Every American living abroad wrestles with some aspect of overseas life, regardless of the number of years on foreign soil. For one of my friends it’s the lack of privacy; for another, not having someone that can relate to her personal issues. Mine is the attention I attract as a foreigner and a white person.
I have never enjoyed being stared at. I can’t imagine many people do, but some are not as bothered by it. In Kazakhstan, depending on how I dressed, I could pass for a Russian – that is until I began to speak and people recognized my clumsy elementary language skills and bad accent. People stared, but not as much as the people do here. In South Sudan, I have no chance of assimilating or blending into the community. At every instance in which I leave the confines of our compound where we work or the UNICEF compound at which we live, heads start turning and people begin unapologetically and unabashedly staring, their gaze as intense as the noonday summer sun. It always surprises me -- it’s not as if this town is virgin territory for foreigners. The various United Nations agencies and the non-governmental organizations working here are many. And while most of these organizations’ employees are African, Yambio is the working home to a few white folks from Canada, Australia, Germany, England, as well as the United States.
So, every day when we take our pre-dinner stroll, I mentally prepare to become the evening spectacle. The reactions vary. The men stare; the women and elderly (few and far between in this country) offer polite, dignified greetings -- if I initiate the exchange; and the boys who are beyond the age of 8 simply give me a look that seems to say “Who you talking to?” They are too cool to bother.
It’s the response from the children that I enjoy. Before I even see the kids that are tucked behind tukuls and trees, I hear the cry of “Kajawa!” (white person) as it’s repeated down the line in Paul Revere style. When I’m feeling sassy, I reply “Sudanese!” knowing they won’t understand my language or my supposed humor. They giggle with delight and gather for a look. Some come forward to offer shy grins and tentative handshakes, their bellies bulging beneath their shirts and dirt staining their beautiful faces. Those who know a few words of English ask “How are you?” “Fine. How are you?” I answer. “How are you,” comes the circular reply. All are surprised when I say the one word I know in Zande – “Guinea Pie (hello),” to which they are to reply “Pie-tay (fine).” But what they really want to hear me say is “bye, bye.” Somewhere along the line the kids began to believe this is how we say hello in English. In another comedy of translation and identity, the “foreigner is coming” call is sometimes issued as “Bangaladee!” The United Nations Mission in Sudan – the police charged with monitoring the Comprehensive Peace Agreement – is largely comprised of soldiers from Bangladesh. Somehow their presence has the kids believing that either “Bangaladee” is another word for foreigner, or that all foreigners are from Bangladesh. Every time I hear it, I can’t help but laugh, never before having been mistaken as an Asian.
By any name, I will happily continue receiving the greetings from these little ambassadors of New Sudan.
p.s. Those of you wondering about the condition of my colleague Val: she was diagnosed with pneumonia and environmentally induced asthma, the former brought on by the amount of dust hanging in the air during the dry season. She has recovered and is happily working again in Tambura to defeat gender based violence.
Thursday, January 25
I’ve been thinking about gender a lot lately. It seems I can’t escape it. Many of the conversations with our Sudanese staff – which his comprised largely of men – inevitably center on gender. It’s not a problem, but it is interesting to be reminded of one’s gender on a regular basis. The most hilarious example of the week involves a trip to our primary health care center in Sakure, not far from the border with Congo, to investigate whether fears of a meningitis outbreak have merit. The roads being what they are in Sudan, the journey takes about an hour and a half at speeds between 30 and 40 kilometers. We expect to encounter two bridges, but are unsure if we’ll find them capable of handling a vehicle. The first bridge, comprised of hewn trees placed side by side, is deemed safe by Dominique, our driver, who walks into the middle of the structure, jumps up and down once, and calls it good. But my survival instinct rises and I decide to cross the bridge on foot. My guise is that I must take a photo of the vehicle making the passage, a ruse that is quickly called. “You know men are stronger than women – that is why we stayed in the vehicle while you crossed the bridge on foot,” says Samuel. “Someone had to be available to call for help if the bridge collapsed,” I reply. It’s all in good humor. The men-versus-women banter continues as we push through brush, branches slapping against the vehicle like rotating brushes in an automatic car wash. Martha, no pushover herself, steps in: “Women are stronger than men. What do men do? They lie around. Women can do all – cook, clean, gather water, collect firewood, care for the children, care for each other -- but men can’t do anything without women. Look at Miranda. She is stronger than a man. She is in the field.” She doesn’t mention herself.
The afternoon passes quickly at the care center. Martha takes an inventory in the pharmacy. The county’s chief medical officer examines patients suspected of having meningitis and orders lumbar punctures to be carried out on two people – despite the fact that these samples won’t be able to confirm meningitis as the sick have been on medication. Samuel conducts a meeting with the village health committee in preparation for building sleeping accommodations for the center’s chief medical person. By the time everyone is done with their respective tasks, the lunch is nearly finished. Samuel grabs one of the two plates remaining; the chief medical officer, Jemis, who happens to be Samuel’s uncle, takes the other. Martha and I are welcomed to take from the platter of oranges in the center of the floor. “Why don’t you eat?” asks Jemis. “I did. I had an orange,” I say. “One lemon is nothing,” he says, shoveling piles of rice and bush meat into his mouth. I’m unsure of what I’m supposed to eat. Surely he doesn’t expect me to eat every orange on the platter. And then, somehow, the men-versus-women topic rises anew. “You know, men are stronger than women. Men can go longer without food than women,” says Jemis, his lips greasy with palm oil. Samuel joins in. “Actually I heard women can last longer than men during a famine because of their breasts,” motioning to his chest while looking at mine.On the rough-and-tumble way home, Samuel, who has been suffering from malaria for more than a week, offers up an unsolicited explanation, perhaps as an unnecessary apology. “There were only two spoons and I needed to eat to make this ride home.” I bite my tongue and smile to myself, bracing for the next jarring bump in the road.
Considering the theme of the week, it’s fitting that it ends with me and Martha sitting in a circle of 20 women at the YWCA. The meeting announcement – handwritten on a simple piece of paper – called on IMC to attend an urgent meeting with “Her Excellency,” the state minister of social welfare. A half hour after the designated meeting time, the minister arrives with her female colleague, the minister of education, in matching tinted-window Land Cruisers. Their beret-wearing soldier and his AK-47 stands guard at the bamboo fence. Their drivers are sent to purchase a case of warm Coca-Colas with pull-tab tops and Arabic labeling. The only man within the circle of women is tasked with taking notes for the minister. Representing any one of the 19 women’s groups in the area, each woman in turn tells of her activities – soap making, tailoring, weaving, facility rentals, HIV counseling. With the meeting being conducted in Arabic, Martha translates for me until her mind drifts off to a place only she knows. I practice looking engaged for three hours, despite only being able to understand the few words mentioned in English: Tuesdays and Fridays, $400, IMC, HIV, tailoring, juice, no respect. It’s clear that the meeting has become part support group. I wonder if this is what the early days of the women’s liberation movement in the United States were like – a hybrid of agenda-setting business and supportive sisterly care.
Now my mind begins to wander from the meeting, soaring over the dirt soccer field with the eagles. My life couldn’t be more different from those of the women surrounding me. As a woman from a country that has mostly worked through the growing pains of equal opportunity and equality, I have choices that are limited only by my fears. Sudanese women have no choice but to marry, to have children, to stay within the confines of their country unless forced out by warfare and natural disasters. It’s not uncommon here for women – girls, really – to marry at the age of 14 and 15. About 28 percent of women are married to men who have other wives, which from a public health standpoint is an invitation to sexually transmitted diseases and HIV. And all women are expected to have babies at each and every opportunity that their bodies allow. Family planning, even for the sake of spacing the children so that the mother’s health isn’t jeopardized, is nonexistent. Women whose bodies won’t allow them to conceive are left by husbands, and sometimes shunned by mothers and fathers. What would these women think of me if they knew my demographics – 40, single, no children? We may be seated elbow to elbow on this waning afternoon, but I know that in many ways we remain worlds apart. With all the facts on the table, would these strong, beautiful women think it was them who had been dealt an empty hand, or me?
Friday, January 19
Johnny Cash is coming through on the stereo - “Precious Lord, take my hand, lead me on, help me stand, I am weak, I am tired, I am worn…” – as we bounce across Yambio County. Milton, the driver, wearing a Mohamed Ali collared shirt, is fond of the cassette tape and pops it in at every opportunity. It doesn’t distract him from bearing down on the gas pedal as he points the vehicle with precision into the ruts of the dirt road that is no wider than the Land Cruiser itself. Fleeing the path in front of us in every direction are entire families on bicycles, women wearing hats of firewood, children plucking papayas from the trees. Men digging a grave stop, shovels in mid-dig, and stare as we fly past. I’m with the immunization team, headed to our primary health care unit in Masumbu village.
A small group of women is already gathered at the modest two-room brick health care unit upon our arrival. Each holds nothing more than a baby in their arms. There are no diaper bags, no shiny plastic keep-the-baby-happy toys, no pacifiers. It is a simple landscape of babies and breasts bared for feeding. The children are dressed in matching T-shirts and shorts or frilly dresses and pretty headbands, their hair in braids, their feet in flip flops. All are oblivious as to what will come on vaccination day in the village.
But first there are procedures. A small lecture about the necessity of vaccinations is given by the smiling county health department worker. A formal group prayer is presented by a mother, everyone bowing their heads in respect. The women sit hip-to-hip on the benches, the first giving the registrar her child’s name, age and past immunizations before taking the center seat of pending torture, the next woman scooting forward. The assembly line has begun.
The shrieking screams start with the needle’s plunge into flesh. A shot to the upper arm prevents measles and one shot to the thigh prevents diphtheria, tetanus and pertussis. Three quick drops of an oral vaccination into mouths wide open with shock and awe prevent polio. It doesn’t take long for the babes in wait to become wise. We watch for the ones who begin crying when yet six stops down the line. These are the ones who kick so fiercely that Martha must hold their legs in place. Mothers who aren’t grasping their children securely enough to prevent wiggling are given a terse finger waiving by the needle-carrying vaccinator who otherwise looks as bored as if she were waiting to pay her taxes.
The wailing wall is heavy with action for four hours. The ringing in my ears has me sure I have witnessed hundreds of babies receiving immunizations. The final tally: 65 children have been vaccinated and about 60 mothers have been given bed nets to protect against malaria-carrying mosquitoes during the night. I am exhausted and I have done nothing but watch. “Congratulations, Martha,” I say, as we seek shade. “You have done good work, even if you have made every child in the village cry today.” “Yes, we have come to receive the noise,” she laughs.
It costs only $20 to fully immunize a child. In helping Kara with her health assessment survey in the neighboring county of Tambura, we learned that only 16.5% of the children under the age of 1 had received all recommended vaccinations, and 15.7% had never received a single immunization of any type. The importance of immunizations cannot be overstated. Only two months ago an outbreak of meningitis killed 11 people here in Yambio County.
Frankly, it is all easier said than done. Travel is difficult here, so sending an advance team to notify the community of vaccination days is often not feasible. Having routine immunization days would provide continuity and perhaps increase attendance. Furthermore, vaccines must be kept cold until administered. The county health department vaccinators carry small coolers to sites for special immunization days. But to allow the regular staff of the primary health care units to provide immunizations on any given day, vaccinations must be supplied regularly – a nearly insurmountable task during the rainy season. Without electricity, refrigerators here are fueled by kerosene. But this too can prove problematic if kerosene is in short supply or the refrigerator begins malfunctioning.
But on this day, 65 children have been immunized. It’s not the country, nor the county, not even the entire village, but it’s a start. Many on this continent teaming with infectious diseases have not been reached. Back in the vehicle for the return trip, Johnny Cash says it all - “Precious Lord, take my hand, lead me on, help me stand, I am weak, I am tired, I am worn…”
A small group of women is already gathered at the modest two-room brick health care unit upon our arrival. Each holds nothing more than a baby in their arms. There are no diaper bags, no shiny plastic keep-the-baby-happy toys, no pacifiers. It is a simple landscape of babies and breasts bared for feeding. The children are dressed in matching T-shirts and shorts or frilly dresses and pretty headbands, their hair in braids, their feet in flip flops. All are oblivious as to what will come on vaccination day in the village.
But first there are procedures. A small lecture about the necessity of vaccinations is given by the smiling county health department worker. A formal group prayer is presented by a mother, everyone bowing their heads in respect. The women sit hip-to-hip on the benches, the first giving the registrar her child’s name, age and past immunizations before taking the center seat of pending torture, the next woman scooting forward. The assembly line has begun.
The shrieking screams start with the needle’s plunge into flesh. A shot to the upper arm prevents measles and one shot to the thigh prevents diphtheria, tetanus and pertussis. Three quick drops of an oral vaccination into mouths wide open with shock and awe prevent polio. It doesn’t take long for the babes in wait to become wise. We watch for the ones who begin crying when yet six stops down the line. These are the ones who kick so fiercely that Martha must hold their legs in place. Mothers who aren’t grasping their children securely enough to prevent wiggling are given a terse finger waiving by the needle-carrying vaccinator who otherwise looks as bored as if she were waiting to pay her taxes.The wailing wall is heavy with action for four hours. The ringing in my ears has me sure I have witnessed hundreds of babies receiving immunizations. The final tally: 65 children have been vaccinated and about 60 mothers have been given bed nets to protect against malaria-carrying mosquitoes during the night. I am exhausted and I have done nothing but watch. “Congratulations, Martha,” I say, as we seek shade. “You have done good work, even if you have made every child in the village cry today.” “Yes, we have come to receive the noise,” she laughs.
It costs only $20 to fully immunize a child. In helping Kara with her health assessment survey in the neighboring county of Tambura, we learned that only 16.5% of the children under the age of 1 had received all recommended vaccinations, and 15.7% had never received a single immunization of any type. The importance of immunizations cannot be overstated. Only two months ago an outbreak of meningitis killed 11 people here in Yambio County.
Frankly, it is all easier said than done. Travel is difficult here, so sending an advance team to notify the community of vaccination days is often not feasible. Having routine immunization days would provide continuity and perhaps increase attendance. Furthermore, vaccines must be kept cold until administered. The county health department vaccinators carry small coolers to sites for special immunization days. But to allow the regular staff of the primary health care units to provide immunizations on any given day, vaccinations must be supplied regularly – a nearly insurmountable task during the rainy season. Without electricity, refrigerators here are fueled by kerosene. But this too can prove problematic if kerosene is in short supply or the refrigerator begins malfunctioning.
But on this day, 65 children have been immunized. It’s not the country, nor the county, not even the entire village, but it’s a start. Many on this continent teaming with infectious diseases have not been reached. Back in the vehicle for the return trip, Johnny Cash says it all - “Precious Lord, take my hand, lead me on, help me stand, I am weak, I am tired, I am worn…”
Saturday, January 13
I am worried about Val, our new gender based violence coordinator from Canada who is based in Tambura. When I left our post there on Tuesday, Val had a serious chest cold. Thursday evening she began having difficulty breathing. By noon Friday her condition had worsened. She had never had asthma. Was it that, or was she was having an allergic reaction? There are no diagnostics at Tambura’s hospital and the medications are limited. At 4 p.m. she was evacuated by a United Nations plane. We wait for word.
The situation typifies the broken medical system here. The war disrupted everything. IMC’s philosophy is to hire local people and train them further. As the lead agency for the Sudan Health Transformation Project, we have developed a string of modest health facilities throughout two counties. The Primary Health Care Units (PHCUs) are staffed by community health workers who generally have nine months of training. They are capable of treating the more common illnesses, such as malaria, diarrhea, coughs and the like. More complicated cases are referred to a Primary Health Care Centers (PHCCs). A person requiring advanced care is sent to the county hospital, managed by the government. However, the hospitals don’t have equipment and aren’t staffed full time by doctors. Traveling to a hospital in Kenya or Uganda is not possible. The only vehicles here are those owned by the United Nations and NGOs. And even if there were vehicles, road travel is long and arduous, particularly when the rains wash out the dirt roads. Only NGO staff has the means to be evacuated by airplane. The irony is not lost on us.
The one doctor and one or two nurses we employ at each of our compounds do not provide direct care; they manage the IMC medical division, ensuring that PHCU and PHCC staff receives refresher training; that the facilities are stocked with drugs; and that the cold chain for the preservation of vaccines is functioning.
One of the largest obstacles to restoring the primary health care system is the dearth of medically skilled people. Men from the ages of 30 to 50 were, for the most part, were not educated in full; they went off to the war. The 20-something set, like our Drs. Nicholas and Alfred, is the first to receive post-war degrees, but they are few and far between in rural areas. A colleague, a nurse who previously worked for Doctors Without Borders, said he was dismayed at the number of people in dire straights waiting in vain for care at the Yambio Hospital. If he were Sudanese, he said, he would have forced his way into the hospital and rendered care. If questioned, he would have said his was fulfilling his duty to his people. But, he is Kenyan. He sees that the Sudanese are numb to death, having seen so many people die during the past two decades. In some ways, the war has never ended.
The situation typifies the broken medical system here. The war disrupted everything. IMC’s philosophy is to hire local people and train them further. As the lead agency for the Sudan Health Transformation Project, we have developed a string of modest health facilities throughout two counties. The Primary Health Care Units (PHCUs) are staffed by community health workers who generally have nine months of training. They are capable of treating the more common illnesses, such as malaria, diarrhea, coughs and the like. More complicated cases are referred to a Primary Health Care Centers (PHCCs). A person requiring advanced care is sent to the county hospital, managed by the government. However, the hospitals don’t have equipment and aren’t staffed full time by doctors. Traveling to a hospital in Kenya or Uganda is not possible. The only vehicles here are those owned by the United Nations and NGOs. And even if there were vehicles, road travel is long and arduous, particularly when the rains wash out the dirt roads. Only NGO staff has the means to be evacuated by airplane. The irony is not lost on us.
The one doctor and one or two nurses we employ at each of our compounds do not provide direct care; they manage the IMC medical division, ensuring that PHCU and PHCC staff receives refresher training; that the facilities are stocked with drugs; and that the cold chain for the preservation of vaccines is functioning.
One of the largest obstacles to restoring the primary health care system is the dearth of medically skilled people. Men from the ages of 30 to 50 were, for the most part, were not educated in full; they went off to the war. The 20-something set, like our Drs. Nicholas and Alfred, is the first to receive post-war degrees, but they are few and far between in rural areas. A colleague, a nurse who previously worked for Doctors Without Borders, said he was dismayed at the number of people in dire straights waiting in vain for care at the Yambio Hospital. If he were Sudanese, he said, he would have forced his way into the hospital and rendered care. If questioned, he would have said his was fulfilling his duty to his people. But, he is Kenyan. He sees that the Sudanese are numb to death, having seen so many people die during the past two decades. In some ways, the war has never ended.
Friday, January 12
In the few days I have been here in Yambio, Martha and I have adopted the habit of a long evening walk. Each night we take a different route, winding through the market or through gatherings of tukuls. We attract attention. I am white and obviously not from these parts. Martha, who is our nurse, is from the Upper Nile region of South Sudan. She is noticeably tall, endlessly thin and has glorious black skin. By her account she is black and the people here are brown. Despite her usual timidity, she strides with confidence through town, calling back to the men who notice us, switching between Arabic, Swahili, and English as necessary. She even knows a bit of Zande, or at least enough to issue greetings. Martha easily answers my endless questions about life here. She is Nuer, a tribe of pastoral people that moves frequently in search of water for their long-horned cows. Martha left for Uganda during the war and was schooled there as a nurse. Along our walk we encounter Samuel, our HR manager, on his blue bicycle. “Samuel, you are all over the place. Every time we go out we see you,” I say. “Well,” he replies, “if I am all over the place then you must be too, because I see you everywhere!” At the young age of 27, Samuel has four children, which is not uncommon here. Though both he and his wife are from Yambio, his wife and children live in Nairobi. The schooling there is better, Samuel explains. Martha, too, is away from her child. Abby is 3 and lives with Martha’s brother in Nairobi. Many of the nationals and ex-pats working for IMC have families elsewhere. Leaving family behind -- be it immediate or extended -- for a job is not unique to Americans in the international public health and development fields.
We are having such a good time walking and talking with Samuel slowly pedaling beside us that we don’t realize the distance we have come. We are 4 kilometers from the compound and darkness is setting in fast. We turn around and pick up the pace. When darkness takes a complete hold, it becomes difficult to see my feet. I choose my steps carefully, avoiding potholes, ruts and rocks. The smoke that never seems to leave the air chokes us. I love and hate the passing motorcycles that both provide light and shine that light in our eyes. When we are nearly to the compound, Richard, our logistician and finance guy, cruises up on his motorcycle. We both jump on and he delivers us – relieved, tired and hungry -- to the UNICEF gates. We agree to either start our marathon strolls earlier in the evening, or to pay attention to our watches.
We are having such a good time walking and talking with Samuel slowly pedaling beside us that we don’t realize the distance we have come. We are 4 kilometers from the compound and darkness is setting in fast. We turn around and pick up the pace. When darkness takes a complete hold, it becomes difficult to see my feet. I choose my steps carefully, avoiding potholes, ruts and rocks. The smoke that never seems to leave the air chokes us. I love and hate the passing motorcycles that both provide light and shine that light in our eyes. When we are nearly to the compound, Richard, our logistician and finance guy, cruises up on his motorcycle. We both jump on and he delivers us – relieved, tired and hungry -- to the UNICEF gates. We agree to either start our marathon strolls earlier in the evening, or to pay attention to our watches.
Tuesday, Jan. 9
It’s still dark outside when a single beating drum pulses into my sleep. It’s Independence Day – the two-year anniversary of the Comprehensive Peace Agreement that ended two decades of warfare between the north and south. The drumming is followed by the familiar sound of the Sudan People’s Liberation Army doing its jogging chanting march through town. It is a show of solidarity, strength and pride. But, everyone wonders how long this peace will last.The peace agreement created a hybrid government – the Government of Sudan, based in Khartoum, remains the official ruling authority, but a separate Government of South Sudan was created. The latter rules the south with its own president and parliament (a Sudan visa is no good here; a separate travel pass is required by the SPLA), but is not autonomous. In three or four years (I’ve heard different accounts) the South Sudan people will vote on whether the south should secede. Southerners predict that their people will vote for the creation of their own nation. I wonder whether the powerful government of the north will allow the separation. If it doesn’t, surely war will begin anew. Both sides have killed and tortured unknown numbers. The government of the north is behind the ongoing genocide in Darfur that has left 300,000 dead and 2 million displaced. It has planes, bombs and killers on camels at its disposal. The SPLA is not as rich with modern weaponry, but it is scrappy and brutal, previously having kidnapped young boys to serve as soldiers.
The civil war began over religion (the north is largely Muslim; the south, Christian and animist), but now oil is the fuel of fights. The south is resource-rich, with 80% of the country’s oil reserves; the north is not. Yet, with the official government based in the north, the oil of the south is for the north’s taking. Most of the investment money pouring in from around the world never leaves Khartoum and the north. Khartoum will continue extracting as much oil as it can from this part of the country before the referendum. I can’t help but wonder why the two sides can’t cement peace into place if they managed to forge a long-term agreement in 2005. The truth is that the peace agreement was forced into place with intense international pressure.
But on this Independence Day holiday, there is no sign of the north. The SPLA marches in formation, guns at the soldiers’ side. A small troupe follows, carrying homemade banners praising the peace agreement. Women cheer them on with their traditional undulating scream of joy that I so love. Throngs of citizens and their bicycles line the perimeter of Freedom Square. Long, repetitive, windy speeches are made by politicians and rulers. In the midst of the celebration, I board a United Nations plane for IMC’s post in Yambio, the capital of Western Equatoria state. I look through the propeller plane’s scratched window at the assembled mass below. Indeed, it is peaceful.
Tuesday, Jan. 2, 2007
It’s a full moon and so we walk after dusk dark as our fatigued minds are insisting on a change of scenery. I’ve come to have a greater appreciation for what Kara has experienced in the past four months – not only in terms of her work, but her lifestyle. Our lives are spent inside the compound with the same people doing the same things and eating the same foods. There is no social life. There are no restaurants or bars. After walking up and down the wide, red, dirt airstrip that doubles as a pedestrian “highway,” we settle on the steps of a building near the compound and take in the glorious golden moon. I can’t help but remember that three months ago at this time I was with my sisters in a hot tub in Phoenix, witnessing a most spectacular sight: a moon adorned with a rainbow halo. Being as it was my 40th birthday, I took it as a good omen that my life would begin moving in the right direction; it had been a long, tumultuous time since the hurricane. Who knew that three months later I’d be watching the full moon from a dusty, charming village in South Sudan – and with a dear friend from home?
Tuesday, December 26
Today presents the first opportunity to do work since my arrival. I finish entering into a database the results of a survey that IMC did recently in Tambura County, and begin doing analysis for the report. Some of the findings are grim. More than 35% of respondents in one location report having to defecate in the bush due to the absence of latrines. More than a quarter have no soap. Only 16.5% of children younger than age 1 have received all recommended vaccinations. In fact, 15.7% have never received a single immunization of any type. Many children suffer from the three big killers of children under the age of 5 in Africa: acute respiratory illness, diarrhea and malaria. More than 24% of respondents (all women of childbearing age) were unaware of HIV. Thirty percent have been beaten by their husbands or regular partners. It is clear we have much work to do here. The situation is complicated by the fact that there is only one doctor in this county – Nicholas, who manages our medical services division. The war disrupted everyone’s lives, making it difficult for people to obtain an education.
On our way through town, Val calls our attention to the police station. A police officer in a camouflage uniform is beating a man who is lying face down before him with a long, thin stick. We stop the vehicle and stare, our minds trying to comprehend what we are seeing. The officer’s stick breaks on the man’s back. He picks up another stick and resumes the beating. “We better move on,” Val says. With the press of a foot on the gas pedal, we do so.
That afternoon, I realize how wonderfully perfect the weather is. It is warm, not humid and there is no want for a breeze. A substantial flock of white-and-black crows is eating the hot red chili peppers off a bush and the small brown eagles are swooping in for a meal of termites. The mango trees are emitting a subtle perfume. At dusk, Kara and I stroll down the main drag of Tambura when the air is rosy pink from dust. The smoke from the evening’s cooking fires gives the air an unusually romantic feel. A small and rather smoky fire is serving as a bug repellant in the middle of a circle of long-horned cows. A few people are drinking beer and dancing at the only “bar” in town – a small brick structure with a few outdoor plastic tables. We are discussing heavy matters: How do we both live our dreams for this career and make a path toward love, family and roots? Damned if we know. Guess we can only pick one and hope that other falls in place.
On our way through town, Val calls our attention to the police station. A police officer in a camouflage uniform is beating a man who is lying face down before him with a long, thin stick. We stop the vehicle and stare, our minds trying to comprehend what we are seeing. The officer’s stick breaks on the man’s back. He picks up another stick and resumes the beating. “We better move on,” Val says. With the press of a foot on the gas pedal, we do so.
That afternoon, I realize how wonderfully perfect the weather is. It is warm, not humid and there is no want for a breeze. A substantial flock of white-and-black crows is eating the hot red chili peppers off a bush and the small brown eagles are swooping in for a meal of termites. The mango trees are emitting a subtle perfume. At dusk, Kara and I stroll down the main drag of Tambura when the air is rosy pink from dust. The smoke from the evening’s cooking fires gives the air an unusually romantic feel. A small and rather smoky fire is serving as a bug repellant in the middle of a circle of long-horned cows. A few people are drinking beer and dancing at the only “bar” in town – a small brick structure with a few outdoor plastic tables. We are discussing heavy matters: How do we both live our dreams for this career and make a path toward love, family and roots? Damned if we know. Guess we can only pick one and hope that other falls in place.
Monday, Dec. 25, Christmas day
When I wake, I find Kara and Val in the kitchen. The cooks have been given the day off. Kara is doing dishes in the only sink, which is behind the free-standing kitchen building. Val is making coffee on one of the small kerosene stoves. At that moment one of our cooks runs through the door, a look of panic on her face. “I heard you were all alone!” she said. Her son had told her. We laughed at her alarm, reassuring her that we were fine and that she had intentionally been given the day off. Guess the word gets out fast when the khawajat (white people or foreigners, in Arabic) are fending for themselves in the kitchen.At 11 a.m. we grab the wooden folding chairs and begin walking to the church. People in their new Christmas clothes are coming on foot from every direction with wooden and plastic stools and chairs in tow. We begin the necessary process of greeting everyone’s stares with smiles. Christmas Day mass is being held outside, behind St. Mary’s Catholic Church. A wooden, roofed stage has been erected and two collection baskets are in place. We are slightly late, but yet we are early. The yard is a sea of people in clothing of colors as bright as the sun is hot. Many boys are wearing camouflage pants and shirts and hats – little generals everywhere.
I begin taking pictures and showing the people the digital photos. The kids love it. One woman who is dancing alone on the stage notices me and approaches. I believe she will be asking me to take a photo of her. I quickly realize, by her dress and her behavior, that she is mentally impaired. With a wide smile never leaving her face, she speaks to me in Balanda, which naturally I don’t understand, insisting that I take from her a currency note. I do not want to take it. We smile at her and notice that others around us are laughing at her. She will not leave; she will not stop offering me the note. I begin to grow nervous, not knowing how to get her to stop offering me the money. I touch my hair a couple times out of nervousness. Each time I do, she touches her own hair. “I think she wants you to get your hair done,” Kara says, not realizing she is mimicking me. Eventually, a woman – her cousin – speaks in Zande to our friend and “cultural guide,” Bridget, our HR manager. She says she is the woman’s cousin and advices that I take the money and then pass it secretly to her. I do so, and shortly thereafter the woman leaves me alone. “She is happy that she has given you an offering,” says Bridget.
The mass begins. One priest says the mass in Zande; another in Arabic. At the homily’s conclusion, the priest who has been speaking in Arabic summarizes the lesson in English – looking in our direction as he does so. Everyone begins craning their necks to look for the khawaja whom he is obviously addressing.
The mass is a blend of Catholicism and African tradition. Girls in white dresses and bright green head scarves dance in orchestrated moves before the alter. One tosses flower petals into the air. Parading around the alter in carefully choreographed steps are the flag-carrying church leaders and ushers. People in the audience shake maracas and play other small percussion instruments.
What I call the boom box contingency is in full swing, surrounding the marimba player and the music group. Each young man wears shades and rap artist T-shirts. Large boom box perch on their shoulder. They are recording the music for playback later. There is no FM radio in South Sudan, shortwave. Therefore, these men record music when they can for their own enjoyment. At the strike of the first note from the marimba, the men in unison click “record.”Following the church service, people move into Freedom Square for the Christmas Day market, which consisted largely of the sale of various home-brewed beers made from millet and wheat -- even sesame. Many areas have been set up to serve as backdrops for photographs. The photographers will have the film developed in Kampala, Uganda, and then arrange for the photo to be given to the families through a series of courier transfers. It’s strange how similar this place can be to New Orleans. I saw similar backdrops set up at the 2005 St. Joseph’s Day.
Sunday, Dec. 24, Christmas Eve
Kara, Lucy, Val and I walk the security route today in order to know it should we need to evacuate the compound on foot. We talk about putting a ladder in the far corner of the compound in order to scale the 15-foot brick wall. The first designated meeting point is a large unoccupied house behind us and to the north. The second is behind the smaller of the two elementary school buildings near the Catholic Church. The final is far down the path, at an intersection of teak trees, next to a small crumbling brick wall.
We decide to turn the security route drill into a hike. It’s good to be away from the compound. Tukuls line the narrow, rutted dirt footpath. Villagers stare as we pass, no doubt wondering what three white girls are doing walking in these parts. They instantly warm, however, at our smiles and waives. Some women shake our hands; some we pass on the path respond only out of obligation. The trail descends slightly in elevation and ends at the Yuba River. It’s stagnant and looks dirty, yet one woman is washing her clothes and a dozen boys are flocking in its water. A handful of girls are hiking up the trail with buckets of water balanced on heads. For many in this area, ponds and streams are the only water source.
Back at the top of the trail, the crowd around the Catholic Church challenges our curiosity. We venture a peek and soon we are inside, standing among everyone as if we had always been there, swaying back and forth to the music. A woman slaps a gourd-like maraca in my hand. All the women are on one side of the church; the men on the other. Some women are wearing blue handkerchiefs with white crosses on their heads, an indication of their membership in a church auxiliary group. Their signature high-pitched tongue screams echo off the stucco walls.
The Sunday market is a meager affair. At this hour (4:30 p.m.) the only produce remaining are green oranges. Most of the venders are selling a combination of plastic shoes, women and children’s apparel, salt, soap, and various other household items. The stores and stalls are simple -- wooden platforms held in place with wooden poles, bed sheets spread on the ground, and in one case a stall covered in UNHCR tarp.
At the sound of what promises to be another holiday parade for the holidays, we bolt from the compound to the main road. It’s a small band of Christian, being led by a priest, carrying a white banner decorated with red crosses. Several nuns in white dresses and headscarves are accompanied by children playing small percussion instruments, a man on a conch-like horn, and a few soldiers with AK-47s.
Saturday, December 23
We bolt in early morning excitement from the compound when what sounds like a marching parade of singing men passes. It is the SPLA marching through the street in camouflage uniforms, guns at their sides, their flag held high. The SPLA is largely comprised of members of the Dinka tribe, though this area is populated mostly by Zande. Hence, the tribal tension.
Donning jackets to fight off the morning coolness, we walk the village. The townspeople, seemingly oblivious to the chill, are doing their usual thing. Men on fancy bicycles adorned with plastic flowers, women carrying buckets and bowls on their heads, children without pants or shoes running about. The children love to greet us, to touch our hands and say “bye, bye.” We happen by the Catholic Church, which is the heart of this town, hoping to take in some of the service. Unfortunately, it is just ending. Women with babies line every pew in this Spartan but substantial church; one is breastfeeding her child. We meet one of the ushers who tells us that his job is essentially to make people behave and to ensure that no one who enters is drunk. We peak into the nearby brick school. Part of the roof had collapsed in a wind storm. The rooms have no blackboards, no seats, no desks; they are only four walls. It’s said that 100 kids crowd into each classroom – so many that pupils have no room to sit.
We tour the MSF (Doctors Without Borders) facilities at the county hospital. They have been managing an eight-bed pediatric ward and a 15-bed sleeping sickness ward. Sleeping sickness is endemic in this area, but MSF has managed to decrease the prevalence from 20% of the population to .05%. Hence, the sleeping sickness ward only has one patient and MSF is leaving this town permanently. The scene at the hospital is unlike any I’ve seen, but is typical for Africa. Families members sit outside, cooking food for their relatives. Other patients lay on mats outside to stay cool. Naked healthy babies with bulging bellies. Little girls with baby brothers and sisters on their hips. All are interested in looking at or interacting with the foreigners.
Later that evening, in the darkened stillness, I hear that the singing and dancing has begun anew. The Christmas celebration continues.
Donning jackets to fight off the morning coolness, we walk the village. The townspeople, seemingly oblivious to the chill, are doing their usual thing. Men on fancy bicycles adorned with plastic flowers, women carrying buckets and bowls on their heads, children without pants or shoes running about. The children love to greet us, to touch our hands and say “bye, bye.” We happen by the Catholic Church, which is the heart of this town, hoping to take in some of the service. Unfortunately, it is just ending. Women with babies line every pew in this Spartan but substantial church; one is breastfeeding her child. We meet one of the ushers who tells us that his job is essentially to make people behave and to ensure that no one who enters is drunk. We peak into the nearby brick school. Part of the roof had collapsed in a wind storm. The rooms have no blackboards, no seats, no desks; they are only four walls. It’s said that 100 kids crowd into each classroom – so many that pupils have no room to sit.
We tour the MSF (Doctors Without Borders) facilities at the county hospital. They have been managing an eight-bed pediatric ward and a 15-bed sleeping sickness ward. Sleeping sickness is endemic in this area, but MSF has managed to decrease the prevalence from 20% of the population to .05%. Hence, the sleeping sickness ward only has one patient and MSF is leaving this town permanently. The scene at the hospital is unlike any I’ve seen, but is typical for Africa. Families members sit outside, cooking food for their relatives. Other patients lay on mats outside to stay cool. Naked healthy babies with bulging bellies. Little girls with baby brothers and sisters on their hips. All are interested in looking at or interacting with the foreigners.
Later that evening, in the darkened stillness, I hear that the singing and dancing has begun anew. The Christmas celebration continues.
Friday, Dec. 22
At the Loki airport for my flight to Tambura, I plop my overweight luggage on a large rotary scale. Thirty-seven kilograms. I am only allowed 15 kilograms. To compensate, IMC cuts back on the amount of cargo being sent. I feel ridiculous. The baggage handlers mark a piece of masking tape with my destination and affix it to my luggage. “When did you come from Nairobi?” asks the security screener Tuesday, I say. “Have you added anything to your luggage since then?” No, I say. “OK you can just go through,” waiving me on without a glance at my luggage.
The 9-seat propeller plane flies over the last bit of Kenya and enters the width of South Sudan. As far as one can see there is nothing but vast emptiness marked by small scrubby bushes, dry river streams, and the colors of tan and green.
We land for refueling in Rumbek. For the first time, I touch foot on Sudanese soil. A tall, graceful man, clad in a cotton tunic and matching pants, who is walking down the airstrip curiously says, “Welcome home.” A sign announces the town as being in New Sudan. An adjacent billboard has a split image – one side warning of the dangers of malaria, the other proclaiming “Celebrating today’s conquerors, nurturing tomorrow’s heroes,” a reference no doubt to the SPLA’s hard-won rule over South Sudan. Back in the air, I see the round, mud, thatched-roofed homes of the Sudanese that are called tukuls. A coaster of dirt lies beneath each tukul, connected in a constellation of narrow foot paths.
At the Tambura airstrip, Kara wraps me in a firm hug. It’s surreal being in this place with a friend. Kara and I both attended Tulane School of Public Health and both spent time in Sri Lanka after the tsunami. Now she manages the IMC operation in Tambura County, a more-than fulltime job. As we walk the short distance to the IMC compound she points out Freedom Square and the Sudan Relief and Rehabilitation Commission office. I’m not even aware that my bags have been delivered to the compound.
I meet a plethora of IMC people at the compound, most of whom are workers either at the compound or at any one of the Primary Health Care Centers or Primary Health Care Units managed by IMC as part of the Sudan Health Transformation Project. It is customary to shake hands with everyone at nearly every encounter, so I extend my hand. Smiles and shakes. “Welcome, welcome,” they say.
We return to the airstrip to watch the landing of the day’s final UNHCR repatriation flight. Refugees are being returned from the Central African Republic, thanks to peaceful times. Women deplane in colorful, patterned dresses. Some of the children are without shoes. All appear healthy. The mood is reserved considering the magnitude of the situation. At the way station the returnees are registered and given a medical screening. Each family is provided with aluminum pots and pans, rice and sugar and lentils, sleeping mats, a plastic tarp, seeds for planting, a 20-liter jerry can, and soap. After a night’s sleep at the UNHCR facility and a breakfast of porridge, they are delivered to the homes of friends or relatives. No doubt it’s been a long 15 years.
After lunch of beef, rice and beans prepared by one of the compound’s cooks, we move to the World Vision compound to check our email on their wireless network. It’s my first ride in a ubiquitous INGO Land Cruiser with the trademark 20-foot antenna and snorkel for river traverses. Everyone stares. It’s a vehicle in a town where everyone uses bicycles or motorcycles, being driven by woman who is white and is accompanied by two additional white women. The office housing the Internet modem is nothing more than a plastic tent. “We have a $3,000 V-Sat and a $2 office,” says Jeremiah. We perch on wooden chairs in the sun, trying to see our computer screens in the glare, wiping from our keyboards the constant rain of cooking fire ashes falling from the sky. A grave in our midst almost goes unnoticed. There are few – if any – formal graveyards here. Families seem to bury their people on their personal property. Most yards have a grave or two. Some are unmarked; some are capped with pronounced concrete beehives. I like the idea of the dead being buried among the living as opposed to being relegated to a mournful cemetery. The circle of life and death is obvious.
Later in the evening, the sound of singing children rings in the distance. People here often sing and dance through the night for celebrations. The occasion is the coming Christmas holiday. I hear the festivities even more clearly inside my room, which looks out on a cluster of tukuls. When I awake in the morning, the children are still singing.
The 9-seat propeller plane flies over the last bit of Kenya and enters the width of South Sudan. As far as one can see there is nothing but vast emptiness marked by small scrubby bushes, dry river streams, and the colors of tan and green.
We land for refueling in Rumbek. For the first time, I touch foot on Sudanese soil. A tall, graceful man, clad in a cotton tunic and matching pants, who is walking down the airstrip curiously says, “Welcome home.” A sign announces the town as being in New Sudan. An adjacent billboard has a split image – one side warning of the dangers of malaria, the other proclaiming “Celebrating today’s conquerors, nurturing tomorrow’s heroes,” a reference no doubt to the SPLA’s hard-won rule over South Sudan. Back in the air, I see the round, mud, thatched-roofed homes of the Sudanese that are called tukuls. A coaster of dirt lies beneath each tukul, connected in a constellation of narrow foot paths.
At the Tambura airstrip, Kara wraps me in a firm hug. It’s surreal being in this place with a friend. Kara and I both attended Tulane School of Public Health and both spent time in Sri Lanka after the tsunami. Now she manages the IMC operation in Tambura County, a more-than fulltime job. As we walk the short distance to the IMC compound she points out Freedom Square and the Sudan Relief and Rehabilitation Commission office. I’m not even aware that my bags have been delivered to the compound.
I meet a plethora of IMC people at the compound, most of whom are workers either at the compound or at any one of the Primary Health Care Centers or Primary Health Care Units managed by IMC as part of the Sudan Health Transformation Project. It is customary to shake hands with everyone at nearly every encounter, so I extend my hand. Smiles and shakes. “Welcome, welcome,” they say.We return to the airstrip to watch the landing of the day’s final UNHCR repatriation flight. Refugees are being returned from the Central African Republic, thanks to peaceful times. Women deplane in colorful, patterned dresses. Some of the children are without shoes. All appear healthy. The mood is reserved considering the magnitude of the situation. At the way station the returnees are registered and given a medical screening. Each family is provided with aluminum pots and pans, rice and sugar and lentils, sleeping mats, a plastic tarp, seeds for planting, a 20-liter jerry can, and soap. After a night’s sleep at the UNHCR facility and a breakfast of porridge, they are delivered to the homes of friends or relatives. No doubt it’s been a long 15 years.
After lunch of beef, rice and beans prepared by one of the compound’s cooks, we move to the World Vision compound to check our email on their wireless network. It’s my first ride in a ubiquitous INGO Land Cruiser with the trademark 20-foot antenna and snorkel for river traverses. Everyone stares. It’s a vehicle in a town where everyone uses bicycles or motorcycles, being driven by woman who is white and is accompanied by two additional white women. The office housing the Internet modem is nothing more than a plastic tent. “We have a $3,000 V-Sat and a $2 office,” says Jeremiah. We perch on wooden chairs in the sun, trying to see our computer screens in the glare, wiping from our keyboards the constant rain of cooking fire ashes falling from the sky. A grave in our midst almost goes unnoticed. There are few – if any – formal graveyards here. Families seem to bury their people on their personal property. Most yards have a grave or two. Some are unmarked; some are capped with pronounced concrete beehives. I like the idea of the dead being buried among the living as opposed to being relegated to a mournful cemetery. The circle of life and death is obvious.
Later in the evening, the sound of singing children rings in the distance. People here often sing and dance through the night for celebrations. The occasion is the coming Christmas holiday. I hear the festivities even more clearly inside my room, which looks out on a cluster of tukuls. When I awake in the morning, the children are still singing.
Tuesday, Dec. 19
It’s my first day at International Medical Corps’ South Sudan office, based in Nairobi, Kenya. The country director, Simon, gives me a security briefing. He tells the terrifying account of how he and four other IMC staff ran for their lives when the Lord’s Resistance Army from Uganda attacked the IMC compound in Yambio in March. My heart rate quickens and I wonder if I am making an incredibly stupid decision. Of course I do not offer this up to Simon. Unsolicited, he says that I can be taken from the field at my choosing should I feel unsafe.
At 12:30 p.m. I leave for the airport only just having receiving my travel pass from an agency of the Sudan People’s Liberation Army, which rules South Sudan. The plane is a 22-seat propeller model. We touch down in a small airport in Lokichoggio, northwest Kenya. White foreigners and black nationals are piling luggage into pickup trucks for transport between the airplanes and the simple and crudely fashioned outbuildings that comprise the terminal. Wilson, an IMC logistician, is waiting for me. The parking lot is populated mostly by INGO vehicles and the World Food Programme flag flies next to the Kenyan flag. While we wait for my luggage to be delivered to the parking lot in a pickup truck, Wilson tells me that he is Kenyan. “The Africans will never be able to be alone,” he says, meaning that his people are incapable of caring for themselves.
I am taken to the nearby United Nations compound, where IMC has a small office and sleeping accommodations. “That way is Kenya and that way is Uganda,” says Wilson, pointing toward a ring of small mountains. Dusty children play alongside the road near a shantytown of rusting tin roofs, women carry items on their heads, men crouch underneath a tree. The roads are pockmarked with potholes. The UN compound is a cornucopia of humanitarian relief agencies. Nightfall brings a sky of rhinestones glittering on a field of inky black African velvet.
At 12:30 p.m. I leave for the airport only just having receiving my travel pass from an agency of the Sudan People’s Liberation Army, which rules South Sudan. The plane is a 22-seat propeller model. We touch down in a small airport in Lokichoggio, northwest Kenya. White foreigners and black nationals are piling luggage into pickup trucks for transport between the airplanes and the simple and crudely fashioned outbuildings that comprise the terminal. Wilson, an IMC logistician, is waiting for me. The parking lot is populated mostly by INGO vehicles and the World Food Programme flag flies next to the Kenyan flag. While we wait for my luggage to be delivered to the parking lot in a pickup truck, Wilson tells me that he is Kenyan. “The Africans will never be able to be alone,” he says, meaning that his people are incapable of caring for themselves.
I am taken to the nearby United Nations compound, where IMC has a small office and sleeping accommodations. “That way is Kenya and that way is Uganda,” says Wilson, pointing toward a ring of small mountains. Dusty children play alongside the road near a shantytown of rusting tin roofs, women carry items on their heads, men crouch underneath a tree. The roads are pockmarked with potholes. The UN compound is a cornucopia of humanitarian relief agencies. Nightfall brings a sky of rhinestones glittering on a field of inky black African velvet.
Saturday, Dec. 16
It’s 9:15 p.m. when I arrive in Nairobi. It takes more than an hour to deplane, purchase a Kenyan visa, and claim my luggage. Many British families are here, apparently coming for holiday safaris. American Christmas music is playing on the overhead system.
I exit the baggage claim area to the lobby, hoping to see someone holding a sign with either IMC or my name on it. A knot of people stares me down. Some people are waiving signs with names of individuals or organizations, but there is no IMC. I begin wondering what I’ll do if there is no one to meet me. I circle behind the crowd with my cart full of luggage, bringing on several “madam, taxi please,” solicitations. On my second pass I spot a small sign fashioned in red marker: IMC, Miranda. The taxi driver takes me to my hotel, about 20 kilometers away. The four-lane highway is decorated with flag -- advertising campaigns for cell phones, milk products, and tires. I can scarcely believe I am in Africa and that I am now a humanitarian aid worker. A dream has been realized.
I exit the baggage claim area to the lobby, hoping to see someone holding a sign with either IMC or my name on it. A knot of people stares me down. Some people are waiving signs with names of individuals or organizations, but there is no IMC. I begin wondering what I’ll do if there is no one to meet me. I circle behind the crowd with my cart full of luggage, bringing on several “madam, taxi please,” solicitations. On my second pass I spot a small sign fashioned in red marker: IMC, Miranda. The taxi driver takes me to my hotel, about 20 kilometers away. The four-lane highway is decorated with flag -- advertising campaigns for cell phones, milk products, and tires. I can scarcely believe I am in Africa and that I am now a humanitarian aid worker. A dream has been realized.
Friday, Dec. 15, 2006
My final hours in the United States. I am realizing a long-held dream to work and live in Africa. Roger and Leigh Ann take me to the airport, after hurriedly dropping off more of my belongings at the storage unit. My determination not to cry is short-lived when Roger says he’ll miss me. He has been such a good friend for so many years. Living with him for the past six months in New Orleans was salve for the soul.
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