on one of the camels and he turns to give us a wave before cracking his whip and moving on.

We slow down every kilometre at the unofficial checkpoints. They are manned by Arab militia (many barely in their teens) who make their living holding up the passing trucks. These are the guys known as ‘Janjaweed’ (devils on horseback) by the other Darfur tribes, including those who have lost family and homes from their raids. It always seems strange to stop and chat, swapping cigarettes and jokes, with guys who may well be responsible for the violence and abuse happening in Darfur every day. But it is also a reminder that we are all humans with the potential for ‘radical evil’ as well as ‘radical good’ (to use Emmanuel Kant’s phrase). And if it had been a different group given the arms, money, power and permission the balance of power could be reversed.

Arriving in Thur we weave through the market day masses to our clinic. As we unload and set up there are already dozens of people waiting and our 15 local staff are busy doing registration, taking vital sign, weighing children, doing dressings, pregnancy check-ups and nutrition reviews. Today I begin by seeing the guys doing nutrition screening and the nutrition assistant who manages the outpatient malnutrition program. We are currently seeing a very high rate of malnutrition from this area and the nutrition program has blown out to over 100 children. This is bigger than any of our other nutrition programs and is ringing alarm bells for me so I need to make sure all the screening and treatment is being done correctly. I find that the screening is accurate with particularly high rates of malnutrition in an area a few kilometres south (which has been particularly affected by bad harvests). With the nutrition assistant I work out some areas the treatment can be improved, then leave him to see the kids and give out lots of Plumpy Nut.

The rest of my day is spent doing consultations – malaria, typhoid, scabies, diarrhoea, coughs and colds, pneumonia, complicated malnutrition, pregnancy complaints, urinary tract infections, STIs… At 4:00 we rush around making sure the sickest patients have been seen then have to turn the others away so we can make it back by curfew (any later and we risk being victim of car-jacking by the militia). We pile back into the car, taking with us a few women and children needing admission to hospital – two infants with diarrhoea and dehydration and a girl with severe malaria.

The return journey is without incident and as we arrive back in Niertiti I join my colleagues is breathing ‘Alhamdulillah’ (thanks/praise God) for a safe and productive day.

Profiling ‘Aladeen’
Aladeen Abakar Suliman, 18 month old boy who attends our Thur Nutrition program.

Aladeen lives with his family in Kass, a village about 15 kms southeast of Niertiti. They have been in the area for generations and are among the lucky ones who have not been displaced by the current conflict. But this does not mean they are unaffected. Like most families in the area they rely on agriculture for a living. Good agricultural land has always been scarce and the land has become increasingly degraded since an earthquake 10 years ago the main river flowing from the Jebel Marra mountains. Recent conflict has not only limited the areas they can farm (due to security) but also seen hundreds of additional families relocated into the area. While most of these families stay with relatives who are already in the area it means the already scarce resources need to be stretched even further. And it because of this background of food insecurity that I meet Aladeen and his family.

Aladeen first came to the MSF mobile clinic one month ago. His limbs and face were wasted, his legs swollen, his skin peeling and he stared listlessly at me as I examined him. These are the classic signs of severe malnutrition – signs I had never seen outside of textbooks before coming to Africa but which now confront me every week. We brought him back to the hospital and he was admitted to the TFC (therapeutic feeding centre) for intensive nutritional care. In addition to high-energy, high-protein food, children are also given vitamin supplements, measles immunisation, de-worming treatment, tested for malaria and treated for any other medical conditions. Within two weeks of intensive nutritional care he was looking like a new child – inquisitive eyes, grabbing hands, and glowing new skin.

On my last visit to Thur, Aladeen was ready to be discharged from the program. He should now have the strength to make it through the rest of the childhood risk period and grow up healthy and strong. Of course, the underlying causes of his malnutrition remain (conflict, environmental destruction, poverty…), and until these issues are addressed we will continue to see more children like him come to our clinics.

Parties
It is not all work and no play here in Darfur, and the last couple of weeks I have been invited to a couple of parties. It was a goodbye party for a local UNICEF worker who was leaving to get married and it seemed like everybody came by to wish him well. There were plenty of sweets, loud music and typically restrained Sudanese dancing (except for one young boy who really ripped up the dance floor!). Everyone was decked out in their finest clothes, with the men competing against each other for the biggest turban and flashiest walking cane. I had my hand painted with henna – and the orange stain is still giving the locals a laugh as they ask me who my new bride is.