Amy's Adventures in Darfur

Global Day for Darfur

2008-05-14T09:08:00.000-07:00

Today, Sunday April 13th, is the Global Day for Darfur and, oddly enough, I don't know how I feel about it. A part of me thinks “Great! Raise awareness, spread the word, remind people to keep involved... provide people with a 24 hour period where they really have no excuse not to do something”. Then another part of me thinks “Why? Why bother?” A few people will go to a pathetically unattended rally or fund-raiser. Some will sign a petition and then will spend the next 364 days of the year doing nothing. Many will think to themselves “Right! I really meant to sign that thing that someone forwarded me once, I'll totally do it later” and never will. Most people will think things like... there's so much need, where do I start, it's so overwhelming, I'm only one person, I give to charity, it's so depressing to even think about it, I have enough stress in my own life to deal with, why don't we focus on the problems in our own country, yes it's terrible but what can I do about it, and so on and so forth. And some people will honestly just not care because it doesn't affect their lives in any way. Yes, those people do exist. While I was in Darfur witnessing the genocide and sending endless stories home that forced everyone I knew to be as aware of it as I was, a friend of mine attended a party in Vancouver where she heard a psychiatrist say "Why should I care about the people dying in Africa?” In one of the Darfur facebook groups that I'm in, someone posted a note on the wall that included the sentence "well if the villagers are too stupid to defend themselves...". I pointed out that they had been disarmed by their government so they couldn't defend themselves (though I may have worded it more strongly than that), but this person still wasn’t particularly concerned. My best friend pointed out, in reply to that post, “I’d like to see YOU try to defend yourself from a Kalashnikov” (Kalashnikov’s being the assault rifles that are used on the civilians in Darfur, in case you were wondering), and that comment gave me an idea. Have any of you ever seen “Celebrity Deathmatch”? If not, here is how it’s described in Wikipedia...
“Celebrity Deathmatch is a claymation parody television show that pits celebrities against each other in a wrestling ring, almost always ending in the loser's gruesome death. It is known for the excessive amount of blood used in every match and exaggerated physical injuries (e.g., one person pulls off a participant's foot, living through decapitations, impalements, etc.)”.
This sounds like the perfect show. Here is my plan to secretly raise awareness by disguising education as entertainment... a special episode where we re-enact a typical fight scene in Darfur. First we take one young Darfuri villager (we can’t take grown men because, well, most of them are dead) and we match him up against 3-4 Sudanese soldiers and 10-15 Janjaweed (also known as the “devils on horseback”). The villager has no choice but to participate, the soldiers are paid to participate and the Janjaweed get to keep the wrestling ring and the arena if they participate (the stipulation being that they have to kill the villager and empty the ring in order to be allowed to keep it, of course). Then we give each participant a weapon. The young villager gets a stick, the soldiers get an Antonov aircraft and helicopter gun ships and the Janjaweed are each outfitted with a shiny new Kalashnikov. Now, before the match even starts we need to lay down some groundwork. Five years before the match begins, we will put the villager in the ring. He can bring some comforts from home, but only what he can carry. Maybe, just to make things exciting, we will toss in a small challenge. He can only bring what he can carry in one arm, because he’s going to have his little sister in his other arm. Oh and we’re going to make him watch us kill his parents and burn down his village just before we start. Alright, in to the ring. In the ring he will be allowed to build himself a small shelter with whatever supplies blow by. Now his food... the villager (and his sister) will be deprived of food for the second half of every month. They have no room in the ring to grow crops, so they will obviously be required to depend on aid and that aid will provide him with roughly half of the calories he needs as the World Food Program (one of our commercial sponsors) has had to once again cut the rations for the people living in the camps in half. In the five years before the match, our villager will live in the ring with his sister and they will do their best to survive. The rations they are given will need to be cooked to be consumed. To cook they need hot water. To boil water they need a fire. To build a fire they need wood. Nope, no trees in the ring. If they want to eat, they are going to have to leave the ring in search of wood. They are technically allowed to leave the ring any time they want. However, the 10-15 Janjaweed are also spending time in the arena during those five years and if they catch the villager out of the ring, they can do anything they want to him. This can range from simply a severe beating if he’s lucky, to outright murder. His sister faces an altogether different fate if she is caught outside of the ropes. What to do? Starve because your rations are inedible unless cooked or risk your life leaving the ring? The Janjaweed may be roaming right outside of the ring where he can see them, they may be hiding among the seats, or they may have gone to the concession stand for a hotdog and a beer. Unless he can actually see them, he will never know if they are there or not. Either the villager or his sister have to leave the ring if they want to live. He will die if he’s caught. She will be raped but probably won’t be killed. The choice is clear. Five years pass, they have survived and it’s time to start the match. Team “Government of Sudan” and their proud sponsors “Government of China” show up ready to do battle. They are well fed, well trained and well armed. Our villager, on the other hand, will be starting the match a) malnourished, b) ill, as most of the aid organizations have had to pull out of Darfur because it has become too dangerous to stay, c) psychologically scarred and d) probably borderline insane after 5 years of slowly starving to death while living in cramped quarters under extreme levels of stress. Fair match. So in one corner of the ring we have the villager. Surrounding the ring we have the Janjaweed. Flying across the ceiling of the arena we have the soldiers in their Antonov and their helicopter gun ship. In the audience (those in the seats and those watching it on TV) we have the world. There are so many people watching the match that they could easily band together and help the villager if they chose to. They astronomically outnumber the soldiers and the Janjaweed and all it would take is enough of them getting involved for the match not to happen. Most of the people in the audience don’t want to be there. Some of them don’t know what the match is about, nor do they care. They change the channel . Others don’t know what’s going on and would probably care if they did, but they have more pressing issues to tend to... like the football game. A lot of them are concerned about the match but don’t want to watch it for a plethora of reasons that tend to involve great concern about their own feelings and how it might make them feel. A lot of them WANT the match to be canceled but they don’t know how to go about making it happen so they sit silently in their seats waiting for someone else to do it. Some of those who want to help but know they need more people on their side go from seat to seat trying to convince people to get up and join them. They keep asking and asking, hoping that maybe this time people will be inspired to get out of their seats. They go to the ring-side seats, where the people who can get things done tend to sit, and they beg there. All it will take is ONE of those people in the ring-side seats to get involved and the match will stop immediately. Meanwhile, in the ring, the villager is watching all of this go on. He can see the cameras and that the seats are full of people. He knows that the fate of the match rests in their hands. Someone has told him that team “United Nations” is coming to tag him out and he keeps scanning the audience, wondering if they’re out there and when they’re going to arrive. The match is about to start... where are they? Too late. The bell rings. The match starts with the soldiers bombing the ring from their plane. The villager can try to get away if he chooses, but running a gauntlet of Janjaweed who are waiting outside the ring for you to run from the bombs so they can shoot you isn’t so appealing. We can’t have the villager die too quickly or people will want their money back. So he will stay in the ring and survive the first and second round of bombs and will still be there when the attack helicopters arrive to shoot his hut apart. He has probably lost an arm or a leg in the initial attack but he’s still soldiering on. As a special half-time event (Do they have half-time events in wrestling matches? Well they do in this one) the 10-15 Janjaweed will gang-rape the villager’s little sister. They won’t kill her though. They don’t want her to die- they want to humiliate and impregnate her. It’s called breeding the Darfuri’s out. Alright, half-time is over. The villager has survived both the bombing and the attack helicopters but now it’s time for the Janjaweed to enter the ring and finish off any male survivors. The villager can make a run for it or he can die when they search the ring and find him. He hides in his hut but is smoked out when they torch the roof. He runs out of his hut, his clothes in flames, and makes a break for the aisle. As he is going through the ropes the Janjaweed take aim and shoot him to pieces. And there you go. Another episode of Celebrity Deathmatch where there is an excessive amount of blood and the loser dies a gruesome death. What do you think?

Reading back over this, I’m aware of how cynical, sarcastic and bitter it sounds. I’m not going to apologize though. Regardless of the tone in which it was written, this is a very realistic portrayal of the life of a civilian in Darfur these days. The last time I sat down and wrote about Darfur (the rant I sent out when Amnesty International was only able to get 500,000 signatures on their petition to the White House) I got a lot of different reactions. Most people were able to take it as a wake-up call regarding their inaction, or as an inspiration to do more. A few people wrote back and defensively pointed out things they have done. And one person wrote to say something to the effect of how people ARE aware and ARE doing something (they’ve seen people wearing t-shirts) and how my being angry wasn’t going to help anything. My only response to that is to wonder how I can be anything BUT angry. Knowing that a people group is being systematically starved, raped and murdered by agents of their own government while the world looks on and does NOTHING is something that SHOULD make people angry. I’m not going to apologize for being angry- you should be apologizing for NOT being angry. Then again, maybe I can’t expect people to care as much as I do, or feel as strongly as I do, because none of you have been there and seen first-hand what’s happening. Maybe, without seeing it for yourselves, none of you can ever care to the level that I wish everyone cared. Maybe it’s unrealistic of me to expect that. And maybe you have all done everything that you can do to help. In that case, this anger isn’t directed towards you. If you can stand in front of the mirror, face yourself and truly know that you have done EVERYTHING within your power to try to end this atrocity (everything you would hope and pray others would do for you if it were you and the people you love being bombed, shot, burned alive, stabbed, beaten, raped (men, women and children), humiliated, starved) then I applaud you. More than that, I envy you. I have done a fairly significant amount of things to try to help the people of Darfur- spending the longest 5 months of my life on the front-lines there, risking my life and my sanity putting women and children back together again and watching the ones who were beyond our help die, writing stories that told people of the things that they weren’t going to hear about in the small newspaper article on page 17, giving presentations, writing articles, trying to keep people involved and inspired, encouraging people to write to (and call) newspapers, television stations, politicians, Oprah- and I STILL can’t look at myself in the mirror and tell myself that I’ve done enough. And if I haven’t done enough, I’m pretty sure that none of you have either. I don’t think that anyone can say that they have done enough while this atrocity is still on-going- while little girls are daily sent out to gather firewood, knowing what awaits them yet having no choice but to go. You know what, forget facing yourself... if you had to sit across from the 6 year old girl whose vagina we had to sew back together my first week there, could you look HER in the eye and tell her that you did everything possible to keep that from ever happening to her again? I can’t. And that probably makes me the worst person in this situation. Because unlike all of you, I don’t have the luxury of not truly knowing. I had her face branded in my mind. I have the memory of the moment I looked between her legs and knew what they had done to her. I can, in a heartbeat, draw on the way it felt to pin her down while she screamed so I could inject her with a sedative so we could fix the damage that had been done. I’m not like the rest of the world who can easily never bring it to mind because it’s worlds away from their reality. I KNOW what a nightmare life there is. It takes actual effort for me to not let myself think about it... to force it from my consciousness so I can get through school or through the day. So while almost everyone in the world could, somewhat honestly, tell that little girl that they just didn’t realize, I can’t say that. I would have to sit there and admit “I made myself forget you. I had to”. I’m sure it would bring her great amounts of comfort to know that, while she suffers, I am plodding my way through medical school in order to one day be able to help even more. I’m sure that she understands that in order for that to happen, I can’t let myself think about what she’s going through, nor can I take the time and the mental energy to keep writing to the powers that be, demanding that something be done to save her. I’m sure.

Today I write this because it’s the “Global Day for Darfur” and I am forced to think about it whether I want to think about it or not (and I clearly prefer not). It is one of the rare times where I let myself remember. I wish I could take every person in the developed world to Darfur with me, to show them the things I saw and to force them to know, as I know, and feel as I feel. Since that is unrealistic, instead I write in an attempt to bring you there as much as possible. If nothing else, maybe I can motivate people to think today.

And since I know that I can and should be doing more, this email is directed more towards me than to anyone else. But that doesn’t mean that you’re off the hook. You aren’t. You are all still on the hook. We all are until we finish this.

My thoughts on Darfur (written in October 2007)

2008-05-14T09:05:00.000-07:00

Today is United Nations Day and it is the day that Amnesty International is going to the White House to hand-deliver a petition signed by almost 500,000 people demanding that something be done to end the genocide in Darfur. that sounds like a lot of people to be signing one petition, but when you consider the fact that there are over 300 million people living in the U.S. (and another 33 million in Canada), it's actually a pretty pathetic number.
A couple of weeks ago some friends and I gave a presentation at my school about Darfur and the atrocities that are occurring there. i did it because whenever i wear my "Save Darfur" shirt, people ask me "Who is Darfur?" or "is that a band?" i did it because there are SO many people out there who have NO idea what is happening in Darfur but who could tell me who Tom Cruise is married to (seeing as how he got 29X more press coverage than Darfur did last year). i did it because 10 peace-keepers were killed in Darfur this month and i sat in class fighting back tears all day when i heard the news, but life around me went on as usual. i did it because the other day the government of Sudan sent troops and Janjaweed into another village where they slit the throats of the men praying in the mosque and shot a 5 year old boy in the back when he tried to run. and then the A.U., the supposed "peace-keepers" retracted their statement that it had been a government attack, despite the fact that an international agency was there and witnessed it all. i did it because the peace talks are scheduled to start in Libya any day now and the people of Darfur are once again being slaughtered as each opposing side tries to gain an advantage on the ground before the talks begin.

It wasn't easy to give the presentation. i thought i was going to be nervous about the public speaking part of it, but that wasn't the hardest part. the hardest part, by far, was re-opening the floodgates. when i came back from Darfur the only way i could start to function as a somewhat normal human being again was to not let myself think about it. in time the nightmares stopped and i pushed most of what i felt about it far enough into the back of my mind that it had almost come to feel like i had been there in a previous lifetime.
going through the pictures was the worst part. when i was home in august my mom had burned me a CD with all of the pictures i had saved on her computer. she had accidentally included all of my Darfur pictures on it and somehow they ended up mixed in throughout the other pictures i had saved from the last year of my life. i sat on my bed and flipped through them. a picture of Abdel-Rhazid, a malnourished, handicapped little boy we discovered in a hut one day. then pictures of me at the park in Vancouver with my healthy, strong young nephews running around playing hockey. a picture of Houda, one of my staff, a young woman who had been impregnated by rape and whose family threw her out. then pictures of my girlfriends and i sitting in the sun on a lawn in North Van, laughing, cuddling. a picture of Khartoum, whose smile never reached her eyes. pictures of my little sister lying down in our backyard, giggling as our new puppy jumped all over her. pictures of the under-weight children in our feeding program, many of whom have fathers who will always wonder if they are his. then about 100 pictures of my 2 year old nephew, a desperately wanted child who is the light of his father's life, with ice cream all over his face. and on and on it went. all i could do was look at them and think why? WHY? why did i get to leave? why did they all have to stay? why would the UN send their helicopters in to get me if we were attacked but not let any of our Darfuri staff get on board as well? WHY??? when my best friend was at the genocide conference in Montreal last week a Rwandan woman stood on stage and told the world that they had failed Rwanda. she had watched as the Europeans had been evacuated with their f***ing PETS, but wouldn't take her Rwandan little girl. another man spoke about seeing the aftermath in Rwanda and how the one image that most impacted him was going in to a church (where many people sought refuge and were subsequently killed) and seeing the remains of a child with a machete buried in his skull. he said that the world needs to see these images and i agree. so many times i wanted to take pictures of the things i saw in Darfur but i was afraid of 'exploiting' anyone. i wanted to preserve whatever shreds of dignity they had left. but now i realize that i was wrong. i should have taken pictures and i should have MADE the world look at them. i should have taken a picture of that 6 year old girls shredded vagina. look at that and tell me that you don't have 2 minutes to spare to sign a f***ing petition.

and my stories.... i was afraid to try to read them during the presentation because the last time i did that i started to cry in front of my class. so i asked Shraddha to do it. and she did. and still i cried, just hearing them. to everyone else they're just words. to me, they're memories. they are memories of a time when i had an idea of what it was like to go to bed every night grateful and surprised to still be alive. it was millions of miles away from my safe, beautiful life in Vancouver, Canada. it was reality. and i couldn't change the channel, turn off the radio or skip that article in the paper to magically make it go away or not be true. i saw it and i know it's real.
so now what do i do? i told myself after seeing "Hotel Rwanda" that i would never let something like that happen again without my doing something about it. so i went to Darfur and i took pictures and i wrote stories and i did everything that i could to tell the world that what you're hearing on the news isn't nearly as bad as it is in reality. it's worse than you can even imagine. and still only a paltry half million people took the time to sign the petition. i can't even COUNT how many bullshit forwards i have been sent about supposedly missing children (who, it usually turns out, aren't missing at all), or not putting plastic in the microwave, or how drinking cold water is going to give you cancer. THOSE topics are important enough to forward information about, but the rape and murder of an entire people group ISN'T? that petition should have made its way across the world and back thousands of times by now. and everyone who thinks they can't be bothered to sign it or forward it should get to go live in one of the IDP camps in Darfur for a little while, praying to God that they aren't murdered or raped when they leave the camp to forage for firewood. it's sure f***ing easy to be US, isn't it? do you see any of us being hunted down like animals and shot in the back as we run for our lives with our children, knowing that we had to leave the rest of our family to fend for themselves because we only have 2 arms? when is the last time someone in North America had to choose which of their children they could carry as they fled their village? how often do couples here debate who should have to go get the firewood, because the husband runs the risk of being killed whereas the wife will just be raped? how many families have been pared down to only those who could run or be carried? would you run and leave your elderly grandparents behind? or your brother who broke his leg as a child and can't walk properly? or your wife who is in labour? (fyi, burning down the hut that the labouring woman and her birth attendant are still in is definitely done). and, if this was happening in North America, would people be not be taking to the streets, SCREAMING for help, protection and justice? remember the outrage over the slow response to Hurricane Katrina? yeah, that response was days. the people of Darfur have been begging us for help for the last THREE YEARS. that whole bullshit slogan "Never Again"? it's bullshit. we don't get to read about the holocaust anymore and tell ourselves that it could never happen in this day and age. we don't get to think of Rwanda as our one failure and tell ourselves that we have learned from our mistakes. we haven't. it's happening again and everyone is sticking their heads back in the sand where it's quiet and comfortable.

i have hardly slept in the last two weeks. i want to publish my stories somewhere that people will have to read them. i want them to see the pictures that i DID take. i want to tell them all of the things that they don't want to hear. i want to have a fund-raiser to raise money and awareness about the biggest humanitarian crisis in the world today. but it seems like people don't care all that much anymore. when i left Darfur i knew that once i stopped sending out my stories full of the horror that is life there people would let it fade into the background. people have their own causes and charities and there are times in the year when people are less likely to give etc etc etc. but i'm in school and i am only home so often, so it gets pushed back and back and back to the point where i know it will never happen.

and i wonder what it will take for the world to really care? will a caucasian aid worker have to die? is that what it will take to get Darfur on to the front page? because no one seemed to give a shit about the 13 aid workers that were killed while i was there and i'm pretty sure that's because they were African. well it's only a matter of time until a caucasian aid worker is killed. we found out we were targets in August of 2006. normally overseas we're seen as neutral, the third sex, somehow superior, or just not really there. international aid workers were spared in Rwanda as the Hutus murdered the Tutsis right in front of them. Monica, on my team in Darfur, told me that her friend had been there with MSF and that by the time it was over her hair had turned completely white. i asked her if that would happen to us and she shrugged and said they would either come in and kill just the Darfuris and leave us, or they would come in and kill all of us, or they would just kill us to make an international statement. no guarantee either way. but thus far they have managed to avoid killing a caucasian. instead, when they attack the aid workers, they rape the female aid workers. they aren't stupid. they know that if they kill her they will bring more international attention to Darfur. but if they rape her the organization will often just quietly pull out in order to ensure her privacy. they know what they're doing, these "gangs of reckless bandits" who the government has "nothing to do with".
and so it continues... and i can either lose my mind over the unbelievable injustice of it all or i can stuff it all back down and get back to "normal" life. and on that note... i have some exams to study for.

News that makes me want to vomit

2006-12-17T12:14:00.000-08:00

in the newspaper....

"Also on Friday a group of six aid agencies said they had been forced to withdraw from Darfur because of the "unprecedented difficulties" of working in the region.

The group - which included Oxfam, the International Rescue Committee, Goal, Concern, World Vision and the Norwegian Refugee Council - said they were becoming direct targets of violence."

just what the people of darfur need right now....less humanitarian aid and less witnesses.

i came across this quote the other day and now, more than ever, as i think of the people i left behind, it rings true...

"De Corde totaliter Et ex mente tota, Sum presentialiter Absens in remota"

translation "with all my heart/ and all my soul/ I am with you/ though I am far away"

-Carmina Burana

Better stories...

2006-12-11T18:36:00.000-08:00

if you are a newcomer to this blog, you will find the more personal stories back in the june, july and august archives. after that they tend to become a bit more general (and a lot more angry). i'm also going to post more pictures as soon as i become less lazy (any day now...seriously...)

Team Life

2006-12-11T17:53:00.000-08:00

another old one that accidentally wasn't posted. it was written in the end of july.

one of the most important aspects of being overseas is your team. i have been insanely blessed in the past, making life-long kindred-spirit friends with the girls on my teams in the philippines and in afghanistan. it was often those friendships that kept me sane and that made the situations there bearable. it was those teams that made me fall in love with working overseas, and that made me expect to always have a team that was a port in the storm.
when i first arrived here i wasn't sure what to expect. steffan (who was going to kerenek) and i had been briefed together and each time it was the same "in kerenek the team is GREAT, everyone gets along, they're all good friends, etc etc. in habillah.... uh, not so much". i was told that the two girls got along with each other, but not with the one guy, and we had no fieldco yet, so it was just going to be the 4 of us to start. when i arrived here i found that i clicked with milena and carmenza, but clashed with andi on a regular basis. it was so weird for me to be on a team that wasn't totally close and loving. it definitely made it that much harder to be here, and i spent a lot of time with my ipod on. shortly before andi and carmenza left for their vacations we welcomed gustavo, our new fieldco (aka our boss), who was a breath of fresh air. his girlfriend, monica, is based in el geneina but she joined us for a week as she's in charge of the medical activities in the project and came to check things out. those days were heaven. gustavo and monica are so funny that it's exhausting to be around them for too long. every day we worked our insane, stressful jobs, and each night after work we would sit outside and they would smoke like chimneys and entertain us with stories from their previous missions- "and then they kidnapped us, but very politely" (somalia) and "there they don't involve civilians in their disputes. if they are going to fight they go out to an empty field and kill each other like gentlemen". eventually the vacationers returned and everything was different- andi was a new man. he was rested, he was relaxed, his face had filled in (he had lost so much weight here that he was actually gaunt) and his sense of humour was back. i was like "who are you and what have you done with andi?". the next two weeks were amazing. we all laughed so much that it hurt, which is the best therapy imaginable. as we got more and more comfortable with each other we all acquired nicknames- i'm 'the beast of beasts', which sounds a lot like the nickname my older sister calls me, which is 'monstergirl'. milena is shtroumpheta, which is smurfette in french, gustavo is 'moustaffa the palestinian' as everyone here is convinced that he is arab and/or palestinian, carmenza is 'carmencita', and gustavo calls the girls, collectively, 'the squirrels' (andi has no nickname but we tease him mercilessly for being 10 feet tall and hitting his head on everything. he does, however, have a stuffed bat who we named 'ignut the coolcool'). when we had guests arriving from the headquarters in geneva gustavo turned to carmenza, the calm one of the group, and said "try to control the beasts, will you?". whenever i would tackle someone (let's be honest, it was almost always milena- what can i say, i miss my sisters) gustavo would start chanting "fight, fight, fight", and then he would ask us to pause while he wet the sand. one day, after we had broken yet another piece of furniture, he laid down the law- "there will be no more fighting..... unless there is mud and i have my camera". milena, who is the weaker one in a set of identical twins, always just took it when i harrassed her, but by the end of her time here she was fighting back and starting to hold her own- i'm so proud :) we were all, also, given characters from the movie 'madagascar'- i'm the king of the creatures in the woods, who sings 'i like to move it move it' but i'm not sure why other than the fact that he's apparently crazy.
we got so close and so attached to each other, and i would have been completely happy to keep things that way until december, so i tried to forbid anyone to leave. alas, this last monday milena finished her mission and went home. it's strange how much it hurt to see her go, and what a huge hole she left in the team. it was also strange how jealous i was of her getting to leave, and how often i got caught up in the fact that someone was leaving, forgetting that it wasn't me. our new nurse is a girl from switzerland named corrine. she's nice and seems quite mellow but, as carmenza reminded me, "you were quite normal for your first week or two, and now you behave like a badly-educated boy", so maybe she'll turn out to be as fun and wacky as milena was :) andi and gustavo leave in early september, which means that we have to have a new logistician and a new fieldco, and those are the only other changes that will happen before i leave. i can't imagine life here without gustavo and monica- our next fieldco has some mighty big shoes to fill.

it occured to me as i was writing about how i tackle and harrass milena that several of you readers were probably thinking "thank GOD she's in sudan". then i started to try to think of everyone who has suffered from my boredom and, aside from my sisters (obviously), i made a list: jaana (who has a quote in my quotebook where she says to me "remind me to never marry anyone like you"), hil (who has a quote in my quotebook "if i was married to you i would divorce you"), em (who holds her own by subjecting me to the goblin, which scares the crap out of me every time), kate gem (who told me once that it was confusing to have someone who was so nice cause her the most pain), kate dubensk (who i have great footage of when i tied her up), sarah naiman (who i have so many quotes from i can't even list them here), kate van (whose skull i accidentally fractured), hannah (who has no siblings so i was just filling in), jill and allison (who made the mistake of sitting next to me in class), lina (who told me once "i love you more than cockroaches, but only just"), mandy (who looked shocked when i bit her the first time, but edwin explained by saying "it just means that she likes you"), lou (whose pregnant belly i used to jostle just before we fell asleep in the midwives quarters, so the baby would wake up and kick her all night)....and the rest of you who i'm sure have many, many stories to tell, which is why if i ever get married none of you are invited to my wedding :)

milena and adam

gustavo and monica

andi and corinne

mere moments before i started vomiting on the airstrip :)

carmenza and abdel-razid

milena after losing a pen-fight with me

amy giving milena "chest pains"... a beloved osborne-smulders family tradition

doctor monica

gustavo, whose most common expression was "i feel lazy..."

explaining the cast of madagascar to monica (who is the hippo)

ok, so occasionally we danced in the rain...

Regaiya

2006-12-02T23:17:00.000-08:00

regaiya starting to fill out

this one is the second half of an email that i couldn't post. this is the part of the email that you can read....

the other woman in my life lately is one whose story is far more affirming. her name is regaiya and she's two years old. when regaiya was first admitted to our pediatric ward she haunted me for days- i would see her face before me at night as i tried to sleep, no matter how hard i tried not to think about her. she was 2 years old and was the most emaciated being i have ever seen, which is saying a lot. she was a skeleton with bones- she didn't even have the swollen belly. there was no flesh. her eyes were sunken and the skin on her face was pulled so tightly across the bones that her mouth was open in a permanent grimace. her eyes were huge in her tiny face and were the picture of suffering. each time i went into the ward i would stop to check on her progress and say hello to her mother. she started out lying, completely still, on her side, and being fed through a nasogastric tube. she never moved and couldn't sit upright. slowly, painfully slowly, she started to move a little. then, she could sit up with help. one day i walked in and she was sitting propped up in her mothers lap, holding a protein bar in her tiny hand. over the last couple of weeks she has come so far it's amazing. she's sitting without help and she's feeding herself. she's still painfully thin but she's filling out and has reached the point where it doesn't hurt to look at her. she's now caught up to the size of most of the children who come in severely malnourished. more than that, she has started to smile. i don't know that she's ever smiled before, or that she even knows what she's doing. when i tickle her feet her lips twitch, then curl up at the corners, but she looks so confused when she does it. she greets me now- i'll go up to her and put out my hand and say "salam" and the last few days she has slowly reached her hand out to hold mine. her mother, like all the mothers here, is thrilled when i take pictures of her and show her on the digital screen. i don't have any of her when she first arrived because i honestly couldn't bring myself to take her picture. it was one of those situations where you want a picture so that people can see that this is reality, but you don't want to be the one to take it. these days it is a joy to see her and to take pictures of her newly chubby cheeks. her existence, her recovery, gives me hope and reminds me of why we are here.

regaiya on her way to recovery

The human suction-machine

2006-12-02T22:22:00.000-08:00

this story contains a moment that was, simultaneously, the funniest and yet the most disgusting moment in my entire 5 months in darfur. it was one of those moments that isn't funny at all when you really think about the situation it occurred in, but we were so tense and so stressed out that when it happened all we could do was laugh. and laugh we did (and by "we" i mean "me". milena wasn't laughing nearly as much, or at all really :) i was literally doubled over and couldn't stand up because i was laughing so hard i could barely breathe. we had a four year old boy arrive at our hospital, unconscious and febrile. his symptoms didn't point specifically to any one thing so it was a bit of a process of elimination. it was late, we were exhausted and we were tense. it didn't look like he was going to make it and no one wants to watch a four year old die. he started to choke on his secretions so milena went to suction out the back of his throat. our suction machine was broken so i had lent the pediatric ward the delee suction device from the delivery room. note: the delee is used by au naturel midwives, or those of us who work overseas and are ever at the mercy of sporadic power-supplies. it is a simple contraption, consisting of one hollow cylinder with a lid on it. there are two holes in the lid and each hole has a tube running out of it. when the baby is born you place one tube into their mouth and nose and you suck on the other tube. when you inhale through one tube you are creating a vacuum in the cylinder which then creates suction in the other tube and it sucks the mucous from the baby's orifices into the cylinder. milena had never used a delee before and it hadn't occurred to me that she may need some instructions on how to use it. she put one tube in the child's mouth, the other tube in her own mouth and she started to suck in. it was all going very well until the cylinder filled up with mucous and saliva- i guess sick four year olds have much more secretions than a newborn. what milena didn't know was that once the cylinder is full of fluid, when you continue to suck on your tube you are essentially using it as a straw. that straw brings whatever fluid is in the cylinder directly in to your mouth- and you are sucking hard to create suction so you end up with a huge mouthful before you realize what's happening (it's never happened to me, thank God). i was watching milena suction him when suddenly her eyes went wide with horror and she dropped the delee and ran from the room. i found her outside spitting violently and repeatedly filling her mouth with water, swishing it around and spitting it out. i am now laughing so hard that i have to sit down. milena is screaming with disgust between each mouthful of water. she asks me what she should do and i say that if it had been me i would be gargling with bleach by now. then i tell her that she can gargle with the vinegar we use for sterilizations, because vinegar is acid. she runs to the sterilization room, grabs the vinegar and takes a huge swig. it did NOT look like a pleasant experience, let me tell you. i, on the other hand, was having a great time. not only did i laugh about it for days, i took pictures of the entire episode. and yes, before my older sister points this out to me, i know that i am a terrible person and there is a special place in hell reserved for people like me (the same place that is reserved for people who swallow live unborn ducklings, apparently even if they didn't know it was alive and were tricked into doing it. long story).

gargling with vinegar

"Shared joy is a double joy; shared sorrow is half a sorrow" - swedish proverb

2006-11-30T22:42:00.000-08:00

sometimes there are no words...

Our 1.2kg baby

2006-11-30T16:55:00.000-08:00

carmenza tube-feeds the baby

at birth

two weeks later

Twins

2006-11-30T16:50:00.000-08:00

an all-night delivery results in two perfect baby boys...mohammed and mahmoud.

me looking like i've been awake for a week. you have to know how little pride i have left to be posting pictures like this... :)

Two women

2006-11-30T16:13:00.000-08:00

these pictures are from a night whose story ("two women")i can't post. it is a night that we tried to keep a girl alive as we waited for her family to come donate their blood to save her life. we waited and waited and waited. they never came.
i like that these pictures are hazy and dream-like as that entire night was hazy and dream-like.

waiting...

blood typing

one of our beloved staff gives their blood to save a strangers child

a life-saving blood transfusion by lamp-light

more pictures...

2006-11-30T13:55:00.000-08:00

i have gone back and added pictures to the stories that they are associated with. if you would like to see them feel free to travel back to the old stories (starting in june).

I kid you not...

2006-11-28T16:35:00.000-08:00

this is an actual conversation that i had with someone over american thanksgiving:

my sister's friend asks me: "is it hard to come back to north america and deal with culture shock?"
i have had some wine so i am more honest than usual (for the most part i just say yes and leave it at that- it's easier that way). i say "actually i'm used to the discrepancies between developing countries and north america- this was my 6th trip overseas. the hard part is coming home and realizing how few people really care about what is happening in darfur. when i was in darfur i was immersed in it, so it was all i cared about. the people i was in communication with were my family and friends who were all aware and who all cared because they knew me and read my stories. it gave me the impression that everyone cared that much. it was hard to come home and realize how wrong i was".
she looks at what i'm wearing and says "you got that sweatshirt at 'the Gap', didn't you? i have the same one".

Milena syringe-feeding our baby orphan (from the story "natural healers")

2006-11-07T13:46:00.000-08:00

Adam, who lost his hand to a grenade

2006-11-07T13:43:00.000-08:00

Playing with toys sent by Jadyn (3yr old from Canada)

2006-11-07T13:41:00.000-08:00

One of our gunshot victims ("you always think it can't get worse...")

2006-11-07T13:40:00.000-08:00

Carmenza with our little amputee ("healthcare")

2006-11-07T13:38:00.000-08:00

Some more pictures...if you click on the picture you can see a bigger version of it

2006-11-07T13:25:00.000-08:00

2006-11-07T13:05:00.000-08:00

Awareness

2006-10-22T09:25:00.000-07:00

this is an email i just sent....

hi everyone, i think this is the biggest group email i have ever sent- but this issue is big enough that i am sending this to every person whose email address i have ever known in the hope that all of you will do the same and that eventually it will reach every email inbox in existence. many of you haven't heard from me in years, if ever, and i'm sorry for falling out of touch. i'm writing now because, as many of you know, i have just returned from spending 5 months in Darfur and i have returned to a continent that seems shamefully unaware of what is happening there right now. when i came through immigration upon returning to Canada i was asked (by two separate people) if i had been in Darfur "on vacation". i cannot believe that in this day and age, with the means of communication we have at our disposal, people can be so unaware of the biggest humanitarian crisis in the world today. it wasn't until i spent the last few days at home that i realized how this could be true. i have seen such minimal news coverage on the subject that all i want to do is cry. last year there was 29X more news coverage on michael jackson and 12X more news coverage on tom cruise than there was on Darfur. i am begging you, on my knees, to educate yourselves on what is happening there right now and then, in turn, to educate others. i encourage you to google Darfur and read the many articles that have been written and apparently rarely read. the people of Darfur are suffering in ways that you and i can never fathom and it is time that we, the blessed few, were aware of it.

with gratitude, Amy

Home

2006-10-20T15:31:00.000-07:00

wow, i can't believe i'm really home. it still hasn't sunk in, that's for sure. the last week has ranged from fantastic to horrific as far as debriefing and re-entering the civilized world. i flew out of sudan on thursday night and spent the night on the plane talking to a man who is working for the A.U. he told me stories that made me nauseous- things he has seen happening in darfur, things he has realized about the A.U. and their presence in darfur. he said that their purpose there seems to be to stand by and watch the attacks happen, occasionally joining in on the rapes. it seems like things just can't get worse, yet they keep getting worse. the stewardess asked us what we had been doing in sudan and we told her we were in darfur. she offered to get us very drunk but i decided against it. there isn't enough alcohol in the world to help me forget the things i've seen and the stories i've heard. i arrived in geneva on friday at noon and started my debriefing. one funny part was that i was scheduled to speak to a therapist, which i had assumed would happen because i had been told by monica that with msf-spain, anyone leaving darfur or somalia had mandatory counseling. later when milena joined me in geneva for the weekend i said something like "when you were talking to the therapist..." and she said "what therapist? i didn't talk to a therapist". we decide that maybe it's because her debriefing had been so rushed. then gustavo joined us and i asked him if he had had to talk to a therapist and he said no. i say, am i the only one who had to? why? and gustavo says "because you put your feelings on the internet". ah. so the debriefing was fine, as far as official debriefing goes, but it was the unofficial debriefing that did me the most good. like i said before, it is talking to the people you were on the field with that helps the most- they are the ones that understand. and had i been given the choice of who i would want to spend time with, talking about my experience, i would have chosen milena, gustavo, aurelie (remember the french girl from my first week in darfur?) and monica. thankfully God worked it out so that i crossed paths in geneva with 3 of those 4 (i missed monica by a few hours). it RULED. milena came to spend saturday and sunday with me, and we basically just walked around, talked and ate. i was averaging 3 milkshakes a day, which is possibly why i got the disappointing news at my medical checkup that i had regained most of the weight i had lost :) on sunday night gustavo finally arrived (after missing a connecting flight that cost him another couple of flights) and we spent the night with him, then i got to hang out with him monday during the day. then on monday night i went to aurelie's for dinner and slept there. as we were about to get on the train she asks me if i have my passport with me. i say yes, why? and she tells me that we're going to france. right, france. between the indian food, the wine, the beautiful baby girl and the company, that was my best night. i could have happily done that for a week. the next day i flew to toronto on a flight that was a comedy of errors. first we sat on the runway for 2 hours while they checked a "dent in our fuselage" (not that i didn't want them to check it. no one wants a dent in their fuselage when they are flying over oceans, no matter how impatient they are to touch canadian soil). then when we were approaching toronto we were told that a plane in their airport had hit a bird, so the takeoffs and landings were all behind schedule and after sitting on the runway for two hours we didn't have enough fuel to wait so we were going to land in montreal. excellent. basically this all leads to my 7 hour and 40 minute flight becoming a more than 12 hour flight, which was fanstastic because it gave me so much extra time to sit next to the psycho beside me. the guy beside me clearly had no knowledge of airplane etiquette at all, as he spent almost the entire flight facing me and sighing deeply. this might not have been as bad as it was if his breath hadn't smelled like carcass. then there was the 4 times that he turned off my tv screen. i kid you not, he actually reached across me and turned off my screen 4 times until i hit him. my sister reminded me that you're not allowed to hit strangers, but i reminded her that you aren't allowed to turn off other people's television screens when they are trying to watch a movie either. i didn't hit him hard- he was more surprised than hurt. i finally arrive in toronto and i am exhausted and annoyed. then i go through immigration and it just gets worse. the two women that i spoke to both asked me if i had been in darfur "on vacation". all i can do is repeat "are you SERIOUS?". neither of them had any idea what is happening there. i was torn between a desire to either burst into tears or start punching holes in the walls. unless you are amish and don't have a television, there is NO excuse for not knowing what is happening there right now. they seemed a bit embarrassed by my reaction. good. i go to get my bags and i stand there and wait until the very last bag comes out and mine isn't there. everyone else has taken their bags and left and i am standing there, alone, watching to see if there are any more bags coming. as i am walking over to tell someone that my bag didn't arrive i see that my bag is in the area with the oversize bags. i sigh, pick it up and finally get a taxi.

so my night in toronto with arin was dramatically reduced in time. instead of arriving at 5, i got out of the airport at eleven. by the time i got to her house, it was midnight and we had to stay up till after 3:30am talking to make up for lost time. the next morning she hit the alarm and missed class, which is apparently the first time she has missed a class this semester. apparently when you're in law school you stop skipping classes (i wonder if the same goes for medical school?). i would feel badly about being a bad influence on her, but really, if it ever came down to comparing who was a worse influence on who, arin would win hands down and the scarring on my liver can prove it. that day was my birthday and i spent it debriefing with msf canada, then flying home. kate, my best friend whose birthday is the day after mine, decided to share her birthday with me, so yesterday was my unofficial birthday. i haven't done much more than hibernate, nor do i have much desire to do much more than that. i'm sticking around for a party on sunday then it's off to oregon to hide in a beach house. more later...

Amy's opinions are hers alone

2006-10-12T07:29:00.000-07:00

i think i am the only person in msf who actually supports the idea of the peacekeepers coming in (granted, i'm not really "in" msf. i started 5 months ago and in a week i will be done. i'm hardly a spokesperson for the organization). over the last few days i have had the chance to talk to a lot of different people in the organization and none of them believe that a military solution will solve anything. i might be inclined to agree with them if they were able to suggest an alternative plan, but they can't. when i ask them what the solution is and how we can stop the people of darfur from dying, they simply say "there is no solution". ok, so they think that deploying the peacekeepers will turn sudan into another iraq, but what else can be done? and if you had to pick, would you pick another iraq or another rwanda? maybe i'm too new at this to not be naive, but i think there has to be SOMETHING that can be done. i can't accept that we just have to sit back, stay out of it and try to get access to the people who are suffering. i think that someone, somewhere has to try to stop what is happening. i had this argument with one of the upper guys last night. i agree with him that we need to get access to the people, but shouldn't we be doing something to try to stop it before it happens in the first place? and if we don't have the capability to do something, shouldn't we be supporting the people who do?

tonight i leave sudan. officially. tonight at 7:30pm i fly out of khartoum and head to switzerland. i arrive friday morning at 11:30 and start my day of debriefing at 12:30. talk about efficiency :) on saturday and sunday i get to see milena, gustavo and monica, who will all be in geneva for the weekend as well. this is the part that i most look forward to. the best debriefings i have had have always been talking about my trip with people who were there. when i came back from the philippines i only wanted to talk to the cebubians about it. when i came back from afghanistan, i only wanted to talk to hil about it. i don't know what it is, but apparently it's a common enough phenomenon that msf canada sets you up with someone who has been back from the field for awhile, so you have someone to talk to when you need it. on monday morning i have my medical checkup (where they get to search my body for parasites), then on tuesday i fly to toronto. wednesday, my birthday, i spend the day debriefing with msf canada, then that evening i fly home. i arrive home on my birthday, october 18th, at 8pm, only 12 short days after leaving habillah :) i can't wait to actually get HOME. i am going to eat mcdonalds frenchfries until i vomit. literally.

Goodbye

2006-10-10T07:56:00.000-07:00

tattoo/scarification

saying goodbye

hennaed

i have never before been so aware of leaving somewhere. i have come and gone from a lot of places in my life.... different cities, countries, continents.... and i have always felt something about leaving one place and arriving in another, but never quite like this. i was SO aware of leaving darfur. i felt the gravel crunching under my feet with each step that i took as i walked towards the small plane that would take me from there. i felt my feet, one after the other, leave the ground as i went up the stairs into the plane. i felt the plane taxiing down the airstrip, and then the moment that we lifted off. i didn't have many specific thoughts at the time. there was a mixture of relief that i had made it out alive and guilt that not everyone else would. the relief didn't solidify until i landed in khartoum. there was a part of me that thought i wouldn't make it out of darfur alive and it wasn't until i arrived in khartoum that i really believed that i was out. leaving was brutal.

my last day in habillah i did get hennaed (my hands and wrists) and, despite my older sisters death threats, i did get tattoed. i got a traditional tribal tattoo to remind me to always pray for them. it is a simple tattoo. the women here cut them into their cheeks or their temples. as much as i'm about solidarity, i decided to get mine on my upper arm. it is 3 one inch vertical black lines in a row. hawa did mine. my staff convinced me to get it done with no anaesthesia, the tribal way, and i am just ridiculous about having to prove that i'm hardcore so i agreed (on the video you can hear aicha say "i hope you don't cry" and i reply "i hope i don't cry either"). hawa opened a new scalpel and made three slices, then wiped away the blood and rubbed in a mixture of ashes and oil. the one thing we hadn't thought of in advance was the fact that we had gone to the whc to do it and i had to get back to the compound immediately for the start of my farewell party. i had worn the traditional african outfit my staff had made for me for the party (a particularly hideous blue and orange outfit, with a matching hat that was so small it cut off circulation to my brain all night) and i had had to take it off to get the tattoo. i couldn't put it back on without getting it all bloody. aicha says "just go like that" (in my tanktop). i say "and get myself shot by your local mullah? tempting, but no thanks". finally they wrap the outfit around me and place gauze over my shoulder and i run into the car and slide down, out of sight.

the party was nice and relaxed. having a farewell party during ramadan guarantees that it is going to be chill as everyone is starving and dehydrated and exhausted :) the one down side was that aicha had been really quiet all day and aziza, our cleaner, burst into tears any time anyone mentioned that i was leaving. i gave my staff the presents that claire had brought and most of them cried. they, in turn, filled my bag with homemade gifts for me, my mother, my sisters, my family, my friends.

the next morning i woke up early and got out of bed for the last time. i went to my wall and put a line through the last empty square on my calendar. i poured a glass of water and went to sit in the courtyard as we waited to hear when the helicopter would arrive. it felt surreal. it didn't feel real to me, but it seemed to feel real to those i was leaving behind. aziza, who i can easily describe as pure sunshine, was subdued and withdrawn. nasra barely looked at me. joyce and josephina arrived and sat quietly across from me in the courtyard. finally word came that the helicopter was leaving el geneina, so we drove to the hospital to pick up my staff who wanted to come wave goodbye at the airstrip. leimona had to stay at the hospital with our patients so i had to say goodbye to her there. she clung to me and sobbed. finally aicha told her that i had to go or i would miss the helicopter and she let go of me, turned and walked away. on the drive to the airstrip i took in every detail of habillah that i could. every hut, every courtyard, every child, every donkey, every leaf. at the airstrip we waited. one by one my friends broke down. some of them hugged me as they cried, some of them walked away to cry in private. they begged me, one after another, not to forget them. to never forget them. to come back to them if ever i could. i told them that i prayed that i could, but that they had to be here- they had to survive this. i had managed to avoid giving a speech at the party, but i had written a letter for them and aicha read it to them and translated it. i told them that i would always love them, always remember them, always be proud of them, always think of them, always pray for them. again they cried. one of them asked me to tell you of life here- of the difficulties they face. i told her that you know. that everyone knows. i told her that i had told all of you most of what i had seen here and that many of you were actively trying to help them. i told her that we would continue to fight for them, even from halfway across the world. i pray that what i said is true- that we will all continue to fight for them until there is peace in darfur.

the helicopter arrived and i slung my bag over my shoulder. i walked towards it, stopped, turned back to look at them all. "i love you guys..... goodbye".

almost done

2006-10-07T08:06:00.000-07:00

what a weird feeling- in less than 3 days i will be boarding a helicopter and leaving habillah, then a day later i will be leaving darfur behind. this last week has been so awful on so many levels (i'll spare you the details). being here after getting out for awhile is so much harder than when i was here before. it's like frogs and boiling water. if you put a frog into boiling water it will jump out immediately. if you put a frog in cool water and start to raise the temperature, it will stay in it until it boils to death because it doesn't notice the change in its surroundings. when i first arrived here there was a peace agreement and things were relatively calm. i didn't know anyone here and had no emotional investment in the situation save that i wanted to help in some way. in the time that i have been here the war has started anew, villages are burning, civilians are dying, hundreds of thousands of people in dire need of aid are denied it because it is too dangerous for ngo's to try to reach them, aid workers are being killed, the paramilitary have been rearmed, the country has braced itself for a war against the u.n. troops, we have discovered that rather than being seen as neutral we will be seen as targets and i have had to face the reality that the people i have come to adore are in severe danger and there is nothing i can do to save them. these things happened gradually and we just accepted them as they occured. it was sort of surreal, really. i sort of knew that this wasn't normal, but i sort of just got used to it at the same time. it was only escaping it for two weeks that allowed me to get some perspective. i didn't want to come back- as humans our instinct is to survive. squashing that instinct and flying into a war zone where i knew i wasn't wanted by the people holding the guns was difficult to say the least. everything in me wanted to just drop off the carepackage and fly back out. i came back and things here were in turmoil. my staff, my team, the situation around us. i have been trying to get out for the last 4 days but haven't been able to due to the helicopter (i really do hate that helicopter). the soonest i can get out is saturday. and time is going forward so slowly it's almost going backwards.
being back here has made me realize that i have changed more than i realized. claire was anticipating me being a nutcase when we met up, but we had an amazing time and i was completely happy. it made me start to think that maybe i was going to escape this experience emotionally unscathed. oh was i wrong. after being here this last week i have come to fear being at home. in the last few days i have realized just how angry i have become. i have so much rage. i thought it was because i hated habillah and just wanted to get away, but i realize now that it's because i love habillah SO much that i am so angry. i love this place, i love these people and in 3 days i am going to hug them goodbye and never know whether or not they survive this. i will go home to my safe little world and i will leave them all behind. every day i will read the news and i will wonder. if/when habillah is attacked i might find out from msf, but not necessarily. and if i do hear of it, i still won't know who made it to chad alive, who died in the initial attack, who died along the way, who lost their parents or their children, who were raped, who watched their children or sisters or friends being raped, who saw their husbands shot in the back. some of my closest friends here would never run because that would mean leaving their vulnerable behind and they would rather die than desert their family. if/when, habillah is attacked i will know that they are gone.

soon i will be home and i will see so many of the people that i hold so dear, and i wonder how i will treat them. it could be ok- i could be so glad to be back that i am the world's greatest person to be around. or it could be awful- i could take all of the anger and frustration that i feel towards the world for not doing something here and i could take it out on those closest to me. when i came home from afghanistan i was awful- i hurt so many people that i love because i was so cold and so detached. i don't want to come home and pick fights with people that subconsciously i feel are safe to pick fights with because even if i hurt them they will still love me. if i come home and i suck, just walk away and give me time. don't feel that you have to put up with it because i'm your sister/daughter/friend and i've been through a hard experience. i want to come home and be normal, and maybe i will, but my return from afghanistan together with this last week have made me wary. i will have a lot of time to process after saturday as i will be waiting until the following thursday for my international flight. maybe it will be good for me to have time to think and reflect. or maybe i'll come home having driven myself completely insane. if any of you point out that i was insane before i even came here and can't exactly blame it on darfur, i am totally going to drop-kick you. just so you know :)

a date with Habillah

2006-10-07T08:05:00.000-07:00

pepe before

pepe after

i'm not kidding when i say that the frogs are everywhere. this was what i found in my mug one morning.

this was written and sent the day before "almost done", which is why i refer to my "email last night" as being so dark and down. my computer connection leaves much to be desired. read "almost done" before this one if you want to keep them in chronological order. not that this blog is even close to being in chronological order. nevermind.

i realize, as i start to write this, that by sending this email i am likely to start hearing the word "bipolar" being whispered as i pass clusters of people at family functions and social gatherings for years to come. thankfully i'm ok with that. it's just that today was SUCH a fantastic day. it was like i had a little date with habillah and we totally fell in love. i know, i know, my email last night was so dark and down and now i'm writing about this wonderful day i had. so i need medication. so what?
my day started early. really early. way before 4am, which i know because it's Ramadan. what does Ramadan have to do with anything? let me tell you.... Ramadan is the month where Muslims fast all day. this means that our staff don't eat or drink anything all day long, in this horrific heat, and then when night falls they get to eat and drink again. one way that they manage not to die is to eat their meals throughout the night. this is accomplished by eating their first meal at dusk, then snacking throughout the night (napping in between) and then rising really really early to make their last meal before 5am. i know how early they get up because they make very sure that everyone knows how early they get up. they accomplish this by walking through the village beating metal on metal at around 4am to wake up the women so they can cook their last meal of the night. they do this for at least an hour. most nights i lay in bed thinking that they are lucky i'm just too damn lazy to get up and get my slingshot out, because i'm a pretty good shot. last night i was already awake by then so i just debated going out to join them. i haven't slept much in the last three nights. three nights ago i was called to an emergency haemorrhage and for the last two nights i have lain awake, unable to fall asleep. they were those nights where you lie on your stomach for a few minutes and then you're not comfortable. you turn on to your right side for a few minutes and then you're not comfortable. you turn on to your back for a few minutes and then you're not comfortable. you turn on to your right side for a few minutes and then you're not comfortable. you turn on to... you get the picture. it's basically a never-ending quest for a comfortable position and a part of the bedsheet that isn't hot and sweaty. so yeah, i was awake for at least an hour before i heard the banging. this is actually good because on the nights when it wakes me up it sounds, through my earplugs, like gunshots that are right outside my window, which sends surges of adrenaline though me that keep me awake for another couple of hours. i far prefer being awake already. but i digress....
so i start my day by picking "a" up at the whc. we are going to go to the market to buy supplies for my farewell party tomorrow. we wander in to the market and it is like i am seeing habillah for the first time. i have never been in the market on a "market" day as we are always busiest on those days. i walk in and it's like the africa that i imagined as a child. the sights, the sounds, the smells. and i repeat... the smells. we get dropped off in the meat section of the market and the smell assaults my nostrils. i have to buy a goat or a sheep to serve at my party and "a" wants a friend of hers who is a butcher to pick out a good sheep for us. i trail behind her and stare at everything on the tables with a mixture of awe and disgust. one man is selling skin, another is selling lungs, another is selling stomachs, one man has rows and rows of intestines drying in the sun. at one point i turn around and almost trip over the recently removed head of a cow. i recoil in horror and everyone around me laughs. i think "a" told them that i'm vegetarian because then they laughed again, louder this time. as we walk away i say to her "do you think they would let me have that? i'm thinking of some really good pranks right now". she rolls her eyes and ignores me. it's probably for the best. we wander through the market buying all of the ingredients for the food that people traditionally eat during Ramadan. most of it is drinks, thin porridges and soups. i had thought that maybe i would be off the hook for the sheep but apparently they still eat meat. we stop at one stall and as aicha is talking to the owner i hear a frantic bleating sound. i look around the corner and see that a horse is pinning a tiny, baby goat in the corner with its huge head. i don't know if it was planning to eat the goat or not, but the goat sure as hell thought it was going to- it was terrified. i grab the owners sleeve and yank him to see and he chases the horse away and lifts the kid by the scruff of the neck. to my surprise, and delight, he deposits the baby goat in my arms. i hold him close to my chest and after awhile he calms down and nuzzles his head under my neck and i can feel his heartbeat slow down. at this point i am wondering how i am going to fit him in my luggage because i totally plan to take him home with me. the stall owner tells me that the mother had left the baby there and i now have visions in my head of bottle feeding it, taking it for walks, letting it sleep in my bed..... "a" tells me that the mother will come back for it and i can't take it home to canada- ever the voice of reason :) i reluctantly hand him to the stall owner with strict instructions to protect him from the horse. we continue on our way and reach the section of the market where you can buy fruit and vegetables. rainy season was good this year and there are suddenly many new food items on the market, stacked in neat piles in the sand. mangoes, watermelons, guavas, cucumbers, tomatoes, oranges, lemons. they are beautiful and colourful compared to a market that only contained onions and garlic for the last few months. a's mother is there in the market and she hands me a bag of lemons from the tree in her yard. i came home tonight and squeezed them to make fresh lemonade. my next wildlife encounter is when we are driving back to the hospital and i see something on the side of the road that makes me yell to mohammed "stop!!!". he stops the car and i jump out. "that goat JUST had that baby!" i tell him and "a", who fail to find it nearly as cool as i do. there, in the shade beneath the tree, is a tiny, slimy, bloody little goat. it's mother stood over it, with her bag of water and placenta still hanging out of her. i squat and watch this brand new little goat attempt to struggle to its feet as its mother starts to lick it clean. it keeps making it onto all four legs before toppling awkwardly over again. mama goat continues licking him, even as he burrows under her in search of a nipple. it was such a beautiful moment to witness. i know, i know, i'm such a midwife. i drop "a" off at the hospital and i head home. on the way home i stop to play with the small gang of munchkins who follow me for a certain number of huts before heading home. i start to pick them up, one by one, turn them upside down and tickle them. they giggle and squirm but keep coming back for more. as i walk home i look around me and notice that the yards are full of tall, green plants poking over the fences. not being able to leave habillah to plant has led the people to plant in every available space within habillah. each little yard is growing sorghum, corn, okra. when i finally arrive home our courtyard contains 5 beautiful little black bodies, enjoying a watermelon. nasra, our cook, has brought her 4 year old son, salah, and her 2 year old daughter, salheah to work. aziza, our cleaner, has her 3 year old son, anas, her 1 year old son, hassan, and a young girl, maybe 6, who straps hassan to her back every couple of hours and brings him to aziza at work so she can breastfeed him. the children are sitting around a pile of watermelon, half of them with no clothes on. they are grinning ear to ear as they devour it and drench themselves in sticky watermelon juice. to add to the mess i introduce them to popsicles. one of my recent packages had plastic containers for popsicles and i had made orange tang popsicles in the freezer. i take them outside and run them under the lukewarm water to free them. the children are unsure of them, but take them anyways. they put them to their mouths and squeal as they realize how cold they are. keep in mind that these are children who don't have refrigerators in their huts. they LOVED them. between the watermelon and the popsicles, they were all lost causes and had to be put under the tap and rinsed off. the boy who brings us the water arrives and his donkey, for once, lets me pet him. i stand there for about 10 minutes rubbing his head and his soft ears. for lunch nasra has fried some catfish that one of our staff has caught in the wadi. this is a new treat- i've never seen fish here before. i'm pretty sure it has about six thousand parasites in it so i don't eat it. after lunch "a" and i head back to the market to pick up the sheep that the butcher has found for us. i am horrified and traumatized to see him pick herbie up, toss him into the back of our car, hogtie him and close the door. yes, herbie. that's his name now. i spend the entire ride home apologizing to him from the front seat, then i get him a big bowl of cool water once we get back to the compound. i have told him that i don't want to eat him, nor do i want anyone else to eat him, but it's a cultural thing and i just hope he can understand that. he's pretty quiet so it's hard to guess what he's thinking. pepe, the sheep for andi's party, had A LOT to say and he said it so loudly and so often that the team was ready to kill him ourselves. now it's nighttime and the ground is alive. lately night has equalled frogs. frogs as tiny as the tip of my finger, all the way up to frogs the size of the palm of my hand. they are everywhere. i love frogs so i walk very slowly to avoid ever stepping on one and i spend much of my time catching them in our house and releasing them outside. i love all wildlife that isn't spiders or insects. at home i never get to hold baby goats or catch frogs or rub donkeys ears or pet camels. and yes, apparently i have become a 7 year old boy.
tomorrow is my last day in habillah. i am getting up early to get hennaed, possibly tattoed (more on that later), possibly corn-rowed again (haven't made up my mind yet, leaning towards no), and then it's party time. the goodbyes have already started. today aicha and aziza already cried. it's not going to be easy to leave them.

My Staff

2006-10-04T13:30:00.000-07:00

This is an old message we just received...if you're wondering why it's being posted after we said you had to request it, we deleted the part of the story that is personal.

it's funny but, in spite of the fact that things are so tense and the country is on the brink of war again, i am loving it here lately. i think the only reason that i am able to find joy here is the fact that every day i fall more in love with my staff. i honestly think i have the best staff on the planet. they are amazing- each and every one of them. i can say this because the two from khartoum (my "problem children") are leaving soon and the ones who are staying are all tied for being my favourites :)
aicha is indescribable. she is our counsellor, the supervisor of the Women's Health Centre and a translator. she is in her early thirties and is the mother of 6 boys (she would have 7 but her first son died). she is, in so many ways, my hero. she is the representative of the masalite women of habillah, which is a bit like being the mayor of the women. she taught herself fluent english and was hired by the ngo's as a translator in her late teens. she didn't know what to do with her paycheque so she gave it to her father. he used it to buy her land, to build her tukuls and to buy her housing supplies. she is now quite wealthy by habillah standards as she owns 2 plots of land in the village, farming land outside of the village and a cow. her wealth would be far greater except that she is also the "social services" of habillah. as a single mother she financially supports her own children, as well as her mother, a handicapped brother, her sister and her sister's children, her niece and her niece's baby, a young girl who was raped and impregnated and whose family was killed in the fighting (and her baby), and anyone/everyone else who comes to her for help (and everyone who needs help comes to her). she never turns anyone down, even if it means handing over her last bill. when habillah was first overrun by diplaced people who were running from their villages, she took 6 families into her compound (actually, she came home to find six families sitting in her yard and she went "uh, ok" and let them all stay :) she also, along with 5 other people who were working for ngo's and therefore had money, bought huge sacks of food and they provided all of the new arrivals with meals until the ngo's could get themselves organized to deal with it. she is strong, she is brilliant, she is compassionate, she is generous to a fault. she is a devout Muslim and if she was the face of Islam that the world saw, people would have a very different opinion of Muslims.
leimona is my 19 year old timid little mouse of a village midwife. her aunt paid for her education and leimona now financially supports her entire family. when i first arrived she reminded me of a nervous ferret. she was incapable of doing deliveries so she had been relegated to helping with the prenatals (basically just taking the patients vitals, as she can't read or write). no one would let her do deliveries as she was so nervous that she nearly dropped the baby in the one birth that they had allowed her to do. i had enough staff capable of covering the birth shifts that i didn't care if she couldn't do deliveries. she is a fantastic worker and i was happy to let her just help with the prenatals during the day. that all changed when the new budget took my two khartoum midwives away, leaving me to find 3 women to do the birth shifts. two of my nurse assistants (hawa and mariam) are able to do deliveries unsupervised now, but i needed a third. i had the choice of training leimona or firing her and getting another, more competent midwife. i love her to death and there was no way i wanted to get rid of her- she's my hardest-working employee and has a heart of gold. my khartoum midwives were convinced that she could never be trained and told me i should never let her do deliveries. gustavo told me that there is no one who can't be trained and he encouraged me to put in the time and effort. so, in the last month i have gone on a "leimona training" onslaught. i started by making her be present at every delivery, and once she was used to them, i started to make her do deliveries under my supervision. she has completely come into her own and she gets more self-confident every day. the other night i had her do a vacuum extraction and she pulled it off perfectly. i also got her to help me train the new girl (we are training another girl to help with the prenatals and take leimona's old position) and she has proved to be a gentle, patient teacher. the more she trains houda, the more she realizes that she knows far more than she ever gave herself credit for. every time i look at her i feel a swelling in my chest- i am so proud of her that i could cry.
mariam is my nurse assistant. she is the picture of quiet dignity. she is the one in the picture i sent- the close-up of my face cheek-to-cheek with a beautiful woman, both of us with cornrows in our hair. she is the mother and grandmother of many. she is grace, beauty and silent strength. when i have staff meetings, trying to deal with the latest problems (that always arise from and swirl around my khartoum midwives) and create team unity, she is the first to apologize and ask for forgiveness. i love that she does that because she has never done a single thing to offend anyone and owes apologies to no one. it is her humility that leads her to apologize for any offense that may have been taken by any of her actions. no matter how much anyone else has wronged her, she is always ready to hug them, kiss their cheeks and renew vows of friendship. her work ethic is amazing- she never stops working (she and leimona) even when we have no patients and the rest of the staff are lying on the mats outside, being lazy and unmotivated. when she was in agony with a tooth infection that had caused half of her face to swell up, i had to order her home to take painkillers and get some rest. she didn't even tell me that she was in pain- i noticed that she was hiding her face and when i yanked down her scarf i found that she looked like a lopsided chipmunk. we sent her to el geneina for a couple of days to go to a dentist and managed to misplace her for over two weeks. she returned yesterday without any of us expecting her and she beamed as we all screamed and ran to hug her. she got off the helicopter and immediately showed up at the hospital to work. i suggested that maybe she should head home for the day to see her family as they had been asking us about her whereabouts for days and i had finally admitted to my staff that i thought we might have lost her.
hawa is my other nurse assistant. she is our plump, dramatic, jolly character. she speaks some english and manages to make me howl most of the time. she is the one who told me i "look like dying person" when i lost all the weight (note: to those who were concerned about my emaciated state, i am fine now. carmenza made me start drinking spoonfuls of cooking oil and i have gained some of the weight back. gustavo told me today that when i was sick i looked like (picture him sucking in his cheeks) and now i look like (picture him puffing his cheeks out). i warned him not to make me kick his ass in front of his girlfriend). when i first arrived and wasn't used to things yet, i was sitting with my staff when someone handed me a glass of tea. i didn't yet know that they drink it when it's boiling, so i took it and dropped it instantly when it burned my fingers. hawa says to me "you hands like new baby!". i tell her that in my country we are firm believers in oven mitts so i am quite uncallused and unashamed of that fact. hawa is the one who throws me over her shoulder when she thinks i am misbehaving, and has given me two "warnings" (when the staff get in trouble they are given 3 written warnings before they are dismissed) for annoying her. i told her that if she gives me one more warning i get to go home. any time that i stay still for too long, she braids my hair or pulls my head into her lap to stroke it. she is always laughing about something and is SO fun to be around.
and that is my staff. i could describe the rest of the staff that we have here in msf and each description would be just as amazing. each one of the people who work with us is fantastic in their own way. they are kind, noble, loving, funny and truly good. i was thinking the other day that we must have completely lucked out when we were hiring, because we ended up with the 70 best people in habillah working with us. then it occured to me that these people are representatives of habillah, and darfur. there is no way that we could have managed to hire the finest 70 people here- what we did was hire people who represent how beautiful most people here are. these people are darfur. they are the reason that we need to fight to save this place.

some of my favourite children

2006-10-03T07:52:00.000-07:00

2006-10-02T16:02:00.000-07:00

people who rule

2006-09-30T14:07:00.000-07:00

i just got this in an email from my friend, aviva. it's just one more example of the small things we can do that can change the world one heart at a time.....

"there is a young girl that goes to the youth group that i volunteer at, she is from sierra leon and has been here for two years and is sooo cute. i always see her dancing and singing and so i asked her a while ago if she takes dancing classes. she said no quietly, she does not have the money for anything like that. so, the next time i went to the YMCA, which is where i go to the gym i asked the woman in charge if there was any way that they would sponsor her and i explained them her story. they said, 'absolutely'!
so today i took her to get registered for the hip hop class. i took her up to the dance studio to show her where to go; it is huge and all mirrors and huge speakers....she was sooooooooooo excited, she threw her school bags down and started dancing around the room and screaming! then she lay on the floor and just laughed and then jumped up and hugged me. she has not danced since she was in africa and has felt totally empty. my god, it was so amazing to see her that excited and ecstatic about being able to take this class. "

another fine example

2006-09-29T08:19:00.001-07:00

of how useless the A.U. presence here has been....

"Investigations of major breaches of the cease-fire, meanwhile, have been stymied. That includes an incident Saturday in which villagers who had been attacked by Janjaweed militiamen two weeks earlier gathered near the ruins of their homes in South Darfur to speak to A.U. investigators set to arrive by helicopter. But the helicopter turned back because of severe rain, and the Janjaweed attacked again, killing 18 of the survivors of the earlier assault and dispersing as many as 25,000 into a remote southern region far from humanitarian assistance or military protection"

reality and my staff

2006-09-29T08:19:00.000-07:00

There are two more emails from Amy that you can request from her Mom (lura@telus.net). They are titled "reality" and "my staff". You will have to write and tell her who you are and how you know Amy. In order to be careful we will not send the messages to anyone we don't know. I know that this all seems terribly clandestine with a touch of cloak and dagger but we've got to be careful. Thanks!

back in Habillah

2006-09-29T07:23:00.000-07:00

family, don't read this first paragraph...

i HATE el geneina. i hate it, i hate it, i hate it. the last 3 days i have had FAR too much time on my hands and that means that i have far too much time to think. because my trip to kenya involved taking 4 flights each way (half of those flights on small, wobbly planes) inevitably my thoughts turn to geoff. i had it under control though, until el geneina. the last time i flew in to el geneina, in june on my way in to darfur, i saw (and mentioned in a previous email) that the air strip has the remains of two downed planes sitting beside it. the planes are fairly intact and i can manage to convince myself that maybe the people inside of them survived the landing. it doesn't make it any less of a painful reminder to see them, but it's a consolation of sorts. this time i flew in from the opposite direction and saw the remnants of two more crashes. these planes, unlike the ones on the other side, are shattered into several large pieces that spread across parts of the field. no one survived those crashes. i see this and i automatically look away but it's too late- i have just seen the red fire truck that sits beside the runway, waiting to douse our flames should our plane crash or catch fire upon landing. and in my mind i am back at geoff's crash site and the coroner is pointing towards the airport and telling us that the firetruck had been en route even before their plane crashed. he tells us that they arrived 2 minutes after the crash. they could have arrived 2 minutes before the freaking crash and it wouldn't have made any difference- he was unconscious before they landed and, if he was still alive, he died on impact. suddenly it's hard to breathe. i hate el geneina. i hate it. i hate it. i hate it.

i spent last night in el geneina, then this morning i took the helicopter back to habillah. with all of the things that people in khartoum and el geneina keep sending with me, my luggage was 25kg over the weight limit (the weight limit being 15kg) and i was afraid they were going to tell me i had to leave the care package for my team behind. if they said i couldn't bring it i would have come back to habillah for basically no reason. i arrive in habillah to find that half of my staff had a revolution in my absence. when corinne and carmenza are done explaining everything that transpired, i tell them that i wish they had emailed me before i came back because if i had known then i wouldn't have come back. they tell me that that's precisely why they didn't email to tell me. i tell them they are jerks. i didn't even go to the women's centre to see them today because i want to fire half of them now, which is not a nice way to come home.
i have only been here for half a day and i am already feeling like i want to crawl out of my skin. i don't know how i am going to stay here for another 9 days. i asked carmenza to give me something that would knock me out for a week but she said no, that it would be unethical or some lame excuse like that.
i think i'm going to go to bed and try to dream that i'm in kenya again...

never far enough away

2006-09-29T07:21:00.000-07:00

cobie and geoff

some of the fam in happier times...geoff, markus, amy, julie, cobie

this was sent in July and I missed posting it....sorry!

yesterday and today were weird days. for the first time since i've been here i pulled out my 'geoff' shirt (the shirt that shannon had made for the memorial bbq) and put it on. i put it on inside-out so as to not have to explain to my team why i was wearing a shirt that says "in loving memory", with his name and a picture of a plane on it. i dreamt of him last night, and spent most of breakfast looking at the royal blue bracelet all who loved him wear, with his name, "forever flying" and the date of his death etched into it. i walked around all day feeling that familiar, deep-seated ache, not sure why i was feeling this way. no anniversary is coming up, no one here knows of him to mention him, i haven't been at a family dinner to notice his absence, i haven't much let myself think of him, or of any of my siblings, lately. the one year anniversary brought closure somehow, and the last few months have been a welcome respite after a year of feeling like i'd been hit by a truck. today i got two emails telling me that the fundraiser for his memorial scholarship fund was last night, and that it had gone well. i had completely forgotten about it, but it seems that even half a world away i'm still connected enough to have sensed something. it reminds me of that scene where truman is trying to explain to his wife that he wants to go to fiji because it's as far away as you can go before you start coming back again. darfur isn't just 10 hours away from my life in vancouver, it's centuries away- and sometimes it still isn't far enough for me.

kenya aka heaven

2006-09-26T10:47:00.000-07:00

claire, ames, sam and blaine

the four of us overlooking the waterhole in our lodge's backyard

claire, amy and the crocodile

the lioness that walked around our van to stalk the baby elephant

the elephant that side-stepped our van and walked around it, within feet of us

perfect. that is the one word that describes my trip to kenya- it was perfect. it was exactly what i needed.

my last email had me stuck in el geneina until tuesday at the earliest (it was last sunday). that day i begged to go to the airport with gustavo to see if they happened to be in a merciful mood and might let me on the plane- no harm in trying, right? we showed up there and it was a total miracle- they said i could get on the plane (we only know of one other time that they have let someone get on at the last minute). i was so excited i could have cried. now the only problem was whether or not i could get my international flight changed back to that night. i get to khartoum and am told that i am an extremely lucky girl because they hadn't been able to change my ticket yet, and had i missed the flight that night i would have been stuck in khartoum until wednesday's flight (arriving thursday). i mentally fall to my knees and praise God. i spend the evening in khartoum with gustavo and monica and we go for pizza and ice cream and gorge ourselves (showering in el geneina was the first time i have seen myself in a full-length mirror since june and it shocked me to see how much weight i had lost. i never thought i would say this, but it didn't even look good. i can't even imagine what i must have looked like when i was sick and so much thinner than i am now- i have started eating a lot more). that night we say goodbye for good as i leave for kenya and they head to geneva and then ultimately to somalia. i can't believe they're gone- they were my sanity for the last few months. i told them that when i'm done medical school i am going to come find them, in whatever crazy country they are in by then. and i meant it.

i stay up that night and catch my flight at 3:45am. i am far too excited to sleep so i drum my fingers for most of the flight. surprisingly no one kills me for it. i arrive in malindi, grab a taxi and finally, after 6 weeks of eager anticipation, arrive. claire is sitting on the patio of our room and books it out to hug me. there are no words to express how happy i was to see her. claire is one of my favourite people on the planet. she is one of those kindred-spirit old-souls who you can talk to, or not talk to, about anything. she's a fellow canadian, a fellow midwife and a fellow spur-of-the-moment fly-by-the-seat-of-your-pants girl. when i told her i was going to new orleans in september she said "should i come with?". moments later i was booking her ticket. when i asked if she wanted to meet me for this vacation she said "not if you're going to egypt you psycho, but i'll come to kenya" (i was unaware of the conflict in the middle east when i suggested cairo, just for the record). she was the perfect person to spend the last week with.
so there we were, in kenya. there was only one problem... our hotel sucked. claire's travel agent had booked it for us and we arrived to find that not only does that hotel not exist anymore, the new one has no reservations for us and the deal we had been quoted was totally out of date. thankfully there were only 2 other guests in the entire hotel, so there was plenty of room for us. oh, and when they say that their hotel is "beachfront", what they mean is that they own a small piece of beachfront land that we have to drive to for lunch. the food sucks and they charge us for everything. and i do mean everything. they charged me when i asked them to call us a cab. so we got into that cab and took off for watanu and a luxury, truly beachfront resort. it was amazing. the food was amazing, the drinks were amazing, the service was amazing, the beach was amazing. all of it. amazing. white sand, turquoise water, palm trees, tropical birds, blue skies, people bringing you cocktails everytime you pause for more than 5 seconds....amazing. the best part of turtle bay was that i got to spend the week with not just one, but three of the best people on the planet. on our first day there i got in the pool to play waterpolo with a big group of people. there was a young british couple on my team and i found myself totally drawn to them. they were so funny that i spent most of the game laughing at them and letting the other team score on us. i got out of the pool and told claire that it was our mission to make friends with them. i moseyed on over to where they were sitting, struck up a conversation and that was it- we became a family of four. blaine and sam, a gorgeous couple who have been together for 7 years, were there on their honeymoon and it became a group deal. that first night we had drinks with them and when they went to have a cigarette i turned to claire and said "i want to marry them". she replies with "maybe they'll adopt us!". by the second day we had already established who sat where at the table for meals, who got made fun of for what, and we had made plans to go on safari together. during the day we lay by the pool, played waterpolo and volleyball, got massages, napped in the air conditioning, drank cocktails and ate our faces off because this resort NEVER stops feeding you and/or bringing you drinks (i kid you not, i'm not even slightly bony anymore). in the evening we would shower off the sand and sunscreen and dress up a bit for dinner. at dinner we would start with the drinks and it just went from there. my one discovery of the vacation, and thank God i discovered it, was that if you drink wine and milk together, you don't get a hangover. ok, hear me out. and yes, this is what i was mercilessly mocked for. i had a sore on the roof of my mouth that wouldn't heal for days. it hurt every single time i took a bite of food or drank anything other than milk, but i was determined to eat and drink regardless. so the first time i drank a glass of wine i had a glass of milk as well. after each sip of wine my sore would sting, so i would take a sip of milk to soothe it. the morning after the first night where we each drank about a bottle and a half of wine, claire was completely hung-over and useless and i was bouncing out of bed, ready to eat breakfast and hit the beach. it was fabulous. consequence-free drinking. right... back to the evenings...after dinner we would sit by the beach to listen to music and have more drinks. sometimes we played cards, more often we just talked, laughed our heads off and danced.

the safari: one of the best experiences of my life. we started out at an unGodly hour and the four of us piled into the van with jeffrey, our safari guide. we drove for a couple of hours on the kind of road that causes brain-damage. by the end of it i'm pretty sure all of my internal organs had torn loose from the viscera that holds them in place and had fallen into my pelvic cavity. aside from that, the ride was fantastic. it was a total glimpse into the real kenya. the people, the huts, the scenery. we reached tsavo national park and began our safari. tsavo national park is 13,000 square kilometers, which i think makes it one of the biggest (if not the biggest) national parks in the world. once we got inside the gate jeffrey lifted up the roof of the van. the roof went straight up and left about a foot and a half of open space, allowing us to stand in the van and look out over the sides, while being protected from the sun (and large leaping animals). we all stood up and braced ourselves to keep from being tossed around. our first up-close and personal moment was with giraffes. they were right beside the road, chomping on the leaves at the top of the trees. they were HUGE, and so weird looking. they walked by us and were so close that we could see their muscles rippling as they started to run. along the entire ride we saw countless animals- zebras, birds of all kinds. antelope, baboons, bush babies, warthogs, dik diks, waterbucks, impalas, gazelle, oryx, and all kinds of african animals whose names i don't remember- but there are 5 animals that are referred to as "the big 5", that are the coolest and rarest to see. of those 5, we saw 4. our next experience (one of the two that made my entire trip) was when we drove right into the path of a wild elephant. it was walking down a path and about to cross the road and we stopped right in front of it. it looked at us, side-stepped us and walked, indifferently, right by our car. i could see his eyelashes and every crevice in his skin- that's how close he was to us. a wild elephant. ENORMOUS. after he walked back into the trees i turned to claire and said "i hope my grandmother saw that". she loved elephants and i have many of her elephant figurines to remember her by. i know she saw it. next we see a lioness by the side of the road, chilling out in the shade of a small tree. we get to the lodge and it is crazy-cool. it is built beside a water-hole and a salt pool, and our rooms overlook them. we sit on our back patio and watch the wild baboons laze around in the field by the water. three of them hop the electric fence that is set up to protect the guests and hang out in our backyard. elephants come at night to bathe themselves in the salt pool and the hotel will knock on your door at any hour of the night to tell you to come see them if you put your name down for the wake-up call, which we did. we have lunch then take off for the afternoon safari. this is the one that kicks ass. most of the time that you're on safari you are driving at a leisurely pace, with everyone looking in different directions, trying to spot a reason to stop. occasionally, however, jeffrey would hear something over his radio then put his pedal to the floor. we, in the back, would be tossed back into our seats, where we would put on our seatbelts and say "i bet it's lions". the safari guides work together and when one of them finds something cool and/or rare, he radioes the rest of them and everyone books it over there. jeffrey never told us what to expect so it was always a surprise. this time we find that there is a lioness to the left of us and a herd of elephants to the right of us. the lioness gets up and starts to walk towards our car. i have developed the habit of yelling to the animals to tell them that i will give them a banana if they come to our car, which no one minds when i am talking to harmless animals, like baboons. the lioness is still coming straight towards us and claire says "am i the only one who is getting scared?". i say "hey lioness!". claire says "shut up amy!". i say "guess what claire said about your mother!". she is coming closer and claire leans down to close the window. she walks RIGHT by our car, then behind it, and comes out on the other side where she proceeds to stalk the newborn elephant. the herd sees her and starts to move away, with the baby sticking very close to its extremely large parent. it was unbelievable. next we see a small group of ostriches, which we hadn't known to expect. we stop and watch 3 males doing a courtship ritual with 2 females. i got it on video and it rules. the sun is starting to set and we are slowly driving through the african wilderness, watching herds of wild elephants walk by, single file, looking like they are moving in slow motion. it feels like a dream. claire and i keep looking at each other and saying, in astonishment, "we're in kenya" "we're on a freaking safari!" "that was a lioness that just walked by us". the sand we're driving through is a deep red and by the end of the day we are all covered in it and our hair is approaching dreadlock status. we head to the lodge where we are so tired from standing and bracing ourselves in the car all day, plus our early morning, plus the hot sun, that we fall into bed at around 9. that night i wake up from a bad dream and can't fall back asleep. i consider sleeping in claire's bed but she's been sick and not sleeping well so i don't want to wake her. instead i head to the back patio where i can watch the animals at the waterhole in the bright moonlight. we are in the middle of nowhere and the sky is a thick blanket of stars. i went back to bed for awhile, then got up to watch the sun rise over tsavo, which was spectacular. after a big breakfast we head back out. this time we aren't out for very long before jeffrey starts booking it towards our next surprise. we get there to discover that we are looking at four RHINOS!!! we had been told all along that we won't get to see rhinos because they have been so poached over the years that there are only 12 left in the entire park (the 13,000 square kilometer park). the guides haven't seen rhinos in over a year and yet, here they are. claire is in awe that we were looking at a 1/3 of their population that morning. it was crazy. we have noticed that each time we say "i really want to see..." we end up seeing it. especially when claire says it. clearly God is on our side so we start saying things like "i really want to see a leopard" (claire), "i really want to see an entire pride of lions" (sam), "i really want to see a million dollars in cold hard cash, lying by the side of the road" (me). sadly i never saw my million dollars, nor did claire see her leopard or her cheetah. we kept driving and saw a van pulled over, which is always a sign that someone has found something cool. we stop and see that they are looking at a herd of zebras, which we have seen a million of and now find unimpressive. then they point to just beyond the zebras where there is a pride of 11 lions lying around. we're watching this and wondering what the hell the zebras are thinking, just hanging out, eating grass, with an entire pride of lions a short distance away. i say that if i was them i would be sloooooooowly walking away, all casual-like, until i was out of sight, then i would run like hell. and this is precisely what they started to do. one at a time, each of the zebras would walk to the right of us, and once they reached a certain spot where they weren't visible to the lions they would totally hoof it into the trees. it wasn't until after they had gone that we saw two lionesses stand up from where they had been lying in the sandpit right beside the zebras, stalking them. 13 lions, not 11. as we drive away we see a van pulled over and people on the side of the road. we ask jeffrey if they are insane, as no one is allowed out of their cars, and he points out that they have a flat tire and all have to lift the van so the guide can change the tire. as we drive by we can see that they are all looking unsettled, so we don't mention that we just went by a pride of lions. we did joke about it though, which probably wasn't very nice of us. i figured that after that we were in store for a flat ourselves, but thankfully we weren't. apparently tsavo used to be really known for lion attacks because it was so desolate that there wasn't enough wildlife to keep the lions fed. the men who were working the railway used to have to walk from nairobi to mombasa and it was very common for them to be eaten by lions along the way. it is now early afternoon and we start to head out of the park. we stop for lunch at a beautiful little restaurant that is perched over a river. some of the men there ask if we want to see the crocodiles so we head down to the river with them. they start to throw rocks in the water, whistling and splashing the water with their hands. and slowly we start to see crocodiles showing up. we are standing on the side of the river and the men toss rotten meat on the ground, encouraging the crocs out of the water. they come out and we are now standing within 6 feet of them. claire and sam start to back up. at one point the crocodile lunges forward and that's it- claire and sam are gone. they were gone before i even had time to turn around to run, so i'm pretty sure they actually levitated up the hill. i have to admit, it scared the crap out of me too. those things are WAY faster than you would think. thankfully the tribal guy stopped him before he got to us. that was one of those experiences that you will never forget. we stood within 3 or 4 feet of a wild crocodile (the one that lunged at us), with no fence between us. awesome. after a beautiful lunch we get back into the van for the bumpy ride home. towards the end of it claire is saying "i think i'm going to have to kill myself if this doesn't end soon. my head is about to fall off". we get back to the resort and shower the centimeter of grime off ourselves. after my shower i am shocked, and thrilled, to discover that i wasn't just filthy, i was tanned! i have never had a tan on my face in my entire life and here i am with a golden hue to my skin. my arms are totally brown but sadly it is only obvious when i put them next to my white, white stomach. still.

on my last night i started to feel sick at the thought of having to go back to darfur. i also made the mistake of getting online and reading geoff's memorial website, which i haven't read since may or june. most of the night was fantastic, but then i felt myself starting to distance myself and feel moody so i went to bed. the next morning i was still in a weird mood and claire was hungover, but we made ourselves join sam and blaine on the beach for a tour with captain john. he took us on a walk through the dead coral (the tide was out) and we had a wicked time. in one tidal pool he coaxed a huge moray eel out of his hole. then one of the men caught him and i got to hold him. slippery little suckers. they showed us all kinds of coral, fish, crabs, starfish, shells. another hole had an aggressive eel in it so they dangled a stick with food on the end of it in front of him and he tossed himself out of the water and up onto the rock that sam, claire and i were standing on. sam jumped back and knocked into claire, who fell into me, who just narrowly avoided falling into another huge tidal pool. then they gave me the stick with the food and i got to entice the eel up out of the water. he was a very unfriendly fellow. not at all like the other big one that i had held. by the end of it we were laughing our heads off and deciding to stay for another week (which we didn't end up doing, sadly :) and that was the end of it. we headed back to the resort and i packed my stuff up. claire was leaving the next day so it was just me going. i said goodbye to everyone, did my best not to cry or throw up, prayed that the flight would be cancelled or bombed or whatever it would take for me to not have to go back, and left. it's a good thing there was no one travelling with me because i was completely uninterested in talking. i hated having to leave them and i hated having to go back to sudan. i half hoped that something would happen at immigration and they wouldn't let me back in the country. no such luck. the one good thing is that i got back to find that rather than spending two days in el geneina i was spending two days in khartoum. rooms with air conditioning, stores with good food and western toilets. luxury. i have spent most of my time here just eating and sleeping in the air conditioning. i fly back to el geneina tomorrow then take the helicopter to habillah on thursday. phil told me that i don't have to go back if i don't feel safe, which i don't really, but i am going back. it's only for 11 days, the au is staying so i feel that the tension will have lessened somewhat (side note: FANTASTIC that the au is staying longer. maybe once they're done we can send in the boy scouts. they are sure to be just as effective. am i the only one who has noticed that the war is back on, even with the au still here? can someone please tell me what they're doing here, besides easing western guilty consciences and assuring khartoum that no one is going to interfere with what they are doing in darfur). i wouldn't go back (and am, in fact, extremely tempted to just fly to geneva from here) except that claire brought a huge care package for my staff and my team, and i owe it to them to say goodbye. i don't think that darfur is safe for caucasians anymore and i'm not going to be very relaxed while i'm in the region. the fact remains that we, the international ngos, are not wanted in darfur by the powers that be, and it is only a matter of time before that is made more obvious. since killing our national staff hasn't worked, we figure it will be an expat who is killed next. i noticed something funny on vacation. when i arrived in khartoum and ate food that required actual chewing (i'm used to soup and rice mostly) my jaw was really sore, likely from me clenching my teeth as i sleep. it hurt for the first couple of days that i was on holidays, then it went away. then when i was on the plane on my way back from kenya, i noticed that i was clenching my teeth again, and by the time i got back to khartoum, it hurt to chew again. it's definitely time to pack it in.

i will be home in less than a month and i can't wait to see all of you who are in van. claire, you are a total rockstar and i absolutely love and adore you. thank you SO much for giving me the best therapy i could have possibly imagined. blaine and sam, the same goes for you. spending a week with 3 people who are so lovely and so pure in heart was the best thing i could have done. this trip was a complete answer to prayer and the three of you are blessings from God. i love you guys.

two women...

2006-09-20T19:08:00.000-07:00

if you are interested in reading this please contact me (Amy's Mom)at lura@telus.net and let me know who you are and how you know Amy and I'll forward it to you...some stories are just too politically or personally dangerous to post!

el geneina, sweet el geneina

2006-09-18T11:42:00.000-07:00

actually el geneina is a total hole, but at least i'm out of habillah! the helicopter arrived yesterday at 2:30pm, (supposed to get there at 9am) so i spent all morning going crazy, thinking it wasn't coming again. when we finally heard on the radio that it was on its way, we screamed and jumped up and down and then i chased our cook around, pinching her butt. having it actually arrive was one thing- the other question was whether or not i was going to get on it. i was so nervous i have no fingernails left. surprisingly, as it was landing, the u.n. woman told us that i was on the list but gustavo wasn't (he who had been waiting since last monday). thankfully the pilot had a different list and we both got on. i was so happy i almost knocked carmenza over when i hugged her goodbye. the part that sucked is that i missed my connecting flight to khartoum. the other part that sucks is that they could only book gustavo on the flight to khartoum today. tell me if this makes sense to you... my flight out of khartoum is tonight and gustavo's flight out of khartoum is tomorrow night. so they book him to fly to khartoum today and me to fly there tomorrow. this means that i miss my flight tonight and gustavo sits in khartoum for an extra day. yeah, makes no sense to me either. the only reason i'm not fighting them about it is because gustavo has been waiting to be with monica since monday and at least he can spend that extra day in khartoum with her. ah, the
sacrifices i'll make for love :) i asked them to try to get me on the standby list today, so we'll see. even if i miss my flight tonight i would rather wait the extra day in khartoum where you can eat good food and sleep in air conditioning.
last night i had the best sleep i've had in the last 4 months. no radio in my room. no one calling me, no one calling carmenza, no one calling the driver, no random crackling static. not a sound. i fell asleep in the livingroom at 8pm, then got up and crawled into bed later. then i slept right through till morning. bliss. i shared my room with two big fat lizards so i felt that it was probably quite spider-free and i slept deeply.

2006-09-16T18:06:00.000-07:00

hello all, greetings from darfur! yes, i'm still here (stupid helicopter), but i'm feeling better about life because i keep getting the greatest emails about the Global Day for Darfur and all that is being done to raise awareness right now. i'm SO happy to hear that my city is gearing up for a huge rally and my favourite singer (sarah mclachlan) is going to be performing at it! please, please, please go to the rally. all of you. and bring everyone you know. if you think that you are "too busy" to go, please look at the pictures i have on my blog and know that those children may well not live to see their next birthday. every single person in my stories is a real human being. and every single one of them stands to lose their life if the world continues to just sit back and watch. none of you can claim ignorance. none of you can tell yourselves that you didn't know. you all know. we all know. this is your chance to make yourself heard. this is your chance to get involved. please go the rally and yell until something is done to stop this atrocity.
much love and gratitude,
Ames

Off to Kenya

2006-09-13T14:31:00.000-07:00

alright, first things first... for the next two weeks please cc any emails you send me to my hotmail account. i'm supposed to leave tomorrow morning for my holiday in kenya and i won't have access to this account until the 28th. i say "supposed" to leave because it just happens to be up in the air at the moment. the helicopter that takes us from here to el geneina is on the fritz and gustavo, who has been trying to get out of habillah since monday morning, is still here. they have a policy of letting the people who have been waiting the longest get on first. i have already told carmenza to have a syringe full of diazepam with her at the airstrip tomorrow because if they don't let me on the helicopter i am going to have an actual nervous breakdown. if crying doesn't get me on, and duct-taping myself to the helicopter doesn't work, i'm buying a camel and hoofing it to el geneina. i'm going on holidays and NOTHING is going to stop me. i can't even express to you how much i need this holiday. monday morning, as we were seeing gustavo off at the airstrip, i fell to my knees in front of my entire team and started vomiting yellow stomach acid all over the sand. not sick. just stress. it was fab. the helicopter is taking off, everyone else has driven away, the sand is swirling all around us, they didn't let gustavo on, and there i am heaving in the sand with a dozen comforting hands on my back.
then there's the fact that my hair has started falling out (carmenza's too). and we aren't sleeping at night. and apparently i've become "quiet", which is worrysome to some, welcome to others :) i feel like i'm on the verge of tears almost every moment that i'm awake, so i try to sleep as much as i can. i was lying on the mat outside of the whc today and joyce felt my forehead to see if i was sick. she says "sudan isn't good for Amy". aicha replies "sudan isn't good for anyone".
we've heard that the local paramilitary have been getting visitors at night. those visitors tell them that the "hawagas" are coming to murder their children and steal their camels. they don't clarify the difference between u.n. troops and any other white people, they just tell them white people are coming. i find it interesting (and mildly amusing simply because it's so not true) that they are trying to get them riled up to fight the peacekeepers by scaring them with tales that have people doing back to them what they have spent the last 3 years doing to others.
and so we sit here, waiting for this all to explode. not far from here, the au is finding mass graves of the people killed in the government attacks. and the world still drags their feet.

"i never thought we would stay alive this long"

2006-09-09T13:32:00.000-07:00

kate just sent me this next quote which, as she put it, is harsh but good. i think it is harsh but true:

"Are you dead? Pain or damage don't end the world, or despair or beatings. The world ends when you're dead. Until then, you've got more punishment in store. Stand it like a man, and give some back. --Al Swearengen"

i don't know why i'm including it. maybe because after this experience i've found it to be so true that reading it could have gone either way. i could have laughed or i could have cried. thankfully it caught me in a good moment and made me laugh.

things here get worse every day. media reports say that the government continues to bomb villages in their ongoing search for rebels- once again, killing the men, women and children of darfur. i watch the ways it is changing the people here. the false sense of security they once had is fading- it is still present but hanging on by a thread. we will be sitting outside the whc, laughing about something, when suddenly we will hear a slight sound and everyone freezes in terror. they rapidly search the sky looking for the source of the noise. "antonov??? antonov???". antonovs are the planes that the government uses to bomb the villages. the men in the planes open the back of the plane and roll the bombs off the back ramp. not exactly a method of precision. hardly surprising that the bombs intended for the rebels structures land on homes full of children. the other day i was sitting with one of my staff when it happened. when we realized that it was just a un helicopter she relaxed. i asked her if the people here were aware of what was happening in darfur and she said yes- they know everything. we sat there in defeated silence for awhile, then she started to speak....."i will never forget the day this all started". the night before, the paramilitary had told the army that they would be attacking a village with rebels, but no one knew which village they were going to attack. it turned out to be a village relatively close to here. when the attack on the village started, the people of habillah could hear the bombs landing and that night they could see the flames all the way from here. at around 8 the next morning they began to see the people running towards habillah. there weren't many men left, it was mostly women running with their children. the few men who remained had run into the fields and managed to escape. it was rainy season and the crops were high enough to hide in. the women of habillah had a quick meeting and decided to put everyone into one of the schools. all of the local women were sent home and told to cook everything they had, quickly, and to bring containers of water. everyone brought all of the money that they had and put it into a pot. a group was sent to the market where they bought 200 sacks of sorghum, lentils, oil, salt and dried fish. another group took the sorghum to the mill to have it ground. everyone brought their dishes to the school and divided them among the new arrivals. the people were told to gather themselves in groups of ten families. each group was given enough food and dishes to feed themselves. this went on for a month before the council finally bought sorghum and donated it to the idps. every day more people arrived as village after village was attacked. both schools filled up and local families began to take the people into their homes. WFP finally arrived and called for the teachers of habillah to help them with a food distribution. each new arrival was registered and finally there began to be some sense of order. for 6 months the villages around habillah were emptied of their rightful owners, then taken over by nomads. the most surprising part, she said, was that you weren't being attacked just by strangers. local people- people who had had their stalls beside yours in the market for your entire lives- had joined in on the attacks. the few people who dared to ask "why are you doing this? you know me" were killed instantly.
while the constant arrival of new people caused chaos here, the attacks happening around habillah were being carried out with order. the big attacks were on wednesdays. tuesday nights were a night of terror as everyone waited to find out if they were next. each area had it's own specific group attacking their villages. the attacks happened in four stages. the men surrounded the village in order to keep escapees to a minimum. the first wave of men entered the village, usually during a time when the men in the village would be praying and in one group that was easy to target. the first group of men were responsible for killing the people and emptying the village. men were the primary targets (chased into the fields and shot in the back), but women and children were not spared if they were easily accessible. once this was accomplished, the next wave of men entered and looted the huts for valuables. all of the pillaged items were strapped to the camels and taken out. the 3rd wave of men were the ones who gathered and stole the animals of the village. once they were out, the 4th and final group came in and burned the tukuls down.
the people who escaped ran for their lives. those who couldn't keep up and couldn't be carried- the sick, the handicapped, the elderly, and some of the children- had to be left behind. some died during the journey. some were killed when they tried to make it to chad- the paramilitary were patrolling the border. the dead were left unburied. if you didn't arrive at the next destination you were presumed dead- no one could go back for you.
if you had to choose between carrying your newborn, your toddler, your elderly parents, your sick sibling, your injured spouse, any of your several young children... who, and how, would you choose?
eventually it came habillah's time to be attacked, as i told in a previous story ("they say we are at peace now"). even when the government assured them that habillah would not be attacked again, no one trusted them. every sunset the people of habillah would quietly gather their things and sneak out of the village and into the forest to wait out the night. it wasn't until the ngo's arrived in numbers that the people felt safe enough to stay.
when she finished her story i begged her to take her children and go to khartoum where their father lives with his other wife and children. i would give her the money to get there. she told me she would never leave her family- and there was no room for them there. "if they kill us they kill us" she said resignedly "anyways, i never thought we would stay alive this long".

crap day

2006-09-08T18:58:00.000-07:00

before today i thought that there was no adrenaline rush greater than hearing margret calling me on the radio in the middle of the night (note: margret is incapable of calling me on the radio without screeching my name frantically and at the top of her lungs, regardless of how minor the issue may be. it is a voice that i will hear in my nightmares for decades to come)(second note: don't get me wrong- i love margret. i have come to find her insanity quite endearing). this, of course, is only because i sleep with earplugs and i manage to not hear the shootings and the bombs that have been happening at night lately. thankfully. this morning i had an adrenaline rush that i'm pretty sure just upped my degree of post traumatic stress about a millionfold. i heard carmenza get called on the radio early in the morning. i thanked God that they weren't calling me and started to go back to sleep. shortly afterwards i heard gustavo call carmenza to ask if she was ok, which i found odd. she assured him that she was ok and i chalked it up to gustavo being groggy and confused which is a typical gustavo state between midnight and noon. when we got up for breakfast they told me that there had been 3 bouts of shooting this morning and it had been really close. one of the bouts had been as carmenza was on her way to the hospital. this obviously puts you a bit on edge. corinne and i headed to the hospital as per our usual morning routine. i got out of the front seat and started towards the WHC. as i was walking towards my staff i saw a huge truck pull up on the other side of the hospital, full of soldiers. this put me even more on edge and i paused. then they started shooting and i think my heart almost exploded. i heard screams and saw my staff turn and run- making it the absolute most terrifying moment of my life. i turned to run back to the car to crawl underneath it. corinne was jumping back into the back of the car. my driver was yelling "mafi mushkila! mafi mushkila!" which means that there is no problem. corinne and i stop for a second and look at him, confused, because when someone is shooting at you there is DEFINITELY a problem and he explains that it is just returning soldiers who are shooting in the air to announce their arrival. fantastic. this village is already a bundle of nerves and you think it's cool to start shooting into the air and scaring the shiite out of everyone?

i get back to the women's centre and find that "h" has been desperately trying to find me. she tells me that a masalite woman had been sitting in the market, selling her things, beside a nomad woman with her baby. the baby had crawled towards the masalite woman who had taken her into her arms and held her. the baby was thirsty so the masalite woman took what she thought was water from beside her and gave it to the baby to drink. what the woman didn't know was that her daughter had bought diesel and put it in that container. the baby became violently ill and the nomads surrounded the woman and started to accuse her of doing it on purpose. once in the hospital they told our staff that she was not to leave until they found out how the baby was, because if the baby died they would kill her. when they started to physically attack the woman, "h" and "m" protected her, with "h" taking some of the beating. they also told "h", who had the good fortune of being in the wrong place at the wrong time, that if the baby died it would be her fault for not providing good care and they would kill her as well. they then announced that they were going to get their men. "h" came flying back to the women's centre to find me and when i heard the story i radioed gustavo. he arrived and convinced both parties to go with him to the police station to sort things out. thank GOD he is a master mediator. these kinds of situations can easily lead to the loss of lives, if not tribal wars. no joke.

i got home after work to discover that two more packages had arrived from my family. i tear them open and then laugh for about ten minutes. amidst all of my treats are 5 small bottles of bailey's. i set it aside for a night when we will need it- whenever that may be. turns out that night is tonight.

(i've deleted this paragraph so you may not understand the rest of this email. sorry)

carmenza, corinne and i were just sitting in the livingroom talking about the "what ifs". we were completely stressed out so i got up, heated up the remaining milk, poured it into 5 small mugs and added bailey's to each one (one for andi and gustavo too). we sat outside, drank it and had to restrain ourselves from licking out the bottles. carmenza keeps telling me how much she loves my mother. by the time we had finished it we were completely tipsy and starting to make jokes about the situation (disturbed jokes- black humour- but jokes nonetheless). we decide that if we wake up (haha, as IF any of us are going to be able to sleep tonight) to find that we are leaving immediately, we are going to eat M&M's and drink bailey's for breakfast.

and the personal aspect.... now i don't even know what i want to happen- i'm so torn. i want them to come in, to give the people i love a fighting chance at a future, but i do NOT want the ngo's to leave. it is the ngo's who are helping to keep them alive with food, water, supplies and medical care. i love our staff so much that it hurts. the thought of us leaving them behind to whatever fate awaits them is TEARING ME UP INSIDE. i want them to be safe. i want them to be secure. i want them to have food to eat and to feed to their children. i want them to have medical care. i want them to be treated mercifully. i want them to live through this and see an end to it. i want them to know, and raise their children in, a darfur of peace.

(sorry, deleted this paragraph too)

so what do i do? a month ago i would have absolutely rejoiced to hear that we were leaving and leapt on the next plane. i could have gone home with no shame- it would have been out of my hands. i hated it here with a passion and i was done. now things are different. i have found my purpose in being here. last night i started to try to clean up my email inbox and i was reading old emails. i found one that i sent to my Christian friends a few weeks ago with specific prayer requests. while none of the one's for darfur seem to have been answered ALL of my personal requests were answered. though grateful for all of them, one of them struck me the most. i had asked for prayer for "the ability to truly BE here, not to feel like i'm just trying to survive until i can get out of here". and that is completely what has happened. in training leimona, aicha and houda, i have come to truly be here. rather than dreading them, i look forward to births now (middle of the night or not). rather than hating having to be at the women's centre doing consultations during the day, i love every moment that i am teaching these women something or watching them practice what they have learned. i am going to be able to leave habillah with a handful of women who are well trained in doing safe deliveries. i have trained, and am continuing to train, ten fantastic tba's in the basics and they have increased their knowledge in so many areas. they are so excited to come to the trainings and so proud of themselves for learning so much. when i have left other countries i have felt like my contribution to that place was done. i had been a temporary bandage on a hemorrhaging wound. when i left afghanistan i felt that all that i had been through there had been for nothing. now i feel like i've actually done something for the people here. in return, they have blessed me immeasurably with their love and their lives.

the problem? as much as i love my staff, i love my family more. i'm not afraid to die- especially if i had to lose my life trying to keep others safe- especially if i felt that God told me to stay. i am a Christian and i know, without a doubt, where i am going. and frankly, after experiences like this, Heaven is a really tempting thought. is there really a place where every day doesn't hurt? sign me up. that would be wonderful for me, but my life is not just about me- i have a family who loves me and how could i make them go through losing another child? the thought of suffering that loss again, even for a second, kills me. a year and a half later, the pain is still there and it always will be. how can i make a decision that might make them, the people dearest to my heart, get another phone call telling them that a loved one is lost to them? i couldn't do it. i can't do it.

maybe tomorrow morning i'll find out that the troops won't be deployed and this entire email will be irrelevant. maybe i'll wake up tomorrow morning and feel that God has told me to stay regardless of what happens. or maybe i'll wake up tomorrow morning and know that it's time to go home. at this point only time will tell.

ps i think i rambled a lot in this email. i haven't had a drink in a really, really long time and i'm definitely still tipsy. too bad there's nowhere to go dancing in this joint :)

some of my favourite excerpts

2006-09-08T18:52:00.000-07:00

i have been trying to go through all of my emails lately, to clean out my inbox before i leave. i can't help but read them all again and be reminded of how much you guys have supported me, in so many different ways, during this experience. some of you have donated money to msf and other organizations working here in darfur, some of you have faithfully prayed for me, my team and for the people of darfur, some of you encouraged me to stay and fight when i was ready to quit, some of you made me feel strong and brave (and cool :) enough to do this, some of you have sent care packages to keep my team sane, some of you have started to tell everyone you know of what is happening here. every single one of these things helps. all of you have made me feel that if I have accomplished nothing else here in darfur, the emails I have sent have accomplished témoignage- the ultimate goal. these are some of my fave quotes from your emails- in no particular order. i'm sorry that i couldn't include quotes from everyone as i erased a lot of my emails before i thought of writing this. if any of you want your names taken off, please let me know (i tried to keep ones that might be private anonymous).

from my mom:

***** donated $100 dollars of her hard earned summer money to World Vision in your name, ***** and ***** both made donations to MSF in your honour, as have **** and ****, and I can’t tell you how many others have said they are or have already donated, all fans of your e-mails! ***** told me today he wanted to help and asked where to send money and your Dad and I have made a donation to both MSF and to the world food program, and my siblings all say they are going to or already have done something

from cobie:

I am also going to have a fundraiser via a garage sale and all the proceeds will be going towards Darfur.

from kate (the poor Masters student :) :

i have zero dollars, no restaurant job to hold a fundraiser like for the tsunami and no community to ask for donations, like jayden's church, having just moved back. so, as pitiful as it might sound, i will write letters. ok? one, every day, by email to our prime minister, one by email to kofi annan and one, every couple days by mail, to the whatever he is called of sudan. i know it's not $ or food, but its what i have right now, time and outrage.

from judy (whose husband is also trying to raise awareness with my stories):

I am going to tell everyone to support MSF.

from jan:

I believe you are doing almost as much by writing about what is going in Darfur and opening our eyes (and hearts) as you are by being there. you are shifting the earth a little under our feet and making us understand that we really can and must do something

from zak:

All I can tell you in that it breaks my heart to hear the reality of what is happening there and drives me to fervent prayer for the people you are working with and for you.

from teresa (and melanie):

You and your team are in my prayers constantly. When I talk to God I tell Him that my request is for the Team in Darfur – you know, Amy Osborne – it’s the team she is working with. And on and on I go. I am sure He understands.

from jean:

I'm here if you want to dump anything now or later

from suzette:

If there is any room for those of us who are motivated to somehow send some food or medicine directly to the people there, please let us know. That's certainly what I'd like to do! (meantime, I can give to hungry people in my community in lieu of those in Darfur.) Otherwise, your previous msg. to me to contribute to MSF stands and that's where my newest charitable donation will go this year!

from melissa:

I emailed Philip Gourevitch who wrote the Rwanda book, Michael Moore, and Codepink the women's peace movement this morning about the Sudan. I noticed that Philip Gourevitch has already written one article about Darfur in the New Yorker so I am praying that this will help. I am exploring other options too, trying to find George Clooney's dad's contact info (he went to the Sudan and got written up) and some other ideas. Now I am off to buy some more food for the children of Darfur with a birthday gift. Yesterday my girlfriend got a donation through World Vision to the children of Darfur, today my friend's son is getting one. If you have any suggestions for anything that I can do that will accomplish more than just me sobbing every time I read my emails, I would get right on it- PS. I think it might be time to let GI Ames out.

from jill:

Amy, what can I do to help? Is there anything you or anybody needs out there that I can send? If I was to fundraise where could the money be sent? Each of your emails remind me of the importance of not only being aware, but more importantly how there is so much to be done in this world...and that I can do something about that. They make me realize that one person can make a difference in the world and that it’s so important to help others in whatever capacity we can

from jay:

I was planning on having a bracelet making party for Sudan tomorrow night. Keep fighting the good fight and remember there are so many who love you and support you and are praying for you!!!!! You are lifted up by the Saints and when you are too weak to even pray just rest in the prayers of those who love you around the world!

from jane doe (i'm going to keep her anonymous because it's a private email, but i love it so much i have to include it):

So I'm up at 3 in the morning thinking and talking to God about what you said......I can't go to sleep. hearing from you is changing and challenging (husbands name) and I. We both know we are made for so much more than decadent Northwest life. I've had a little pilot light burning in my heart to do missions, mostly it is kept small by my desire to have my kids actually grow up. I love being a mama, but motherhood has made me timid I'm afraid. There are no bribes or guarantees with God. What scares me nearly as much is raising children that think this is reality, that hear news and think a fleeting "oh how terrible", and never do a thing. So hearing from you has made me remember my calling and ask God when and how and that I could trust Him more with my children. Pray less for their safety and more for the heart of Jesus to burn in them. It breaks my heart hearing what's happening over there, it makes me terribly uncomfortable, and I'm thankful. I want to be unable to sleep in the middle of the night, not simply because of heartburn and #2 likes to kickbox me in the liver (6 weeks or so to go), but because there is so much brokenness in this world and Jesus is so needed and where are all the workers He's calling out, and why aren't I one of them?

from my friend's father:

Your letters make me want to become a real ambassador of Jesus, to redouble my efforts and use what is left of my life to make a difference.

from michael:

All the time I have put into raising awareness, getting petitions signed, and urging the government to take action, I can't believe that I know someone who is actually there and there to help

from a beloved friend (who recently lost her baby daughter):

Thanks for speaking to your comfortable western friends about these horrific things. Gets me out of my depression long enough to think of someone else and pray and do whatever small action I can to stand with you and them.

from dawn:

Ames, just to let you know we are praying for you - we had our annual retreat and prayed lots for you. You are in our thoughts often.

from colin:

You're opening my eyes to a world that was pretty much out of comprehension for me before.

from claire (who is flying all the way to kenya to meet me for my vacation and who asked if she could come here to help as well):

Ames. I want to be there so badly. It's making my heart ache. do you need medical supplies donated? there's been a good response for donated baby things...still want that? And money I'm getting money...what should I do with it?

from caz:

i have asked my home group to pray for you...and i have been too

from lina:

I was praying for you in the middle of the night last night when i couldn't sleep. bless your brave heart to be filled with God's love and grace and energy for each day

from aviva:

i share as much info that i can that i am learning from you.....i have looked more into doing a fundraiser and as soon as i stay in victoria for more than a week i am going to do more planning. your emails motivate me to take action.

from bethany:

you are in my thoughts and prayers and heart and yah- sometimes even my dreams. ha ha ha.

from tint:

i read this paragraph that made me think of you..."My aunt told me about a group of people in Guinea who carry the sky on their heads. They are the people of Creation. Strong, tall and mighty people who can bear anything. Their maker, she said, gives them the sky to carry because they are strong. These people do not know who they are, but if you see a lot of trouble in your life, it is because you were chosen to carry part of the sky on your head."

from mangs:

I know that you are bringing light there, you are. even though it might not feel like it, and it is
worth it. I am always praying for you. Anyway, I just wanted you to know that I started supporting msf , that IS something that I can do right now and that is something that helps me sleep at night.

from jessie:

i would give anything to fly and be with you right now. love and encouragement, joy and peace i am sending you,

from naiman (whose contribution is to make me laugh out loud every time she writes):

i'm also taking a course called Jewish responses to catastrophe. i think it'll be really easy because the response is usually "oy vey"

from two of my best friends (when i wanted to quit several weeks ago and asked for advice):

we think you should stay. What? Aaaargh! Right? And right now you're thinking, too late, I've already got my ticket to come home. Well, I think that would be ok too, just so you know. BUUUUT....if God called you over there, which you still feel He did in your heart, then that's the task before you, and all the things that are bothering you are things you and people who love you will pray for. I guess when He calls you to something, it's not always fun or pleasant, and at times you don't even feel like you can keep going. Cheesy, but that's when your love for God and your desire to let Him strengthen you through trial and your faith in His purpose for you over there has to kick in. Essentially, we feel your pain, and worry and pray for you, but we stick to my incredibly sage advice (lol) from before (did I really say that? I don't even remember it, but it's true) that you have to stay until you feel strongly called home. And with my vast psycho-analytical experience, I don't think you feel called home. I think you're just having a hell-ish time and you're exhausted beyond belief. To sum up, God called you there to serve Him. If He wants you to do this, ask for His help in all the ways you need it. Remember, BE SPECIFIC! And ask for a peace in your heart to come home when He wants you to.

from ryanne:

I have also passed your emails on to many people who have all responded....unusual, I don't always get responses.. Mom's who are praying for you, friends who ask what can we do? Some people who were truly in the dark about Darfur and have been inspired to find out more

from milena the atheist:

I STARTED PRAYING FOR YOUR SAFETY, I THINK JUST CROSSING THE FINGERS ISN'T ENOUGH ANYMORE

from mike and mandy:

You're in our thoughts and prayers. We pray that God guides your hands as you teach other midwives, catch babies & comfort and befriend other women.

from phil:

you are in my prayers...hang in there

from rachel:

Do you remember when we were in Squamish somewhere - You and I were walking along a one-lane road with a huge curve in it and we heard vehicles quickly approaching from both directions and it seemed a crash was inevitable. My first reaction was to close my eyes and look away and your first instinct was to jump into the middle of the road and hold up your hands hoping to attract the drivers' attentions before they collided into one another. I am always reminded of that day when I read about what you are doing places like Afghanistan and Sudan. You are jumping into the middle of the danger, holding out your hands and offering whatever help you can give

from jenn aka granola:

You have a responsibility to share what you are experiencing with everyone who can't experience it for whichever reasons. Please just promise me you'll feed the midwife so she can feed the women, don't starve the midwife.... be well. and sleep whatever it takes. sleep. if you have to break free and dig a hidden cave where no one knows, go there and sleep! I love you and miss you and want you to be full.

from hooles:

your stories spring tears to my eyes every time... I pray for your heart to be held in GREAT hands, loved, nourished and protected. You call us all to give more, to be more noble and to open our eyes.

from mayan:

You remind me of the ground i walk on and what it is to be a diligent, humble servant. I know that what compels you to go to the places you go and do the things you do is an awesome thing. I am so grateful you are in the world, and sometimes even in my personal world.
what can other people do to help?

from tanya:

I don't have much to say but want you to know that I'm thinking and praying for you.

from kate gem:

We all remember you in our prayers

from kathryn:

Continue......have faith in who you are, what you do, no matter what it is

from lindsey:

I am so grateful though that those women have you - they need a person to love and protect them and be an advocate for them. some days it's painful to hear the stories because a part of me demands to be there with you but is locked into this life of motherhood here and the other part of me is grateful for the excuse to not be there. i love you, I'm so proud of you, I'm inspired by you, and I cry and laugh with you.

from Christian:

I hope you find both increased faith and a sense of accomplishment for doing something that many people are too scared to do. I wish you health, safety and stubbornness.

from grubb:

I've been praying for you lots - and for the people there. I'm praying for the pregnant woman you told about who will deliver 'early'. Anyway I really appreciate having your list to pray over... many of these things I've already been praying for just by reading your emails. Oh and I'm already planning your next Africa trip for you, haha. I'm sure you don't want to think about it, so just leave it to me. :) Want to go to Liberia next year?

from efrat:

i just wanted to let you know that I miss you and love you, and hope that you are being as safe as you can. Please be careful from all the jackasses out there, and come home safely but when you are ready to.

Yaron and Adi: offered for me to come stay with them during my vacation time, to swim in a pool, sleep with air conditioning and have them feed me bamba till I burst J mmmm, bamba……..

and that, my beloved family and friends, is all. many of you have written sweet, beautiful, encouraging things to me and if they aren’t included in here it is because I didn’t want this email to be about me- I tried to choose the quotes that showed what you are doing, what you have done and how you have been affected. I included some of the ones about me simply because they were quotes that gave me strength, faith and courage when I needed those things in order to stay here. your contribution was to give the people here a midwife who could train them and who could continue to bear witness.
in response to your emails and to the qualities you have mistakenly attributed to me…. I ask you to know that if there is anything good that I have done here, it’s not of me as I am merely a flawed human being. anything good that comes of this trip is of God. anything good in me is of God.
much love and blessings,

Ames

home for my birthday!!!!!

2006-09-05T12:59:00.000-07:00

i just set my return date and i should be arriving home on my birthday!!!(october 18th for you ignorami :) i was going to get home november 1st, but the idea of being home for my (and kate's) birthday was just too nice to pass up (family dinner!!!). plus, i feel like my work here is coming to an end. my staff get better and better every day and i have started to be around the WHC less in order to make them depend less on the presence of an expat- they take much more initiative when i'm not there to make all of the decisions for them. i feel like i can leave in october and know that the women's health centre is going to remain fantabulous. not that this means
it's going to be easy to leave- it won't be. my emotional attachments here are going to make it such that it's never going to feel like a good time to leave- especially knowing what i am leaving them to. knowing that, i just had to set a date and i will deal with it when i always deal with things(one day in the distant future in therapy :) my earlier leaving date also has something to do with the U.N. troops. i don't want to be here much in october as the A.U. will be gone, the U.N. will be under pressure to set a date to deploy and i don't want to be anywhere near this country when they set a date. plus, if they set a date for october or november, we would be evacuated anyways.
i just calculated that i only have 22 days left in habillah. i leave for my
holiday on the 14th and i get back on the 28th (flight schedules make it so that i'm on holidays for 5 days and i'm sitting in el geneina or khartoum waiting for flights for over a week), then i leave here october 9th. what an odd feeling to finally settle into a life so different from your own and then leave it to go back to what you're used to.
alright, time to get back to my ipod (aka my lifeline)

Sudan launches new offensive

2006-09-05T12:56:00.000-07:00

please e-mail me (Amy's mother) at lura @telus.net if you wish to read this e-mail and if I don't know you please tell me how you know Amy... I'm sorry to sound so dramatic but there is too much at stake here to take any chances... :) L

Amy's Wishes

2006-09-01T07:09:00.000-07:00

i think a lot of you are nervous to use or forward my emails after i wrote about being self-conscious- which is entirely my fault. i just wanted to let you know that at this point you can forward them to anyone on the planet (who doesn't live in sudan or have any connections here) and encourage them to send them on as well if you think it will raise awareness of what is happening here. we need everyone on board right now. every person we know and every person they know and so on and so on. also, if you want information on how you can help financially (like i said, every dollar counts) please go to my blog and you will find some links on how to donate specific things to the children in darfur. thank you my family and friends (and their families and friends).
Amy

A few places to donate

2006-08-31T09:56:00.000-07:00

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 www.worldvision.ca and the link for the Darfur donation is https://www1.worldvision.ca/CampaignsSecDM2.nsf/sudan?OpenForm&id=03368750

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.

www.wfp.org

http://www.msf.ca/donate/waystogive.htm

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.

www.reliefweb.int

Judy

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

2006-08-31T08:35:00.000-07:00

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Amy and Mariam from "Amy's Staff"

2006-08-31T08:13:00.000-07:00

2006-08-31T07:59:00.000-07:00

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Photo

2006-08-31T07:49:00.000-07:00

The Latest

2006-08-30T16:03:00.000-07:00

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

2006-08-30T16:00:00.000-07:00

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

2006-08-30T15:39:00.000-07:00

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

2006-08-30T15:38:00.000-07:00

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.

'A MATTER OF REGRET'

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."

Aid Workers Under Attack in Darfur

2006-08-21T10:21:00.000-07:00

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

2006-08-21T10:20:00.000-07:00

fyi....

Violence in Darfur reaches catastrophic levels: UN relief chief / AFP /
10.08.06

DATELINE: GENEVA, Aug 10 2006

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

2006-08-21T10:19:00.000-07:00

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

2006-08-21T10:13:00.000-07:00

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?

from Ames

2006-08-11T13:32:00.000-07:00

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".

care packages

2006-08-09T13:14:00.000-07:00

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 lura@telus.net for the address as we are not allowed to show it here on the blog!!

Thanks, Amy's Mom

we sit together

2006-08-09T13:10:00.000-07:00

"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. mine....pink, 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.

"i hate your job" "so do I"

2006-08-07T14:06:00.000-07:00

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.....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.

she

2006-08-04T14:16:00.000-07:00

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.

the sitch

2006-08-03T16:07:00.000-07:00

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".

lolololol

weird

2006-08-02T07:12:00.000-07:00

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

update

2006-07-28T08:02:00.000-07:00

there is a more recent letter from Amy, but due to the risks involved to the key players I cannot post it on her blog. If you know her personally and would like to read it you can e-mail me (her mother) at lura@telus.net and I'll send it to you. ps please pray for her safety

sorry

2006-07-27T13:47:00.000-07:00

the wings that we found all over the floor the next morning

hey all, just to let you know so you don't worry, the radio silence may continue for awhile. a number of factors are at play. the first one is that i just honestly don't know where to even begin. it seems like every other day we face some strange new crisis, many of them life or death situations (not for us- for our staff, our patients, etc). i get overwhelmed and don't bother writing because i can't tell it all. also, i have had very limited access to the computer lately (the guy who works on it is on it ALL the time). the only time i can get on is at night, which isn't going to happen for the next 18 days or so. we're in the midst of the most disgusting phenomena EVER. there is a huge flying ant-like thing that is going through some crazy life-cycle stage right now and at night the air is so thick with them that there is nowhere to go but into your mosquito net (and far away from any light source, like the computer). you honestly can't fathom how many of them there are, so i had to get out from the safety of my net to take a video and pictures to prove it. in the morning the ground is COVERED in huge wings (on our dishes, in our food, carpeting the entire floor inside as they come in towards the light) and dead wingless insects. this morning i poured myself a bowl of cornflakes and wings. then i decided that i actually wasn't that hungry. they say it only lasts 20 days and they'd better not be joking. last night i turned to gustavo and said "sorry but i'm leaving tomorrow". he says "are you serious?". i say "no, but i wish i was". then, to top it off, i was planning to write today, to get back into the rhythm, and our generator died. this means that we can only use our small one that can only run for 3 hours at a time and then has to rest for several hours. so now, the only time i have to write, the battery is running out and i have about 2 minutes left. adios.

dysentery

2006-07-21T14:26:00.000-07:00

yup, i had my first bout of bloody diarrhea yesterday. such a nice way to start your day really. i went to find carmenza and told her that i didn't want to take cipro because it makes me nauseous. she prescribes me an injection a day of an antibiotic for four days, which is fine with me. as we're walking to the pharmacy she says "do you want us to give it to you intravenously?". i say no, injections are fine. she says "are you sure? we can just put a cannula in and you can keep it in for the four days". i say that sounds a bit drastic, i'll just take the four injections. she says "are you SURE? it's really painful". i'm thinking that she thinks injections are painful (because she's clearly not as hardcore as me) and that she's sparing me 3 injections if they put in one i.v. cannula, so i say no, it's fine, injections don't bother me. milena and i go into the dressing room and she tells me she wants to put it in my thigh. i say i'd prefer it in my upper arm. carmenza says to put it in my butt, which i flat out refuse. we compromise on thigh. now i have to take my jeans down, which is more than i bargained for (not doing a lot of shaving these days), so carmenza guards the door. milena puts the needle in and all of a sudden she injects me with LIQUID FIRE. i was in so much pain i could barely swear. she kept injecting and i kept writhing on the table, biting my hand, covering my face, cursing her mother, trying to stay still enough that she wouldn't break the needle off in my leg. she apologized profusely, but the only thing i wanted from her was for her to stop injecting lava into my thigh. holy shiite. afterwards i had to lie there for a few minutes to get my breath. as i limped out of the room carmenza says "i told you it was painful". i tell her to shut up.
tonight i agree to getting the antibiotic intravenously so milena decides to just inject it straight into my vein, rather than putting in a cannula. i'm definitely nervous after yesterday, and for good reason apparently. she starts to inject and i immediately start to try to get away from her and her syringe of torture. she's telling me to stay still and i'm telling her to get it the hell out of my arm because it burns like acid. she takes it out and i do lamaze breathing for a few minutes. finally she puts a cannula in my wrist and injects it into that. it burns but not nearly as badly, so i sit and accept it as gustavo takes pictures of the look on my face (it was not a happy look). i tell them that next time i have dysentery i'm not telling them, i'm just going home.
yay africa.

note: about two months after this story happened, carmenza figured out why the injection is SO painful. we were dissolving the powdered antibiotic in a small amount of sterile water and injecting it. what we should have been dissolving it in is a liquid that contains an anaesthetic that numbs the site as you inject it. our other option would have been to dissolve the antibiotic in 1-2 litres of water before injecting it. good to know :)

natural "healers"

2006-07-19T13:31:00.000-07:00

you may need to click on the picture of the baby to enlarge it in order to see the scars on his abdomen

this girl was burned with a cow's horn to cure her kidney infection

every sunday and tuesday from 3 till 4pm i train my nine tba's. we sit under the shelter in the waiting area and drink chai and i teach them about whatever topic seems relevant at the time. often the topic is chosen for me by my witnessing a practice that i want to talk more about. today's topic was one that has been a long time in the coming.... i wanted to talk about the extremely disturbing practices that i've seen employed in the name of tradition and natural healing.
the other day i had a patient come in complaining of fever and severe flank pain. she had the signs of a urinary tract infection and i suspected a kidney infection as well. i asked her to lift her shirt so i could determine the location of the pain. she lifted up her shirt and i gasped. "what HAPPENED?" i ask joyce. the entire area of skin around the kidney, front and back, is covered with large circular burns, each full of numerous blisters. some of them are necrotic. joyce explains that the natural healer had taken a bulls horn, had sanded the blunt end, had placed it in the fire and had used it to burn the girl. "what??? why???". to heal her, of course. i prescribe her a round of antibiotics and tell joyce to make sure that the girl knows that it is the medicine that is going to get rid of her pain, not the burns. and that was just the intro. the next patient i see who has experienced natural healing is a 40 day old baby whose mother died in childbirth. his grandmother brought him in as he was severely dehydrated after a prolonged bout with diarrhoea (thanks to bottle feeding). his entire stomach is covered in vertical scars where they cut him with a razor from below his nipples to below his bellybutton. again i ask why. "to get rid of the bad blood". "what bad blood?" "the bad blood that is making him sick". then there was the 2 year old diabetic whose parents circumcised her in order to "heal" her, and ended up killing her. then there was the little girl who had a bad cough who had her uvula cut out without anaesthesia and died. then our driver came to me and told me that his infant daughter was crying too much at night and his wife wanted to take her to be cut. i asked him to bring the baby in and we discovered that they weren't burping her and she was having gas pain. hind tells me about a man who broke his arm. he had it casted at the hospital, then went to a natural healer. the healer removed the cast, shredded his arm and packed it with wet mud. i ask hind if it worked and she says "i don't know. he is died now". today a child who had been transferred to the SFC was moved back to the TFC as her mother wasn't giving her the food and it was also discovered that she had been circumcised. i ask my staff what they think of natural healing and they're pretty divided. the "city" women think it's ridiculous, but the village women sheepishly defend it. hawa had hurt her foot before i got here and had had it treated by carmenza. she points to a scar where a woman had cut her foot open and thrown wet sand into the wound, and credits it with curing her. i say no, you had it treated by a doctor who then immobilized it until it was healed. all your natural healer did was expose you to infection. i ask them to tell me more about the common practices so i know what i'm up against.
at the training today i sat down and told my staff (midwives, nurse assistants and tba's) that i want to explain why natural healing doesn't work and is, in fact, dangerous and what needs to happen instead. we start with diarrhoea. diarrhoea is cured here by the healer pulling 4 of the child's teeth, with no anaesthesia and no sterile equipment. the healer decides which four of the teeth are the "bad" teeth, and they use their dirty instruments to yank those teeth from the child's gums. i explain that there is no medical rational to this practice and, instead of this, they need to know how to properly handle diarrhoea. i teach them how to make ORS at home, which is as easy as putting a pinch of salt and 4 fingers full of sugar into a glass of water, and having the child drink a cup after each episode to avoid dehydration. next i address the cutting of the uvula (the thing that hangs at the back of your throat). this practice is used to treat coughs, vomiting and oedema. the patient is held down and a sharp knife (from now on just assume that no anaesthesia is used and nothing is sterile) is used to slice the uvula off. occasionally they also cut out the tonsils for good measure. as someone who had their tonsils removed under anaesthesia and thought it the worst pain imaginable upon waking, this thought makes me literally nauseous. i explain that cutting anything out of the throat is not going to cure coughing or vomiting or anything for that matter. most coughs and vomiting will spontaneously resolve themselves given time, and the ones that don't need to be checked by a doctor. i decide not to broach the circumcision topic too much as i'm waiting for my trusty companion and right-hand woman (aicha) to get back to be my translator. i figure it's a sensitive enough subject that i want someone with a gentle spirit and a good command of the english language to translate for me. next i bring up the taking of the razors to people's skin. this is used for fevers, among other things. i tell them that rather than slicing people open, they should remove the clothing, sponge the patient down and fan them to cool them down. if the fever is high, during malaria season or recurrent, they need a medical checkup. as far as any other illness, there is nothing that is going to be healed by slicing someone open with a razor and rubbing wet sand full of animal excrement into them. the next practice is one that actually gives me shivers to think about....it's the treatment for jaundice. the healer has a forked metal prong that is put in the fire until it is red-hot, then it is applied to the upper arm, the forearm and the freaking fingernails. i ask them if they realize that putting hot pokers on people's fingernails is a method of torture in some countries. they laugh, i don't. i tell them that jaundice equals doctors appointment. period. and saving the best for last... the treatment for headaches. there are many treatments for headaches here and none of them involve tylenol. one method has the healer wrapping both hands around the patients throat and squeezing tightly until the person starts to pass out. i tell them that in my country that's called attempted murder and it's highly illegal. the next method involves the healer making two deep vertical incisions in the patients temples, then smearing the wound with ash, which actually makes a tattoo that i thought was for decorative purposes. another method has the healer gather the skin in the middle of the forehead in order to bite it. another tradition has the person tie a string around a tree and then walk around it once in the morning and once at night. of all of the many methods they told me about, my favorite, by far, is the one where the person runs head-first into a certain kind of tree 3 times, twice a day. this was the point where i started laughing so hard i could only sputter "that is the WORST cure for a headache i have EVER heard of". they laughed at my reaction to every single remedy, but this one killed them. this is the point where i ask them if these remedies actually make sense to them. if my leg is broken, does it make sense to take a big stick and break it in 6 more places in order to feel better? they laugh their heads off, which is their response to almost every single thing i do, so i don't know if they grasp the absurdity of the cure or if they just think it's funny to shock me.

so that was the extent of my fight against the medical practices that i would, personally, rather die than be subjected to....

"you always think it can't get worse, and it always gets worse"

2006-07-18T09:51:00.000-07:00

a search for blood donors

milena doing blood typing

mohammed prepares the car for an emergency transport to el geneina

after the bed collapsed beneath us

and again, where to start, where to start....
the day started slowly, with all of us sitting silent and bleary-eyed at the breakfast table. the night before, the dogs of habillah- every single one of them- had held some sort of dog symphony and we were all awake much of the night. by early evening we were splayed across the livingroom, each of us with our individual ipods blaring with earphones shoved in our ears, each pretending that no one else in the room existed. someone heard the radio and carmenza took the call. when she came back into the livingroom we removed our earphones long enough to ask what was up. she said that it was the hospital and that 7 patients had just arrived from Gobe. we wondered aloud what sort of fiasco could have resulted in 7 casualties that had to be referred from Gobe, and the only thing we could think of was that it was soldiers who had been injured fighting. we all got up and decided to join carmenza, partially out of a desire to help, partially out of curiosity and partially out of pure boredom. as we pulled up to the hospital someone pointed out that there was a huge truck in the courtyard. we got out of the car and entered one of those situations that causes you to look around for the cameras because you think you've stumbled into a scene from a movie. it was pouring rain and, thus, there was no moonlight. our hospital has no electricity, so we arrived to find a huge crowd gathered around the truck trying to unload patients by the light produced by weak flashlights. i was holding a fairly powerful lantern so i stood in the middle of the crowd and held it up over my head à la statue of liberty so my team could determine what the hell was going on. the truck that had backed into our courtyard was a huge flatbed truck, and the back of it held 6 patients, soaking wet, shivering, wrapped in large, bloody bandages. carmenza and milena started to order the men to carry the stretchers to the small, dark hall between the dispensary and the dressing room to get the patients away from the curious crowd and out of the rain. we asked the staff to ask the people what had happened and to translate for us. they told us that the patients had been at a wedding in gobe when someone had unleashed a hail of bullets into a crowd of dancing women, killing a woman who was 8 months pregnant and wounding 6 others. there's no time to really think about that, it's time to make sense of the chaos. triage begins: vitals are taken, i.v. lines are started, tetanus vaccinations are given, patients are sedated, wounds are unwrapped and exposed. at one point i looked over and watched milena crouched in a small, dark corner, trying to start an i.v. line on a little girl who had been shot, with only the light of a fading lantern, and all i could think was "this is insanity". the wounds were unbelievable. one small hole where the bullets entered and complete and utter destruction where they left the body. kalashnikovs. two of the patients are seriously injured and we know we need an emergency transport to el geneina, but the roads have been closed to us after too many attacks on ngo's. a couple of days ago an ngo about 140km away was attacked and one of their staff was killed. you probably didn't hear about it because it was "only" a sudanese national staff member. after an extremely long night that involved far too much carnage, the patients were as stabilized as they were going to get. finally we went home to try to sleep for the few remaining hours until daylight, when we could transport the patients. i think i managed to sleep for a couple of hours, and then i heard my radio. i curse the world and get up for the delivery. the delivery took awhile and then, at the last minute, the baby went from 'head visible' to 'head out' in about 10 seconds. the 4.2kg sumo baby tore his mother, in spite of her having had 3 previous deliveries. after the delivery i went to examine the tear so i could determine whether or not hawa could suture it, or if i was going to have to break down and do it myself. i opened the wound and cursed the world again- the woman had torn through her anal sphincter. i radio carmenza as i'm not trained to suture tears that serious, and she comes to join me. with carmenza and i busy in the delivery room, and gustavo meeting with local security people to determine just how high the risk was to travel, milena was left to prepare the patients for transport. once my patient has been sutured, we join milena who is frantically taking blood types from the patients relatives in order to send a donor with each of them. in the craziness carmenza cuts her arm open on one of the doors and needs stitches. gustavo is about to leave with the patients and none of us are allowed to go as he is not willing to put any of us at risk. he is going to take the patients halfway, to mornei, and then one of our cars from el geneina will meet them there and take the patients the rest of the way. i take off my St Christopher necklace (patron saint of safe travel) from sarah gem and hand it to him. he thanks me and slips it into his pocket. carmenza needs someone to suture her arm- gustavo the doctor is leaving, milena puts her hands in the air and says "i'm a nurse", and i say "well, it's not exactly the tissue i'm used to suturing, but i can do it". we go into the dressing room and i am so tired i can barely keep my eyes open. i set up the sterile field and i'm about to start suturing and carmenza stops me, saying "maybe i'll just clean it before you start stitching". i had been about to suture her arm without first CLEANING the wound. suuuuuuuuuuch an idiot.
finally we head home for breakfast, then it's back to the hospital to see patients. my national doctor went on holidays two weeks ago, then decided to stay home for an extra month and a half, which means that i see her patients all day long, then i'm on call for deliveries every night. when gustavo heard that i had been called to a delivery shortly after getting home the night before, he remarked "i think they're trying to kill you". i reply "i think they're pretty close to succeeding". i get home for lunch and i find carmenza at the table eating, and i see milena on her bed in the livingroom, facing the wall. it looks like she's listening to her ipod, which we all employ as a polite way of saying "pretend i'm not here", but when i look closer i can see that she's sobbing. i go lay beside her and throw my arm over her. it's the first moment that i've seen anyone show any emotion over what the previous night had entailed. somehow in the moment we had all turned off. we dealt with the injuries, not really allowing ourselves to acknowledge that 4 of these patients were little girls, that somewhere in gobe there was a dead, pregnant woman who had left 4 children behind and that someone had shot them with a kalashnikov as they danced.
milena is still crying when suddenly she yelps "there's an ant in my ass!". she jumps up, whips off her pants and starts frantically searching for the offending agent as carmenza and i take pictures of her. now we're laughing. the moment passes and she sits down and starts to cry again. i pull her towards me and she lays her head in my lap. i motion for carmenza to sit on the other side of her and she comes from the table and sits down. and the bed collapses beneath us. she says "i told you i gained 2 kilos on vacation". now we're laughing again. we get up and decide to eat lunch. as we're eating they tell me that the car from el geneina hasn't made it to mornei, and no one can reach them by radio. the required contacts are every half an hour and they haven't been heard from in 2 hours. we spend the afternoon tensely waiting for news. i pray that they were just robbed but that they're ok. we talk about the night before and milena says "you always think it can't get worse, and it always gets worse". she starts to cry and carmenza tries to comfort her, saying "only a week left for you". milena says "and a lifetime left for them". carmenza tells her that she can't let herself think about it, she can't let herself think like that or it will be too hard. too late. now carmenza is in tears. me? i'm far too tired to cry.
finally there's news. our car from el geneina was stopped by 4 gunmen who shot warning shots into the air. the staff pull over and are ordered out of the car. one of our staff is an arab and he is confronted by the men. they ask him why he is helping the "hawagas" (white people), who only help the masalite and not the arabs and they accuse him of working for the UN. he tells them that he is working for msf because msf helps everyone, including the arab nomads. they tell him that he should join them and he politely declines. they say that they'll be taking his driver and car but he asks them to allow them to continue because there is a medical emergency. they beat our driver for not carrying enough money and demand to know what tribe he is from. apparently his tribe has no problems with the nomads, so they stop beating him. they cut the radio; tell the men that they will let them go this time, but that next time they will kill them and release them. the staff make it to mornei where it is decided that everyone will stay until the situation has been assessed. the little girl, our youngest victim at 10 years old, starts to crash and needs to get to el geneina for surgery or she likely won't make it through the night. the drivers decide to chance it, and they transport the patients back to el geneina on the same road where someone had just very seriously threatened their lives if they were found on that road again.

and that, my friends, is enough.

random short stories

2006-07-14T08:46:00.000-07:00

the other morning i was woken up at 2:30 by the squawk of my radio. the nurse tells me that one of my high-risk patients is at the hospital in labour, so i crawl sleepily out from under my mosquito net, pull on my msf t-shirt and go to find our on-call driver. awat stumbles out of his tukul and opens the car doors. we get in, we buckle up, i reach up to turn on the interior light as he plugs in the flashing red light on our roof (safety regulations for travelling after dark). we pull up to our gate and he stops as the guard reaches up and bends our huge antennae so we can make it out under the low gate. once we are outside of the gate he pauses, turns to me and says "hospital?". i say "no, mcdonalds. i really feel like french fries". he looks at me blankly and i sigh "yes, the hospital". seriously, where else would i be going in habillah at 2:30am?

gustavo once asked his driver in darfur why it was that you saw the women, not the men, carrying the loads here, and carrying those loads on their heads. the man gave him a lengthy explanation about how the girls were taught from a very young age to practice walking with things on their heads, and how women were more graceful and better able to balance things, etc etc etc (translation: the men here are lazy yahoos). they were driving as they spoke and they happened to drive by a man who was carrying a large load on his head. gustavo turned to his driver with a questioning look and the driver explains "that man surely has no wife".

milena "and then there are spiders, who have 6 legs..."
gustavo "how many legs?"
milena "6"
monica "well yeah, the handicapped ones"

gustavo, our fearless leader

monica

our new fieldco is gustavo, an argentinian doctor in his late 20's. i love him for 2 main reasons (ok, more than 2, he's laugh-out-loud funny so he is clearly my new best friend). one, he paces. when he is stressed out or thinking, he paces around the courtyard like a caged animal. i love this because any kind of pacing reminds me of arin, who i love to be reminded of. two, he walks around singing "true colours" all day long. when i tell him that it's a bit unmanly to be singing cindy lauper songs he insists that he is singing the phil colins version. the gustavo set comes complete with an amazing girlfriend, monica, a doctor from spain. together they make up one of the funniest couples i have ever met. they are both bosses of our team (gus is directly in charge of the team here and monica is in charge of all of our medical activities) without being each others boss. occasionally during a meeting they will disagree about something and gus will end it with "monica, not in front of the children!". other times they will talk to each other in spanish, leaving the rest of us feeling like you did when you were a child and adults spelled things to each other so you wouldn't understand. one of gus' favorite stories is about the time he was doing rounds in argentina with a doctor who was notoriously bad at his job. as they stopped at one patient, the patients daughter told them that the man was having pain of some sort. the doctor replies "well you need to move your legs!". the daughter says "but doctor, he doesn't have any legs. you amputated them". without missing a beat the doctor says "then move the rest of your body!". now whenever gus says or does something stupid he says "then move the rest of your body!"

alright, can't write about what i actually want to write about, so you got this instead....

"there is a work beside which all else strikes me as useless. that is the work that seeks to raise the status of childhood everywhere. that every child, from pole to pole, would come into the health and happiness that is their due. if everyone who had ever loved a child would but do their part, this would come to pass"

"some days you just have to hate life"

2006-07-14T08:45:00.000-07:00

"pa-ra-check hey!"

that quote was borrowed from my friend, erin stopes, who wrote it in an email from the philippines once. i think it quite adequately describes yesterday. the other two quotes that adequately describe yesterday were uttered by my team-mates... yesterday. one simply stated "this is an awful country". the other, as we crawled into our beds at 3am, said "today was a horrible day". i agree on both counts.
where to start, where to start..... well, the biggest issue is one that, for security reasons, i can't write about, which is far more frustrating for me to write than for you to read, trust me. it's a story that will play itself out however it plays itself out, and we have no choice but to see where the tide takes us. there are a number of ways that it could end, but for now we can only wait and see. when i am home and have access to communication devices that are available only to me, i will tell the story.
and then there are the parts of the day that i can talk about.....
at lunchtime i started to feel queasy and i wondered if milena had given me her sickness from a couple of days ago. by dinner i was lying on the bed in the "livingroom" (we don't have couches here in darfur, so we use bedframes instead) trying not to vomit and wondering how sudan could possibly get any hotter. milena woke me up and asked me if i wanted dinner. i declined, saying that i felt like i was going to be sick. she asked me if i had a fever and i told her that it was quite impossible to tell in this heat...that i have felt like i have a fever for the last month. she felt my face, then went to get a thermometer. when she took the thermometer to check it she was SO excited to discover that i did, indeed, have a fever. instead of the expected compassionate, nurse-like response, she throws her arms up in the air and yells victoriously "revenge!". i guess i should explain.... three days ago, as mentioned, milena was sick. when we took her temperature and found that she was feverish, we told her we were going to do a paracheck, which we were quite excited about because hey, it's something to do. the paracheck is a test for malaria and it sucks. the kit comes complete with the test and the lancet that you use to stab the fingertip hard enough in order to get a full drop of blood. she flat-out refused to let us do it, claiming to suddenly feel quite well. as she lay, sick and miserable, on the bed, gus, monica and i made up a "paracheck dance" that quite closely resembled 'the locomotion', complete with a chant "pa-ra-check hey!". milena's response was to get up and do her own song and dance, borrowed from one of the squirrel-like creatures on the 'madagascar' dvd, proclaiming herself to be "phy-si-cally fit! phy-si-cally fit!". as expected we won, and i had to poke her finger twice as she pulled it away the first time and it didn't go deep enough. she was so irritated and monica got a great picture of her giving us the finger and looking at us like she hoped we would die :) the test was negative and she recovered. now, of course, it was my turn for a paracheck and milena couldn't have been happier. i say, first of all, that no one is doing a paracheck on me until i see the dance. they happily oblige and do the paracheck dance around the room. my second stipulation is that they have to do a venapuncture (take the blood from a vein in my arm with a syringe) as they are NOT taking it from my finger. the last time i had a fingerpoke was in the philippines when grubb peer-pressured me into it because she needed to test the new glucometer. i accidentally called her a 'mofo', which i thought was mine and bones secret swearword. i don't know who was more surprised... grubb that i called her a mofo, or me that she knew to be insulted by it :) monica was totally shocked that i preferred a venapuncture over a fingerpoke and i explain that i have no problem with needles, and i let my students practice everything on me (i.v.'s, injections, venapunctures) except for fingerpokes- fingerpokes hurt like hell. i would rather that they took it from my eyeball than my finger. so milena takes my blood, the test is negative, and i lie back down to just let whatever it is run its course.
the only problem with my being sick was that the timing sucked- i had a patient in labour. right before lunch when i was still at the hospital hawa, one of my nurse assistants, came to find me. lacking the english to properly explain herself, she took me by the elbow and dragged me to the delivery room saying something about "moya" (water) and "bleeding". a woman lay on the delivery table, and joyce (one of my khartoum midwives) explained that she had been in the market and water had started to come out, with blood. i can see that there is enough blood to concern me, so i use a speculum to try to see if her cervix is open enough to see if any placenta is visible. the membranes are coming out of the cervix and joyce is looking over my shoulder and says "that's the placenta!". i say no, it isn't, it's the membranes. she starts pacing around loudly proclaiming "that's the placenta! that's the placenta!". i say no, it isn't, it's the membranes. she's now getting mad that i'm not agreeing with her and i finally say "joyce, you are a midwife and you know what a placenta looks like. this is not the placenta so please chill out". hawa looks over my shoulder and says quietly "this no placenta". i smile at her and nod. ok i say to my staff, her membranes have broken and she needs to deliver this baby so it's time for some labour stim. i tell her she can get up, walk around, eat, drink, shower, etc. as i was talking i stood by the woman and, like a total midwife, put my hand on her belly. that was when i realized that something was definitely wrong. i turn to joyce "didn't you say she was 9 months pregnant?". she says yes, that she's 9 months. i use both of my hands now and i remove her 600 layers of cloth so i can feel her bare stomach, and i wince. i turn to my staff and say "she's not 9 months. she's not even close". we measure her fundal height and it's 24cm (in north america you can usually associate the number of centimetres with the number of weeks pregnant the woman is- therefore a full-term pregnancy would be 40cm for 40 weeks gestation. here we assume smaller babies, but you would still expect a term fundal height to be at least 34 cm). maybe i'm wrong, i hope. maybe it's just so small because the baby is so engaged. i leave my staff to monitor the labour and i go home for a very long afternoon of meetings and being sick.
after the first meeting, when we took a break lest we all kill each other and/or ourselves, i go back to the hospital to check on the patient. the bleeding has stopped and her vitals are good. leimona listens for the baby's heartbeat and she tells me that it's too slow. she beats it out with her finger and i ask if she's sure it was the baby's heartbeat and not the mother's. i take the fetoscope, place it on her belly, and listen. nothing. i move it...nothing. i move it again and again, until there is nowhere left to listen. the mom says the baby is still moving, so i choose to think that it's just my hearing loss that won't allow me to find the heartbeat.
later that evening i hear joyce call me on the radio. i step outside for better reception and tell her to go ahead. "i can't find the fetal heartbeat" she tells me. "i know" i reply "i don't think there's one to find".
i went back to bed and fell into a restless sleep until i heard my radio at 1am. joyce tells me the patient is ready to deliver and i reluctantly pull a shirt over my tanktop, still sweating and feverish, even in the cool night. milena sits up in bed and tells me she's coming with me, which i had so been hoping she would say. i felt like crap and the last thing i wanted to do was a delivery, but the midwife on call was joyce who was, unfortunately, born minus the sensitivity gene. the moment i knew that we were going to deliver a dead baby i decided that i was going to do the delivery and i didn't care if i had ebola and was bleeding from my every orifice. i was not willing to subject a woman who was on the verge of a stillbirth to a birth that was anything other than gentle.

note: the rest of this story may not be something that everyone wants to read....

we arrived and i took joyce's place at the foot of the bed, as the woman had started to deliver there. in the low light it looked like the head was out, but it seemed misshapen. i took my lantern and turned it on, and i heard milena say "what is that?" it didn't look like a head, and with further examination i discovered that the baby was breech and that we were looking at her slightly malformed back/butt. the mom pushed until the body was out and then she gave up. we sat there for awhile, waiting for her to push again, staring at this lifeless body lying half out of her. after awhile i asked joyce to ask her if she wanted to push and joyce said no, she has no more strength to push. i told her that it was almost over, but she needed to push a few more times. no, she was done. it was hard not to understand. what motivation is there to work that hard when you know that your baby is already gone? i tried a few more times and still she shook her head, completely defeated. i finally reached inside and brought out the little arms, then tried to maneuver her head out while inflicting as little damage to it as possible. when she finally arrived we were all as silent as she was. "baby, you came too early" i whispered. i cut the cord and handed the baby to leimona, asking her to clean her so the parents could see her. the mom hemorrhaged and i ended up having to subject her to several injections, an i.v. and countless uterine massages. each time i would say "i'm so sorry", which was true on so many levels. when the mom was stable i got up and went to wash my hands. i asked joyce to bring the baby for the mom to hold, and she told me that they didn't want to see her and, in fact, no one wanted to look at her. she was to be wrapped up and buried without being seen. milena and i looked at her with surprise and walked into the delivery room where the baby lay, wrapped in gauze from head to toe and tied with string. we looked at the shrouded figure, we looked at each other, and finally i said "i think she deserves to be seen". milena agreed and we closed the door and unwrapped her. she was small, but not too small to have survived had she been conceived in a developed country. her head was damaged from the pressure of remaining in the birthcanal for so long, and from my efforts to get her out. her skin was raw and peeling in places. we touched her hands and her feet, so little and perfect yet so cold. she was beautiful. we looked at her, we held her and we acknowledged that she had lived. she left too soon, but she was here.

it's all about improvising

2006-07-11T17:44:00.000-07:00

as much as i support the fact that our tba's deliver the women in the kneeling position, i had to find a way to explain to them that part of their technique was making the delivery harder on the women, not easier. as the woman kneels, the tba lies in front of her and puts both of her arms through the space under the woman, between her legs. with both of her hands she reaches up and cups the butt area, and pulls forward as hard as she can as the woman pushes. their reason for doing this is because of their concern that the woman will tear towards her rectum (i think- i didn't completely understand the explanation). in the first delivery that i saw one of them doing this, the baby was big, the mom was small, and the last thing we needed was a tba making the pelvic outlet smaller. the midwife with me was mariam, who doesn't speak english, so i couldn't explain to either of them why i wanted the tba to stop doing it. each time she would go to do it i would just say "lalala!" (nonono!), and she would look at mariam for an explanation, and mariam would just shrug. i radioed for one of the nurses who speaks english to come translate for me, and i tried to explain through him, but they still just seemed confused. dilemma: how do you explain to women who have absolutely NO medical understanding that there is only one moveable bone in the pelvis and that that bone needs the freedom to move back to make room for big babies? how do i get them to understand that, by pulling that bone forward, they are actually making the space available for the baby smaller, and are making it harder for the woman to give birth? i thought of showing them pictures of the pelvic bones in the obstetrics textbook we have here, but these are women who would likely have a hard time grasping the concept of visualizing the pictures in 3D. i thought longingly of the pelvic bones i had in afghanistan, and the life-sized pregnant dummy that i used to train my students there. i smiled at the memory of making cervixes out of playdough stolen from an operation Christmas child box, to teach them how to check the different cervical dilations. and then i got an idea.... i kept an eye out for a couple of days before i finally found something that would work. in our shower we have a small, white, plastic garbage can, and i stole it and replaced it with one of the bigger, coloured ones. the next step was finding scissors or an exacto-knife, of which we have neither in the entire compound. i finally end up borrowing andi's blunt swiss army knife, and i pray that i won't sacrifice too many fingers for this project. i sit in my room with my obstetrics book open, my pencil in one hand, the newly cleaned garbage can in the other. i sketch a pelvis onto the garbage can and i start to carve through the hard plastic. by the time i'm done, i have a plastic, anatomically correct pelvis. at the next lesson i had with the tba's, i showed them the baby's passage through the pelvic bones and, by manoeuvring the little plastic tailbone, i could show them the effect that their technique had. it was awesome- they totally got it and not a single one of them has done it in a birth since. the other benefit of the new pelvis has been that i can use it and our "baby" (the dirtiest, ugliest, most ghetto hand-made doll on the planet) to explain other complications- namely shoulder dystocias.

in my remaining 5 months i have to train these women as much as is humanly possible as once i leave my position likely won't be replaced. in a perfect world there would be births all day long and each of the midwives would be at enough births with me, and see enough complications, to be completely trained and competent by the time i leave. seeing as how births are notoriously unpredictable, and most of them prefer to happen at night when only the most competent midwives are on call, i don't see this happening. this has lead to my next case of improvising. if i don't have real patients giving birth to real babies, i will use fake patients giving birth to our ghetto baby. the last few afternoons i have taken the midwives into our delivery room and we have simulated births, with me throwing in random complications for them to "handle". one of them happily climbs up onto the delivery table and shoves ghetto baby up her shirt, and one at a time the tba's and midwives "deliver" the baby according to what i tell them is happening. "the baby's head is out but the body won't come, what do you do?" "there is a tight cord around the neck, how are you going to handle it?" "the baby isn't breathing...." "the mom is bleeding....." and so on and so on. my hope is that by practicing enough they will get a feel for things and when the time comes they will know how to handle it in reality, or will at least be comfortable with it enough not to panic.

my next project is one that has me wishing i hadn't cheated my way through sewing class in grade 8. i've decided to try to sew together a dummy like the plastic one i had in afghanistan. i figure if i can sew a pair of pants and a shirt together, then stuff the clothes with cotton or something, i can put my plastic pelvis in there and make a cloth uterus and vagina, and we can do some more realistic simulations. as much as my midwives and tba's are all very quick to whip a breast out to feed ghetto baby, i don't imagine they would be super excited about the idea of taking their underwear off in the name of training.

on a more serious note: the security situation around habillah is getting more and more tense. the number of ngo's being robbed on the roads outside of the village has increased a lot in the last week, and yesterday one of the drivers didn't stop when they were ambushed and their car was shot at, and hit twice, as they sped away. no one was hurt, but no thanks to the idiot driver. everyone knows that when you are held up you stop, you keep your hands where they can see them, you get out of the car and lie face down on the ground, you take the contents of your pockets and put it on the ground in front of you, and you do exactly what they tell you to do, with no sudden movements. if you want to get shot, you keep driving or you run. the people from unhcr came by the other day to ask us if we were travelling along a certain road as they had to get a message to some refugees there and no one was allowed to drive that road because of the security issues. we say no, we aren't allowed to travel on that road now either and the woman says "well if YOU guys aren't using that road then NO ONE is using that road". msf has a rep for being kind of hardcore. by the way we are now, officially, the only expats in habillah who haven't been attacked in any way. yes kate, i just knocked on wood :)

uninvited guests

2006-07-09T07:07:00.000-07:00

one of the things that i love the most about living overseas is the fact that every once in awhile you are assured an experience that is completely foreign to the life you generally lead. while each day often contains 23 hours and 55 minutes ranging from complete discomfort to mind-numbing boredom, you can almost always count on having at least 5 minutes that you can look back at and think "now THAT was new". i was called to a birth the other day and it was proceeding relatively uneventfully. i was standing at the back of the room, leaning against a supply table, when something in the corner of the room caught my eye. i look more closely and it appears to be a stuffed toy of some sort. it's roundish, about the size of my hand, grey, and covered in spikes. i prod it with the antenna from my radio and i jump back a bit when it hisses at me. "what the...?". there, in my delivery room, is a freaking hedgehog! a hedgehog. he's not disturbing anyone, in fact he appears to be in the midst of a siesta, but the midwives are all walking around in flip-flops and i don't think anyone would appreciate walking into our cross, spiky little friend by accident. i take our apgar chart and start to shoo him across the room, out the door and into the courtyard. he hisses at me the whole way, as i ask him to please not take it personally but i have just implemented a no hedgehogs in the delivery room rule. once we're outside i stare at him more closely. yup, you're really a hedgehog. random. the birth proceeds and the woman delivers. she is in the kneeling position on the table, the placenta is out, and i am watching leimona with the baby, leaving joyce, one of our most experienced midwives, to help the tba with the mom. i go to check on them and i find that joyce has walked away to do who knows what, and the tba is standing there continually cleaning the continual stream of blood that is trickling out of our patient and onto the plastic sheet. the puddle of blood that she is trying to wipe up just keeps being replenished, and she hasn't thought to lift her head and wonder what the source of it might be. i say "uh, ladies? i think it's time for a lesson on observational skills". after everything has been taken care of, we are transferring the mom to a bed and the tba is just about to hand the mom her new babe, and all of a sudden i look up at the wall and jump back about 3 feet (which is as far as i can go before i hit the other wall- it's a small room- or i would have jumped further). as i jump back i'm pointing at the wall and saying "holy shit! look!". the women all look to where i'm pointing and they all have the same reaction. no, not a spider.... a huge scorpion. our patient is right under it, and i grab her bed and pull it away from the wall. someone goes running for one of the guards, who comes in wearing thick rubber gloves and carrying a large stick. he slays the beast, but not before i got a picture of it. once it's over we're all outside and people are chatting excitedly about it. everyone wants to see my picture so i turn on my camera and they pass it around. zainab, one of our nurses, walks by and i say "hey zainab, want to see who decided to join us in the delivery room just now?" (of which she probably understood "hey zainab" and nothing more). she looks at the picture, jumps out of her skin, starts yelling excitedly in arabic, pointing to the picture of the scorpion, pointing to her foot, making expressions of pain and suffering... for about 5 minutes. finally someone turns to me and translates "she was stung on the foot once". i say "so i gathered".

upon discovering that my room is reknown for being an oven at night, i started sleeping outside in the courtyard under the tree. this means that i've taken the 5 minutes of the day that were my absolute sanity, and i have extended it to become my favourite hour or two of the day. the best part of my day prior to this was always those last few minutes of light before our generator was turned off. i would grab my toothbrush and head out into the courtyard to brush my teeth at our water source. as i stood in the courtyard, alone in the dark, looking up at the huge, starry sky, the words of a paul simon song would always play in my head. "joseph's face was black as the night. the pale yellow moon shone in his eyes. his path was marked by the stars of the southern hemisphere, and he walked his days under african skies". every night it played in my head, and every night i would stand there in awe, remembering that i was standing under african skies. now each night i set up my bed outside. my mosquito net falls around me, and i slip into my safe little cocoon. i lay on my back and stare at the moon through the branches of the tree, and that song plays in my head. my mosquito net ripples with each breeze, and it shimmers under the light of the moon. whether or not i sleep, i love to just lie out there and feel the cool night air on my skin, and i pray and i think and i lie there in awe of the fact that i'm in africa. it's a time of complete peace and comfort....most of the time. one of the first nights i was lying in bed and i had a moment of wondering what i would do if one of those spiders got in and was caught with me inside of the net. as anyone who knows me can attest to, even the thought of large spiders puts my startle-reflex on overdrive. as i was lying there contemplating what i would do in that circumstance i felt something on my forehead and, i kid you not, i almost wet my bed. the funny part, the part that i laughed my head off at as soon as my heart started again, was that what i had thought was a spider was actually my own hand- i had flung it over my head earlier.

the children of the TFC

2006-07-08T08:01:00.000-07:00

my gang of shadows

abdel-razid

ahmed

mariam

sunshine and raincloud

afternoons can be slow at the womens centre, especially on the days that aren't market days. after lunch the patients trickle in slowly, or not at all, and my staff have time to get other things done around the centre. once things have been cleaned, gauze has been cut and folded, schedules have been written up, drugs have been ordered, we have time to lie on the mat outside and relax. this is usually about the time that i wander over to the TFC tent and harrass the children.
there are now 21 children in our therapeutic feeding centre and when milena got here 5 months ago there were 3. to be admitted into the TFC program you must be less than 70% of what you should weigh for your height (severely malnourished). when the child first enters the program they may be admitted into the pediatric ward to treat all of the things that can go wrong with your body when you're that malnourished: dehydration, infections, hypothermia, hypoglycaemia, heart failure, severe anemia, etc. once they are medically stable they are put into phase I of the program. phase I is the stage that is meant to stabilize the child and restore their electrolyte and metabolic imbalances. you slowly introduce food back into their body to avoid shocking the system, which can kill them. this is done by giving them small, frequent meals of low energy food. this can be the hardest part as the children are often lethargic and have no appetite. watching their mothers pin them down and try to force life-giving food down their throats as the children scream is a definite low point of the day. daily, the children are weighed, have their vital signs checked and have a medical check-up. when they regain their appetite and lose their oedema, they are transferred to phase II. the purpose of phase II is to get the child to gain a lot of weight, very quickly. this is done by giving the kids a very high energy diet. children stay in the TFC until they reach 80% of what they should weigh, and then they can be transferred to the SFC (supplemental feeding centre). being in the TFC requires that the child spends all day at the hospital, and their mothers or other care-givers stay with them and are responsible for feeding them the food we provide. like i said before, this is to prevent the mother from taking the food that is provided for the most malnourished child and sharing it with her other children. some parents, upon being confronted with the fact that their child hasn't gained any weight, have confessed to being so hungry that they have eaten the food themselves. once the child enters the SFC, they become an outpatient. the family comes every two weeks to receive food and enough food is provided that the family can feed its other members as well, ensuring that the malnourished child receives enough. the children stay in the SFC program until they reach 85% of their desired weight, and then they are discharged (usually to fall back into a state of malnourishment and be readmitted).
while i love all of the babies in the TFC, there are some who, admittedly, are my favourites. one of them, abdel-razid, is one of the things here that makes me stay. he's 4 years old and has never spoken and never walked. we found him in his tukul when we were doing our milk distribution, alone, expressionless and naked on the floor. he was the first child i saw here who looked like the pictures you see on those informercials- the ones that make you turn the channel because who wants to see images like that and be faced with the inadequacy of your response? his arms and legs were long- the length that a 4 year old should be- but there was little on them other than skin. we convinced his mother to put him in our program, which involves her carrying him and her newborn the whole way to the hospital each day and leaving him with his two young brothers to care for him while she takes her newborn with her to collect firewood outside of habillah (her husband is absent- dead or not, i don't know- and i think that that newborn girl is a result of her collecting firewood). the two brothers, neither of which are yet 10, are complete opposites. i don't know their names so i refer to them in my mind as sunshine and raincloud. one is always smiling, and the other is the angriest child i have ever met. his face is set in an expression of permanent rage and he seemed physically unable to smile until the first time i tickled him and he collapsed on the ground in a pile of guffaws. he is now my shadow. abdel-razid sits on the mat outside, banished due to his inability to toilet himself. he sits on a mat and when he urinates it soaks through into the sand beneath him. there are times when i come to see him and he is so disgustingly filthy that i lift him under my arm (holding his urine-soaked shirt away from my clothes), traipse to the nearest water supply and rinse him down. when i am having those moments where all i want to do is go home, i go to the TFC tent and find him. i sit behind him and pull him to sit between my legs. he leans back against my chest and looks up at me with the purest eyes i have ever seen. when he looks at me he looks right into my eyes, he tilts his head to the side as though asking me a question and he smiles. i stroke his head, i tickle his feet and he laughs. sometimes when i play with him he gets so excited that he squeezes his eyes shut, tosses himself onto the mat and bangs on it with his fists as he howls with laughter. other times he lifts his hands to my hair to entwine his fingers through it. his favourite activity is to hold string and spend hours running it through his fingers, and my hair is apparently a welcome substitute. milena took the most beautiful pictures of us one day. my favorite is one where he is sitting between my legs, looking up at me. my head is bent down and he is touching my face with both of his hands. she and i were looking at the picture later and i remarked that i couldn't wait to hang out with him in heaven when he could actually talk to me. she looked at me with complete surprise and said "do you really believe that's going to happen?". of course i do.
along with abdel-razids two brothers there are 3 other children who make up my gang of shadows. one of them is ahmed, 5 years old and as tiny and frail as a baby bird (i can lift him over my head with one hand). he's ambulatory and has energy to run around now, and he just loooooooooooves to steal my sunglasses. his caretaker, and sister, is mariam. she's 7 or 8 years old and is the only girl in the club. the last one is a boy of maybe 13 who cares for his baby sister. he is bald and has a distinct tribal look that i see from time to time here. he tries to act like he's too cool for our antics, but he's definitely not too cool to run like hell when i decide to chase him.
it has become a daily ritual now, and pretty much the only exercise i get here. i sneak along one side of the tent and creep up on the 5 of them who are usually sitting out back with abdel-razid. the women inside have seen me coming and start to smile. i reach the back of the tent and once i round the corner i pounce on whoever is closest. they all scream at the top of their lungs and run for their lives. the one i caught is thrown over my shoulder and paraded out front for all to see. he/she is held upside down and tickled until i think they may pee. the first victim is released and i put on my sunglasses so i can scan the landscape without them seeing where i'm looking. the other 4 have inevitably crept closer, kind of hoping that i'll go after them next, yet kind of terrified that i'll go after them next. if i pretend not to see them, they slowly inch closer and closer. ahmed, the youngest of the group, often comes a bit too close (and if he doesn't, one of the other 4 will generally help him out by giving him a shove in my direction before fleeing) so he tends to be the one i catch the most. the rest of them i just chase around like the nutty hawaga (white person) everyone considers me to be. raincloud is too fast for me, so i have to ambush him if i want to catch him. getting him to laugh makes me feel like i've accomplished something that day. eventually the heat catches up to me and i go back to the mat and lie on it, dripping with sweat. my staff tell me i am crazy and i nod tiredly.

faith the size of a mustard seed

2006-07-05T13:36:00.000-07:00

it was just starting to get dark when i heard a voice on the radio. i automatically perked up as there are only two people who get called after dark, one of which is carmenza, the other of which is me. no one called to me that i was wanted so i stopped listening to the rest of the call. carmenza came out into the courtyard a moment later and had her bag slung over her shoulder. like the eager future med student that i am, i asked her if she was going to the hospital and why. she said a child had been bitten and it was really bad. i, of course, told her that i was going to go with her. as i threw on a t-shirt i wondered what kind of a bite would be bad enough to call the expat doctor after hours. we had recently had a snakebite that had been near-fatal, so i thought maybe it was that. then again, there were also scorpions and all kinds of sketchy dogs around. all i really cared about was it not being a spider bite. on the ride to the hospital i asked carmenza what had bitten him. she replied "the father". i say "his father BIT him?" and she says "no, bit, bit" in a spanish accent and makes a punching motion with her hand. i say "beat?". she nods. i slink down in my seat realizing that this is not going to be fun at all. i want to get out and walk home but it's after dark and we're not allowed out after dark. we arrive at the hospital and enter the pediatric ward to find several people bustling around one bed. we step in and i almost vomited. a 9 month old baby lay, unconscious, on the bed. his father "accidentally" beat him in the head with a stick while he was "fighting" with the baby's mother, the staff tell us. i say "using the word 'fighting' implies that there were two active participants, which i somehow doubt, and can someone please explain to me how you ACCIDENTALLY beat an infant unconscious with a stick?". there's no answer, and i'm not surprised. carmenza gets to work checking the baby and with each discovery she looks more and more distraught. she checks his pupils and tells me that one is completely dilated, while the other is the total opposite. he has no response to pain and his hand stays limp as the nurse digs for one of his tiny veins to start the iv. part of his skull, a part that should be bony, is soft to the touch. carmenza tests his reflexes and he has none on the right side of his body. the baby's mother sits at the opposite end of the bed, perched tensely on the edge, watching with desperate eyes. i stood beside her and unconsciously put my hand on her shoulder. she surprised me by quickly reaching up and grasping my fingers. at one point i notice a man standing nearby and all of a sudden i realize that i am about to lunge at him. "is this the father?" i ask, and someone says no, so i decide to spare his life. one of the nurses tells me that the father was arrested right after the accident, so drunk he could barely stand. i tell them that if one more person refers to it using the word "accident" i am going to officially lose it. finally the iv is started, the examination is finished, and the staff clears out. i ask carmenza if he's going to make it and she says that it would be a miracle if he survived the night. we talk quietly, knowing that his mother can't understand us, and we agree that maybe for his sake it would be best for him to just let go. this isn't a country that takes care of its weak. those who are physically handicapped, comatose, brain-damaged or anything beyond the scope of normal are burdens to be borne. this is a country where people (around 20 children in habillah alone) with any sort of psychiatric issues are chained to a tree in the yard all day long. yes, you read that right.
the baby lay at the top of the bed, naked, unmoving. i gently prodded his mother closer to him, and showed her that she should talk to him, touch him, hold him. she was hesitant, but i sat beside her and stroked his arm, and told her that it was ok. as we sat there, just the three of us (carmenza had walked away), i wanted to pray for him to be healed but i hesitated. i knew that God could heal him, but a part of me just didn't believe that He would. maybe if it was some amazing Christian who knew what he/she was doing it would work, but i knew it wouldn't work for me. finally i decided that i had nothing to lose so i lay my hand on his head, over the part of the skull that had been caved in, and i prayed. i prayed that he would be healed and that he wouldn't suffer for the sins of his father. i prayed for compassion for the man who had almost killed him. maybe he's always been a violent alcoholic and is worthy of nothing but contempt, or maybe the events of the last few years have so emasculated him, and so destroyed everything good in him, that he can't help who or what he's become. maybe he was once good and noble and kind.
we arrived home that night and parted ways. carmenza went to bed to cry and i paced around the courtyard too full of some overwhelming emotion to stay still. i took a cold shower to cool off and angrily told God that i was done here and i was going home. i'm done being the witness, i'm done seeing this kind of crap, why do You keep calling me to these places? have i wronged You in some way, because i'm REALLY sorry if i did. forget my pride, forget not being a quitter, forget probably never working for msf again, i don't care what people think. i'm done. i went to bed early and put on my worship music (always guaranteed to chill me out), and at some point i must have fallen asleep and ground my teeth all night as i woke up with an aching jaw. we woke up the next morning and were surprised that no one had radioed during the night to say that the baby had died. we arrived at the hospital and were stunned to see that the baby was breastfeeding! the nurses told us he had opened his eyes briefly, then floated in and out of consciousness. i sat down again and smiled at his mom and she smiled back with a look of such relief i almost cried. i lay my hand on him again and prayed again. ok God, this was a start, but we both know You can do better than this. each time i came back to visit them, he was doing better and better. his mom and i became friends and we would sit on her bed and i would show her the pictures in my digital camera and she and the mother of the young boy in the other bed would sit and laugh delightedly. two days later the baby was awake and alert. physically he seems to have returned to normal. he's a bit young to ask him if he knows what day of the week it is, or where he is, but i have faith that in a few years he can answer those questions.

p.s. if you think you have some medical explanation for this, i don't want to hear it :)

"they say we are at peace now"

2006-07-05T13:34:00.000-07:00

it was a slow morning at the women's centre and i had only had 3 official clients. my fourth, unofficial, patient wasn't on the books. this left me with a lot of time hanging out in the consultation room with "a", the masalite who, i hope, will take over the women's centre when i'm gone. "a" speaks fluent english, arabic and masalite and is, for all intents and purposes, a female mayor of sorts. as a woman who is educated, intelligent, compassionate, relatively rich and incredibly well-respected, she is privy to every piece of information that exists in habillah, and today she shared more of it with me than i could have ever possibly hoped to hear. it reminded me of the first night i arrived home from aghanistan, when kate d, kate v, peter and nathan were waiting at my house and stayed up late into the night with me. i showed them my pictures and told them story after tragic story until the point when kate d lay down and begged "please stop". that was the moment that i realized that i was numb to the point where they had just become 'stories' to me- i had forgotten that those words still had the capacity to hurt those who heard them. today as "a" was talking, i started by listened raptly, wishing i had a tape recorder so i could remain faithful to every word of it in this repetition. towards the end of it i just sat there, stunned, and the only words running through my mind were "please stop, please stop, please stop". (it took hours to tell the stories- they aren't all included here).

it all started when joyce, one of our midwives, came into the room and told me she needed to talk to me. there was a woman whose husband wanted to know how pregnant she was as they had only been married 2 months and she seemed much further along than that. thankfully (yes, i've learned to become thankful for these things) he was only planning to divorce her if it turned out she was pregnant with someone else's child. joyce did an examination and decided that she was around 5 months pregnant- and that's when she asked me to double check. the woman came in and i asked her to lie on the examination table. as soon as she lifted up her shawl i could see that she wasn't just 2 months pregnant. upon feeling the fundus and the baby, i wasn't surprised to find the heartbeat with the fetoscope. we sat down and "a" started to talk to her. she turned to me and told me that the girl said she had only been with her husband and there was therefore no way she could be more than 2 months pregnant. i told her that we knew she wasn't two months pregnant, but that we would never tell anyone that and she was free to tell her husband whatever she wanted. i asked "a" to ask the woman if she wanted to tell us what had really happened. they spoke for awhile and then "a" turned to me and said that the woman was going to go home and tell her husband that she was 5 months pregnant and if he divorced her, he divorced her, but he wouldn't kill her (they were masalite, not nomads). she had 5 children from her first husband who had been killed in the fighting and this man had married her anyways, so she hoped he would be understanding. she left and i asked "a" what the woman had said. she stared off into space and told me that the women whose husbands had been killed in the fighting were the ones who were the most defenceless. at night they had no one to protect them. during the day they had no one to help provide for their children. some of these women had given in and were now selling their bodies. it was going to happen anyways, and this way they could at least buy food for their children afterwards. girls were doing the same, as some of the older men used their desperation against them. in the name of survival, and the survival of their children, these women are forced to compromise everything they believe in and when they became pregnant they are ostracized for it.

i asked "a" how it was that habillah remained free from major attacks, and she told me the story. it was august, i'm not sure what year, when she heard the plane overhead. she went outside and saw it flying low over habillah and then she felt the first bomb hit the ground. she ran inside and told her children to lay on the ground and she gave them a verse from the koran to recite. the plane passed over habillah, dropping more bombs as it went. her husband had been walking down the street with a friend when one of the bombs dropped. he hit the ground and lived, while his friend stood standing and was torn apart. anyone who was on the main "street" was annihilated, men, pregnant women, children- they found many of their remains blown up into the trees. a male neighbour ran into "a's" yard and told her to take her children and run as they were going to level the village. she gathered her 6 little boys, the youngest just a month old, and ran for the forest. it ended and they cautiously returned, only to realize that it wasn't over and run back to the forest. when the bombing started again, two of her sons bolted into the forest and weren't found for hours. there was a woman there who was in such shock that when she finally went to give her children some food she looked at them, stopped short and started screaming when she realized that she had saved children who weren't hers, and hers were missing (her children were later found). they spent the night in the forest under a tarp that "a" had thought to bring and they slept in the mud.
the next day there was a huge nationwide uproar about the attack. many in the upper eschelons in khartoum had come from habillah and they were furious about the attack on their former village, family and friends. a helicopter was immediately dispatched for habillah, holding some high-ranking officials who were sent in to have a meeting and do some damage-control. during that meeting the paramilitary surrounded habillah and prepared to finish destroying the village, as was always the case. the planes bombed the villages into shock, horror and submission, and the next day the horsemen rode in to rape and pillage. the problem this time? there were government officials present in habillah that day, and one of the paramilitary commanders was at that very meeting. the officials, realizing that, for once, their safety was in jeopardy, demanded that the commander stop the attack. they then decided to convince the nomads to leave habillah standing as it would benefit them to have it still exist. where will you buy your sugar and your soap if there is no market? no, leave the village standing so that you can use it to your advantage. and so they did. and this is why habillah remains standing, one of the few villages that wasn't destroyed.
and now? now there is this tentative "peace" in the land. the paramilitary are still armed and are still in complete control of this area. they can beat and steal from the villagers right in front of the police and soldiers and neither of them care enough to step in. they can kill without consequence. no one will leave this village, or any of the other IDP camps, until the paramilitary are disarmed and controlled. many of the people talk wistfully of when the UN peacekeepers will arrive and protect them. then, they say, only then will they feel safe enough to return home. and yet... "a" told me that the paramilitary had already told them what will happen if and when the peacekeepers arrive. the moment their planes touch down in sudan, whether it's here or khartoum, the paramilitarty will kill every single black african that they can. their belief that the peacekeepers are here to fight them and protect the blacks has made them decide that they will take as many of the blacks with them as they can. you came here to defend the black sudanese? oh, sorry, there's no one left for you to defend. go ahead and kill us, you were going to anyways. suddenly people aren't so excited about the prospect of being "rescued". being rescued only sounds like a happy ending if you live to see it happen.

"a" finally trailed off and came back to an awareness of the room. looking at me she said incredulously "they say we are at peace now".

i relent

2006-07-05T13:28:00.000-07:00

ok, forget my last email. seriously, in the last day i've received some of the most amazing emails i've ever read (some from people i don't even know)- all of them encouraging me to keep writing as is. some were inspiring and made me think, some were hilarious and made me laugh, and hence i have been persuaded (yeah yeah, make me laugh and i'm jelly in your hands. i'm just that cheap). as much as all of the letters were beautiful and/or funny, i'm going to include the two quotes that most cemented it for me. one is from my best friend kate and, although her Biblical facts are slightly off, the point she was trying to make is a sound one :)

"even Jesus used some naughty words there at the end when his scene got stressful. but think how different the story would be if he hadn't yelled about it, and if no one had written it down"

this is the girl who also gave me this piece of advice when i was first leaving for aghanistan...."i know in the Bible they're pretty clear about not doing this, but if it comes down to it...fall to your knees and pray to Allah- God will understand" (a quote that can still make me laugh out loud). the other quote was from my friend mayan, who said this:

"I will come to africa via sea turtle and break your femur if you try to hold back for MY sake".

as tempted as i am to provoke her to fulfill that threat, i feel that when push comes to shove, she wouldn't really come via turtle.

alright then, on with the stories........ but don't say i didn't warn you

a little self-conscious

2006-07-04T07:55:00.000-07:00

one of the first conversations that i had with aurelie was one morning in khartoum. we were all sitting in the livingroom having coffee after breakfast and, although french is their first language, she and letitzia were having a conversation in english, trying not to be rude to steffan (german guy) and i. i waited for a lull before saying "feel free to speak french. i'll still understand you and steffan (whose eyes had glazed over by this point) isn't listening anyways". aurelie looked at me, a bit surprised and said "you understand french but you can't speak it?". i say "i speak it, i just don't speak it perfectly". she smiles and asks "a little self-conscious?". i reply "no, a LOT self-conscious". and that pretty much summarizes how i'm feeling right now. a LOT self-conscious.

i keep getting emails from people either asking me or telling me that either they're forwarding my emails, or their friends are reading my blog now, etc etc etc, and i'm starting to feel self-conscious. in my previous travels i have written similar emails and i wrote them imagining that only my family and friends were reading them, knowing that a) they loved me in spite of whatever i wrote or b) i couldn't care less what they thought of me anyways. in a way i was writing purely for myself (they were a diary of sorts), and in a way it was to allow the people who loved me a small glimpse into what i experience on these trips.

now?.....well, now i find myself starting to wonder what i can/can't, should/shouldn't write about. i filter, i censor, i second-guess. if random people are reading my stories because they want to know the reality of life in darfur am i boring them when i write about my own, personal moments here? if people who are hostile towards "religion" are reading them, should i refrain from telling stories about the growth of my faith? if there are conservative people reading them should i not swear or be honest about how much i want to kill people here sometimes? do i sound like a self-indulgent princess for those days when i feel like i can't bear to witness other people's suffering for the pain that it causes me just to see and/or hear it, when they are the ones who have to actually experience it? if there are days when i hate it here, hate my team, hate everything and want nothing more than to come home is one of my supervisors going to hear about it via the msf grapevine and suddenly my having a bad day/week/month becomes a huge deal?

the last few days i haven't felt like writing at all because i feel that everything i write is now subject to scrutiny. i fear coming across as a drama-queen or, worse, draining to the people who don't know and love me in spite of my inability to not take these stories to heart. i see people starting to resent the fact that i try to bring you to darfur, if only for a moment, to realize that these stories aren't fiction and that it's your responsibility as human beings to f***ing do something. i envision people opening their inbox in the morning and seeing an email from here and either not being able to delete it fast enough or, worse, reading it for the thrill of the brutality of the stories. i've never sent the hardest stories in the mass emails, but now i don't want to include any of the hard stories because i don't know where the line between témoignage and some strange sense of voyeurism lies. i hate feeling this way. i don't know what to do to now. i don't want to not feel like i can be open, and tell the stories that i want to tell. i'm thinking of scrapping the blog, and if people don't want to receive the emails they can just not read the stories. maybe i'll send some stories to whoever cares to read them, and designate some to only family and friends. i don't know yet. for now i'm just not going to write. maybe when i'm not sick and exhausted and frustrated and hating it here, i'll decide that i'm going to write whatever the hell i want, and anyone who has a problem with it can bite me. until then...as we say in radio contacts....over and out.

just another day in habillah

2006-06-28T13:15:00.000-07:00

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

2006-06-28T13:13:00.000-07:00

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. wrong...it 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.

FANS!!!!

2006-06-27T15:00:00.000-07:00

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.

quick note

2006-06-26T16:58:00.001-07:00

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.

contact info again

2006-06-24T12:51:00.000-07:00

ok guys, i've received a bunch of tentative emails asking if you can email me at this address ( msfch-darfur-sat@geneva.msf.org) 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.

cheers,

me

Day off

2006-06-23T16:39:00.000-07:00

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...:)

témoignage

2006-06-22T09:40:00.000-07:00

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.

Life here

2006-06-19T16:31:00.000-07:00

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.

Habilah

2006-06-19T16:21:00.000-07:00

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)...love 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.

smooches,

Ames

greetings from Darfur

2006-06-19T16:10:00.000-07:00

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