Chasing Chaos: My Decade In and Out of Humanitarian Aid

by Jessica Alexander

Not long after I arrived, Hurricane Katrina struck New Orleans. We all gathered around a small radio and listened to the reports coming out of the United States. CNN and the New York Times website had plenty of images of the flooded streets, makeshift shelters, and Red Cross volunteers running around handing things out.

  “This looks just like Africa, except the people are too fat,” my American colleague said.

  Later that day, I spoke to my dad. “This is our tsunami, Jay,” he said somberly. It had been eight months since the Indian Ocean tsunami of December 2004.

  It was the first time I felt that my father understood what I did. But I wanted to correct him: Katrina was not nearly as devastating as the tsunami. Suddenly, Americans were grappling with things that were familiar elements of daily life in other parts of the world: plastic tarps, outbreaks of disease, former-football-stadiums-turned-displaced-person camps, theft—and the endless search for places for people to defecate. No longer could Americans sit in judgment of the rest of the world when violence and disease erupted during times of crisis, or criticize from their couches the length of time it took for a proper response to start. This was happening in a country with money, a federal agency specifically tasked with on-the-ground disaster relief (FEMA), rule of law, and a functional government. But all over the world, even in America, people were people, desperate and ready to do what it took to feed themselves and their families.

  After months of weekly camp meetings, Ahmed, the camp committee leader, and I were friends. It was hard to know how old Ahmed was—his head was always wrapped in a white turban and his body cloaked in a matching djellaba. A soft-spoken gentleman with subtle mannerisms, Ahmed carried himself with the wisdom and authority of an elder, and the other committee members and I treated him as one. Even though we communicated through Ishaq, he and I had an unspoken understanding; sometimes I knew what he was saying just by the tone of his voice. Regardless of the scams going on in the camp—the forgery of food cards, the regular theft of materials, the bribery and internal politics—I felt that Ahmed was always straight with me.

  One day after a camp meeting with the usual agenda—overcrowding in the schools, the broken latrines in block A13, the food distribution disputes from the week before—Ahmed approached Ishaq and me.

  “My niece is sick. Can you come see her?”

  “Ahmed, I’m not a doctor,” I said.

  “I know. She needs help. I don’t know what else to do.”

  I suggested he take her to the clinic, and he looked down. “I already have.”

  “OK. I’ll come tomorrow. I promise, Ahmed. I have to go now.”

  The next morning I was back in the camp to meet with an agency about where camp residents’ cattle could graze. They had started developing a pasture on a parcel of land that the residents had already cleared to build a prayer space. We needed to find an alternative.

  Ahmed was waiting for me at the registration center. As soon as I saw him, I remembered. “Your niece,” I said. “I’ll come after this meeting.” He waited patiently in the corner until we finished.

  “OK. Let’s go.” Ishaq came with us to interpret, and we piled into the vehicle and drove to Ahmed’s tent. His plot of land was larger than that of many other families. He planted shrubs around the periphery to make a gate and I almost tripped as the cuff of my pants got stuck on one of the twiggy branches.

  Ahmed pulled back one of the plastic sheets to his tent, and we slipped inside. His sister, meek and soft, sat on the floor with a large pillow covered by a towel on her lap. She looked up as we walked in, but her face was stoic and expressionless. Ahmed said something quietly to her. She slowly pulled back the towel covering the pillow.

  Underneath lay her infant daughter. Her malnourished body was tiny and frail; her head twice its size, swollen and puffy. It looked like a balloon floating on top of a skeleton. The child’s nose was distorted, her eye sockets sunken in, her cheeks and forehead bags of fluid. When she moved her head, her neck twisted awkwardly, too weak to support the bloated mass. She let out muffled gasps of discomfort.

  “Oh,” Ishaq sighed.

  I felt queasy. I had never seen anything like this.

  “Have you taken her to the hospital?” I asked.

  “Yes,” Ahmed said, crouching down to touch her.

  “What did they say?”

  “They can’t do anything for her. There is surgery she can get, but it’s only in Khartoum.” He covered her head again and stood up.

  “OK, well, she has to get to Khartoum then,” I said. sternly.

  “Yes. We have to get her to Khartoum,” Ishaq repeated to me in English.

  “We’ll get her to Khartoum, Ahmed,” I said to him. “We’ll get her to Khartoum,” I said again, looking at his sister, who was still sitting on the floor.

  I went back to the office but none of the doctors were there. So I called the only doctor I knew I could reach—Dad.

  “She has hydrocephalus. Swelling in the head. It’s a congenital condition. They usually catch it in utero in the States,” my father said, when I’d finished describing what I’d seen. He was sitting in a lounge chair on the beach in Fire Island.

  “Will she die?” I asked.

  “If she’s not treated, yes. She needs to be shunted. They drain the fluid from her head and she can be OK.”

  “Her head’s already huge, Dad. How much time?”

  “It’s hard to know from here. But she needs to get treatment soon.”

  THERE WAS AN URGENCY about this situation that felt new. Perhaps it was the personal relationship I had with Ahmed, but whatever it was jolted me into action. The attacks in Tawila, the Janjaweed raping women, the rainstorms—these were all out of my control. But a sick child? That I could actually do something about. I went to Mark.

  “There’s a girl in the camp. She has hydrocephalus.”

  “What’s that?” he said, looking up from his laptop.

  “It’s swelling in the brain or something. Her head is huge, Mark. She needs treatment. The family has exhausted all their options here. We’ve got to get her on a plane to Khartoum and soon.”

  He leaned back in his chair, sighed, and combed his fingers through his hair. “WFP won’t let IDPs on the flights. You know that.” The World Food Programme was the UN agency that transported aid workers in and out of Darfur by plane.

  “Yeah, I know. But can’t we pay for her and her family to get on a commercial flight out there?”

  “We can’t do that. We can’t pick and choose IDPs to fly to Khartoum for medical treatment.”

  “OK, well, then I’m going to pay for their flights,” I informed him.

  “I don’t think you can do that, either. It will be seen as coming from our agency even if you are paying out of your own pocket because you’re employed by us.”

  I called the Khartoum office and asked them. But I got the same response. “Last month there were a few IDPs with heart conditions who needed to be sent to Khartoum,” the emergency coordinator told me. “We couldn’t do it. We can’t send some people to Khartoum and not others. It would just be chaos.”

  I talked to the health coordinator in one of the clinics who said the same thing. “There were people with lung issues in the camp a month ago,” she told me. “We couldn’t take them all to Khartoum.”

  “So what happened?” I asked.

  “Two of them have died already,” she said.

  With every rejection, my resolve intensified. I hadn’t been confronted with this degree of clinical detachment before. How could I go back to Ahmed and tell him that there was nothing I could do, nothing that the humanitarian community could do, to help? That I was sorry, but he would have to watch his niece die. For the next week, I spent my nights dreaming of exploding heads, and my days negotiating with WFP, UNICEF, UNDP, none of which would agree to help get the girl on the flight because it wasn’t “in their mandate”—it wasn’t, in other words what they had come to Darfur to do and, therefore, they weren’t respons
ible for it. Large aid agencies like these developed programs for tens of thousands of people—large-scale operations that provided a little to many. But working at an individual level—a case-by-case basis—wasn’t what we were in the business of doing.

  I sat across from Wilbens, the logistics officer from the United Nations’ World Health Organization (WHO), which oversees health care in emergencies. Certainly it had to be in their mandate.

  “Look,” he started. “We have requests from IDPs to go to Khartoum every day. If we took up every request, we could not operate. It’s sad, I know.” Wilbens smiled.

  “We can’t set this precedent. If we fly this girl and her family to Khartoum for free, how do we tell the next sick person that we can’t fly them?”

  “Shouldn’t we be flying sick people to Khartoum for treatment? I mean, shouldn’t that be part of our job? We’re here to save lives and reduce suffering, aren’t we?”

  “We can’t save everyone, my dear,” Wilbens said.

  Wilbens had a point, as did everyone else, and I may have been wildly naive. I could understand their arguments in the abstract. My personal relationship with Ahmed was clearly blurring my logic. But giving shelter, some measly food items, a few bars of soap, and providing overcrowded schools and medical care that wouldn’t stand up to malpractice lawsuits at home—this was the sum total of the humanitarian operation? This was the best we could do? With all the resources spent on getting us here, trucking us around this foreign land to “help,” was this it?

  “Don’t even bother. Let this one go,” Lila instructed me over dinner one night. “It’s not going to happen, so you shouldn’t worry your head about it anymore.” Others weren’t as sympathetic. “All the time you’re spending on this girl, you could be helping a lot of other people. Get back to your job,” Mark told me over a smoke in the office a few days after our initial meeting, when he knew I was still obsessing about it.

  But I refused to rationalize the path of least resistance. I was determined to get this girl to Khartoum, no matter what logistical challenges I had to overcome, no matter what arcane UN bureaucracy I had to navigate, no matter the number of people sitting behind desks who politely said, “No, I can’t help.” I had heard “no” many times before as camp coordinator: when we didn’t have the funds to purchase crucial sanitation equipment; when we weren’t able to transport rice to a sister camp because of an impassable road. “No, it is not possible” was the uncomplicated way out, but I often found that bending rules and mandates here and there, and a bit of creativity were the only ingredients required to turn the allegedly impossible into reality.

  I had learned this persistence from Mom. She was the woman who always asked—politely, yet sternly—if she could “speak to a supervisor” when things weren’t going her way. One time, our family was taking a vacation to Block Island and we were late for the ferry. We sat in the car as a crewmember gestured for my father to roll down the window and then proceeded to inform us that there was no room for our bulky Buick station wagon. We’d have to wait for the next ferry—which wouldn’t depart until the following day. Mom leaned over my father from the passenger seat to speak to the deckhand. “What about there?” she said, pointing to a spot at the edge of the boat. She unbuckled her seat belt and got out of the car to show him.

  “Ma’am,” he said, “the boat is about to leave, there is no room for your car.” Dad turned around to address my brothers and me. “Watch your mother, kids. Just watch.”

  I peeled my skinny legs off the sticky plastic seats and leaned forward. Through the windshield, I saw Mom sit down on the divider between the boat and land. “We have a reservation for this ferry. There is one more spot left and my family is getting on it. I’d like to speak to the captain!” People on the upper deck were dangling over the railing to see what was going on below. Finally, the man pleading with her gave up. He opened Dad’s door, told him to slide over, and drove the car onto the boat. The back wheels grazed the edge.

  “Thank you,” Mom said, wiping her hands on her shorts as she stood up. “Come on, kids!”

  WHILE I WAS TRYING TO talk my way onto a ferry—so to speak—Ahmed was making plans to help his sister, her husband, and their daughter get to Khartoum through the desert on the back of a donkey cart. I found him in the camp that morning.

  “Ahmed—I’m trying. I really am.” He looked at me with confusion. What could I tell this man? That there is not one agency here that is willing to pay for him?

  “They’re leaving by donkey tomorrow,” he said.

  “Give me one more day, OK?” I pleaded. “And then they go.”

  A few days into my quest, I learned that a prominent agency in Darfur regularly flew planes filled with supplies back and forth from El Fasher to Khartoum. Most of the time, though, the planes were half empty. That night, I approached Jean-Pierre, the agency’s logistics officer, and told him my story.

  “I think we can probably manage this,” he said.

  “Really?” I couldn’t believe it.

  “I mean, we’ve never done it before, but I don’t see why not.”

  “That would be so great. What do I need to do?”

  “Why don’t you come to my office in the morning and we’ll figure it out. It may be a bit tricky, but we’ll see.”

  He seemed genuinely interested in helping Ahmed’s niece, and I was so grateful to have met him. As we continued talking, I learned Jean-Pierre was in his midforties and had worked in Kabul and Peshawar; he had a sophisticated European accent that suggested a peripatetic childhood and degrees taken at various continental universities.

  It turned out that when Jean-Pierre called the operation “tricky” he actually meant necessitating nothing short of a minor miracle. Jean-Pierre laid out the requirements the next morning: Ahmed’s family had to sign a waiver stating that they would not seek help from the agency once they landed in Khartoum and that they had no expectations that they would fly them back to Darfur; a doctor had to accompany them on the flight; they had to have all of the proper identification and travel authorizations in order; and an ambulance had to meet them at the airport. And all of this would have to be arranged before the girl’s condition got worse. I left his office deflated and angry at myself for having been hopeful the night before, knowing by now that nothing came that easy in Darfur.

  But somehow, it all came together. By now, everyone in town knew about this case and the crazy girl who thought she could rustle up an airplane. A doctor that I had worked with previously happened to be going to Khartoum in two days and agreed to fly with the girl. A friend of mine in Khartoum, a nurse, agreed to pick the family up at the hospital and say that her vehicle was an “ambulance.” Ahmed would sign whatever piece of paper I put in front of his face and happily took a pen to the dotted line when I rushed back to the camp to explain the situation to him.

  The only thing left was the travel authorization. Ahmed had no identification, no birth certificate for himself, let alone his sister or her daughter. But Ishaq’s cousin worked at the Ministry of Social Welfare and was able to pull together a special transit pass that would satisfy the airport guards. Breathless, I returned to Jean-Pierre’s office with all of the required documentation. He seemed surprised, but dutifully inspected the paperwork nonetheless. When he reached the bottom of the final sheet, he looked up and said, “OK. They go.”

  I dashed back to Ishaq’s office. “They’re going!”

  He stood up. “Really?”

  “Yes, the authorization came through just now!”

  He leaped over to me, and I swear he was about to hug me. He got a hold of himself—a Muslim man cannot embrace a woman unless she is his wife—and just touched my shoulder. I touched his, and for a few minutes we bounced around like that, giddy and laughing. When I told Mark that everything had worked out, he seemed impressed. Coincidentally, I ended up having to be in Khartoum for a meeting on the same day that Ahmed’s niece arrived. That morning, I met with the Sudanese doctor who
would see her at the hospital and told him I would cover any medical costs. He smiled. “I will not charge these people anything.”

  I went with my friend in our makeshift ambulance to pick up Ahmed’s sister and child from the airport. She carried the little girl through the terminal on the same large pillow she had been clutching when I met her. She covered her baby with a towel that both protected her and shielded her from the stares of strangers. I showed them to my friend’s “ambulance” and we embarked down the crooked Khartoum streets.

  When we reached the hospital, the doctor was already waiting outside. Ahmed’s sister took my hands in hers and held them for a few moments before she scooped up her heavy baby, and carried her through the hospital gates.

  Back in Darfur, my situation was getting harder and harder to bear. I dreaded going back to the compound, unsure if we’d have power, but certain I would be facing another empty night. I met a German guy who was in town for a few weeks doing a water assessment. We had nothing in common. In fact, I found him pretty annoying. But I hooked up with him anyway. In the field, age and nationality really didn’t matter. You mingled with people much older, or much younger, from dozens of different countries. As long as you shared some common pop culture references, had traveled to the same parts of the world, and could basically speak the same language, you’d get along just fine.

  Being with the German temporarily alleviated the boredom and the monotony of my nights. He had a car, so sometimes we drove through town just to break up the scenery. But we couldn’t go past a certain checkpoint. It felt like we were on The Truman Show—the invisible borders of our world as rigid and impassable as actual walls.

  But after five months and the onset of Ramadan, everyone seemed to unravel at once. The Sudanese, who fasted all day, walked around in a trance. Ishaq was still usually full of energy, but most of our other colleagues gave up. Some pulled mattresses out of storage, laid them in the halls, and napped. Those of us who were eating didn’t bother trying to rouse them. It seemed cruel and dangerous, in this heat, to have to work without water. And when they spoke, the Ramadan-induced halitosis was so putrid you couldn’t help thinking it’d be better if they didn’t.