Six Months in Sudan

by Dr. James Maskalyk

  friday the 13th. that is when i fly. three days. were these the ones i have been waiting for all this time? they seem ordinary.

  i spent an hour last night looking at flights, responding to emails. at dusk, i folded my computer into my backpack, and started home. i quickly encountered some acquaintances from another ngo out for a walk. i tried to talk, but could not. the words that came were jumbled and strange. i had spent an hour in an unfamiliar interspace, pulled from this place to place to place to place at a hundred kilobytes per second, and it had left me dizzy and uncertain. it didn’t fit well with the cows, and the water pumps, and the women balancing buckets. after a short, stilted conversation, i returned slowly home. by the time i arrived, i found the ground beneath my feet.

  and it is still there. here. abyei’s brown ground. all dust when i came in february, cracked and shifting with the wind. now, as i look out at a black and heavy sky, soon to be thick mud. it has changed. completely.

  this is the point where i begin to wonder what i have changed. this is when you start the questioning, only now, just as the days push up against one another. you don’t have today and tomorrow any more; you have lost them. in their place, TODAY and TOMORROW, too swollen to change, and you live them like a race.

  so i was in the tb office today thinking about what i will leave behind. as i was balancing in the interspace, the one between here and there, then and now, one of the young tb patients walked in. she is about eight years old, and has been on treatment for two months. after the first meeting, i have not seen her parents. she comes every week on her own and always wears the same torn, overlarge black dress. she peeks around the corner, then bashfully slides into the room barefoot, and steps onto the scale. she answers my questions shyly, only with nods. when i finally place the foil packages in her hand, she skips out of the room. i adore her. so brave.

  when i saw her this time, for the last time, i had this overwhelming urge to give her everything. i didn’t even know what everything was, i just wanted to give it.

  and i knew then that i was thinking about things the wrong way. when the plane takes off and the abyei ground falls from beneath my feet for good, the best things i will have left behind are not the ones that can be summarized on my end-of-mission report. they are the bright, beautiful parts of the day that can only be lived here. there are many. i will miss them.

  “DR. JAMES, HOSPITAL. CHANNEL 6.”

  “Hospital, go ahead.”

  I am on call, for the last time.

  “The woman with burn is having heavy breathing, over.”

  “I’m coming. Over and out.”

  I reach to the chair beside me, feel for my headlamp, click it on, look at my watch, 00:12. I tangle through the mosquito net, take my scrubs from the rope, put them on, pick up the pharmacy keys, my stethoscope, walk to the driver, “Mustashfa,” he rises from his chair sleepily blinking, gate opens rumblerumble, Land Cruiser starts gruffly, we roll past the military compound, I slam the door shut, walk through the front gates of the hospital, the nurse is there with a flashlight, no generator at night any more, too much power, gas too expensive, only candles and flashlights, mosquito nets hang like spiderwebs, spooky.

  “This way,” she says, shining the flashlight in front of my feet, not in front of hers.

  We round the corner (the hospital is like the back of my hand), and enter the dark room.

  As soon as I cross the threshold, I can hear her breathing. My instant thought, my first, before I even register her family gathered around a single candle, five of them looking at me carefully, is, she’s dead.

  I don’t need to know any more, don’t need to examine her. But I do. Maybe she can feel the bell of my stethoscope on her chest (her breathing … noisy … like marbles shaking in the hose of a vacuum cleaner …), or my fingers on her wrist (her pulse is fast … thready …), or my hand on her stomach (soft … no peritonitis …).

  “Do you want oxygen monitor?” the nurse asks.

  “No.” Just her chart.

  The nurse has it in her hands. I look back over this woman’s hospital story, her fevers, her medicines. Oh. Here’s where she came in, from days away, her perineum burned with boiling water. And here’s the hemorrhage, her bed full of blood, took her to the operating room. Okay. Right. She arrested. Here’s where, as I was getting my blood screened to donate, the young soldier in dark glasses who didn’t know her came to the hospital and said, “I heard someone needs blood,” and I saw Haj, his uncle, our oldest nurse, in Abyei for decades, beaming proudly, and the boy gave and saved her and she started to get better, and our talks of transfer grew less frequent and the antibiotics started to work and we were happy, Mohamed and I.

  All that in scribbled notes, dots of vital signs, cross-hatched marks of delivered doses. There were no more medicines to try, nothing that could change the story at this point, no one who would read it after this.

  I stand up, let her hand go. It lands limply by her side. I face the family.

  “Malesh. She’s very sick. I don’t think she will live until morning.”

  Sepsis. I think she has sepsis. There are bacteria in her blood, dividing from one into two. The antibiotics killed millions on millions, but one became resistant and now there are simply too many.

  “It’s her breathing. It is too bad.”

  She has inhaled her own vomit, her own dinner, a glass of water. That, or she has acute respiratory distress syndrome. The bacteria make a waste, a toxic waste, and it causes capillaries to become weak, to leak. Her lungs are full of water, water mixed with proteins and salts. It will drown her.

  “I’m sorry.”

  For her. For you. For me. Because as soon as I step off the plane, you all will collapse and I’m sorry I feel so much relief at that thought.

  I leave her gasping in the room.

  I walk to the nursing desk, and scribble an order on her chart.

  “Furosemide,” I say. Useless. “And oxygen.” Useless.

  “There’s nothing more I can do.”

  Don’t call me about her again.

  I walk through the hospital gate. The driver is waiting, napping. I rap on the window and he starts the truck. We roll down the driveway, past the dark military compound, and home.

  I walk into my tukul and look at my watch. 00:22.

  WHAT TIME IS IT? Nine.

  “Laurence, what time do I have to leave?”

  “Eleven-thirty at the latest.”

  Gotta go to the hospital, say goodbye to Aweil. To the market, take some pictures, fuck the rules. Get my emails off the computer. Shit. That’ll take a while. Say goodbye to Mohamed. Clean my tukul.

  In a whirlwind rush, I grab my camera.

  “Anthony, see you at eleven-thirty, right?”

  I half jog to the hospital, 460 paces, this is it, the last time.

  Stupid cannon.

  “Hey, Majak … yeah, last day … nice to know you … okay.”

  Push past him. I’ve got all these toys Aleza sent me. Aweil.

  “Hey, sweetheart. I like your new dress … Come here.” She lurches towards me.

  The spinning top. That’s the best.

  “Here, check it out. Pretty.”

  And the super bouncy ball. And the bubbles too. I sit her on my knee.

  “Well, beauty. Be good. I hope you find your dad and he loves you and you go to school and have ten children and a hundred cows and you live forever. Okay? Complete survival. Don’t forget.” I don’t want to put her down.

  Oh, here are the brothers. I’ve got more toys. The parachute and this crooked airplane. Here.

  “And this one’s for your brother. No, not for you, your brother. Here, watch.”

  It flies crooked, too.

  “Here’s a little soccer ball. It rules. No, that’s it. I’ve got to save some.”

  I set Aweil on the ground and spin the top. She shrieks in delight, and I hurry away, top still spinning. I do not look back.

  The feeding center recu
bra. I’ve got all these glow-in-the-dark bracelets.

  “Hey, moms. Hey, babies. Come here.”

  This little girl’s my favorite. She has been in and out of here three times. So shy.

  “Yeah, you. Hi, sweetie. Don’t be afraid. Here. It can go on your wrist. Like this.”

  It looks like a piece of ordinary plastic.

  “Sorry, hon. It’ll make sense tonight.”

  What time is it? Ten. I don’t know if I will see Mohamed.

  “Bye, Majak. Say goodbye for me to everyone. Angela, here, take my pharmacy keys. I’ll see you back at the compound.”

  All right. Got my camera. I should take a picture of that water pump. Been meaning to for months.

  I jog to the start of the market, to the queue of girls hammering up and down on the pump handle, one-two-three, one-two-three, again.

  “No, don’t stop. Keep pumping … Oh, forget it. Come here. All of you. Yeah, see a camera. Look. That’s you. See? Hey, let’s all bend over it like this, look at the camera. One, two … Click.

  “Look. It’s all of us. See? You. And there’s you. Look. Okay, gotta run.”

  I dash into the mud market. Click.

  And the restaurant. Should show people that. Uh-oh.

  “Oh. I’m sorry. I get it. No picture. Sorry.”

  Whoa. They were not happy. Must be military. Wonder which side. Lucky. Don’t need trouble today. What time is it? Ten-thirty. Shit. Back to the compound.

  “Anthony, we still on for eleven-thirty? All right.”

  Okay. I won’t sweep my tukul. Gotta put my email messages on this data stick.

  What time? Eleven. Shit.

  “Angela. Here is my Swiss ball. Yeah, Swiss mission, Swiss ball. And here’s the cement dumbbells. Yusuf says he wanted the barbell, but it’s up to you. This protein powder I opened once. Its pretty awful, but not as awful as black and brown.”

  Eleven-fifteen.

  “Anthony, you ready? I’ll grab my things.”

  Eleven-thirty.

  “Laurence, brother, goodbye. I am glad I got to know you. Good luck with the drivers and all those hard parts. I’ll see you somewhere in the world.

  “Julie, take care of Laurence for me. Make sure he gets the office finished. And the garden. So far it’s only radishes, but you never know. If anything grows, let me know.

  “Angela. Don’t work so hard. Try to take a rest. You’ll figure it out. If you need anything, anything, have any questions about anything or anyone, any patients or the TB program or … What? … Okay, we gotta go … You have my email … bye … bye … bye …”

  11:35.

  “Anthony, stop at compound 2.”

  I’ll ask the guard. “Is Mohamed here?”

  At the mosque.

  “All right, let’s go.”

  Mount Abyei. Tim. The market road, flooded. That’s where I used to run. The road out of town. Here I am.

  So green. Wow. That man, praying in the middle of a field. Beautiful.

  “Shit! Anthony, give me the handset.”

  My travel permit. It’s expired. Goddamn.

  “Julie for James, Julie for James.”

  No fucking way.

  “James, this is Laurence. Julie has gone to the market. Over.”

  “Laurence, I don’t have a travel permit.”

  Silence.

  “Do you copy?”

  “I copy. Stand by.”

  “Anthony, stop the car.”

  I am flying south. They’ll stop me at the airport.

  “James, Julie is going to get one and deliver it to you at the airstrip. Do you copy?”

  “I copy. Should I get on the plane without the travel permit?”

  “Stand by at the airstrip. Over.”

  Twelve. Plane at one, forty-five minutes from Abyei. Checkstop. Waved through.

  “James for Laurence.”

  “Go ahead.”

  “Julie is on her way.”

  Twelve-fifteen. Airstrip is quiet. A few other cars. Do I get on the plane if it comes? No. I’ll bargain for more time.

  People are standing up. There’s the plane.

  “James for Julie.”

  I see them. The plane lands.

  “Here you go, James. Should work.”

  “Julie. Thank you so much. Good luck.”

  I board, the plane turns on its heel, and with one last look to the side, Abyei falls away.

  (out)

  17/07: soon, suddenly …

  I am sitting in Khartoum’s airport. For the moment, everything is life size. The crying kid next to me, the men walking to the airport mosque with prayer mats, the man smoking under the “no smoking” sign. Soon, the hatch on the KLM flight will close, the announcements will begin overhead, and the telescope will start to swivel. By the time I arrive in Europe, it will have turned completely and everything in Sudan will seem far away.

  I tried to have a simple conversation with the driver on the ride here, but I couldn’t manage. Every thought was short-circuited before I verbalized it, my neurons a crossed jumble of sparking wires.

  So much left unwritten. There are a million things. I wanted to write about the Casio F91-W, how it is the watch for all developing world traveling needs, reliable and unglamorous.

  I wanted to tell you how some of the women in the hospital, the mothers of the children in the TFC, wrote and sang a song to Laurence and Angela when I was on my R&R, wishing them strength. I wanted to describe better the team, Laurence the logistician who I would trust with my life, Marco and his calm, wise ways. All these things, untold. And many more. Alas.

  In some cruel twist of fate, I already miss Abyei. How can that be? It is already strange to feel untethered, to not have responsibility in something so worthwhile.

  I will write some more posts, perhaps with a different frequency, as I see how well the next places fit.

  Oh, the flight boards. I just looked back over the post, and I capitalized everything for the first time. Huh.

  Soon, suddenly, not Sudan.

  CHAPTER IV

  WOW EVERYTHING IS FOOD.

  The bus from the airport is slipping quietly down Geneva’s summer streets. I am sitting in the back, dirty and unshaven, marveling. I can’t take my eyes off the stores we pass.

  All this stuff.

  The bus angles around the corner, bending in the middle. The corrugated rubber at its swivel point bunches.

  Bakery next to bakery next to convenience store.

  The bus slows to a stop. The street name is called out in French, then flashed in bright electronic letters on a small billboard near me. A woman waits at the rear door. She has a walker. A young man wearing iPod earbuds helps her board, lifts her walker with one strong arm and puts it beside her.

  Everything is straight, right angles.

  I try to think of Abyei, and I bounce back to here, my dirty nails curled around the back of the seat in front of me, staring. My stomach turns. I need a bathroom.

  An announcement in French.

  This is my stop.

  I pick up my two bags, red with Abyei’s dust, and step past the woman with the walker, nearly knocking her with my swinging duffel. The doors hiss shut and the bus pulls away.

  I’m standing on the edge of a sidewalk in the morning sun. The air is sweet and full. I am two blocks from the MSF office. I’ve never felt less anywhere.

  I walk the final distance and pass through the sliding doors. The same woman is at the front desk, bright and cheerful. I put my bags at her feet and she looks at me and smiles. Halfway home. Halfway gone.

  I point to my name on the arrivals board.

  “That’s me.”

  She hands me a stapled piece of paper. I tear it open. Times and dates.

  “You are scheduled to meet with Diana at one, but Alex wants to meet with you at some point.”

  “Alex?” I ask.

  “He’s the director of communications.”

  “Oh. Sure. What time is it?”
/>   Twelve.

  “I can do it now. Can he?”

  She calls. He can.

  “I’m going to go downstairs and get a coffee. Can I have a key to the storage room?”

  Bags, gray boxes. I look in North Sudan’s. A package for me. From Jack. I open it. Music. A false thumb for magic tricks. I can’t wait to see that guy. I shut the door and walk downstairs.

  Coffee machine. I fumble in my pocket for change, plug it in. The machine whirs hot coffee. Can you fucking believe it.

  I sit at a round table. To my left is someone halfway to the field getting briefed. Burma.

  A tall man with a beard approaches me. I stand.

  “Alex?”

  “Yes. James, right?”

  “That’s me. Glad to meet you.”

  “Let me grab a coffee. We’ve got a lot to talk about.”

  “Sure.”

  I sit down. He turns to the machine.

  Whirrr.

  He returns to the table, sits, crosses his legs, crosses his arms. Frowns.

  What?

  “I have some concerns about your blog.”

  What?

  “I came across it the other day.”

  The other day?

  “And I was surprised at what I found there.”

  But I sent the posts before they went. I followed the rules. I thought about security. The videos were big, so I just … I thought I was … I thought you would have …

  “It made me upset.”

  But MSF … the feedback … from Canada. And the U.K. You used it for fundraising.

  “The video of the hospital. Shot from the hip.”

  It wasn’t.

  “The video of your last day … staged.”

  No.

  “And your readers … a couple of medical students.”

  People from everywhere. Jamaica, the Philippines. People in this office. My parents, my friends.

  “If we wanted an article about Abyei, or videos, we would have sent professionals.”

  But you didn’t.