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...

Thursday, August 31, 2006

A few places to donate

Hello again, Melissa here.
Many of you have asked how you can help. I don't know what the best thing to suggest is, but I did discover that you can make donations through World Vision's online catalogue to the children of Darfur. I know that Amy does most of her birthday and Christmas shopping in their catalogue. If you have a birthday or special occasion coming up you could request that people give a donation in your name instead of a present. The website is and the link for the Darfur donation is

Also, I was sent this by someone on Amy's email list, it has some great information about where to donate:

Here is the link to the World Food Program (they are responsible for most of the food aid in the world and operate at only 10% overhead which is why many people have not even heard of them!) and MSF's donation page.

People often get turned off different organizations because of the actions of a few unscrupulous individuals. The big ones have excellent websites these days which allow people to see what they do and where their money goes. The Reliefweb has links to all the organizations so people can check them out. The other thing about this link is that it is an excellent site for staying on top of all the latest in humanitarian issues. On their opening page it says it 'Serves the needs of the humanitarian community'. It is the site I try and get my students to stay on top of as the first step in helping others is awareness of the problems. Everything is here - news, agencies, volunteer opportunities, so feel free to pass this on to others.


Have a great day and keep a good thought for our girl and the people she is there to help.

Amy and Mariam from "Amy's Staff"


Wednesday, August 30, 2006

The Latest

well, it looks like the troops in darfur are no longer a secret. i'm glad that the world knows. maybe now they will do something to prevent another slaughter. then again, maybe not.

Amnesty warns of new crisis in Darfur

Sudan is engaged in a military build-up in its remote Darfur region despite a May peace deal, threatening to create a new human rights catastrophe unless U.N. troops are deployed soon, rights groups Amnesty said on Monday.

The Security Council will on Monday discuss a draft resolution proposing deployment of around 20,000 U.N. troops and police, despite Khartoum's rejection of any Darfur mission.

But Amnesty International in a statement on Monday supported U.S. claims that the government was preparing a new offensive in Darfur against some rebel factions who did not sign the May peace deal.

"Eyewitnesses in el-Fasher in North Darfur are telling us that Sudanese government military flights are flying in troops and arms on a daily basis," said Kate Gilmore, Amnesty International's executive deputy secretary general.

"Displaced people in Darfur are absolutely terrified that the same soldiers that expelled them from their homes and villages may now be sent supposedly to protect them."

Khartoum submitted a plan to the Security Council which would send more government troops to Darfur to stop the violence instead of a U.N. force.

But Amnesty and Washington say the 2.5 million war victims who fled their homes to miserable camps in Darfur viewed government soldiers as part of the problem not the solution.

"How can Sudan -- which appears to be about to launch its own offensive in Darfur -- realistically propose being a peacekeeper in a conflict to which it is a major party and perpetrator of grave human rights violations?" Gilbert said.

After mostly non-Arab rebels took up arms in early 2003, Khartoum armed militia to quell the revolt.

Those militia stand accused of a campaign of rape, pillage and murder that Washington called genocide.

Khartoum rejects the charge but the International Criminal Court (ICC) is investigating alleged war crimes in the region.

Critics say Khartoum rejects U.N. troops because it fears those soldiers would arrest any officials likely to be indicted by the ICC, even though the two institutions are separate.

But with an African Union force monitoring a shaky truce in Darfur struggling to find cash to pay its around 7,000 soldiers and failing to stem the violence, time is running out for a U.N. transition.

Rebels and the United Nations have accused Khartoum of bombing in Darfur since the May deal in violation of a U.N. Security Council resolution prohibiting offensive flights in the remote west.

OK Maybe I Was A Bit Harsh

i lay awake most of the night last night- something that happens when i have things on my mind that i would rather not think about. those things appear when the lights are off, the noise has dimmed and every one of my distractions (aka my team) has long gone to bed. i lay there thinking about the situation here, and how devastating it is, and how angry and heartbroken and frustrated i am about it. i wondered if i would have a crisis of faith- wondering where God is in all of this. i wondered if i would still be able to believe in a loving, merciful God after 5 months in a place where evil prevails. i wondered if i would ever be able to look at the world, or people, with hope again. i also thought about the email i just sent, where i made the mistake of accusing the entire world of looking the other way as the atrocities here continue. there is a huge part of me that is losing faith in mankind, and the world in general, but i know that not everyone is sitting back and letting this go on. i know a 3 year old boy, jadyn chomlack, who went around his church asking everyone for donations to buy toys for "the sad children in sudan". i know a 17 year old, michael garfinkle, who started a club at his high school to raise money and awareness. he has been yelling about what's happening here for as long as he has known about it. he's 17 and he knew more about darfur than i did until i got here. my friend aviva is now volunteering at a refugee youth centre and just took 2 teenage boys who are refugees from darfur to summer camp. she is telling everyone she knows about their stories and what they have been through. my friend judy's husband, john, is trying to get my emails published. the deal we struck is that he will do all of the work and i will use any profits to serve the people here. my sister melissa has been emailing everyone whose address she can get her hands on...from the local press to oprah. two women, teresa and melanie, who have been friends for 56 years and who have never met me are sending us packages and emailing to ask what the people here need and what more they can send. one of them told her hair dresser about us and her hair dresser has since refused to take any tips, asking that the money be sent here instead. Countless people have all taken time out of their lives to come here and serve the people. these people aren't jobless and looking for some entertainment- they are doctors, nurses, business professionals. they are putting their lives at home on hold for anywhere from 3 months to a year and coming to immerse themselves in a suffering that can't even be imagined in order to try to alleviate it somewhat. there are people out there who are doing what they can. the thing is, i know that if EVERYONE out there was doing what they could, this would end. if everyone was writing to the press, to the politicians, to the U.N., if everyone took to the streets to scream about the fact that nothing is being done, something would be done. you are all educated and you are all affluent (you may not think of yourself as affluent, but if you are reading this on your own computer, you have more resources than most of the world) and this gives you power. the people who run our countries put stock in what you say. you can all write letters. you can all hold fundraisers. you can all write a cheque. you can all tell everyone you know about what is happening here, and encourage them to get involved. many of you have skills to offer and could come here and volunteer.

my mother wrote in response to my last email, telling me that people want to help but they don't know how. i believe this. i also believe that we have moments of really wanting to help, but then we get distracted by life's little details and we end up doing nothing, in spite of all of our good intentions. i am the exact same way when i'm at home and am at a safe distance from these things. maybe this is why God has to physically drop me in the middle of these situations in order for me to actually do something. you can all contribute something, no matter how small or insignificant it seems. please search your souls, find out what is being asked of you, and give it.

The World Must Stop Doing Nothing

i was just listening to my ipod and the words of an old song suddenly took on a whole new meaning. it's a song that was written by babyface and stevie wonder about domestic abuse and the lyrics are now describing the situation here in darfur:

"how come? how long?
it's not right, it's so wrong
do we let it just go on?
turn our backs and carry on?
wake up, it's too late
right now we can't wait
she won't have a second try
open up your hearts as well as your eyes"

i have been in darfur for 3 months now and the situation is getting worse, not better, and the world STILL isn't doing anything about it. in the last two weeks 13 more villages have been destroyed. countless lives devastated. people murdered, women and children raped, possessions pillaged, people displaced. it's like we've learned nothing from situations like the holocaust and rwanda. there is a time when the world has to set aside diplomatic relations and get f***ing involved. tomorrow the security council is going to meet in new york and because the government of sudan is planning to boycott the meeting, nothing will happen. nothing will be resolved. the government here will continue to wage their secret war against their own people, while telling the world that they are fighting the "rebels" who are hiding among the civilian population. collateral damage happens. the world will tell themselves that it's an awful situation and that they wish it wasn't happening. but it IS happening. right now. every single day people are being murdered and beaten and raped and robbed and degraded. every single day. every single day that the world doesn't get involved is one more day that the crimes here continue unchecked. maybe the world can live with that, but i can't. maybe if everyone was here with me instead of safe at home and if they, too, fell in love with the people here- the people who are being targeted and wiped out- the world would fight against this. one day we are all going to be held accountable for our actions, or lack thereof.

UN Darfur meeting set whether Sudan attends or not

UN Darfur meeting set whether Sudan attends or not / Reuters/ 24.08.06

By Irwin Arieff

UNITED NATIONS - The U.N. Security Council president challenged Sudan on Thursday to attend a meeting next week on the crisis in Darfur and said the session would go on with or without an official Sudanese presence. Nana Effah-Apenteng, Ghana's U.N. ambassador and the council president for August, acknowledged, however, that the Monday meeting would be scaled back after the Arab League asked for its postponement and Sudanese President Omar Hassan al-Bashir urged the council "to be patient" on Darfur.
Tens of thousands of people have died and 2.5 million been driven from their homes by violence in Darfur since early 2003. To put down a revolt by mostly non-Arab rebels, Sudan's government armed mainly Arab "Janjaweed" fighters, who have waged a campaign of rape, plunder and murder. With U.N. officials warning of a new humanitarian disaster in the western Sudanese region, the United States and Britain have asked the council to quickly adopt a resolution clearing the way for the 7,000 African Union troops now in Darfur to be replaced by a U.N. peacekeeping force more than twice as big.
"Darfur is on the verge of a dangerous downward spiral," U.S. Assistant Secretary of State for African Affairs Jendayi Frazer said in Washington.
"We must stop the genocide," she said, announcing plans to head to Sudan
on Friday to press President Bashir to let in U.N. troops.
The plan has the African Union's backing. But Bashir has repeatedly refused to consent to a U.N. force in Darfur. Effah-Apenteng called the meeting to get Sudan's views on the draft resolution and an explanation of its rival plan to instead deploy 10,500 more government troops in Darfur.
Some human rights groups and council members see the Sudanese government plan as a ploy to prevent the deployment of U.N. troops so the slaughter can continue unchecked.
But Arab League foreign ministers, meeting in Cairo last Sunday, appealed to the council to call off the meeting and give Khartoum more time to carry out its own plan.


Sudan's people and not the government were to blame for opposing the U.N. plan, Bashir wrote the council. "Accordingly we request the Security Council to be patient and not be in a hurry to adopt a new resolution on the matter," he said.
But Effah-Apenteng rejected postponing the meeting -- set to take place in the council chamber with full media coverage. That prompted Sudan's government, the Arab League and the Organization of the Islamic Conference to say they either would not participate or would send low-level officials.
That decision "was a matter of regret to some of us on the council," Effah-Apenteng said. But most of the council's 15 members wanted to "leave the door open" because all believed a force could not be deployed in Darfur without Khartoum's consent and acknowledged negotiations could take some time, he said. He would now meet with Sudanese diplomats at the United Nations to propose a meeting behind closed doors instead.
"If they can come, fine. If they don't come, fine," he said. But if Sudan persisted, he would go ahead with an open meeting and invite U.N. peacekeeping officials to use it to comment on the Sudanese proposal, he said.
"The situation in Darfur is very grave," he said. "We don't want to be accused of inaction on this issue."

Monday, August 21, 2006

Aid Workers Under Attack in Darfur

Last month Darfur's worst-ever month for violence towards aid workers

Aid agencies say insecurity is preventing vital assistance reaching those who need it, demand end to rising violence

Four international aid agencies working in Darfur today said that July was the worst month of the three-year old conflict in terms of attacks on aid workers and operations. Eight humanitarian workers were violently killed in Darfur during July. The agencies - CARE, International Rescue Committee, Oxfam International and World Vision - joined forces to express alarm at rising violence and deteriorating humanitarian access since the signing of the Darfur Peace Agreement on May 5. They warned the increasing insecurity is crippling their ability to reach people in need, with potentially disastrous consequences.

As well as the eight deaths, July saw many other aid workers attacked and intimidated, and there were more than twenty incidents of humanitarian vehicles being hijacked or stolen.

"The targeting of humanitarian workers is completely unacceptable. Since the signing of the Agreement, Darfur has become increasingly tense and violent, which has led to the tragic deaths of far too many civilians and aid workers. A full and comprehensive ceasefire must be implemented immediately," said Paul Smith-Lomas, Oxfam's Regional Director, one of several organisations to have a member of staff killed in recent weeks.

Tensions within many of the camps for the region's two million displaced people have steadily risen due to opposition to the Darfur Peace Agreement(DPA). Violence is increasingly quick to break out, putting at risk aid workers who are delivering vital services. Meanwhile, the under-resourced and poorly supported African Union police and troops who are supposed to be providing security appear to have reduced the scope of their efforts to protect civilians since the DPA's signing.

The agencies called upon those responsible for protecting civilians and creating a secure environment for aid operations, particularly the African Union, to prioritise having a 24/7 presence and regular patrols in areas around the camps.

The humanitarian response in Darfur is the largest in the world and has managed to stabilise the horrific health and nutritional conditions that were seen in the early stages of the conflict. However, the agencies warned this response is now under threat. Some areas of Darfur are seeing levels of malnutrition once again on the rise, and outbreaks of acute diarrhoea in the vast camps.

"The danger is clear. If we cannot access the people who need assistance then the humanitarian situation is going to rapidly deteriorate. As usual in Darfur, civilians are the ones to suffer, from being attacked, displaced, and also from being denied access to the assistance that they urgently need," said Kurt Tjossem of International Rescue Committee.

In the last month, more than 18,000 people have fled their homes in North Darfur in the face of fighting and attacks on their villages. Three and a half million people throughout Darfur are dependent on humanitarian aid, yet vast areas such as the Jebel Marra mountains and virtually the entire northwestern region, are almost completely inaccessible to aid agencies due to the violence and insecurity. Recent fighting has forced many agencies operating in and around Kutum in North Darfur to temporarily suspend their programmes.

The agencies called on all parties engaged in the conflict - those who have signed the DPA and those who have not - to immediately adhere to the ceasefire and allow humanitarian operations unhindered access to the people in need. They urged the international community to do more to pressure all sides to end the ongoing violence.

Signed: CARE, Oxfam International, International Rescue Committee (IRC), World Vision

·Deaths of humanitarian workers in Darfur during July 2006

July 6 A Care staff member was shot dead at a water point in Kalma, South Darfur
July 13 A Relief International driver was shot dead during a hijacking near Saraf Omra, North Darfur
July 19 A SUDO driver was shot dead during a hijacking near Mershing, South Darfur
July 20 Three workers from the state water corporation (WES) were beaten to death in Hassahissa IDP camp, West Darfur
July 27 A Tearfund staff member was beaten to death in Dereig IDP camp, West Darfur
July 28 An Oxfam staff member was killed during an attack on a village in West Darfur. He had previously been abducted during a hijacking in May.

Half of these incidents have taken place in camps for displaced people due to the increasingly volatile atmosphere within the camps since the signing of the DPA. Many of the displaced oppose the agreement.

·The UN recently announced that humanitarian access levels in Darfur are now worse than in 2004, lower than 80%, with most access being via air. One in five people in Darfur are therefore not receiving the assistance that they need.

·Since the Darfur Peace Agreement was signed on May 5, the situation in Darfur has become increasingly complex. Rebel movements have split into numerous factions and there have been widespread popular demonstrations against the agreement within the IDP camps. Banditry and general lawlessness is now rife. Militias, rebel groups and government forces have all clashed on a regular basis.

A News Report about Sudan


Violence in Darfur reaches catastrophic levels: UN relief chief / AFP /


UN humanitarian chief Jan Egeland said Thursday that the number of violent attacks in Sudan's strife-torn western region of Darfur had more than doubled so far this year, reaching catastrophic levels. "If there hadn't been a war in Lebanon we would all be up in arms about the deterioration in Darfur," Egeland told a news conference.
"We have record low access in Darfur and we have recorded a more than 100 percent increase in violent attacks and clashes in the first half of this year compared to the first half of 2005," he added. "It's going from really bad to catastrophic in Darfur."
Nine aid workers have been killed in the past five weeks in the region, according to the United Nations. Incidents involving relief workers have increased by 139 percent, while 30 aid agency vehicles have been hijacked since the beginning of the year compared to nine last year.
"We cannot keep up with the situation even though we have the biggest humanitarian operation on earth going in Darfur," Egeland said.
The UN's human rights office warned in a report Wednesday that the Darfur Peace Agreement is "doomed to failure" because the human rights situation in the region has deteriorated since the accord was signed in May. The report estimated that 250,000 people were cut off from urgently needed assistance.

I'm OK, It is OK

t occurs to me that my last few emails have been pretty heavy (for which i make no apologies- this is sudan and life here is heavy) and a lot of you seem concerned about my mental well-being lately. i just wanted to reassure you that i'm ok. there are days that are awful, days that are neutral and days that are good. i just don't tend to write about the days that are good because those would make for very short stories..."today i lay on the couch and listened to my ipod. the end". rest assured that i do not wake up to dead bodies every morning, nor do i go to bed every night covered in the blood of the innocent. not that there aren't days like that, obviously there are, but they are in the minority.

the flies and the spiders seem to be in some sort of reproductive race to see who can take over sudan first. to be honest, i don't know who to root for. yes, spiders are of satan, but at least they don't spend hours dive-bombing my ears and nostrils as i'm trying to read. and it's a good thing that they don't because i can basically guarantee that the day a spider dive-bombs any part of me will be the day i die of a heart attack. i know that as a Christian i shouldn't believe in karma, but i had a seriously karmic moment the other day. there was a spider on the screen and i had a rolled up magazine that i was using to kill flies. i went to hit it, completely missed and hit the screen beside it. the screen then acted like a trampoline and bounced the spider right off it, at me. those are the moments that make naiman's quote "it almost doesn't make sense why someone doesn't have a camera on us all the time" come to mind.

thank you for your concern. as you can see, i am still ok enough to be preoccupied with spiders. it can't be all that bad :)

in case you're wondering about the cause of my sudden psychological upswing, it's quite simple really. i came home from work last sunday and went to bed, and i didn't get up till wednesday. i tried to go to work thursday morning, broke out in a cold sweat, went home and went back to bed till saturday. another fever knocked me out of commission and i got 5 days of desperately needed rest. aside from the fact that i couldn't eat (and still can't) and therefore lost more weight, i feel SO much better. speaking of losing weight, we don't have mirrors here so i had no idea how much i had lost until i got to work on saturday morning. my staff looked at me in horror and hawa says "amy! you become small!". they stand around me, clucking in dismay, running their fingers over my now-prominent collarbones while i laugh and say that i stand almost 6 feet tall and there isn't a single category in the world in which i would qualify as small. after that, no matter what i try to do (for instance, roll up the mat at the end of the day) they stop me and say "you are still weak!" and shove me towards the nearest chair so they can do it for me. i then sit in the chair, roll my eyes and remind them that i had a fever, not a heart transplant. they didn't stop shooting me worried glances out of the corners of their eyes until today when i arrived at work and treated them to a spontaneous ballet recital. no, i don't know ballet. i took one class when i was 3 and pretty much all we did was run around the room pretending to be butterflies.
alright, 24 days till i leave for my vacation in kenya. i think i can make it, i think i can make it, i think i can make it...

Health Care

once when i was young, i was playing in my grandparents backyard with my cousin and my little brother. we were trying to climb a rock wall when one of the bigger rocks came loose, rolling down onto adam's foot and crushing it. it was a long time ago and my memory of that day is fuzzy, but the one image still in my mind is of his screaming, people streaming out of the house above us, and someone swooping him into their arms and running up the stairs with him. when he came back from the hospital, with his leg in a cast, he was all smiles. he was spoiled rotten, showered with toys, candy and attention, we all signed his cast, and the only inconvenience was his spending the summer on the beach with his casted leg in a plastic bag. we have pictures of him smiling a huge toothy smile, wearing his dirty cast as he played in the sand. and that's the way it should be. when a child hurts itself, as children always do, someone should swoop down, pick them up and rush them to the hospital. that hospital should be nearby, like they are in my world. it might feel like it's 5 hours away when you're driving there in pain, but it's really only a short distance and you always get there in time. there should be doctors there. those doctors should have the equipment that they need, and they should be properly trained. if you need medicine, it should be available, like it always has been for me. these are basic human rights. everyone deserves timely, equal access to health care. it is not a privilege, it is a right. we have a patient right now who didn't have timely access to health care and it has now changed the course of her entire life. she's 10 years old, small for her age, adorable, and she fell from the tree she was climbing. when she landed she broke her leg. she broke it badly. both her tibia and her fibula snapped in two, and both protruded from the skin. a horrible injury, but had it been treated in the developed world, she would have been fine. surgery, stitches, casts, rehab... who knows what it would have taken, but she would have been fine eventually. instead, she broke it here, in "this f***ing place" as carmenza has started to refer to it as. she is a nomad and lives out in the wilderness. it took her family 12 days to reach us. in those 12 days she had no anaesthesia. no aspirin, no tylenol, nothing. by the time she reached our hospital her foot was dead. black, smelly, dead. it hung from her leg by a piece of rotting tissue. carmenza cut it free with a pair of scissors. we can't transport her to el geneina, so carmenza cleaned the wound, removed the dead tissue, wrapped her stump and admitted her. today we went to the hospital when one of the nurses radioed to say that "parasites" were coming out of her bandages. we knocked her out and carmenza unwrapped the wound. one fly had managed to get into the dressing and had laid eggs. maggots crawled on the wound, disgusting but useful. they only eat dead tissue, not live tissue, so they actually help clean wounds. still gross, don't get me wrong. carmenza cleans it, and as the little girl slowly starts to regain consciousness she is yelling something over and over. i think that if we could understand her we would probably find her drugged ramblings funny. then the nurse translates that she is calling for her father because she is dying. oh. not funny. when the wound is clean it is rebandaged. until the family can find a private car to take them to el geneina, there is nothing anyone can do for them (msf will pay for the trip, but we can't take them and put ourselves at risk on the road). when she gets to el geneina they will take off more of her leg. if things go as they usually do, the infection will return and they will take more off, and then again, and then again.
as i write this i know that most of you won't be able to understand the full implications of this story. you have never visited homes in the philippines and found the emaciated handicapped child the family hides in their home, never actually killing it but slowly starving it in the hope that it will die and they won't be held responsible. you weren't with me in afghanistan, watching the man with the paralyzed legs drag himself through the mud and sewage with his hands. you haven't witnessed the utter degradation that is the life of the handicapped in the developing world.
this isn't the world that we, the elite few, are used to. this child's life is forever altered. there is no rehab center here. there are no advocates for the disabled here. there are no physical therapists here. there are no prosthetics here. there are no crutches here. there are no wheelchairs here- even if there were, there is no wheelchair access because there are no roads or sidewalks to wheel on. she is a girl, thus already a burden to her family. now she is a nomad girl who can't even walk.
i have never seen carmenza so affected by a patient. she is devastated and threatening to take up smoking. she knows what this girls future holds and there is no way to save her from it.
how do you find a way to be grateful for all that you have ever had, without being bitter that not everyone else has it as well?

Friday, August 11, 2006

from Ames

4 births in 15 hours. all good. one of them was beyond beautiful. the young mother had lost a son in the delivery, and had one surviving daughter. i, ever the libra craving balance, hoped that this one would be another boy. her son was born easily. he slid into the world and let out a lusty cry. everything was perfect. i wiped him off as he gazed around the room in wonder. he had stopped crying and was instead taking in his new surroundings. afterwards i went into the courtyard to wash my hands and i found a young man waiting there anxiously. he saw us and we smiled at him, signaling that everything had gone well. he stood up and began to sing praise to God, for the safe arrival of his child, for his wife surviving the delivery. when he was done i bowed slightly and said "mabrook" (congratulations). joyce did the same and said "it's a boy". his face broke out in a huge radiant smile. he practically danced away to tell his family the news. i stood there and smiled. i took a deep breath and noticed that the rain had left a sweet smell in the air- like strawberries left in the sun.

in the last couple of weeks i have read some amazing books and i am going to share two excerpts that i think speak so much to the situation here.
the first one is from the book "night" by elie wiesel, about his experiences as a teen in the concentration camps. the author won a nobel peace prize and his acceptance speech is included in the end of the book. here is part of it:

"and then i explained to him how naive we were, that the world did know and remained silent. and that is why i swore never to be silent whenever and wherever human beings endure suffering and humiliation. we must take sides. neutrality helps the oppressor, never the victim. silence encourages the tormentor, never the tormented. sometimes we must interfere. when human lives are endangered, when human dignity is in jeopardy, national borders and sensitivities become irrelevant. wherever men and women are persecuted because of their race, religion or political views, that place must- at that moment- become the centre of the universe"

the next one is from a book called "the secret life of bees". it speaks more of my role here than of the situation at large:

""are you writing in your notebook?" he asked, his face and voice suddenly, oddly, desperate. i looked at him and nodded. ..... "come on, you've had your five minutes," the policeman said. august placed her hand on my back, urging me to leave. zach seemed as if he wanted to ask me something. he opened his mouth, then closed it. "i'll write this all down for you," i said. "i'll put it in a story". i don't know if that's what he wanted to ask me, but it's something everyone wants- for someone to see the hurt done to them and set it down like it matters".

Wednesday, August 09, 2006

care packages

Thank you all for your generous care packages (Amy hasn't actually received any yet but she's been told there are some in Khartoum and many in Switzerland) however, I received a note from her today saying she has been asked by MSF Switzerland that no more parcels be sent there as they are having a hard time getting anyone to go there, so the parecels are stuck in Geneva, as such in the future if you are planning to send anything, please use the Khartoum address, can you please contact me at for the address as we are not allowed to show it here on the blog!!

Thanks, Amy's Mom

we sit together

"is he ok?"
"no, he died"
"of course he did"

it was late in the morning when i went to ask carmenza something. i found her outside of the isolation room, squinting in the sunlight, trying to read the results of a urinalysis she had just done. i ask her if she's busy, or if she can come see one of my staff who is sick. she's busy. she says that the situation in the isolation room is an emergency, and she's afraid the patient is going to die. what's wrong with him? he's having gastrointestinal bleeding and he's going into shock. i assume that he's old, but she tells me that he's only 30. oy. i leave her to her emergency and i eventually head home for lunch. an hour or so later she wanders into the courtyard and i glance up from where i'm zoning on the bed in the livingroom. it's only a day after my brutal day and i'm still not entirely present. "is he ok?" i ask. "no, he died". "of course he did" i say- it seems only fitting in this week that we're having. we have lunch and i head back to the hospital to train my tba's. i arrive back at the women's centre and the waiting area, our usual congregation spot, is empty. "where are the tba's?" i ask joyce, starting to wonder if i have the right day. she tells me that they have gone to sit with his body and i step around the corner and see that the family has taken him to be washed in the large sand lot right beside the women's centre. several woman are sitting in the sand, facing where his body is being washed. joyce looks past me and i turn to see where she is looking. an elderly woman is walking slowly across the sand. she walks with a cane and each step takes effort. she walks alone at an impossibly slow pace. everything about her is dignified. "she is the grandmother" joyce tells me. i almost start to cry merely at the sight of her- even in her grief she is regal. behind her another woman is being half dragged by two women, each clasping one of her arms. "she is the mother" margret whispers, and tells me that she had collapsed upon hearing of his death. the two women take her to a spot just across the field from her son's body and deposit her in the sand. across the field the men are gathered. they have placed stakes in the ground and draped beautiful coloured sarongs around them in order to wash his body in privacy. his mother is sitting alone in the sand and i go sit down in the sand beside her. she looks at me and a tear runs down her cheek. i put my hand on her back and say softly "malesh" (i'm sorry) "malesh". she nods. we sit together. women come and sit around us. one at a time they crawl towards her, touch her, try to speak and end up sobbing. she sits there silently. she keeps looking at me and she looks confused. we sit together. we sit side by side, sometimes touching, sometimes not. at one point she moves her hand towards mine and i reach my hand out to take hers. we sit and look at our hands... they couldn't be more different., soft, smooth. hers.... black, creased, callused. she touches my hand and i trail my finger along hers. she motions towards my sandaled feet. they are covered in dried blood from the awful births the day before. i hadn't had the energy to shower yet. i nod, i know it is there. we sit together. i can feel the sun burning my skin, but i can't leave. everything is silent, except for the sounds of mourning that surround us. she turns to me and says something, but i don't understand what she is saying. i just nod. sometimes she rocks back and forth, but mostly she is still. we sit together. at times she looks over at me and the look on her face is completely vacant. in those moments i wonder where she has gone and if she'll come back. i silently pray for her- i can't imagine a pain worse than losing a child. sometimes she cries and i cry with her. i can't help it- i'm exhausted on every level and i have no reserves to keep any semblence of an emotional guard up. i cry with her, i cry for her, i cry for myself. i am half there with her and half lost in the memory of the day this was my family, my loss, my grief.
the men across from us move into formation to pray. some of the women near us move away to let other women come to his mother. i move back to sit with aicha and joyce. i look around and i see that we are surrounded by a huge crowd of women that contains all of our staff, and most of habillah it seems. i sense that there is something about this death that i'm not getting. aicha tells me. she tells me that this is the third child that this mother will bury this month. one son was killed a month ago, she doesn't know how. her teenage daughter had committed suicide by drinking poison two weeks ago. and now today another son. all in one month. suddenly her silence makes sense. her vacant look. the deadness in her eyes. her collapsing at the news. i would be insane by now if i was her.
a woman near me begins to wail. she is saying something through her sobs. aicha tells me that this was their aunt. she had no children of her own, and had lived with them, helping to raise these children. "our children are gone" she is sobbing, "our children are gone". my tba's surround her, place their hands on her. i can see the grief in their faces as they murmur consolations. the surviving sibling, another brother, has broken down at his brothers body. "my family is dead" he says over and over. the men lift the body, wrapped in a blanket, onto the back of a donkey cart. as it starts to move i feel joyce's hand on my elbow. "stand up" she whispers. we stand. everyone stands. i put my hand on my heart. the donkey cart slowly moves past us. his mother is lifted and dragged behind them. his grandmother begins her slow journey after them.

Monday, August 07, 2006

"i hate your job" "so do I"

on friday we were raised to a phase 3 level of security (there are 4 levels, and level 4 is a mandatory evacuation). the issue was a minor one, and we felt safe the entire time. it was more to make a point to the local authorities (about them taking our security seriously) than anything else. this meant that we were on lockdown in the compound for friday, saturday and sunday, with exceptions made only for life-saving measures at the hospital. my first exception was convincing gustavo to let me go deliver a baby that was breech. he insisted on coming with me, even though i reminded him that the threat had been against him which made him a liability in my opinion :) my second exception was yesterday when margret told me that a woman who was having her fourth baby had been pushing for 3 hours with no progress, and she thought she had a bandl's ring. i dragged carmenza along and we both agreed that the woman was fine, she was just pushing ineffectively. i spent the next 2 1/2 hours stimulating her push reflex (where you put two fingers into the vagina, with the pads of your fingers down, and apply downward pressure while she pushes) and carmenza told her over and over again how to push, while she continued to ignore us. we told her that she had to push properly because her baby's head had been compressed for too long, and it needed to come out. the heartrate was dropping and we were getting frustrated because she wasn't listening to anything anyone was telling her. the security on the roads is so bad now that we can't transport patients, even to save their lives, so we had to get her to deliver here. by the end of it my arms were aching from the exertion of trying to stimulate her push reflex. finally, finally she delivered a beautiful baby boy who we ended up resuscitating for quite awhile. i went home, back to captivity, leaving them under the care of my staff. that night i was lying in bed, sleepless. maybe i knew what was coming. margret called me on the radio to tell me that a patient had been transferred from gobe with a retained placenta. i told her i would come and as i was getting dressed i heard carmenza, also sleepless, at my door. i told her i had been about to see if she wanted to come too, so she went to put a shirt on over her pyjamas. i wasn't particularly concerned. manual removals can be dangerous but i've done them before and i know that i'm good at them. carmenza would give her some anaesthesia, i would go in and scrape the placenta off the uterine wall with my hand, and we would be home in bed in an hour or two. so, completely wrong. we get there and i find that the woman had delivered almost 2 days ago, and her cervix is almost completely closed. i can barely get my hand in to her vaginal canal, nevermind her uterus. she has a huge mass on her cervix that further limits the space available inside. the manual removals i've done have all been right after a delivery when everything is open and stretched out. this was like putting my entire arm into a vise. i won't try to explain how hard it was because there's no way that i could make myself understood. carmenza was there with me and even she had no idea why i was sweating so hard with the exertion and why i was wincing in pain until i asked her to try as her hands are much smaller than mine. then she got it. by the end of it, 3 hours later, we were blood-soaked. finally we had managed to manually dilate her enough to get our hands into her uterus, and i could grab the placenta. i couldn't take it out without taking her entire uterus out as well as it was completely attached to the wall. i started to rip it to shreds with my fingers and on carmenza's last turn she could pull it out piece by piece. throughout the entire procedure the woman, who was sedated, moaned in absolute agony. the umbilical cord was black and rotten, and she had a raging infection that was likely the reason that her baby had been born dead. it was awful and indescribable. we had a young, beautiful girl in the room beside us, in labour with her first child. the tba asked me to come check her as she was fully dilated. yeah, i say, she's definitely fully dilated... i can see the head. i look at her belly and i ask margret how high her fundal height is. she doesn't know so i measure it and, with the head at the introitus, she still measures 47cm. then someone volunteers that she's a fraternal twin. cool, i say, looks like we're delivering twins tonight. i leave my staff to move the woman with the placenta off the delivery table, clean everything and get the primi onto the table, as carmenza and i book it home to change our bloody clothes. we come back and get ready to deliver twins. by now it's 3 or 4am and we're exhausted from the two previous patients, both of which took unusual amounts of physical exertion. we had been told that the girl wasn't having contractions, which is why she hadn't delivered yet. no, she was having contractions, she just wasn't feeling them. and she hadn't delivered because her baby's head was caught at her huge circumsizion scar. she had been subjected to the worst kind of circumsizion- infibulation. she had been sewed closed, aside from one small hole. it was the first time i have ever this kind of mutilation and, appropriately, it was also the first time i've seen carmenza angry. she called the mother over and told her exactly what she thought of her having done this to her daughters. the delivery took hours and we were fading. she felt no pain with her contractions, prompting me to say to carmenza at one point "maybe she has leprosy", so we had to keep a hand on her gigantor belly and tell her when to push. she never pushed hard, which made sense because what motivation do you have to push if you aren't bothered by your contractions? we couldn't even use the age-old "it will all be over if you just push really hard a few more times" because she was so chill about being in labour, laughing with us, smiling with us. we were totally falling in love with her, in spite of the fact that we were so tired and just wanted her to deliver so we could go to bed. finally it became clear that she wasn't going to deliver, despite my having cut through her scar, my first episiotomy in my entire history as a midwife :( we hadn't been able to find a fetal heartbeat all night, and we were at a loss. we prepared to go home to talk to gustavo about helicoptering her to el geneina. as the entire night had been unfolding, the woman who had delivered the day before (ineffective pushing) had been lying in bed with her absolutely gorgeous baby boy who was rapidly going downhill. once when i walked by, she grabbed my leg and took my hand, putting it on his chest. he was burning with fever so i unwrapped him and showed her to fan him. we all somehow knew that he was dying, even though his heartrate and breathing were still good. everytime i walked by, i would see her husband sitting on the edge of the bed, holding the baby, staring sightless at the floor. the mother would look at me and beg me with her eyes to save him, but there was nothing we could do. as we started to head out of the delivery room to talk to gustavo, i saw the mother and the grandmother clutching his body, and i sat down beside them. the grandmother unwrapped him and when i felt his head it was cool- he was gone. his mother, who had just lost her 3rd child, rocked back and forth in an agony i can't even fathom. her motions were restless and lost. she moved constantly and with no apparent purpose. i told carmenza to go without me and i sat there and held her as she cried. slowly something amazing happened. between our three patients we had over a dozen women holding vigil out in our waiting shelter outside, some of them knowing each other, some not. one by one they entered the room, found a space and began to weep. the room filled with their grief as they joined the mother in mourning the loss of her son.
his father returned and he took his child in his arms. he looked up at me and said, in english, "my son.....". this was when i finally let myself cry. i asked him if he wanted a picture of him with his son and he said yes. then he wrapped him in white cloth and took him home.
carmenza came back and told me that gustavo was going to contact el geneina and try to get the patient on the helicopter, otherwise he was thinking of doing a road movement. we went home and waited for him to finish talking to the staff in el geneina on the sat phone. we sat outside with corinne and andi who had recently woken up, and none of us spoke much. finally gustavo came out and said "you're going to have to cut the baby into pieces to get him out". i won't tell you the words that came out of my mouth, but a rough translation is that there was no way in hell that was ever going to happen. carmenza refused as well. gustavo explained that this was all they would do in el geneina anyways, and that once the baby was that far into the birth canal there was no other way out. then he says that maybe we can do a craniotomy and again i rebel, as does carmenza. i tell him that if any of those things have to happen, i refuse to be there and i don't ever want to know about it- i will transfer the patient care completely. finally i ask if we can see if Save the Children (another ngo) has a vacuum extractor or forceps we can borrow. he and corinne agree to go on a search, and carmenza and i go to bed. twenty minutes later gustavo knocks on my door to tell me that he found a vacuum extractor in the anc. MY anc. i had been told that ours was broken and had been sent to el geneina for repairs, which wasn't exactly true. nice to know now that it was too late to save the baby from the day before. awesome. i go wake up carmenza and we go back to the hospital. corinne comes as well, which i think she definitely regretted. i had to cut two more episiotomies, bringing my total to 3 in one day....3 in the 7 years that i've been a midwife- f***ing circumsizions. i put the metal cup into her vagina and attach it to the baby's head. aicha starts the suction and i begin to pull him out by his scalp. i know that he's dead so the protocols go out the window- i just need to get him out. i pull and pull and pull, and as i pull i realize that it's not twins, it's one huge baby. i pull more, and slowly, slowly, slowly he begins to come. i finally get his head out, and i have pulled off patches of his scalp in the process. when the head comes out, her water comes as well. it is thick and black and the smell of it is enough to make us almost vomit. her infection was huge and the baby had been dead for awhile. the smell was overpowering. now i start trying to maneuver his body out and i can't get him out. it is the worst shoulder dystocia i have ever experienced. had he not died inside of her, he would have died in the delivery. i do everything that i know to do, and still he won't come. i pull with all of my might, making this the third patient in this one neverending day that i am manhandling. for 20 minutes i try, having carmenza apply suprapubic pressure, then trading places with her, then trading back. i use all of the strength that i have. when i feel his neck break in my hands, i step back and try not to pass out. this is a nightmare and any minute i'm going to wake up and be safe at home, in canada, in my yellow room. hawa, one of my hefty national staff, volunteers to try and i happily hand it over to her and step outside for a breath of fresh air. i go back in and i see corinne watching hawa. "welcome to labour and delivery" i say, as she has no experience in obstetrics and was interested in observing while here. "i hate your job" she tells me. "so do i" i reply. i go stand by hawa and as i stand beside her i hear the loud crack of his breaking bones and then she brings him out. she had managed to break his collar bone enough to get him out. his skin is coming off in patches and he smells as badly as the water did. i wrap him up and put him on the table so i can deal with the placenta. when the patient is stable i take the huge baby boy outside and bathe him. i think back to the first time i ever did this in the philippines and how i was crying so hard i couldn't see. this time i'm numb. i bathe him, i wrap him up in a clean towel and i bring him to show him to his mother. she moves the towel so she can better see him, she looks at me and smiles. he looks like her husband. i have wrapped his body and his skull so all she can see is his face, and his face is perfect. her twin sister and i wrap him completely in white cloth and his grandfather comes to take him. carmenza asks me if i'm going to suture her back up and i say no, i won't. she says that she'll suture her for me but she won't resew her closed either. she and aicha go speak to the husband, one of our workers, and explain to him that it's not good for her, it's not good for women. he tells them that he loves her and wants what is best for her and to not resew her. i fall in love with him that instant.
when it is all over, although in some ways it will never be over, we come home and i crawl into bed. it is early afternoon and life here is so loud you can barely hear yourself think, and i still sleep like the dead. i wake up and it's dark. i push my mosquito net aside and reach for my sandals in the darkness. i am paranoid about shaking them off before i put them on as i get way too many ant bites here. i shake them off, slip them on and walk across my room to turn on my light. when my light is on i look back towards my bed and see a dark shape right where my shoes had been. it runs when i approach it, and i can see that it is a scorpion. i chase it, step on it, remember bethany telling me that they always travel in pairs, and i leave my room, vowing never to enter it again. this is on top of my vow to never use the latrine again as last night gustavo was locked in there with a snake. i just want to come home.

Friday, August 04, 2006


she was fourteen when they invaded her village. she was fourteen when they came in and began to kill indiscriminately. she was fourteen when they murdered her parents and all of her siblings save one small sister. she was fourteen when they raped her. she was fourteen when they impregnated her. she was fifteen when she went into labour. she was fifteen when she pushed for days, to no avail. she was fifteen when her baby died inside of her. she was fifteen when she was finally taken to a medical facility. she was fifteen when they put metal instruments inside of her to crush her baby's skull. she was fifteen when they pulled her baby out of her in pieces. she was fifteen when the trauma suffered during her delivery wore a hole between her vagina and her ureter. she was fifteen when she began to leak urine from her vagina all day long. she was fifteen when her offensive odour turned her into a social pariah. she was fifteen when she started to deny herself water so she would leak less....smell less. she's sixteen and she came to us. she's sixteen and we told her we would help her. she's sixteen and we have set up an agreement to get her surgery in another town, and we will cover every cost. she's sixteen and we went to give her the news she has been waiting a year to hear. she's sixteen and we can't find her and no one knows where she is. she's sixteen and she's gone.

Thursday, August 03, 2006

the sitch

ok, this is an email i wrote already (in response to my sister telling me to be strong, healthier, safe and brave), and i've decided to copy and paste it because i'm just that lazy....

"as for me being strong.... i seriously almost quit yesterday (loooooooong story. far longer than i plan to write about). i wrote a huge email explaining my reasons and asking for advice, but then i had a 2 hour talk with gustavo and he was great as usual and we figured everything out. i'm still stressed and mad at my superiors (i asked for an extention for my holiday and was refused. i had asked because the staff in khartoum had given my national doctor 2 months off without bothering to ask me how it would affect the women's centre. they did it to save themselves money because otherwise they would have to pay to fly her back to khartoum again in 2 months. they get to save money and i get to do two people's jobs for 2 months. i see her patients all day and i am on call for births 24 hours a day. on fridays, as everyone else is relaxing for their one day off a week, i'm doing deliveries. maybe i'm just burned out, i don't know. but if i am then it's the fault of the staff in the capital and the least they can do is give me a couple of days longer when i finally get a holiday. the national staff get to extend all the time, but not the expats. one of the expats in the capital gets to take a month unpaid leave but i can't extend my vacation for 2 unpaid days. awesome) but for now i'm going to stay. gustavo is still fighting them to let me have more time off, telling them that its the most justified request he's ever seen (this is his diplomatic way of saying "she's about to have a nervous breakdown" :)

as for me being healthier....this place just isn't good for me. i've lost 10 pounds in the last month, my nights (when not doing deliveries) consist of dreams full of bloody murders or women hemorrhaging at deliveries, i have a huge cold sore (my mouth herpes) which likes to appear when i'm stressed out and worn down, it's so hard to get up in the morning that it actually hurts (even if i didn't have a delivery. i wake up at every sound because i'm so afraid of missing someone calling me on the radio). being on call every minute of every day is going to give me an ulcer at the very least- the radio makes a loud staticy sound every couple of minutes and i notice it every time.

as for me being safe.... it looks like someone (hmmm, i wonder who?) is trying to turn the people against the ngo's, which is easy to do in such a tense situation (ngos aren't wanted here by the powers that be, but they can't blatantly make us leave or scare us into leaving because they don't want the UN peacekeepers to come). there have been two incidents in the last two weeks where ngo workers were going to take water samples from wells in the idp camps and someone started rumours that they were going to poison the wells. the people they were there to help (the idp's, not the paramilitary) killed the workers. all of them. now the newest rumour is that people who are giving vaccines (us), food (us) and water (not us) are trying to poison the people. this tactic is pretty clever because if ngo workers were being killed by the paramilitary it would encourage the belief in the international community that outside intervention is necessary. if it is the idps killing us it's totally different. you think that people would never do that to us because they know us, they trust us, they love us... but the other workers that were killed had been working with those camps for 2 years already.

as for me being brave.... i'm ALWAYS brave, you know that :)

i've decided that i'm going to come home early, it's just a matter of how early. as kate said, the situation here may make the decision for me, but if not i think i'll come home early november, maybe earlier. i'm so burned out already and one month off to see everyone and have Christmas and be overwhelmed won't be enough for me to recover before i start med school. i have to be serious about med school and not start it on a bad foot. my staff are becoming more and more easy to train (in the last couple of days) and it's going to be hard (they have huge personal problems amongst themselves. yesterday one decided to resign and i was about to fire another one for lying about me. things are better today) but i think if we all commit to it, i can have them well trained in a few months and leave here feeling like i actually accomplished something and i didn't go through all of this for nothing."

ok, this is the best part of the response i got from my sister when i sent her this email....."Don't stay longer just to get your packages, I will buy you everything that I sent you again if you just come home".


Wednesday, August 02, 2006


hey guys, tonight carmenza got an email from a friend that made her realize that she hadn't received his last email, and i got an email from a friend who forwarded me an email that she had already sent and it hadn't arrived before. sometimes when we download it will say that there are a certain number of emails to download, then it will download less than that. now i'm worried that people are writing to me and i'm not receiving it and they're thinking that i just haven't bothered to reply. if you've written to me and i haven't replied, the odds are that i never received it. i try to reply to every email and usually do unless i receive a couple in a row before i had time to reply to the first, and then i just send one reply.
alright, i really really hope i haven't missed any of your emails, or hurt anyone's feelings. if you emailed me and never heard back, please send it again!
alright, it's been a long, long last few days and i'm going to bed.
love, Ames