Six Months in Sudan

by Dr. James Maskalyk

  so, i wished, then got it. i am off to sudan. a small town in the middle of the country, right on the border between north and south. for those with a grander memory of the struggle there, you will know that it has been at war for decades. much of it is between the south and the north. it is a conflict about resources. and allegiances. and history.

  darfur has become a media story, particularly in the past three years. there the war rages on, and the fighting is vicious. but sudan has rarely been at peace since its independence in 1956. it has more people displaced from their homes, because of conflict, than any other place in the world. most of them are from southern sudan where war still smolders. the people there feel deeply the effects of chronic conflict. for a nation, it is like a chronic disease. one wastes away from thousands of tiny insults.

  the place that i am going is called abyei. you can check it out on google earth. it looks like a smudge in the sand. it sits in an area claimed by both sides but owned by neither. tensions, i have been told, are high.

  i will be working in a small hospital with a small team. the patients will be regular size. the mission is a new one, and there isn’t much infrastructure. aside from that, i know little else. i will find out more in geneva.

  boarding now. i learned something else these past few months: one shouldn’t think with certainty about the future. it has helped see me through.

  that’s it for me. boarded. wine service. better take it while i can get it. soon, suddenly, sudan.

  I ARRIVED IN GENEVA on an overnight flight and stood sleepless, blinking under bright lights. I hefted my two bags from the circular parade of black cases and looked at the clock. I was overdue at the MSF office with still a train to catch.

  This is the way it works in MSF as a volunteer: you are either in or you’re not, you buy it or you don’t. You take public transit and stay in hostels. You brief sleepless and fly economy. An unnecessary dollar spent on you is one less for the field.

  I put my backpack on and tightened the straps until it felt snug and weightless, then stopped at a kiosk to get a train schedule. Minutes later, the Swiss countryside was blurring beside me.

  I walked from the train station, with my backpack on and my suitcase rolling behind. The office was twenty minutes away by foot. Geneva was temperate, its streets bare of snow. Taxicabs slowed beside me and honked. I waved them on.

  On a final corner sat a building draped in scaffolding, and behind bright metal bones a banner shouted: “Malaria!” I pushed through the glass doors and into a hallway lined with posters. One showed a pill set like a jewel into a gold ring; another decried rape in the Congo. People walked past them, talking loudly, papers under their arms. A woman with a large backpack on edged past me and out the door. I walked to the front desk. The woman behind it hung up the phone to have it ring again. I smiled and waited.

  On a whiteboard beside her was written a list of names and countries: people leaving on mission, people coming home. Mine sat misspelled in the “Out” column and, beside it in brackets, “MD North Sudan.” When she was done, I pointed at it.

  “That’s me.”

  She looked down at her busy desk. On it was a piece of paper with names and times: my briefing schedule. She handed it to me. At the top was: “James Maskalyk MD (Sudan) Stay in Geneva: 12.02.07 to ????”

  She showed me to a room where I could store my things. It was full of luggage. People leaving, people coming home. The walls were lined with rows and rows of gray plastic boxes, on their mouths written “DRC” or “Mozambique” or “Myanmar.” Inside some were letters, or small bound parcels making their way to the field. They were grouped together geographically. I traced my finger from Asia to Africa, from South to North, and next to “Tschad” sat a box labeled “Northern Sudan.” I shook it. It was empty. I stepped from the room and closed the door.

  I sat in meeting after meeting, sleep headache bunched behind my eyes, and tried to concentrate. Facts that were meant to illuminate my days, the course of my months, were laid out before me. I was told about life on mission, how one should behave around alcohol, around drugs, about the perils of sleeping with one’s team members. I was given the layout of the hospital, the pattern of pathology, the hierarchy of responsibility. I was told about the diseases I would see, ones that my medical training rarely touched, ones I had encountered mostly in textbooks. Malaria, tuberculosis, guinea worm. In my satchel was a sheaf of papers I had already printed off, some on leishmaniasis, some on leprosy.

  I would have no access to x-rays in Abyei, no basic lab tests. The nearest surgeon was three hours away, and the road to him was not always safe. I would be expected to birth babies and handle trauma. I was asked if I would perform an abortion if it was medically necessary. I said that I would.

  I was responsible for the Sudanese people in the hospital, but so too the expatriates on my team. I was told that the doctor I was replacing was leaving after only three months to pursue a master’s. I wondered how many master’s started in March.

  During my last meeting of the day, I learned more about Abyei. The project was the crucible where North meets South. In a peace agreement signed two years before, the one that ended Africa’s longest, bloodiest war, it was agreed that the Abyei question would be settled later. Soldiers from each side faced each other across an invisible divide and between them sat the hospital. And our compound. And soon, me.

  Everything around Abyei was a vacuum built by twenty years of guns. One that both sides, South and North, were trying to get people from all over Sudan to fill in preparation for a referendum that was to determine Abyei’s fate, and with it the destiny of Sudan.

  There were a few other NGOs in the area, and a large UN mission. Together we were in the middle of nowhere. Us and thousands of Sudanese people returning to make a home where there was none; canaries in a coal mine.

  I shook my head clear. I was in the security briefing with the operational director. This was important. I should write this down.

  Where’s a pen?

  “All right. Well, I guess the biggest risk is full-scale war. Not very likely at the moment, but it can change quickly. Okay?”

  “Okay.”

  “Things in that area are very tense. It is a very important area for both sides. Historically, but mostly because that is where most of the oil fields are, okay?”

  “Okay.”

  “I haven’t been there. Not yet. It’s still pretty new. So far there has been no real fighting. A few small skirmishes, some gunfire, nothing too hectic. The North and the South take this place very seriously, and are very much in control of the militia. Not like Darfur. You’ll be given more specific details in Khartoum.”

  “Okay.”

  I looked at what I had written. “War” and “oil.” That should be helpful.

  In Germany during my pre-departure training, I had watched colleagues get phone calls or emails (“I’m going to Sri Lanka!” or “They offered me Myanmar!”), and silently crossed my fingers for a place at war. I took French lessons so that I might end up in Congo, or Chad. I read books about Sudan.

  The country was at war, and had been for years. The conflict had not ended, it had shifted fronts. Currently it was Sudan’s western province of Darfur that was on fire. In Abyei, for now, the fighting had stopped, and in its place was a shaky truce. I was going to where I wanted to be. Close to war and its consequences.

  Pushed by the sharp thrill of being somewhere new and rare and exciting, pushed towards that free feeling where anything can happen. Pulled because I wanted to understand. I understood the blind actions of large companies because they were a multiplication, a millionfold, of a greed I knew, stripped of accountability. I appreciated the wisdom of the Red Cross’s silence because I have, at least briefly, known patience. I valued MSF’s vigor and indignation because I understood outrage at injustice. But war, I didn’t know it. Not yet. Not well. But it’s in me somewhere.

  I think there is at least one other reason I wanted to be in its
way. As a new medical student, I was in the hospital one afternoon, sitting in a small, windowless room with a man and a woman, my teacher behind me. We had discovered a tiny tumor in the woman’s brain. It had spread from a cancer in her lung she didn’t know she had. It was incurable. I was going to tell her. Minutes before, my teacher and I had sat at an Arborite desk in the nursing lounge as he explained how best to deliver bad news.

  “I have some serious news. You have an aggressive form of cancer,” I said. “It is very advanced. It must have spread quickly. We’ll do everything we can, but at this point there seems little chance of cure. I’m so sorry.”

  I watched the color wash from her face. Her husband sat beside her like a stone. And I, for the first time, understood that though I was living, I was also dying. I have never forgotten it.

  Because of that, part of me wants to walk towards it.

  AFTER TWO DAYS OF BRIEFINGS, they were nearly done. My last meeting was with a woman in the communications department. I explained to her my intention to write a blog, and my hope that it would allow a different exposition of life in the field. It would be insistent, rough, and fresh. It would fit our mandate of témoignage, of bearing witness. MSF Canada was fully supportive, had set up space on their web page that could be updated by text email, even by SMS. I was going to be the first to try it out.

  The communications liaison was reluctant. She explained to me that an MSF worker, the year before, had kept a blog in Sudan. In it, she had come out heavily in favor of the Darfurians, and labeled the Khartoum government complicit in the tragedy playing out there. It was an unwise public declaration when our presence depended on the permission of the northern Sudanese government. All of our visas, all of our supplies, most of our national staff were passed under Khartoum’s watchful eye. It was an administration known for its attention to details.

  Anything I posted would be read not only by my family and friends but by Khartoum. That was certain. And if they perceived we were interfering in their activities, they might begin to interfere with ours.

  I said I would take great care. I had been briefed in Canada by the communications department, and was aware of the risks for my team as well as for MSF in a country known for its resistance to outsiders. My interest was not in telling the political story, not exactly. It was detailing the medicine of poverty. Readers could draw what conclusions they wanted. I passed to her the URL of the few posts I had written so far. She promised to read them.

  “I haven’t been to Abyei yet,” she said. “Hope to get there. It’s difficult, though. Good luck.”

  I stood up from her desk and walked upstairs to my last order of business. The administration desk for Sudan was on the wide second floor, in the middle of a cubicle maze. It was covered in papers and passports and its phone rang incessantly.

  Behind it sat Catherine; beside her, a map of eastern Africa. Thick black strokes carried out from its different countries, each ending in a flower of passport-size photographs. From Darfur, three lines arrived at a field of pictures and names. From the center of Sudan, a lonely mark arced out past the edge of the paper and stopped at a label that read “Abyei.” Surrounding it were five small faces. The team. A field coordinator, a logistician, an administrator, a nurse, and the doctor I was due to replace. I leaned closer.

  Catherine hung up the phone. I smiled and handed her my photo. She took a piece of tape, doubled it over, fixed it to the back, and pushed me into Abyei’s orbit.

  “Your visa’s still not ready. We can never tell with the Sudan embassy. Especially Abyei. People have waited for weeks. Keep checking back.”

  I left her to a ringing phone and went downstairs to the library. I grabbed a book on meningitis from the shelf and sat down on one of the rough couches in the middle of the room. A woman sat down beside me and folded her arms unhappily. She was short, her blond hair pulled back in a loose ponytail.

  By this point, after even my few days in and out of the MSF office, it was obvious who was on their way to the field and who was coming from it. Those who were leaving were well dressed and curious, their eyes full of questions. Those coming home wore their months on drawn faces, curiosity stamped out.

  “Where are you going?” I asked.

  “Sorry?”

  “What country are you going to?”

  “Sudan. I’m a midwife.”

  “Yeah, I’m going to Sudan too. Doctor. Darfur?”

  “No, I was supposed to go to a place called Abyei. But they just refused my visa. Khartoum said they don’t need any more midwives. I’m going back to Italy.”

  “Oh. Shit. I’m supposed to go to Abyei too.”

  “Do you deliver babies?” she asked.

  “Not if I can help it.”

  “Well, you’ll have to. It’s a mess there. They have no midwives at all, not at all. But what can I do?”

  “Sorry.”

  “Yes.”

  She stood up.

  “Hey, my name’s James.”

  “Antonia.”

  “Well, I hope I see you down there soon,” I said.

  “Maybe. Who knows. And I hope you’re not wasting your time. Ciao.”

  One day passed, then two, then three. I would walk to the office and stand meekly in front of Catherine’s desk until she acknowledged me with a shake of her head that meant “not yet.” I would give her my email address again, or remind her of the phone number of the guest house. The rest of the time I wandered Geneva’s streets or sat in my small room, reading about tuberculosis and staring at the blank brick wall.

  It became Friday. No word. The embassy closed at noon, and if my passport wasn’t returned by then, I would be in Geneva at least another weekend.

  I looked at my watch. Ten to twelve. I steeled myself for Catherine’s frustration at my insistence, and picked up the phone.

  16/02: visa.

  my visa has come through. i am going to pick it up at 5 o’clock, the end of the day. i leave tomorrow at 5 a.m. for khartoum. the midwife had her visa refused. apparently sudan is happy with the quality of deliveries in abyei and feels that there is no need for further expertise. wait until they get a load of me. the red carpet will stretch all the way to europe.

  i do have a few tricks up my sleeve. one of them is that one with the fake hand, where you greet the woman and say “hi, i’m dr. maskalyk” then turn away leaving her holding the hand. i use it to scare them out of labor.

  this morning, half asleep, i stumbled into the hallway of my tiny hotel and ran headlong into a man my age holding a toothbrush. “dentifrice?” he asked. i returned to my room and found him some toothpaste. we chatted. he was with msf too. most of us in this place are. it’s like a halfway house. we are either halfway gone, or halfway home.

  he is a logistician. he was on his first mission in guinea-conakry, but was evacuated a few days ago, after only two months in the country. guinea is at war with itself. the government has recently imposed a 20-hour curfew to deal with increasingly violent protests. msf treated 275 wounded in the capital over the weekend. neither of us knows what has happened since.

  “what now for you?” i asked.

  “no plans. no idea. good luck,” he said and turned away.

  FIVE O’CLOCK. CATHERINE was gone but on her desk was an envelope with my name on it. In it were my passport and ticket. I walked down the stairs and out the sliding doors of the MSF office.

  On my way back to my hostel, I stopped at a pharmacy to pick up tablets for malaria, and next door purchased a package of Gauloises. I had decided to start smoking. Restart. I knew I would have company in Sudan. Cigarettes were tools. They marked minutes. The downside is that they’re not easy to like. I needed practice.

  My passport felt heavy in my pocket as I climbed the steps to my room and let myself in. My suitcase was laid wide on the floor. In it were many of the things I had been carrying around with me for the last two months, from place to place, from Germany to Brazil to Toronto to here. I had been through it, packin
g and unpacking, then again, trying to pare down what I needed even further. The flight to the field, from Khartoum to Abyei, I would be allowed only 15 kilograms of luggage. I grabbed my stack of books, hefted them up and down. About 5 kilograms. My computer was 2. Halfway.

  I took a cigarette from my pocket, lit it, and sat down in the middle of my scattered belongings.

  There was no way to tell what would start tomorrow. I could not see Khartoum, could not make that place real. Tomorrow it would fall up at me from the ground, and once I landed, I would be met at the airport and the work would begin. I stood and picked from the wastebasket a map of Geneva given to me on my arrival, and smoothed it flat. I put my jacket on, slipped the Gauloises in my pocket, and went down to the street.

  Hours later, back beside my bags, I started to put things back in, layer on layer. I stacked my books at the bottom of my backpack, and on them my camera, a set of small speakers, and the balance of my clothes. I set my running shoes on top.

  It was nearly 2 a.m. I was to be picked up in three hours. I undressed and lay in bed. My mind swam in circles. I looked at the clock: 3 a.m. I imagined blackness.

  My alarm went off. I dressed, put my backpack on, and clunked my suitcase down the stairs. A car was waiting for me, and in the back seat was a tall black man. He stepped from it and offered me his hand.

  “Ajak. Just ended my mission as field coordinator in Congo. Going home to Nairobi,” he said.

  “James. From Canada,” I said as I loaded my luggage into the trunk. “I’ll be in Sudan tomorrow. I’m on my way to Abyei.”

  “Oh?” he said, brightening. “My family is from there. Ajak Deng. Mention my name. People will know me.”

  I took a pen from my pocket and wrote it down.

  “Are they all as tall as you?”

  “Yes,” he said, and opened the car door for me.

  “Just a minute. I’ll be right back.”