Amy's Adventures in Darfur

I started this blog when I left for Darfur in June 2006. I was working as a midwife with MSF aka "Medecins Sans Frontiers" aka "Doctors without Borders" but this blog contains my own opinions and stories- not those of MSF. It is less political than I want it to be and I have been unable to post stories about certain topics due to the fact that this is on the internet and accessible to anyone. I wish I could tell you all of the stories but since I can't, I will tell you the ones that I can...

Wednesday, June 28, 2006

just another day in habillah

this morning (as i was sleeping after being up all night), a nomad man, along with his cousin, brought his wife in for an appointment. he explained that his wife was pregnant and he wanted to know exactly how pregnant she was. he had been away until a month ago and if his wife was more than one month pregnant he had orders from his family to kill her and throw her body in the wadi (the river). it's times like this where i'm glad i don't speak the language. it's probably good that i can't say to these men "do you really think your wife WILLINGLY cheated on you, you total idiot? you wouldn't have married her if the women in her family hadn't held her down as a child, cut off her genitals and sewed her closed, not only denying her any sexual pleasure, but also causing her pain every time she has sex". i'm SO sure she went out and found a boyfriend while you were gone and it wasn't just one more example of the women here having no right to their own bodies. you can't imagine the words that i omit when i write these emails. or maybe you can.

and on a lighter note:

an ngo was carjacked outside of el geneina recently. the carjackers took everything, as per usual, but gave the expat 1000 sudanese dinars (about $4) to buy water for his long walk home :) such considerate carjackers....

our newest team member arrived today. his name is gustavo and he was telling us about some of this other missions while we ate lunch. one of his funniest experiences was when he first arrived in somalia. for the first two weeks whenever he introduced himself to people he got really weird reactions. people's responses ranged from total shock to gut-laughter. finally, after two weeks, his staff felt comfortable enough to tell him why. apparently in somalian the word "gus" means penis, and the word "tavo" is to touch. he was telling everyone he met to touch his penis.

my butt is covered in huge welts courtesy of the bug that flew up my pant leg last night. i didn't mention this before but, in order to kill it without desterilizing my gloves, i had to run backwards into a wall with my butt (more than once). again, remember that no one there spoke english and they had NO idea that there was an angry creature caught in my pants. they probably thought it was some crazy white-girl birth dance.

like i said previously... another day, another thousand mood swings :) how many days till i'm done?

wishing I was a waitress at Denny's

when i was in midwifery school we had a class one day where vic was teaching us about complications. she mentioned that seeing some of these things in a delivery was about the time that you started wishing you had become a waitress at dennys. now is that time for me. remember those two labours i had, where i wasn't sure if i would be awake all night or not? well, it's 5:04am and i just got home from the hospital and all i want to do is go home (really home) and be a waitress at dennys. tonight was the worst night i have ever had as a midwife, and i have had some crappy nights as a midwife before.

this story has nothing to do with the situation here, i'm going to use medical terms and not bother explaining them and it probably won't be of interest to everyone so feel free not to read it as it sucks.

i ended my email last night because i heard my radio. it was miriam, one of the village midwives, telling me that one of the girls was ready to deliver. i headed to the hospital to watch the delivery and help out if any complications arose. they arose. the girl had a long pushing stage and when the head finally came out, it stopped right there. i tried to use it as an opportunity to train the tba how to handle a shoulder dystocia, but it soon became obvious that it was a real dystocia. none of the million women in the room spoke any english and weren't able to understand anything that i was asking them to do, so i finally just had to physically move the tba out of my way and take over. the baby finally came, but she was flat and had thick meconium staining. i tried to bag her but the mask was too big and i couldn't get a seal, so i did mouth to mouth, which is really disgusting when a baby is covered in meconium. meanwhile her mother started to completely try to bleed to death. she was hemorrhaging everywhere and i was trying to resuscitate a baby while trying to tell the women who don't speak english what to do. the baby started to breath, but was still in rough shape so i radioed for carmenza. she didn't hear me so i asked my driver to go to the house to wake her up and bring her to me. by the time she got there the baby was doing better and i had the hemorrhage under control. the delivery room, after the hemorrhage, looked like a murder scene. i, covered in blood as well, looked like i was the perpetrator. i won't go too into detail because they were, in hindsight, funny moments and the night ended up being so unfunny, but i did also have two other things happen during the hemorrhage. one was that a huge bug flew up my scrubs and started to bite me on the butt, and i was wearing sterile gloves so i couldn't get it out, so instead i jumped around yelling "bloody hell- there's something in my pants!" (forget not that none of these women understand english). the other thing is that, obviously, one of those spiders decided to make an appearance. thankfully by that point in the evening i was just like "not in the mood for you AT ALL" and he met an untimely end at the bottom of my shoe.
as soon as mom and baby were settled in bed, the next girl decided that she was ready to push. i went home for a minute to change my bloody clothes and get a drink (no, not that kind of drink. not that i couldn't use one of those) and carmenza decided to join me for the next birth. to make a very long story short, the girl was a total rockstar. it was an amazing labour. at one point she let out a groan, then got up off of the delivery table and walked outside. we followed her outside and found her kneeling in the sand, pushing. we spread out in the sand around her and just let her labour under the stars. we stayed like that for awhile, until she decided that she wanted to go back inside. the baby was coming slowly, too slowly, and when the head finally came out it pulled back immediately (the turtle sign). all i could think was that there was no way i was getting two dystocias in one night. was another dystocia, another case of pea-soup meconium and it was worse than the first. thankfully carmenza was there so when the baby boy was born limp and blue, i cut the cord and tossed him to her. the mom was alright, so i left her with the midwives and joined carmenza at the table with the baby. he was exactly like the baby girl that had been born a few hours before, and she had been ok so i wasn't particularly worried. babies are always so easy to resuscitate, unlike adults. carmenza did some mouth to mouth until his heartbeat started to slow down too much. she did some compressions and i took over the mouth to mouth. slowly he started trying to breathe. it took a long time for him to come around, and even then his breathing was laboured. he was cold and we had no way to warm him up (surprising that someone can feel that cool to the touch in this heat) so i held him close to me under the intense suturing light while giving him breaths when his breathing slowed down. finally he stabilized and leimona, one of our village midwives, really wanted to hold him, so i motioned for her to keep him close to her and wrapped up, and to keep stimulating him (for the midwives who are reading this, i don't know why i didn't kangaroo him. at first i wanted to be able to give him breaths easily, and then afterwards i thought he was stable). carmenza agreed to suture the patient because i hate doing it and told her we would be done a lot faster if she just did it for me (bring back any memories of davao, jones?). i watched her suture and every few minutes i went over to check on the baby. the last time that i went over, his lips were pale and he was limp. he wasn't breathing and his heartbeat was painfully slow. i put him on the table and started chest compressions and mouth to mouth again. carmenza came to help me and she took over the compressions for me. i don't know how long we tried to save him, but it seemed like hours. the room was full of people but somehow it was just him, carmenza and i there. the suturing light hung over him, improvising as a heatlamp and my only awareness was of every detail of his still face, his white lips, carmenza counting in spanish as she physically beat his heart for him, and me begging him to breathe. there were times when we thought he would make it....his heart rate would speed up towards normal and he would try so hard to breathe. each time it was only fleeting. finally carmenza listened to his lungs again and told me what i already knew... he needed more medical intervention than we had to offer. we kept trying, knowing that the nearest facilities that could save him were two days away. finally he made the decision for us and his heartbeat slowed down and wouldn't speed up again. when it reached 20 beats/minute, carmenza took a piece of gauze and opened his eyes. she touched the surface of them with the gauze and he didn't react. she sighed and said "he's dying". then she looked at me and said "i think it's time to stop". i started to cry and nodded. i wrapped him up and took him to his mother who lay in bed waiting. i handed her to him forgetting, in the moment, the ritual ("who gave you this baby?" "God did") and no one bothered to remind me.

Tuesday, June 27, 2006


yes, we got fans and suddenly all is well with the world. sort of. mostly.

today i was planning to write only about the things that i love here to balance out the huge amounts of reality i subject you guys to and, with one exception, that's what i'm going to do.

so aside from the whole rageful anger towards the nomads, the ride home yesterday was beautiful. adil pointed out such things as the huge termite mounds that dotted the land alongside the road. they look like those sandcastles you make as a child, where you let the watery sand slip through your fingers and pile on the ground- only huge, red and full of termites. he also showed me the trees that have leaves that are instantly fatal to any donkey who takes a bite. at one point during the ride i won a contest that sarah and courtney had in afghanistan to see the youngest camel. the mother camel was just standing up when we came upon it, and the newborn's fur was still wet- what i would give to be a camel's midwife :) herds of camels, goats, cows, roamed freely, munching on whatever green they came across. the landscape, while still mostly dry and cracked, has random patches of green from the recent rainstorms that show up in very distinct places. you'll be driving along and everything is brown, brown, brown, brown, then green. it reminded me a bit of duck, duck, goose- you just never know when it's going to happen. apparently the whole countryside becomes green and lush come "rainy season", although i still maintain that this promise of cooler weather in this supposedly coming "rainy season" has been but a cruel joke. every time you ask a local when rainy season is supposed to start, they say "fifteen days". they've been saying that since mid-may. i'm actually glad that i got here when i did, as i get the chance to see the two sides of darfur. part of the year green and beautiful, part of the year sandy and desolate. adil asked me a question at one point that was so odd, yet so interesting. he asked me if my country was "sand or soil". that kind of sums up the difference between our two countries- mine is soil, his is sand. hey, has anyone else noticed that if you take the word "sand", mix the letters up and throw in a u, you get "sudan"? coincidence? i think not. the "road" is two tire tracks in the dirt though the middle of the wilderness and i have absolutely no idea how anyone can figure out how to get between the villages (especially once it rains and the tire tracks are washed away). there were definitely times where i felt that my driver was just making it up as he went along. he knew the road pretty well and managed to fly between the bumps and mostly slow down in time to hit them. mostly. i sat in the back, amidst the huge boxes of supplies we were bringing back with us, trying to shift around and find a comfortable position in the sliver of space i was alotted. with that and the 8th time i had to hear "caribbean queen" the idea of getting carjacked started to sound more and more appealing. at least the walk home would have been quiet and i could have stretched my legs out :)

i got called to the hospital at 3am today and found a woman who was miscarrying and hemorrhaging. my first instinct was "crap, call the doctor", only to remember that when it comes to obstetrical emergencies, i'm the "doctor" and the last resort. so i did my first solo D&C, made possible only because hil let me do one once in afghanistan (THANK YOU HIL!!!!). i definitely patted myself on the back when it was done :)

i have two labours right now, which could mean another night of wakefulness, or it could mean nothing of the sort. the women here have this insane ability to reach something like 7 or 8cm dilation and then decide to go to sleep for the night and get up and pick up where they left off in the morning. it's so nothing i've ever seen before. speaking of things i've never seen before... today i had my tba's simulate a delivery in the tukuls to give me an idea of how they do things. most of it was great, but then after the "delivery" one of the tba's puts a cup to the mouth of the tba who had just pretended to catch the baby, and she took a huge mouthful of water and fully spat it at the woman who was simulating having just given birth. i was so surprised and they all just howled at my reaction. they told me that it's to wake the mom up after having given birth, and to make the baby cry so everyone will know that the delivery is finished and the baby has arrived. it's definitely one of those practices that isn't harmful, so i just laughed. one part of the birth process that i love here is that once the delivery is done, the mom is stable and getting into bed, the baby is wrapped up and everyone is about to come in and meet the baby, the tba makes a motion of handing the baby to the mother and she asks "who gave you this baby?" and the mother puts her hands to her chest and says "God did", they repeat the motions and the question two more times, "who gave you this baby?" "God did", "who gave you this baby?" "God did", and then, depending on the sex of the baby, the mom chooses which breast to feed from first (left for boys, right for girls, i think).

and the part of the email that sucks... we have had a little girl here who has been in and out of our hospital repeatedly. she's 2 1/2 and has diabetes and our hospital doesn't have the resources to provide insulin so she comes in in really bad shape, gets treated until she's stable, then goes home to repeat the cycle. we knew she would die of complications eventually. well, she wasn't given the chance to die of complications. her family decided to circumsize her and she died 2 days later of complications related to that.

i hear my radio, gotta jet.

Monday, June 26, 2006

quick note

Tera and Amy in Afghanistan

so i did it- i transported a patient by road to el geneina yesterday and i managed to arrive with life, limb and car intact :) now that i've done it once, i'm not nervous about doing it anymore. it was actually a beautiful drive. kind of indescribable really. the BEST part, by far, was the air conditioning. it was the first 4 hours that i've spent in sudan where i haven't felt like barfing from the heat. it was basically heaven. the downside? having to listen to the same tape over and over and over again for fear of hurting my drivers feelings. who's the guy who sings "caribbean queen"? (billy ocean?). that was the tape and we listened to it no less than 4 times (i know this because that's how many times i had to listen to caribbean queen). after a night in el geneina i'm now heading back to habilah in convoy with MSF france.

side note: one of the drivers just brought me a coke, and it's so cold and so refreshing that i just want to crawl into the bottle and float in it. gotta love el geneina where people have fridges that keep things colder than lukewarm :)

the patient that i transported presented with what i think is a placenta previa (not yet an emergency), but upon examination i also discovered her swollen left leg, with pain in her leg and her chest and a cough (potentially deep vein thrombosis- a huge emergency). it seems weird that in my entire life i've never had any experience with DVT, and in one month i lose my friend Tera to it, and almost lose a patient to it. people always say that you can't run away from your problems because they'll just come with you, and this trip is certainly proving that to be true. the first thing i saw when i got off the flight to el geneina two weeks ago was the remains of two plane crashes. it's always nice to start off a trip feeling like someone just hit you in the gut with a sledgehammer. the night before i transported my patient here (we can't transport at night, no matter how much of an emergency it is), i dreamt of tera all night and kept waking up feeling heartsick. it would take me a minute to realize why thinking of her hurt so much, and then i would remember that she was dead. she was only 31 and she's gone. it seems like every day something happens that opens an old wound, but i think it's a good thing. i haven't let myself really process a lot of the last few years, and maybe now that my life has slowed down a bit it's time to do that. there's absolutely nothing to do here when i'm not working, which leaves me plenty of time to journal, reflect, pray, think things through.... i'm kind of glad actually.
alright, time to head.

Saturday, June 24, 2006

contact info again

ok guys, i've received a bunch of tentative emails asking if you can email me at this address ( and the answer, again, is yes...please! just remember to put my name in the subject line, delete anything that i've written to you if you're replying to an email of mine, don't send attachments and write daily :) also, i can't get internet access here (we download emails via our satellite phone) so if you have written to my hotmail account in the last week and a half, i haven't read it. for those of you who wanted a mailing address, i would recommend using the geneva address as i think it's the best guarantee that i'll actually receive anything. if you are sending anything other than a letter, make sure to keep it under 1kg (not my rule, obviously :)

my two stories of the day: first, i found another one of those spiders in my room last night, causing me to look Heavenwards and ask "are You serious???". if this is a test then i have no problem admitting that it's one that i'm ok with failing. second, i spent today doing a cd rom workshop on STD's and i was not, i repeat NOT, prepared for the full-blown, colour pictures. the first one that popped up was of a man with gonorrhea (the picture was not of his face) and it was all i could do to not cover my face and run away screaming "MY EYES! MY EYES!". needless to say, it was a light lunch today.



Friday, June 23, 2006

Day off

there is something afoot in habillah and we don't know what it is. today at the hospital one of our nurses handed us a letter from the local "police" station. the letter told us that we are no longer allowed to leave habillah without a police escort due to "security issues". every time we plan to leave habillah we MUST inform them and they will send a car with us. milena and i, ever the cynics, decided immediately that it was less about our security than it was about us not seeing things that we're not supposed to see. our staff validated our suspicions by telling us that the chadian rebels have been gathering outside of habillah and the nearby villages, preparing themselves for an attack on chad. if this is true, it would lend a lot of validity to the accusations by the government of chad that the sudanese government is supporting the rebels. being a neutral organization means that we won't allow the police to escort us, so tomorrow andi gets to have the pleasure of informing the police of this. i figure the worst-case scenario is that we have to cancel our mobile-clinic program, which would suck as i was planning to start going out with them. i'm not going to say much more as it's just speculation at this point.

be forewarned, the rest of this email may only be interesting to my plethora of midwife friends :)

as predicted, my first official day off started early this morning with a birth, hence no sleeping in. the number of births, and patients, at the WHC have picked up dramatically the past couple of days, leading hind to remark "i hope you're happy with yourself". i totally am :) i got home from the hospital only to be radioed immediately that there was another woman ready to deliver (which i may have made it to if we had drivers on fridays instead of my trekking to the hospital each time). the earlier birth was the first one i've seen on a friday, which is the one day off here. only the midwife on call is present at the deliveries on friday unless one of the tba's brings the patient in, in which case she stays as well, so there were far less excitable midwives there twittering about. it was a bit more peaceful than usual :) as much as i'm a fan of calm, peaceful births, there are too many midwives here who want to be trained and having a huge party at each birth seems to be fine with the mothers. the age-range of our midwives and tba's spans decades, but they all turn into crazy, giggly teenagers with each birth. the ones from habillah aren't used to the idea of an actual 'birthroom', and i think it intimidates them. one of the tba's, a woman i would guess to be in her 70's, gets so nervous about having to wear gloves that she stands at each birth with her gloved hands up in the air, terrified to touch anything and get them dirty. whenever i ask one of them to do something, like hold the woman's legs for her, or get her water, they all clamber to do it and do it so enthusiastically that all i can do is laugh.
the midwives from khartoum (the capital city), used to being the experts compared to the "uneducated" village midwives, have not taken such a liking to the fact that i actually agree with far more of the village midwives practices than with theirs. when i first arrived they were telling me that the tba's deliver the women in their huts in the kneeling position. rather than gasping in shock at the archaicness of it all, as i gather i was supposed to do, i said "that's awesome! let's try doing that here as well". the delivery table, a symbol of all that is wrong with birth today, no longer stays flat, keeping the women on their backs. half of it is propped up as far as it will go, and then i employ pillows to get the woman as upright as possible. the stirrups no longer hold legs and are now mostly used as arm rests for the midwives :) the practice of routine episiotomies on primis (first time mom's) was the first thing i abolished, much to their extreme dismay. thank GOD the two primis who have delivered since i arrived have only had small tears. the midwives were convinced that any primi without an episiotomy would undoubtedly end up with a fourth degree tear (through the rectum). the birth this morning was the first one where the baby wasn't ok, and my first instinct was to turn on the suction machine to suction the bloody, meconium-stained fluid from his nose and mouth. uh, don't have those here, so i try to use the manual one and it doesn't work. i then turn to the delee and pray that none of it ends up in my mouth. his colour was bad and his heartbeat was sluggish and as i stimulated him i asked milena to get me the oxygen. she tells me that we don't have oxygen. i say "are you serious??? in the entire hospital?" yup, serious. if i want oxygen we need to get andi to drive the generator to the hospital, then bring the oxygen concentrator over to our side of the hospital and set it all up. i could probably have oxygen for the baby in about half an hour. awesome. thankfully he ended up being ok, but i definitely had one of those moments where you just stand there and wonder what the hell you're going to do with none of the equipment that you're used to. ah well, it's all about improvising and making do, non?
as for my staff, i'm really lucky. the expat midwife who was here before me set up an amazing system for training the women. the centre runs smoothly and all i have to do is supervise and work on the details of training them for births. some need more training than others, but that will come with time and experience. most of them (aka the ones from habillah) are SO eager to learn, and so humble. the midwives from khartoum....uh.... not as much :) one of them actually said to me "i'm not here to learn, i'm here to work". i tried to tell her that we're all here to learn, but it was during a delivery and it just didn't seem like the time to have that conversation. i'm not looking forward to dealing with people who are set in their ways- this is why i hate having to be the supervisor. i would so rather just deliver babies all day.
another way that i'm lucky is with my team. there are only 4 of us, which means it would completely suck if we didn't get along as well as we do. not everyone loves everyone, but the girls all love each other, and i get along with each person individually. carmenza, our colombian doctor, is the sweetest, gentlest soul. english is a new acquisition for her, and she still manages to make me laugh out loud with most of our conversations. SO funny. milena is our crazy nurse from switzerland, but originally from macedonia. she speaks pretty much every language on earth (she speaks german with andi, french with me, english with carmenza (who is eagerly awaiting our new team member who speaks spanish as his first language as well), italian with francesca (from another ngo here), and macedonian with her family. oh, and she's basically learned to understand spanish in the last 3 months as well. she, too, is hilarious and entertaining. milena leaves in a month and i pray that the nurse who replaces her is nearly as quirky and fun.
alright, this computer is too hot to be this close to anymore.

note the tba with her gloved hands in the air...:)

Thursday, June 22, 2006


as someone who basically lives each new experience whilst simultaneously writing about it in my mind, sometimes i find adjusting to such completely different cultures kind of exhausting :) either it's that which is exhausting me, or it's my complete inability to sleep due to the heat, donkeys, dogs, goats, flies, fleas etc etc etc. i liked not being able to sleep when i was sharing my room with aurelie because lying awake talking was such a great way to process and decompress. now that she's gone, lying awake all night ranges from stressful to just plain boring.

side note: one of our guards just came into the office to batten down the hatches for the apparently imminent sandstorm (we have metal windows that can be latched shut against the storms). they were NOT kidding when they said that the rainy season here was preceded by "violent" sandstorms. you can barely breathe for the dust, and i get to wait them out more or less inside. i can't imagine what it'll be like when i get caught in one outside. i feel like it would be just as much fun as burying my face in the sand on the ground and inhaling.

the past couple of days have been relatively slow at the WHC (women's health centre). we had a couple of huge storms and the people who have land within habillah or just around the edges of it are spending this week planting their crops (hence not many patients). that sounded hopeful until "h" told me that the paramilitary had already told the farmers to go ahead and plant, and they will be by later to collect everything that is grown. also, no longer waiting for the villagers to leave habillah, they have taken to coming into the village to help themselves to the animals that are still left here. rather than there being the expected safety in numbers, the villagers are weaponless and unable to defend themselves against the guns that the paramilitary were supplied with by their government. all the people here can do is submit and hope to not be hurt in the process. it seems like every other day we hear of a villager being killed by them. it makes me frickin crazy. i have this strange love/hate relationship with the fact that the colour of my skin renders me safe here. i hate that the militia can, and do, hurt/rape/kill any villager they please, but they won't hurt me because doing so would bring too much attention to what is happening here. how is my life any different than that of the people here? why would the world care that much more if i was killed here, simply because i carry the title of a "humanitarian aid worker"?
we've only had 3 deliveries since i arrived, which is making me a bit restless. i thought it was just that the women wouldn't leave their homes at night to come deliver with us, but "h" pointed out that there are also far less pregnant women than would be expected from a population this size as so many of the men were killed in the fighting or have left to find work.
in the TFC, the increase in numbers continues. yesterday we transferred 3 children from the SFC (supplemental) back to the TFC, meaning that they had slipped back into a state of severe malnourishment. "h", my sudanese bosom buddy and the national doctor in the WHC, and i were talking today about how maddening it is to watch these children starting to slip back, and to be unable to intervene until they reach a certain level of starvation (70% of what they should weigh). during home visits with our community health workers it was found that some families are down to only enough food for the next 2-10 days, and the next WFP distribution isn't until august. for those of you who have asked what you can do to help... i think it's beyond individual donations (although that certainly helps). i would encourage all of you to start raising awareness, hold fundraisers and urge the governments of the world to get a clue. i'm a fan of msf and i think they are incredibly conscientious about where they spend donor money.

on the plus side, i have loved having this slow few days in order to just get to know my staff and the patients and their families. outside the WHC is a sheltered waiting area, with a huge woven mat on the sand, and a thatched roof against the sun. we've spent the time lying around, melting in the heat, laughing and talking. they have shared their stories with me and in return i have dazzled them with my magical digital camera that allows them to see pictures of themselves for the first time. i now spend much of my time taking pictures of the women and showing them the picture on the screen. the look on their faces is complete confusion, then amazement, then they laugh their heads off. my cheeks seriously hurt sometimes. i LOVE sitting there and watching the women interact, greet each other in their singsong chant, sit down and arrange, then rearrange their flowing gowns, nurse their babies, make fun of each other (and me. excessively:) h and a translate the majority of what is said, and the topics range from the heartbreakingly serious to the completely ridiculous. it's a nice balance- i think it's a welcome respite for many of them to just come sit and laugh for awhile. yesterday the sudanese women were making fun of us (the expats) for always getting sick here (every other day. sigh). they said it was our own fault for living lives so free from germs, drinking clean water, etc. then h motions to one of the babies from the TFC who is crawling around outside (and who promptly picked up a dirty sandal and started to suck on it). apparently he was building immunities. somehow i don't think that using a baby from the TFC is a good example for why i should live a dirtier life :)

another side note: yesterday i made the mistake of mentioning that the spiders here weren't that bad compared to other places i had been. the team informed me that there was a big, scary kind here but they had only ever seen them in the garden, and never in the tukuls. so about 10 minutes ago i went into my room and a huge beetle ran across my floor. i was chasing it out, telling it that it was NOT welcome in my room and all of a sudden i stopped midsentence. there, on my wall, was one of the big, scary kind of spiders. of course. it was in one of those precarious positions where if you give it any forewarning it will have the chance to escape behind a pile of your things. carmenza got one of the guards for me and i tried to explain to him that if he missed and the spider escaped, i was going home on the next plane. no, he doesn't speak english but i still felt it was important to say it out loud. he missed, of course, and i actually screamed and jumped up and down like a total girl until he managed to kill it. carmenza then asked me to sit down, breathe and have some water. what can i say.. i am in dire need of therapy (and a stiff drink).

well, another day, another thousand mood swings. i can go from complete joy and absolutely loving it here, to staring at the 6 months left on the calendar and wondering what the hell i was thinking, all in a matter of moments. i'm definitely so glad that i'm here, i just pray that it does some good. i've been warned that i will likely leave feeling like i did absolutely nothing, but to remember the true purpose of my being here- témoignage. témoignage is french for "testimony" or "witness". it basically means that if nothing else we are here to witness the events and to tell the world. i want the people of habillah to know that the world hasn't forgotten them. please don't forget them.

Monday, June 19, 2006

Life here

when you first arrive in habillah it's easy to get the wrong impression. life appears to go on and peace appears to have taken root. people have set up huts, and lives, here and appear to be in no hurry to return home to their former villages. the obvious fighting and the burning of villages has died down. this is why the donors have stopped seeing darfur as the latest sexy hotspot. in reality the village of habillah, rather than being the oasis that it seems, is a prison. in talking to the staff at our hospital, and the people throughout the village, it's obvious that no one is leaving because it's just not an option. at a meeting with the staff each of them told a bit of their story, and they were all the same. their villages were attacked by the paramilitary, people were killed in such humane ways as the men being locked in the mosque and burned... labouring women and their tba's were killed in their huts....families fled in every direction, most of them unable to find each other again and to be left wondering if their children, mothers, fathers, grandparents, had survived the attack. every person on our staff had lost at each one member of their family in the attacks. the people escaped to nearby villages that were safe for as long as it took the janjaweed to finish looting the previous village, and then they were attacked at their newest location. now "safely" residing in habillah, these people can't leave the village for fear of their lives. one woman went out to search for firewood yesterday and never returned. the janjaweed patrol the areas around us and the people aren't allowed out. the janjaweed have taken up residence in the abandoned villages and aren't about to let the rightful owners return to their land. this may not be as desperate a situation as it is if it weren't for the fact that the WFP has cut the food rations in half. these villagers are unable to leave the village to plant crops, or to search for firewood, and they are entirely dependent on humanitarian aid. and that aid, while starting at just enough, has been halved. the people have no choice but to risk their lives by leaving the village to forage or to slowly starve. those most at risk are the families with no men. the children from these families are the ones that we will get to watch slowly start to starve in the next few months. those who, now, don't count as officially malnourished are living on the brink. their skin stretches tightly across their chests, with the bones of their sternums and clavicles clearly visible. their stomachs are rounded, showing the first signs of what's to come. we had an excess of high energy milk that was about to expire, so we spent today driving around to the 100 families deemed most at risk. we stopped at their huts and had them bring out a container that we poured a litre of hot milk into. shortly into the day we were being chased by a crowd of children with bowls, begging for milk as well. how do you explain to hungry children that we know how hungry they are, but that we only had enough for the very hungriest? soon enough they may all look like the 4 year old boy who we had to pour the milk into because he wasn't strong enough to hold the bowl himself. but until they are starving enough, no one will help them.


our delivery room

our pediatric ward

an upscale tukul

sunrise over habillah

water delivery

so first things first...forget about that internet access in habilah dream. the organization is flying someone in to repair their lost connection, but it'll take awhile and realistically, by 'awhile' i mean 'probably never'. if any of you have written to my hotmail account since my last email, i can't read it. however, feel free to write to me here as long as you don't send ANY attachments. the next important item is that between typing on a french keyboard (things just aren't where they're supposed to be) and typing on a french keyboard where the letter 'a' takes about 5 tries, there will be much less flow in my ability to write and therefore i will probably get bored sooner and thus expose you to far less lengthy emails :)

so...habillah/habilah/habila (don't ask) it. first i'll tell you about the living conditions here in our compound so my mother can be suitably shocked and horrified :)... well i mentioned the outhouses already, and the lack of fans right? some more details: here, milk really does come from cows (i can hear kate replying "it comes from cows here too, sweetheart", but we all know that it really comes from the supermarket). a local woman milks her cow every morning, then comes and sells it to us. we boil it to kill all of the inevitable parasites (don't be disgusted- it's no worse than the pus and antibiotics in the milk you drink at home), we strain it, and we drink it. water? well, water comes from donkeys. every morning a boy arrives with a donkey carrying a huge rubber bag full of water over its back (the same way that everyone who can afford a donkey collects their water here), and empties it into our containers. we take some of it and boil it, then filter it. the rest is used for showering, dishes, etc. some of our floors are cement, and some are sand. everyone except for me sleeps in their own little tukuls (huts) in the courtyard. i turned mine down in favour of a room next to the office with painted walls where i can see anything coming a mile away (and yes, i'm refering to spiders). in spite of the fact that a majority of our "windows" are screened, there is a plethora of insect activity everywhere, which is especially fun at the dinner table. i had a fly actually fly up my nose already. while it was highly unpleasant, i'm sure the experience was far worse for him. the entire population of habilah is either 20, 35 or 70 years old when taking medical histories. the village is swarming with chickens, yet there are almost no eggs (leading andi to conclude that we have successfully solved the age-old debate of which came first). in my first day here i got engaged and had my first baby: apparently you have to be engaged or married in order to be respectful enough to do pelvic exams here. there was a quick moving over of one of my rings, a gratefulness that i had brought a picture of boaz and i with me, and it was just that easy. as for the baby, i had a dream last night that i gave birth to my first child (it was a boy. sorry mom, no granddaughters for you just yet). phil thinks that it was symbolic of my plans to birth this new project.

i arrived yesterday by helicopter and had my first small tour of habilah while flying, while landing, then once on the ground. flying by helicopter was cool because we flew close enough to the ground for me to have an amazing view of the landscape. there's truly not much to see, yet it's so easy to see why africa can get so under your skin. the village is surreal, with an earthly beauty in spite of it's history and it's poverty. the landscape and all structures upon it are shades of brown and red, caked with the dust that permeates the entire atmosphere. the people, however, dress in brilliant, vibrant colours that show an incredible contrast with the setting. men in white hats and long, white robes sit on the sides of the road in the shade, mostly telling the children who are following us to leave us alone. the women walk down the 'roads' carrying huge bundles of wood or pots on their heads, and with babies strapped to their backs. the children are dirty and run around barefoot sporting torn, filthy clothes. these children don't fit the criteria for being malnourished, but they certainly aren't anywhere close to being considered well-nourished (this will change soon as the WFP has cut the food rations in half due to a lack of funding. there has already been a big increase in the number of children being admitted to the therapeutic feeding centre at the hospital). each dwelling is set apart by a "fence" of sorts, some of them made with woven straw, some with brick, others with dried, spiky brush. each fence encloses a perfect square, and within that square compound lie the tukuls of the people. some are fairly well built, while others look thrown together with whatever material happens to have blown by. the village of habilah, once home to around 5,000 people, has swelled to around 25,000 with the influx of the IDP's (internally displaced people). however, rather than living separately from the villagers, the idps here are integrated into the village, making it hard to know who is displaced and who isn't. the people have started to try to make a life for themselves here. as aurelie put it "they've taken an abnormal situation and made it normal". another difference here is that the nomads and the villagers get along, leaving habilah with a peace that has alluded other villages/idp camps.

our little hospital is adorable as are those that staff it. i got to meet our staff, and see the different sections of the hospital, getting a small idea as to what it is that we're doing here in habilah. there are examination rooms for the out-patients who come in daily for the more minor illnesses and injuries. the inpatient ward is where the patients who have to be admitted stay (side note: one of the patients in the ward is a beautiful 10 year old boy named Adam whose hand was blown off when he picked up and played with a random grenade (the third victim from his village in the last little while). he lay in his bed with one stump and his three remaining limbs wrapped in white gauze and he still managed to give us a blinding smile). when we got to the women's centre, the women i'm going to be working with in the centre came out dancing and singing, while one of them emitted what sounded like a high pitched war-cry. one of them came running to hug me and they started to show me the small, handwritten signs on their clothes that read "well come mrs Amy". there's a little room with 2 beds for the women in labour, and a small adjoining room for the deliveries. i almost died when i saw the new "delivery table" complete with stirrups. yeah, no. on the plus side, everyone here breastfeeds and it seems that nestle hasn't managed to get a foothold in sudan just yet. their milk powder and babyfood is sold in the market though, so i'm sure it's just a matter of time before infant formula starts contributing to the infant mortality rate here as well. behind the two rooms is a private courtyard where the labouring women can walk around, rinse off or use a private latrine. we went to the TFC next, which is the therapeutic feeding centre. one large tent contained 10 small, malnourished children, each with a mother or older sister to care for them. they stay all day so the families can be taught how to care for them (and so the mother doesn't divide the food between her other hungry children) and at 5pm they go home with a bag of food for the night. once the child reaches a level of 'moderate' malnutrition, they graduate to the SFC (supplementary feeding centre), where the family comes to pick up 2 weeks worth of food at a time. next we saw the small room that has been converted to an operating theatre. surgical cases are refered to el geneina unless it's night and travel is forbidden, or it's a life or death emergency. the last surgery was a c-section on a woman who had an obstructed labour for 2 days. when she went into shock the team set up an impromptu operating table and performed the surgery. my first real conversation with andi the logistician was him telling me about standing over the table, trying to hang a light so they could see what they were doing, and looking down and making eye-contact with the patient, and how it felt when they delivered her of a dead baby, then lost her as well 3 hours later. not something that a former businessman deals with in austria very often.

my team here consists, thus far, of myself, carmenza, milena and andi. carmenza is a doctor from colombia, milena is a nurse from switzerland, and andi is the former businessman from austria. the others i've mentioned are just here for a visit from headquarters. bruno is the guy in geneva overseeing the msf projects in sudan (and other countries as well), phil is the head of mission in sudan and, leaving the absolute best for last, aurelie (french, but living in geneva) who deals with communications. i LOVE that girl. she is the epitome of all that is cool about europeans, while managing to not possess a single of the stereotypical negative qualities. i've loved having her here for my first week, and i'm trying to convince her of her need to move herself, her husband and their baby to sudan simply to hang out with me.

alright, i'm bored of writing. there are some stories i want to tell about a couple of my encounters thus far but i've long reached the end of your attention-spans, as well as my own. maybe another day.

ps i may not post all emails on the blog, because it was pointed out that i can't control who reads it and things that i say can be linked back to msf. the emails that contain the more sensitive things won't be posted, if and when i feel like writing emails that contain sensitive things.



greetings from Darfur

hey all, it looks like i may have internet access in habilah on occasion. one of the other ngo's has it and apparently they let other expats use it when they aren't on it! for now that remains to be seen, but it's a distinct possibility and it will allow anyone who wants to email me to do so at my hotmail account. today in one of my briefings i was told to only give my msf email address to my family and close friends in order to control the number of emails they have to download on the satellite phones. i nodded, thinking 'yeah, and will YOU be the one to decide which of my friends gets to be considered close enough to get my email address? oh, and p.s. i have about 100 relatives, no joke".
today i'm in el geneina, the capital of west darfur (erase from your mind any and all pre-conceived notions as to what a capital usually looks like/consists of. replace those notions with huts, sand, donkeys and goats). i'm at the UNHCR compound using their computers after a day and a half of more security briefings and waiting around for more security briefings. on the plus side: one of those briefings taught me how to speak radio ("echo golf for hotel alpha, come in". seriously, how cool am i?). the unhcr compound also has air conditioning and western toilets. luxury.... i may never leave. after only a day of true msf living (and it gets worse tomorrow when we leave for habila) i can say that i have huge respect for this organization, and i am going to be SO hardcore when i'm done here :) the living conditions in the philippines and afghanistan are a 5 star resort compared to our compound here. we use eastern 'toilets' (a hole in the ground), we don't have windows to protect us against the violent sandstorms (hence the sand in my every crevice). the compound has 4 regular expats so they have 4 knives. and they have NO fans. none. today at lunch as i sat at the table trying to not die of heat stroke, i asked why they didn't have fans. andreas says 'we have a logistician who is very aware of justifying the use of our donors money'. i say 'and survival isn't justification enough?'. apparently not. if you can't justify the use of a fan in sudan, you can't justify the use of a fan anywhere. the heat is merciless. today i went to the latrine at the office (i made the mistake of taking my anti-malarial pill on an empty stomach. you don't even want to know how revolting it is to have to put your face anywhere near that hole. if i hadn't been about to barf anyways, i would have after that for sure). the latrine there has no roof (surprisingly a nicer design than the one at the guesthouse. less smelly and claustrophobic) which meant that i was almost completely under the sun, as was the metal door. when i was ready to leave i went to open the door and i felt like i had just picked up a hot iron by the wrong end. i looked at my watch and debated whether it was worth waiting until sundown to try opening the door again.
steffen and i got a small tour of el geneina today when one of the national staff took us with him to buy some supplies for me to take to my team in habilah ( its amazing the things they had to ask for: ketchup, oranges, oil, coffee, etc). the market here is amazing, and it's going to KILL me to not be able to take pictures of it. it's so familiar in so many ways, yet so completely different in so many other ways. this place makes afghanistan seem developed- and habilah is supposed to be even more remote. as one of the doctors put it in one of her briefings "make no mistake- you ARE going to an entirely different planet". (side note: this is the same woman who had a coughing attack during our meeting and said "i think i'm allergic to the dust here". i think to myself "yeah, it's probably that and not that you just chain-smoked through this entire meeting"). i won't bother describing it as it wouldn't sound that different from how i described el geneina in general. just minus the huts and put in small stores. still teeming with donkeys and goats, still nothing but sand.
well, my driver is here so i must jet. i leave for habilah tomorrow by car- my choice. if i have to face that road at some point, i would rather that the first time be with other people and there are 3 msf staff visiting that are taking the road to check it out. if i have to get robbed at some point, let it be tomorrow when i'm with 2 guys and i'm not the only foreigner :) just kidding family! sort of.
love Ames

Monday, June 12, 2006


hello all, greetings from sudan! i'm not in darfur yet (i'm in khartoum, the capital of sudan) so don't expect this email/posting to be uber exciting. just to forewarn you....
so....geneva. definitely an experience. beautiful, rich, glamorous, and an odd place to spend a few days before heading to a poverty-stricken, war-torn country like sudan. i'm pretty sure i was the only person over 12 who was wearing jeans. i think geneva can be summed up pretty well by saying that right next door to the MSF headquarters is the local ferrari dealership (for those of you who don't know, msf is short for "medecins sans frontieres", which is "doctors without borders" in french. it's just easier to type). there were 3 days of endless meetings where i managed to glean the one piece of information i was actually looking for: i asked the woman who had been in habilah before me if she had seen any large spiders there. she replied "no", then she thought for a second and started to speak again, which was when i put my hand up and said "nope, that's all i want to hear, thanks". on thursday a friend from home, efrat, joined me as she's in switzerland working on her masters. it so ruled to have a friend there to see the city with. we conquered my jetlag by staying up talking until midnight, which meant i no longer fell asleep at 7 and woke up at 3am. i woke up friday morning and with my first moment of consciousness i smiled and thought "i'm going to africa tomorrow". friday was a half day at msf, then we walked around the old city (mostly so i could tell my parents that i had seen some of geneva. i could have happily sat chatting in a cafe all day, eating cheese and ice cream. not that i didn't do that- i totally did). saturday morning steffen, another msfer heading to darfur, and i got up at an unGodly hour and caught our first flight. it was a fun trip, mostly because of steffen the germans insistence that i "improve his english language!". we met up with giles the english guy (as if someone named giles would be from anywhere else) in amsterdam, then we all flew to khartoum together. the flight was crazy. i looked out my window at one point, and there was nothing below us but sand- and it stayed that way for the last couple of hours of the trip. we started to debate how long we would survive if our plane went down in the sahara, and that's about when i started to get very thirsty. landing was an experience, as the clouds that we had to pass through were made of dust and sand and you couldn't see the ground until you were almost on it. i could, however, see the flight tracker in front of me that gave the usual information on miles left till the destination, local time, etc. my favourite part was watching the outside temperature go from -54 degrees celcius in the sky to 42 freaking degrees on the ground. at 6pm. sorry american friends, i don't know what that is in fahrenheit. stepping off the plane was not unlike opening the preheated oven to put your baking in. except that rather than putting your cookie sheet in and closing the oven door, you climb in alongside your cookie sheet and close the door behind you. yeah, welcome to sudan.
the airport was a breeze thanks to the guy who grabbed my bags without asking, put them on a cart, and took off past customs with them. he raced by them with no problem, thus sparing me the insanely lengthy search for alcohol, pornography, etc, that i would have had to endure. he did, however, try to charge me $100 for it. i was glad that i got to escape customs as a friend had included one of her amazing paintings in her plane letter and it had 2 naked women in it. i spent part of the flight debating whether or not to jiffy clothes on them, and finally decided that i couldn't desecrate such beautiful art.
i can't really describe khartoum as i've seen so little of it, but what i have seen has been brown and hot. the heat is relentless, but it's actually not as bad as it was in the philippines because there's no humidity (at all). this does not, however, mean that it's pleasant in any way, shape or form. the first night i slept like a starfish, bringing back memories of the philippines and my last couple of weeks in afghanistan. those of you who have been there know exactly what i'm talking about. you sleep with splayed limbs because you can't handle having any part of your body touch any other part of your body lest they stick together. last night i discovered the air conditioning in my room and actually managed to get some sleep. not a lot of sleep, mind you- i tried to kill a medium spider before bed and it escaped behind the dresser. there was a part of my subconscious that was well aware of that all night.

i was told that we (steffen, my new gay boyfriend, and i) fly to el geneina tomorrow, then "if the roads are safe" i'll part ways with steffen and be driven to habilah a day or two later. otherwise they'll take me in by helicopter. how does one determine that the roads are/aren't safe? your guess is as good as mine. don't they discover that the roads aren't safe by something happening? wait, update: we were just told that we will be helicoptered in the first time as they don't want the bandits to catch us with all of our stuff and get the idea that holding up msf vehicles is a good thing. my ipod will not be coming on the transports between camps with me. i'm not about to lose it, and i'm even less willing to die because all logic escapes me and i refuse to hand it over ("no, seriously, you don't want it- you don't even have a computer to charge it on! here, take my shoes instead. how about the doppler?"). i shouldn't joke- my mom reads these :)
in the plethora of briefing papers i've acquired, my favourite by far is the one that tells you how to handle yourself in certain situations in sudan. it's written in pure sarcasm, apparently in response to the idiot things that people have done in the past. i read the first 2 or 3 not realizing that it was a joke, thinking "really?" until i reached the one that advises you to dress like britney spears and to make sure that your thong is showing in order to gain the respect of sudanese men. the best ones for sure were the ones on how to handle the janjaweed. one of them says something like "when pulled over by the janjaweed don't give them your security money. tell them you have nothing and are just a volunteer. they'll understand- they're volunteers too!" another one was "never pull over at janjaweed or military checkpoints. accelerate and use your horn. they'll definitely know who you are and that you're in a hurry".
speaking of dressing like britney spears.... i discovered upon unpacking that i had managed to pack like someone who has never once left their hometown. i hear that sudan is hot, so all i do is pack tanktops. for those of you who aren't familiar with sharia law, i would just as soon walk down the road butt-naked as i would in a tanktop. since being here all i've been able to wear is my new msf t-shirt. so, off to the market. when did i become such an idiot?
alright all, i'm out of things to write about (no comments from you, dad), so until my next adventure, or my next email access, i bid you adieux....

Thursday, June 08, 2006

definitely out of titles

thankfully i'll be in sudan shortly and my internet access (or lack thereof) will force my mother to have to come up with clever titles when she posts my emails.

Quote of the day: "eight thousand people die from AIDS every day because treating them is not 'cost effective'" -a poster on the wall here at msf

Observation of the day: trying to type on a french keyboard is about as much fun as having a root canal (sorry dad, but it's not like you think people enjoy those visits to your office, right?)

Question of the day: how is it possible for people to live in geneva, the city of chocolate, bread and cheese, and not weigh 500 pounds and have to be moved with cranes?

so i'm just killing time right now, waiting for my daily onslaught of meetings and information to start. i just had a checkup at the hospital to get my diploma saying i'm healthy enough to go on this trip. i have to say, european doctors have quite a different approach to performing check-ups. i definitely felt that she, at the very least, should have taken me for dinner and a movie first. oooh, there's a very pregnant woman standing beside me and it's taking some serious self-control to not reach over and palpate her large belly. and now she's drinking a coke- that's awesome. if she lights up i am no longer going to be responsible for my actions. dad, you'd still wire me bail money after that root canal comment, right?

seeing as how i'm saying nothing of interest (to you, or to me) i'm going to end this. my friend, efrat, is coming to geneva to hang out with me tonight and tomorrow, which so rules. maybe i'll get a chance to enjoy geneva for a moment, rather than forever associating it with endless meetings and videos on such uplifting topics as genocide and female circumcision.

au revoir...

Monday, June 05, 2006

my contact info over there

for those of you who actually still send mail the old-fashioned way (and i'm pretty sure that i'm only referring to my sister right now) and who requested my mailing address over there, here is the info:

Street 55 house 21
Al Amarat-new extension
Office Phone
+249/183 58 19 88 (i'm sure that many of you will be calling me regularly for the $20/min that it will cost to talk on our satellite phones. on a positive note: those of you who call me at 3am when you're having a breakdown will no longer be waking me up- it'll be mid-day for me :)

Letters and parcels sent through Geneva should be labelled with my full name and the project/country where i am working.Parcels should also include a brief description of the contents.
MSF SwitzerlandMs. Amy Osborne - Mission Habilah - N. Sudan / DarfurRue de Lausanne 78Case Postale 1161211 Geneva 21Switzerland

ps M&M's are always welcome as they are probably the only chocolate that won't melt the moment they set foot on african soil.

shall we all take a quick moment to laugh at the fact that i packed 40kg of luggage, only to discover last night that i'm only allowed to take 20? oh, and the hours and hours and hours of burning french cd's onto my new ipod (let's be honest- fee was the one doing most of the work) was apparently a waste of time as we accidentally deleted all of them. sigh.

ciao all- i'm leavin' today :)

Saturday, June 03, 2006

ok, have patience, i'm just figuring this whole blogging thing out. frankly, i'm just setting it up and then i'm going to make my mother do all of the work while i'm gone. i'll have limited email access and no internet access while i'm gone, so when i can send emails i'll send them to mi madre and she can post them on here for me (this is assuming that she's willing to be my blog-slave, which she may very well not be).

i leave for sudan in 2 days, and i'm hoping to have a chance to write a lot about it. most of you are aware that when i'm overseas i write EPIC emails (no joke) with stories about my time and my experiences there. you can read my stories on here, or you can skim them, or you can not read them at all. it makes no difference to me as i pretty much write them for my own sake anyways. i often find that writing the stories out can be therapeutic, and i also use them later in my scrapbooks. well, i plan to use them later in my scrapbooks. i just happen to be (literally) 9 years behind in scrapbooking. one day when i break both of my legs, i'm just going to spend that 6 weeks in bed scrapbooking.

alright, time to get back to panicking (so much to do, so little time to do it in). i think i'll pack while i panic (no one can accuse me of being unable to multi-task).