Mosque Sex Education

Mosque Sex Ed – Profiling ‘Abdullah’ – Christmas –New Year

Christmas greetings from Darfur! Here is another update from Darfur for you to read while you nibble on the leftovers from your Christmas feast.

Sex Education in the Mosque
A couple of months ago I got an unusual request from some community elders. I was invited to visit the local mosques during Friday prayers to talk to the men about sexual health!

How did this come about? Well, as part of my regular teaching sessions with the medical assistants we had been talking about sexually transmitted infections (STIs) and the alarmingly high rates we have detected in the local area. This is particularly concerning because of the damage one particular STI (HIV/AIDS) has done in other parts of Africa. HIV/AIDS is not widespread here currently, but the social stigma regarding condoms and ignorance of sexual health combined with the population displacement and conflict make Darfur a perfect place for a catastrophe. This got one of our older medical assistants thinking, and after talking to some local imams and sheiks he came to me with the idea of having sex education in the mosques!

We brainstormed some ideas together and came up with a 20-minute presentation about nutrition, hygiene and sexual health. Unsurprisingly there are some things I cannot say. For example, I cannot say ‘condoms’ - so instead I say that there are ‘ways of preventing sex infections are available at the hospital’. There are other things I can only say in a particular way. For example, I cannot talk about ‘birth control’ or ‘preventing pregnancy’ - but I can talk about ‘family planning to space children’. The final draft seemed rather simple and quaint to me, but the old medical assistant assured me that it would be great.

Our first talk was three weeks ago, and proved an interesting test case. I dressed up in my best jaalabia (robe), tagia (cap) and markoub (leather shoes) and headed for the Friday prayer gathering at the nearest mosque. After prayers finished the imam announced a special talk by the khawadji doctor from Australia. I took my place at the front with my translator and surveyed the crowd with some trepidation. Two hundred faces looked at me with serious curiosity. I raised both my arms with a hearty Asalaamu alaykum and, having received an encouraging reply, launched into my talk.

All was going unremarkably until I got to the bit about sex, at which stage a murmur ran through the crowd. Then one of the old men sitting closest interrupted my translator to make some comments of his own. Uh oh, did I say something wrong? The attention level was certainly increased. I started talking again and got through the talk without major incident. But as I said thank you and went to sit down a crowd of smiling men crowded around me. They were all holding out their hands to shake, saying thankyou and wishing peace and blessings upon me. I realised with some relief that the talk had been very well received and the interruptions were just to clarify some important points. [The audience particularly liked the Quranic references I slipped in and my (very bad) attempts at speaking Arabic]

Since then I have visited two other mosques with the same message and the effect is filtering all around town. Men chat about it over tea and at work, women talk about it as they collect water and look after their kids. This has all been a very pleasant surprise and it seems my old medical assistant was exactly right about what sort of message to deliver (and how to approach the socially sensitive bits). Next week is my grand finale at the big mosque in the northern IDP camp. It holds a couple of thousand people for Friday prayers so will be quite an experience!

Profiling ‘Abdullah’
Abdullah Mohamed Abdukareem, 4-year-old boy, who has lived his entire life in one of Niertiti’s IDP camps.

Abdullah’s family left their village in 2004 and came with hundreds of others to Niertiti to find safety. His parents only planned to stay until the attacks against villages stopped and it was safe to go home. They had no idea that four years later ‘home’ would still be in the cramped confines of an IDP camp.

Abdullah was born in the shadowy confines of his family’s camp hut. His grandmother (an experienced birth attendant) guided his mother through labour, tied and cut the cord, then cleaned them up and wrapped them in a blanket. It was the rainy season and Abdullah’s mother remembers lying on the bed with her newborn baby watching water leak under the UNICEF tarpaulin and run down the wall. A pot of water boiled on the wood fire in one corner. Their entire possessions were bundled against the opposite wall. At that time their one-room mud hut was home for Abdullah’s three siblings, mother and grandmother (his father was seeking work in a nearby town). I am sure Abdullah’s mother wondered what sort of world she was bringing her newborn son into.

Abdullah spent much of his first year slung on his mother’s back as she went about her daily work. Every day she would trek down to the river to collect water, and then carry it back up. Later on water pumps would be installed which meant she only had to walk a few hundred metres. Once a week Abdullah’s mother would go to the forest to collect wood with the other women and return with it bundled high on their heads. They also wove grass baskets and table mats which they could sell at the market. Once a month they would cue up and collect food rations from the World Food Program (WFP). Every household was issued with ration cards which they would show when they came to receive their portion of grain, oil and beans. Ration cards were valuable and Abdullah’s mother had heard that some people had got more than one while some others had missed out. But everyone she knew had a ration card and they guarded them closely.

By the time Abdullah turned two, life in the camp had improved. His father had found some business trading items at the market. He had also added another room to the hut and fixed up the leaky roof. Abdullah’s mother was kept busy looking after her 4 children. Water pumps had been drilled, pit toilets were dug and areas had been built for washing clothes. There was a new hospital. And the camp population had grown to over 8,000 people.

When Abdullah was four he was brought to the hospital for the first time. He had a high fever and cough and had been complaining of pains in his head and neck. His father had just brought him home after a two-week trading trip out of town. At first his mother thought he had picked up another minor infection. But when she saw him getting sicker in the evening she decided to take him to a doctor. He was looking very sick when he arrived at the hospital and examination showed signs of meningitis. A sample of CSF was taken and the quick-test confirmed meningitis. Antibiotic treatment was started immediately and he made a full recovery over the next 5 days. Fortunately this turned out to be a sporadic case, but after a meningitis outbreak last year (which claimed many young lives) we were all on alert for another epidemic.

Abdullah is now back to playing marbles in the dirt, wrestling with his playmates, chasing chickens and throwing rocks at the donkeys. In the next year or two he will start school. But beyond this his future is uncertain. There is still no possibility of his family returning to their village – a village he only knows through stories. For Abdullah, the IDP camp is his home and will remain so indefinitely. But he has lots of friends living nearby, plenty to explore, a secret hiding place (perfect when he gets in trouble), and a khawadji doctor who might have some dried dates for him today.

Christmas in Darfur
I didn’t really expect much from Christmas this year. Darfur is a long way from family and friends and the people here are mostly Muslim. But while there were no gaudy decorations in the streets, no carols playing in the shops and no extra wads of junk mail in the letterbox, Christmas did not pass unnoticed. In fact, this Christmas has been the most multicultural and multifaith Christmases I have ever celebrated.

The MSF team here is mostly made up of local Darfuris. However, many of the doctors, medical assistants and nurses are from other parts of Sudan, as well as France, Japan, USA and Ethiopia. As we are all living and working together away from our wives, husbands and children we become something of a surrogate family to each other. This was particularly noticeable on Christmas Day. As the sun rose over the Jebel Marra mountains Christians and non-Christians alike rose early to pass around Christmas greetings. Many of the Christians dressed up in their best (and loudest) African dress and headed off to church. A visiting preacher put on a great service, with singing and dancing from many different tribes. Then a feast was prepared and we all shared Christmas in our home away from home.

As we ate we talked about our families back home. Sara, a nurse from south Sudan, told of her own 4 children and the 3 orphaned nieces and nephews she had also taken in. Her eyes welled with tears as she described the joy and pride she felt when she last saw them. They were healthy and going well at school – thanks to the money Alice earns and sends back to them regularly. Andrew, an 80-year-old medical assistant from south Sudan, told me of his life as a guerrilla fighter during the southern resistance movement (including training in Israel!). His children are all grown and scattered around Sudan – and even one in Sydney! Simon, a medical assistant from south Sudan, told me of his wife and 3 children. He gave an aching-heart sigh as he told me of speaking to them on the phone today. It will be another 2 months before he sees them again. Dr Abdulatif is recently married and gave cute love-struck smile when I asked about his habibi.

As I sat among this beautiful bunch of people I thought of the diverse and amazing lives they have all led and the unlikely circumstances that have brought us to Darfur. Here we are working in imperfect harmony to provide health services to people in need. And while we are all driven by different motivations, I was reminded of the simple dreams that we all share. Dreams of peace, health and happiness for our families, friends and communities. It was then I recognised the Christmas spirit was as strong as ever. Here was a spirit of gratitude for the lives we have had, the love we have shared and the relationships that give it all meaning. Here was a spirit of hope for a better future, where everyone can enjoy peace regardless of race, religion or any other artificial segregation.

Happy New Year!
I hope 2008 has taught you plenty and left you with many beautiful memories. It has been a phenomenally memorable year for me! May 2009 see you rise to new challenges, grow closer to friends and family and play a part in making the world a more just and friendly place.

Oranges, Camels, Satellite TV

Vaccinations – Profiling ‘Halima’ – Oranges, Camels, Sat TV

I have spent the last week back up in the Jebel Marra mountains. The purpose of my visit was both to assist with our vaccination campaign and also train the local health workers. It is a beautiful place to visit and I probably won’t get another chance to stay there so I have come away with loads of memories. So join me now visiting some villages, meeting the locals and seeing some funny sights.

Vaccination Campaign
The vaccination team was up at dawn and ready to hit the road with Landcruisers piled high with all the equipment needed to vaccinate a small town. Today the destination was Buldong – a 45 minute drive from our Kutrum base along a series of dusty, rocky tracks in some of the most beautiful country on earth. Along the way our ‘town-crier’ hung out the window bellowing into a loudspeaker reminders that today is vaccination day. The community had already been saturated with news of this with local sheiks, imams, teachers and other leaders spreading the message for weeks prior. Indeed, half the people we passed were heading to Buldong especially for the vaccines – children on donkeys, babies strapped to young girls’ backs, family groups walking briskly in a cloud of dust.

On arrival we met the rest of the team who had made their own way from their respective villages. Already a couple of hundred brightly clad women were sitting in the morning sun with their children awaiting our arrival. Today we would vaccinate around 1000 women and children – a big organisational task. But it was the third and final week of the vaccination campaign so the team was well-oiled and leapt quickly into their respective roles – registration clerks, nutrition screening attendants, crowd controllers, vaccinators, cooks, drivers (whose first job of the day was to slaughter the goat that had been brought for lunch).

Before starting the vaccinations I joined the campaign supervisor, Mama Joanna, in telling everyone about vaccinations and thanking them for coming. I then took the opportunity to spread some health messages about nutrition and hygiene, which were listened to particularly attentively (though I am sure the oddness of who was delivering the message will be remembered much longer than the message itself). Then the women and children all filed through – polio drops, Vitamin A capsules, iodine, measles and pentavalent injections. It took us until late afternoon to finish up and by the time we returned back to Kutrum the sun was sinking below the dusty horizon. It was a good day. After a cold shower I sat down to eat and play cards before retiring early for another early start tomorrow.

The vaccination week finished up successfully and will be followed up in January with a final round to complete the campaign. Vaccine preventable diseases (e.g. measles) are among the biggest killers among displaced and war-affected persons, and in the past couple of years a number of epidemics have swept through Darfur. Since the Jebel Marra villages are all under rebel control there are no government health services – including no immunisations. So the MSF vaccination campaign this year has been a valuable addition to our regular clinic services.

Profiling ‘Halima’
Halima Isak Esau, 23 year old woman from a remote village in the Jebel Marra.

Halima has known war for as long as she can remember, but it was in her teens that she noticed things really changing. Her family is from a village just west of the Jebel Marra and they lived a relatively luxurious life as farmers and traders. Halima remembers market days with pleasure, when visitors would come from all over the region to trade. She particularly loved seeing the Arab nomads who would ride in on camels wearing such exotic clothes and jewellery.

Halima’s father was good friends with one of the old Arab men called Sheik Ahmed. Each week she would see Sheik Ahmed come and join her father to drink fresh milk, eat stewed meat, share stories and laugh loudly a boisterously. One day Sheik Ahmed gave her a purse made from goatskin. She was so delighted that she decided that next time the Sheik visited she would give him some beads that she was putting on a string. But that was the last time she saw Sheik Ahmed. When she asked her father why, her father explained that some bad things had been happening and it was not safe for Sheik Ahmed to visit anymore.

Those bad things would soon come to Halima’s town and send them running for safety. Unlike most of the displaced villagers, who sought sanctuary in the larger towns, Halima’s family fled deeper into the Jebel Marra. This was much less safe – indeed it was the frontline of the war – but Halima’s father believed that they would be better off staying in the mountains. These mountains have now become the heart of a rebel movement that would quickly grow stronger and more organised. Indeed, all of Halima’s brother would end up joining the rebels, growing their hair long with dreadlocks (like their hero Bob Marley), toting old Kalashnikovs, and wearing the SLA badge proudly (which is simply Sudan’s flag upside down).

I met Halima while doing some village visits spreading news about the vaccination campaign. Her family heard brought me to see her after she had been in bed for 2 weeks with fevers and skin sores. After ducking into her hut it took a minute for my eyes to adjust and what I saw was quite shocking. Halima lay in bed with her whole body swollen and seeping with pustules. She was boiling up with fevers and must have been in dreadful pain. After chatting and deciding that she could return with us to the clinic we helped her into the Landcruiser and slowly bumped back along the road.

Three days later she is much improved. The fevers have gone, her skin is healing, her face is showing human features again and she can give me a smile as I say salaam. If Penicillin had a face I would kiss it, such are the miracles the simple antibiotic can produce. She is much better, but still needs follow-up, not least because she was diagnosed with leprosy in the past and it seems she may not have completed all her treatment.

By chance I met one of Halima’s brothers later in the week. He came to the clinic with a group of SLA members to seek treatment for one of their wives. It was after nightfall so they joined us to eat some bread and honey. As we chatted Halima’s brother introduced one of the other guys as a ‘Janjaweed’ and laughed. It turns out that this guy is one of the Arabs who have switched sides to join the SLA against the government. I wondered if he could be related to the Sheik that Halima remembered from her childhood. It is indeed a peculiar world!

Oranges, Camels and Satellite TV
It was Eid holidays this week, and since I was in Kutrum I trotted around doing the obligatory house calls after work each evening. I met lots of beautiful people but a few scenarios stand out.

One evening we walked through the lush orange orchard that is owned by one of our watchmen. It is ironic that his son was treated for malnutrition when their farm is so productive – perhaps a result both of market forces (the best produce is sold) and simple lack of understanding about nutrition. The Jebel Marra is probably the most fertile ground in Sudan and its oranges are particularly famous. I am told that oranges from the Jebel Marra even adorn the tables of the President.

After returning from the orchard we called in to see our triage attendant. As I entered I noticed a huge homemade satellite dish propped against the wall and thought it kinda odd since there was not even electricity here. But after handing around dates and juice our host treated us to a full display of his satellite television setup. For electricity there were two solar panels lying on the grass roof of his hut, alongside a tray of dried tomatoes – both now soaking up the moonlight. He brought the TV outside and propped up against the fence, then proceeded to unroll the electricity and satellite cords over the gravel. After playing around with the set-top box the TV flickers to life and Al-Jazeera news channel shines with crystalline clarity. I am suitably impressed. The entertainment soon draws some neighbouring children, while a curious camel pokes its head over the fence to catch the sports headlines.

I have been continuously impressed with how well informed the people here are about what is happening in the world. Politics is a topic of hot discussion and I am sure that some of the villagers here could outgun our supposed expert foreign correspondents in their commentary on African affairs. They have certainly taught me plenty!