Médecins Sans Frontières Suspends Work in Detention Centres in Misrata
Pibor, South Sudan, 23 January 2012
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20 January, 2009
Farewells
My last few weeks were spent tying up loose ends, completing some pet projects and saying lots of goodbyes. The end of my mission has come so quickly, but as I reflect on everything that I have seen and done I find it difficult to believe it is has been only 6 months. A list of highlights is impossible, but here are a few memories from my last week.
Homecoming Challenges
Since leaving Darfur I passed through Paris, Sydney and Melbourne before heading to Tasmania to spend some quality time with my family. I am still reaching for the mosquito net when I wake up, but the novelty of hot water has faded and I actually wonder if squat toilets are not anatomically better for bowel functioning. I know culture shock is invariably worse on return home and I am sure it will be awhile before things get back to ‘normal’. I just hope I can find enough friends who I can continue to share my experience with – there is nothing worse than finding those closest are apathetic about something I am so passionate about. So I will ask you (as I ask myself) what now? Will this adventure just be filed in the ‘interesting story’ box or is there something more that we can do?
Personally, I don’t want my involvement with Darfur to end here.
24 December 2008
Profiling 'Abdullah'
Abdullah (real name not used for privacy and security reasons), is a four 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. 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'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 four 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 8000 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 five 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 Médecins Sans Frontières 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 all talked about our families back home. 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.
12 December 2008
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. There are no government health services in the Jebel Marra region, including no immunisations. So the Médecins Sans Frontières vaccination campaign this year has been a valuable addition to our regular clinic services.
28 November 2008
I have just returned to Darfur after enjoying a week of rest and rejuvenation in Cairo, Egypt. My 'holiday' was nice - I visited the pyramids, camped in the desert, made new friends and avoided becoming a road trauma statistic - but I am very pleased to be back to work in Niertiti.
What's New?
Returning to the field after my break I was surprised how much news there was to catch up on - good, bad, quirky and frustrating. Construction of a new sheltered area in the hospital courtyard is complete. Built from tree branches and grass it now gives a cool shaded area for patients and their families - and room to triage. A new doctor and medical assistant had arrived, as well as the new international staff midwife and remote clinic doctor - finally giving us an almost full medical team.
IBM Language
There are three words in Arabic that visitors to Sudan cannot avoid - insha'allah, bukra, malesh. Sometimes it seems that entire conversations can be based around this IBM vocabulary. I was at the airport the other day and arrived at check-in to find my flight cancelled. "Malesh" the attendant sympathized. When will the next flight be? "Bukra - insha'allah", and off I went to return the next day. So for anyone planning a trip to the Arabic speaking world, learn these.
a.. Insha'allah means 'God willing' and is a disclaimer for any future plans.
b.. Bukra means 'tomorrow', which is when most things will happen (insha'allah).
c.. Malesh means 'sorry' or 'too bad' and is usually said with a big grin when something has just gone wrong.
In Darfur this language carries a deeper meaning and conveys a fascinating mixture of hope and fate. People here are faced with huge challenges, frequent disappointments and never know what tomorrow might bring. A mother sitting beside her dying son looks up at me when I explain we are doing all we can and says insha'allah, reminding me that despite our best efforts ultimately he is in the 'hands of God'. Our car slides down a muddy bank into a river and the driver smiles malesh, then we all pile out to drag the car back onto the road. My assistant tells me of the raid on his village and how difficult life is as a displaced person, then startles me with his dream of resuming his study bukra, when there is peace. In this case bukra still seems a long way off.
24 October 2008
Unpredictability
Hours after I last emailed, things got pretty hot here with the acceleration of sporadic shooting. At the hospital, we saw bullets in chests, and abdomens, and necks, and legs… One miracle man had a bullet course right through his neck without destroying any vital structures.
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. And before I knew it, things felt like normal again for me too.
Profiling ‘Aisha’
Aisha (real name cannot be used for privacy and security reasons) is the 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 depends 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 into 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 Médecins Sans Frontières 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 Médecins Sans Frontières (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, caused by 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 M that he just needs a final dose of antibiotics before she takes him home. Five days in hospital is a big deal for M, as it means five days away from her work and livelihood. So she 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, jokes that it looks like I want to keep him for myself. I am tempted. 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, deceased parents, child-headed household, family illness, poverty…
From Darfur with love,
Hamish.
10 October, 2008
I have been here in Darfur for almost two months now and continue to experience a crazy mix of exhaustion, exhilaration, frustration, anticipation, despair and hope. But things have also become very ‘normalised’ (a psychological coping strategy that I am sure all humanitarian workers experience).
Working here is a huge balancing act just trying to do the best within our limitations. I am frequently reminded that we can only do so much, we cannot save the world, and that without us there would be no access to health services at all. It is very true.
A Day in the life (Part II)
In the last letter, I began to describe the nuts-and-bolts of daily life as a medical humanitarian aid worker. I left the story at the end of the hospital ward round, so will pick it up from there now.
By the time the ward round is finished, it is early afternoon. Usually I take a lunch break, but it is the fasting month of Ramadan now so I convince my translator to skip his break and promise we will finish up early. By now there is a line of patients waiting outside the doctor’s consultation room who have been referred by the medical assistants in the outpatient department for review. I admit a child with pneumonia, a man with hepatitis, and a woman with pyelonephritis.* Another child comes with suspected appendicitis, so I arrange for him to be transferred by taxi to Zalengei hospital, two hours to the west. I lance a big boil on a boy’s leg, review a couple of nasty wounds, and find the other referred patients can be treated without needing admission.
After reviewing a few of the sick patients from the ward round, I handover to the other doctor and collect together all the patient files to collate for the statistics. Today I am pleased to handover by 3:30pm (usually it is closer to 5pm) and get back to the office to start on the stats. It is part of my job to do the stats and medical reports, as well as organise medical education, look after staff health and supervise the hospital, nutrition program, outpatient department and mobile clinics.
I try to get all this finished by 6pm, though today we have the end-of-week team meeting that stretches a bit later. This last week has been particularly busy as we are short-staffed and my big reports were all due. So I have been burning the midnight oil to push out a 75+ hour week (finishing each night in the dark as the generator switches itself off at midnight). This is certainly not something I plan to make a habit of! I promise myself no paperwork tonight and a full day of rest on Friday (our one-day weekend).
I return to the living quarters, throw down my gear, have a wash and do some cooking (we have a cook who prepares our evening meals, but I usually like to cook something extra myself). Sunset is around 7:30pm, and during Ramadan I have made a habit of joining the other non-local Sudanese staff (who live in the same compound as I do) for the evening breaking of fast. We kick back, eat, drink tea and chat. I hear all about upcoming marriages, how life is away from family, which villages they are from, and what their plans in life are. It is always intriguing to hear common human aspirations and life experiences presented with their unique cultural and individual expressions.
By the time we finish chatting, it is after 9pm and I am ready to wind down and go to bed. So after my evening exercises, reading and meditation, I duck under my mosquito net and drift to sleep.
Rich Africa
A friend reminded me by email of the richness of life in Africa – “a richness not defined in dollars, cents and possessions…”. It is a blessing to be working in such an environment (and without the ‘unnecessary necessities’ of my car, house, mobile phone, career, shares, technology etc.). And perhaps it can also be a reminder to all of us about what is truly important and necessary in life.
From Darfur with love,
Hamish.
* Pyelonephritis is inflammation of the kidney and its pelvis caused by bacterial infection.
12 September, 2008
It is a beautiful sunny Friday in Niertiti, my one free day for the week, and I have just returned from a stroll along the river. In the midst of the Darfur chaos, it is so essential to take time out and observe the peace and beauty that surrounds me.
Seeing the beauty
It is a particularly impressive time of the year now, with regular rain keeping the rivers and waterfalls flowing and the hills covered in green vegetation. As I meandered along the river, dozens of men, women and children were bathing and washing clothes, the rocks covered with bright dresses, shawls and shirts drying in the sun. Smaller children splashed and jumped around in the pools, and made a particular effort to show off when they saw a khawadji (foreigner) walking past. Their smiles and laughter never fail to amuse me, and I had had more than a passing thought to throw off my shirt and join them under the waterfall today!
Burnt out villages
One of the enduring images of my trip into the Jebel is seeing the remains of burnt out Fur villages. Mud brick walls of houses still stand, without roofs and charred black from fire.
Here in Niertiti there are around 24,000 internally displaced people (a relatively small camp), with most arriving here in 2004 after the first big wave of violence. However, attacks have continued all over Darfur, and the last big influx to Niertiti was as recently as December 2007. In the whole of Darfur, over 2.2 million people have been displaced – accounting for more than one quarter of the world’s refugees and displaced persons. These numbers are way too big for me to comprehend. But seeing the numbers translate into real people; that is something even more mind-blowing.
In hope
Equally incomprehensible is how people here manage to do so well. After all that they have been through and the daily struggle of survival, the astonishing thing is that people don’t just give up. Maybe it is an innate survival instinct, maybe it is the hope that things will improve, or maybe it is just the fact that they all have children/parents/friends who continue to give life meaning and purpose. I don’t know, but for this hope I am extremely grateful and very humbled.
I realise that this letter I have completed neglected the medical side of what I do here. Most of my time is spent consulting with patients, supporting the medical assistants and keeping the medical side of things running smoothly. In the past three weeks, I have seen things ranging from the bizarre to the tragic, from donkey attacks to kids dying from renal failure, from obscure tropical diseases to the pussiest abscesses imaginable. But more on that next time…
From Darfur with love,
Hamish
7 September, 2008
I am halfway 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 you 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 Jebel 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 Médecins Sans Frontières runs a clinic three times a week. As I walk into the office 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 therapeutic food, 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.
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.
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 signs, 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 and is showing 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 therapeutic food.
The rest of my day is spent doing consultations – malaria, typhoid, scabies, diarrhoea, coughs and colds, pneumonia, complicated malnutrition, pregnancy complaints, urinary tract infections, sexually transmitted infections… At 4:00pm, 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. 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 lives with his family in Kass, a village about 15 km 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 hit 10 years ago. Recent conflict has not only limited the areas they can farm (due to security), but has 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 is because of this background of food insecurity that I meet Aladeen and his family.
Aladeen first came to the Médecins Sans Frontières 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 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. 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 Aladeen 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. Aladeen (real name cannot be used for privacy and security reasons) is an 18 month old boy who attends our Thur nutrition program.
From Darfur with love,
Hamish.
26 August, 2008
It is now one week since I landed in Niertiti. I am still finding my feet here, and this letter will no doubt betray the fact that I have teetered on the edge of being overwhelmed by the situation here. There are three obvious reasons for this. Firstly, the clinical side of things is insane and the resources so very limited. Secondly, this is Darfur and the recent and ongoing events are evident everywhere. And thirdly, perhaps most significantly, I have a warm home and secure life to return home to in six months’ time regardless of what goes down here. For the 23 000 internally displaced people, the ‘security’ of the camps here and the skeleton services provided by humanitarian organisations is all they have – and even that could be ripped away at any minute. This stark reality was beaten into me on day one and I don’t think I can ever really reconcile how these two worlds can co-exist.
Inside a camp
I’d always wondered what it would feel like being inside a refugee camp. Sure, we have all seen the pictures on TV, but what is it really like? After touching down in the helicopter, one of the first things I did was to walk through the camps with a local Médecins Sans Frontières worker, herself an internally displaced person. This was not only informative, but an encouraging start to my mission.
The camps are rather haphazard, poorly defined affairs, emerging from the edges of the town itself and extending out into the plains. Most residents have been here for at least a few years so the dwellings are quite impressive little mud-brick homes, with an average of eight or ten people staying in each. The pride the people take in their homes is impressive and I was really amazed to see how liveable such a situation could be made. I ducked into one residence and was introduced to the four generations housed within. The feisty great grandmother pulled me inside to point out her small wood-fired cooking pit and the jumble of pots and blankets that constituted their entire estate. There was no shame; and nothing to hide; just smiles, openness and profuse thanks for being there (not that I had even done a single thing for her to thank me for yet).
Bore wells have been installed at points throughout the camp with communal clothes washing areas alongside. Pit-latrines are shared, one between about half a dozen households. At the edge of each ‘block’ is a kind of carpark – only it is for donkeys not automobiles. And from what I can see, donkeys are driven hard, being the grunt behind the transport of everything from food rations, to firewood, to families.
As I left the camps, I felt really uplifted and affirmed, as the world had just confirmed to me that this is exactly where I was meant to be.
Reality check
The next morning seriously brought my elation down to earth. Overnight there were gun-shots I am assured that this is a rarity, but as I lay in bed the following night thinking of the crowded mud brick houses of the camp residents I realised what it meant to be truly vulnerable.
Since then, I have seen dozens more reasons for both elation and dismay. If vulnerability is the defining feature of displaced persons, then their response to this surely shows the depth of the human capacity to survive. So while my hospital round each day is full of kids and adults who have tipped over the edge of vulnerability; it is also full of survivors against all odds. I see seriously sick kids and adults make amazing recoveries, and know that this is mirrored in their families and communities who seem to bounce back from almost every assault.
I suppose as a fresh medical aid worker this paradox is the most important thing to hold on to. To see both the suffering and the joy; the trials and the survival; the sickness and the life. I will no doubt need regular reminders of this, so pray that in another few months I will not be either calloused or broken.
Signing off from Darfur with love,
Hamish