Suddenly…Sudan.

the boy, as of 9 am this morning, is working to breathe. he is leaning forward, balancing his tiny shoulders over his big belly, trying to increase the space inside his lungs, hoping to pry open even one more tiny alveoli and squeeze some oxygen into it. last night, we started the hospital generator so we could use the oxygen machine and give him some help. it kept him alive this long.

last night, as he was struggling for breaths, i was struggling to sleep. it is not a new one. years old. decades. as i start to tip, i realize that i am and become glad. the realization wakes me and i find myself in an uncomfortable flat landscape, wind whistling by, the possibility of being struck by a live thought from any side.

…… the boy… did i use humidified oxygen… i did…. what haven’t i… no… tomorrow…. figure it out tomorrow….. (yawn) ….. oh, good…. here i go…. sleep… no…… Thursday today….. how many left…… shhhhh….. tired…… quiet….. the event horizon of a black hole…… that’s what i want to be….. no thoughts…. nothing in… nothing ou….. silent…. black…..

two days ago, i was walking home in the rain. in the distance, i heard the sound of a siren. oh, i thought, an ambulance. i guess they are on their way to the hospital. wait a minute….. what? ambulance? from where? people arrive on donkeys.

the sound approached, and a white truck with an ambulance stencil on the door flew past, its siren informing only me and a frightened goat of the emergency it held. i suspect that when you are considering becoming the driver of a new ambulance in a land of donkeys, the chance to use the siren is a firm pro.

it was new. from agok. it was the first i had seen of it. the emergency it contained was a woman who had delivered a child eight days ago. in an effort to clean her after, they had doused her perineum in boiling water. she had thick burns around her vagina, on her buttocks. three days ago, she developed diarrhea and the burns were deeply infected. the child had died because she was in too much agony to feed it. she spent eight days in the bush, screaming.

… black….. crowsnest…. i bet i could fall asleep in a crowsnest…. wind… curled up on the wooden planks…. listing back and fort….. clouds above wind… starless…. tilt…. tilt……

yesterday, i was administering medicines in the TB area. developing the program has been a priority for me here. i was cutting foil pill pouches into correct numbers, to make sure taking the correct amounts is as easy as possible. dozens of patients walked in and out, some coughing, others not. i weighed them, talked to them, lauded their commitment, listened to their story. i watched an inpatient, our newest and sickest, leave the recubra where we placed her because of our bursting rooms. she was leaning on a long stick which she would plant in front of her, then catch up with it. in the morning sun, they cut the thinnest of shadows. she slowly picked her way across the field, leaned her back against the wall outside my door, and slid down until her head, hanging between her sharp shoulders, hung between her sharp knees. i finished with the patient in front of me, rose and tapped her shoulder. she is deaf. she stood, shakily, and sat in the chair. i started to cut the foil. as i did, shrill cries came through the window. i knew what they meant. i kept cutting. Margaret came to the window, and pressed her forehead up against the wire mesh.

“you know where that is from, don’t you?”, she said.

i did. the baby her and i spent three days feeding from a syringe had died because, at some point, we went home to feed ourselves. i finished cutting the pills, and explained through gestures as best as i could how to take them. more wailing. i gestured for the next person.

…. tilting….. a hard, blue iceberg…… take an iceaxe and chip out a chair….. sit….. watch the ocean float a fleet of ice….. sun glancing glinting through cracks….. cold bright light…..

margaret and i walked home from the hospital together. i told her that i see her going through a similar transition that i did. you feel that if you leave the hospital, let your guard down for one second, someone might die. for fear that it will not get done, you take the syringe and feed the child yourself, you hold it, fret over it. it becomes a symbol of your success, the reason why you came in the first place. if you can’t save them all, if you can’t be there all of the time, at least you can save this one, at least you can be there for this one. so, you try. you keep on looking after him. even in your sleep. you hang on too tightly.

…..cold………..statue…. crawl into the middle….cold brass…. dark….curved….. echoes……

a few years ago i wrote a list of ten things i wanted to do before i die. sleep inside a statue was one. i have no idea why, but i have a strong imagination of how deep the sleep would be there, the sharp smell of brass, only the most insistent rays of light bending around corners, muffled museum echoes. i have eyed the henry moore outside toronto’s AGO. it has the right curves, but it is not as deep as my dream.

that tapping mirror bird is at it again. click click click. and me, i am off to the hospital.

saturn.

margret, our new nurse. the child, all angles.

a mantis celebrates after reconciling gravity and magnetism seconds before being eaten by a lizard.

makuch.  me.

thanks to all of you who commented. today, after one week on tuberculosis treatment, he has defervesced. this morning, he struggled to a shaky stand. i will report more as the week passes and I get a chance to read your comments. i have only infrequent and poor access to the internet, so have only been able to read a few. two have mentioned stevens-johnson syndrome
which is a great thought. he did have ulcers before he came in, but i am not sure what treatments he may have received prior to presentation. it is common to find empty bottles of penicillin in patient’s pockets. i will let you know.

i have just more than two weeks left to go here. i finished my
end of mission evaluation with my field co the other day. we talked about how i arrived to be so tired. part of it, i explained, was that i never really feel like i leave work, that a corrider stretches from the hospital to my tukul. i suspect that is why i often write about life away from it, when i can find it.

so, to life outside of the hosptial. it keeps apace. the garden is
planted. carrots and lettuce. it will grow after i am gone. i will leave the facile metaphor buried with the seeds. we are in the midst of a deluge, so i wonder if any will remain where they were planted, or if they will be carried away on the hard clay.

abyei’s fields are flooded. the people in akur are now stranded on their island. we tried once last week to reach them, but had to turn back. yesterday, after days without rain, we finally made it. with this latest torrent, it might be weeks.

i went for a walk yesterday, through the market, and took the long way back. there is nothing much to buy there, no local fabrics, no aromatic Sudanese spice, no exotic fruits. but it is the centre of life for the people here. shop after repeating shop selling batteries and soap, stools clustered around tea pots and hukkas, someone repairing bicycles, parts scattered around him like bones. i would show it to you, but we only take pictures in the compound and the hospital.  there are too many soldiers, and abyei is too sensitive, to be wandering around wearing ones camera and a foolish grin.

i passed tukuls along the way. inside many of them sat families
talking. i wondered about their conversations. what do they talk about? at home, I talk about music, current events, music, films, books, music. and them? music too?

“hot today.”

“yes. hot. it’s always hot.”

“true.”

“soooo… how was the wedding last week? did they serve the goat i sold them?”

“no they didn’t. everyone was waiting for it, but they just served beans. can you believe it? we all saw it sitting right there, plain as day. i mean, how many times do you get married? three or four times, tops. if you’re not going to serve goat at your wedding, then when?”

“ridiculous.”

“definitely. everyone is talking about it.”

“… … ….”

“… … …”

“my little one was sick the other day. diarrhea. i took him to the hospital. he’s better now.”

“did you see the kywyja?”

“yeah, briefly.”

“was he wearing a different pair of sunglasses?”

“yes. black ones.”

“I’ve already sold him three pairs.  what is with that?”

“i have no idea.”

on my walk, i was peppered with “kywyja! kywaja! my friend!”. i ignored most of them, pretended not to hear. people are used to Europeans driving by in fast landcruisers with tinted windows, not walking like everyone else. they want to get my attention, to interact.

we all respond differently to “kywyja” like mzungu in other parts of africa, it means white person, or rich person. it irks me. i hear it, and instantly, despite myself, i am irked. i can’t help; it. i am not sure if it is because i am from a culture that teaches ethnic generalizations can only be pejorative, or if i have a point, that i am not like the kywyja that just drive past. nor the english colonizers. i am different. the name’s james.

after five months, i want to be anonymous. i want to be scenery,
not seen. i am not sure if that is typical of us as individuals, or just of of me. i walk through the market, and through the hospital, and somehow imagine that i don’t stick out, that i fit in just like everyone else.

but i don’t. when i run past in the morning, people stop brushing their teeth and stare. some children in the hospital cry when they see me. others work up the courage to touch the hairs on my arm.

i talked to my translator it. he said that when he was small, he
was the same. he wanted to follow us, to watch what we ate, to see how we slept, to see what made us different. i told him that, for me, the i couldn’t avoid thinking of kywyja as an epithet. he was startled.

kywyja, it is not informed by the terrible history that the western world shares, of slavery and conquest, where people with visible differences were only either commodities or obstacles, not quite human.  for many people here, and in other places, their knowledge of us is from dropping food from planes, or traveling from place to place spending money without having a job. we seem irreconcilably different. much more different from them than we are the same.

no matter how it makees me feel, of course kywyja is not an epithet. nor is it a term of affection. it is a measure of distance. the distance is approximately 50 cm, the clearance of a landcruiser from the ground.

well, it appears my conversation had some effect.  so far, so good.

I have another child, however, with whom tough talk is not working so
well.  I am hoping that some of you might have some tropical
medicine experience, or know someone who does.

I admitted a 3 year old child to our feeding centre ten days ago.
he has been admitted twice, before my time, for severe
malnutrition.  the previous charts are not available, so it is
unclear if there was a precipitating illness to the previous admissions.

this most recent one was precipitated one month ago by a rash whose
intitial characteristics are  uncertain.  this was followed
by decreased appetite, cough, and intermittent fever.  I am
cautious with interpreting the histories I receive, the same patient’s
can change from day to day.  on further questioning, the mother
reports the child has been ill since shortly after birth when he
developed diarrhea and vomiting.  according to her, he has never
been well enough to walk.  I have been told, however, that during
his previous admissions, he gained some weight with appropriate feeding.

this time it’s different. he is not gaining weight, and is deteriorating.

on presentation, he had a low grade temperature of 37.8 C, and a pulse
rate of 120.   he was severely wasted and had a
non-productive cough.  he had a rash of healed ulcers, primarily
on his face and active ulcers in his ear and on his lip.  he also appeared
to have a serous otitis media.  he had non-supperative cervical
lymphadenopathy, and no other nodes.   his lungs were
clear.  further exam showed splenomegaly with mild
hepatomegaly and no ascites.

as per protocol, he received broad spectrum antibiotics, in this case
intravenous ceftriaxone because he was refusing oral medicines (and we
are out of gentamicin).  this was changed to amoxicillin as he
began to eat nutritional supplement and drink well.  he also
received anti-parasite treatment.  three days after admission, he
developed a high fever, 38.7, and developed more ulcers on his penis
and around his anus.  at this point I was considering disseminated
tuberculosis, immuncompromise from HIV (PCP, fungal skin lesions), and
less likely, but possible, congenital syphilis (though he would have
likely been symptomatic sooner).  I treated him with benzathine
penicillin for syphilis and yaws, and started cotrimoxazole.  we
have no x-ray, and our labarotory technician was away.

once our lab tech returned, the complete work up that is available to
me was normal.  hemoglobin normal, negative malaria
smear/paracheck, urine normal, stool negative, HIV negative, syphilis
negative.  in the past two days, though his mother says his cough
is better, he has developed several mouth ulcers on his lips and buccal
mucosa.  also, the skin around his axillae and antecubital fossa

given his chronic cough, cervical lymphadenopathy, and frequent
readmission to the TFC, I considered the possibility of another chronic
disease, tuberculosis.  the mother denies tubercular contacts, but
in five months, I have only had one patient admit to knowing someone
with a chronic cough.  as he was not improving after seven days of
antibiotics, and had not gained an ounce despite eating, I started him
on tuberculosis treatment.   he has not improved after five
days, and when I left, his temperature was 38.6 and he was listless.

I have seen a response to tuberculosis drugs take longer than this, and
the problem may be poor administration or absorption.  to this
point, I am convinced that the drugs have been effective for most of
our patients,  so I am not questioning efficacy.  it could
also be a version of immune reconstitution syndrome.

I am wondering if I should be more strongly considering
kala-azar.  I have no history of a primary lesion and the ones he
has seem atypical.  there is also a possibility that this is
something non-infectious, and autoimmune (Behcet’s?), though I am
surprised by the high fever.   nutrient deficiency plus
chronic malaria?

so.  stumped.  no more tests.  no google images.
nelson’s textbook of pediatrics, harrison’s principles of internal
medicine, manson’s tropical diseases, and me.  and, somehow, you.

for non-medical types, particularly the squeamish among you, now is a
good time to bounce to facebook.  for the rest of you, please
post, or send your comments to:

james.maskalyk.md@gmail.com

it is Friday, our day off.  it is 830 and the sky is a disappointing blue.  at this point, I crave clouds.

my plan for the day, after I finish this, is to break some ground
beside my tukul and make a garden.  I am going to plant
carrots.  I will leave before they are ready to eat, but I can
watch them start.  and it seems like honest work.   like
washing dishes.  I am looking forward to it.

the child I talked about, the one with the blind mother, is somehow
alive.  i took the tube out of his nose, and he is drinking.
he is still so very thin, his skin stretched tight over his ribs, like
paper over a wire frame, like if you turned your back, he could blow
away.  but not for long.  if I have my say,  he will be
so fat he will be able to waddle through the eye of a
hurricane.   and after him, the next one the same.  in
fifty years, people will be writing about abyei’s epidemic of obesity,
and the graph will start in 2007.

I wrote “in twenty years”, erased it and wrote “thirty”, and finally, “fifty”.

maybe fifty.  if I am alive, I will be an old man, eighty
three.  I will walk down abyei’s streets, shaking my head.  I
stop for a rest in an otherwise empty coffee shop.  the man behind
the counter will take off his computer glasses, and smile.  he is
in his 50’s, fat, pleasant.  we will start to talk.  I will
start to tell the story I have already told to five disinterested
strangers, how I was here once, fifty years ago.  there was
nothing.  only a hospital.  and now, all this.  he will
shake his head with me.  he was born in abyei, lived here all of
his life.  he too has seen it change. he lived in a tukul, made
from grass.   there was no electricity, no trains.  two
of his brothers died from diarrhea.  he nearly died too.
when he was three.

“how old are you now?”

“fifty three.  more or less.”

“was your mother blind?”

that is one version of the future.  it already exists; it simply
needs to be arrived at, uncovered, rolled into place.  another is
that this place remains forgotten, largely untouched by the best of the
best things in the world.  your attention, like mine, turns to
other more personal matters.  we read about abyei tipping once
again into war, about thousands displaced.  we shake our
heads.  in fifty years, as an old man, I will look at abyei on
google universe .  all I will see are sticks and plastic bags
fluttering in an empty field.

but for now, we are here.  I meant to say this before, but I
haven’t.  whenever I write “we”, I don’t just mean the team or
msf,  I mean the larger, more collective sense.  you and me,
and everyone we know.   I mean the “we” as a species that
has, through culture and nature, manifested a system of
humanitarianism.  that support the idea that we should put
ourselves in the middle of the world’s worst places, the ones that
threaten to tilt into war or be swallowed by disease.  or, like
abyei, both.

I believe this sincerely.  we are here, you me and everyone we
know,  because there is something inherently valuable to our
presence.  it is a manifestation of a quality we value in
ourselves as individuals, one that when exercised feels entirely
correct.  the feeling of standing between two people who are angry
enough to fight, or stopping to help someone stranded by side of the
road, and once you do, you realize the perceived risk is less than the actual one.   the mission in abyei, like the
ones in afghanistan and the congo and bolivia, is that feeling
multiplied a million times.   we all share it, we all know
that it is better than the one we have when we turn our heads and
pretend not to see.  so, that’s why I am here.  because of
that part I share with you and everyone we know.

as one person, i can’t make either of those abyei’s arrive.
I only have a vague idea where they lie, and the world is too
heavy.  it’s a rudderless ocean liner with six billion people on
it, barreling towards the future, full steam.  we can’t even budge
it.  all we can do is walk to the side that lies in best direction
and bring some friends.  there is nothing to say we can’t make it
a bit of a party.  and, maybe, if we want to be extra sure, we
lean over the railing a little bit.

i’ll bring the boy with the blind mother once he is fat enough.  he’ll make for good ballast.

at this point in the story, the character is watching time catch up with him like it was an elastic that just snapped off of a finger. in an instant, it will be upon him, and in an instant more, hurtling past, pulling him at full speed into the future.

but for now, in that vacuum before the instant, before it all starts to rush towards the end, things are calm. it is dusk. the swallows are sitting on the rafters of my tukul, warbling round words. a bat just brushed past my face, keenly swerving at the last second. through the thin grass wall that separates the compound from our neighbours, someone is playing the same tape they have played every night for months. last night, we took turns standing on chairs, trying to take pictures of Saturn in the cup of the moon. did you see it?

the hospital is busy, but i don’t think this is news anymore. we are full. all we can do is make more room. there are no other places for people to go. the vacancy sign is painted on.

this morning, i saw a pregnant woman who had severe eclampsia, and whose blood pressure, despite delivery of the baby, continued to climb. drugs that i would normally give only when a patient was attached to every monitor i could think of are infusing a few hundred metres away with only “30 drops per minute” written on the clear bag. she bit her tongue so severely during a convulsion that she can neither drink, nor talk, nor properly breathe. on her heels, a child who would not stop seizing. on his, a pregnant woman with deep jaundice, drowsy and confused.

my field coordinator and i finished the latest round of quarterly statistics. we poured over our monthly collection of indicators. how many admissions, how many of them with measles, with diarrhea, the number whose parents left before we could finish treatment. the ones i couldn’t stop from dying, the dead ones. ghosts.

“and in april, james, how many maternal deaths.”

“one.”

“are you sure?”

“yes. sure.”

of course i am. it was like my graduation. or like the birth of my child will be. there are bits of it that sit in my memory like pieces of stained glass, frozen moments, unforgettable. the seconds were like jewels, precious, expensive.

“ok. deaths from diarrhea.,….five. wow. is that right? it seems too many.”

“yes, that’s right. five.”

and yes, too many. five times too many that feeling where i don’t know what else to do. ten staring eyes too many. it is my job to go through these statistics every month, to tally the numbers, balance our admissions, to glean something from the numbers. i do it by going through the charts. many are familiar to me, their stories that i have written on the front of it are often mine. so too the scribbles inside. i handled them, started at them, thought over what to write next, what twist i might add to change the plot for the better. they are like a living thing, a paper memory. i divided them into two piles. the living, and the dead. i tally the living first. there are more. then i turn to the other pile. it is like a reverse role call. john deng, 5 years old, diarrhea? absent. miriam kuol, 23 year old woman, possible brain abscess? absent. atoch matem, 3 year old girl, malnutrition? absent.

when you sit on this side, with the chart in your hand, you seem to have only answers. on the other side, with the chart in your hand, when you looked around, all you saw were questions.

so, now we have done it for the time i have been here. february through june. the cured and the absent are now pressed into numbers, their charts pressed into boxes, these pressed into a corner of the pharmacy. a memory mine.

when i traveled through africa last time, writing about HIV, i was determined to tell the story using as few numbers as possible. what does 40 million living with HIV mean anyway? would another zero make us act? 400 million? would 4 million make us feel better? numbers numb us, they lose their meaning. watch an audience glaze when they hear them. nowhere in the zeroes is a human face.

we sent our numbers today, and i don’t know who will read them next, or what story they will tell someone who never got a chance to see the faces.

each morning i wake to the tac-tac-tac of a bird pecking against the mirror that hangs on our shower wall. he cocks his head at his reflection for a second, then tactactac. i wonder if he is trying to set his image free, or if he wants to break through to the other world and its greener grass. it is dusk, but he is there now, tactactac.

it is raining. as happens during this season, the day gathered heat, lifted water into the air, then threw it down in a gale. the respite from the high temperatures that baked us four months ago is a blessing, one we gladly accept even if with it comes an armada of insects trying to make meals of us.

tactactac.

there is more life now, everywhere. green grass, red flowers, summer burnt trees flagged with leaves. those birds i spoke of, the ones that walked through a village that i passed, their shoulders hunched like old men, have arrived to abyei. they siphon frogs from the swamp that flanks my run on a road lettered with the upside down white S’s of snakes caught flat by truck tires. each day brings new black beetles, mantises, scorpions. we shake our shoes before putting them on. this morning when i moved my clothes trunk to clean behind it, i found a hedgehog. neither of us were particularly pleased. i chased him back and forth behind my bed, from corner to corner to corner to corner, until i routed him out the door. he curled up in a ball in the short grass outside my tukul, convinced he had found the perfect camouflage.

the hospital is full. it is always full. exceeds capacity. bursting. people sleep packed in rooms or angled closely on verandas. we moved the children recovering from malnutrition to one of the measles recubras. we have no space anywhere else.

two… no, four swallows just flew into my room, and are diving in small circles. now they are sitting on my rafters, arguing about something.

we are seeing more cases of malnutrition than before. children who are teetering on starvation get diarrhea, lose their appetite, and fall right into it. another one last night. his mother is nearly blind. i saw her feeling for the wall as she approached the scale for the daily weighings this morning. i wonder how well she can see him. if she can feel the skin that hangs loosely in tiny folds on his belly, his knobby knees. i met him for the first time this morning, on rounds. i sat down on the edge of his bed, half listening to my translator ask his mother questions in dinka looking around the room, then finally at him. he was looking at me. then, in spite of myself, all of a sudden, instead of looking at him, i was seeing him. after so many months of aches, one tries to guard himself better. when he sees someone so sick, he learns to hope for the best and prepare for the worst. the problem was, in this case, he fixed me with his eyes. they were quiet and interested, and i had no choice. now i sit here in my tukul with birds arguing overhead, prepared only for the best.

i made a mistake when i arrived, early on, of becoming not only interested in the fate of a patient, but invested in it. a small child, orphaned, thirsty, feverish. after a few weeks of treatment she was only worse. i treated her for everything i could think of, and things i couldn’t. i held my breath during an HIV test. finally, i started her on treatment for tuberculosis. she recovered. completely. she smiled for the first time, laughed. i saw her grow, saw her learn to walk, and to talk. she is in the hospital still, and i see her every day.

but, during those tense days where her fever climbed, and she stopped eating, and then she couldn’t roll over, and i saw the first edges of last breaths, i thought to myself, “yeah, i don’t think i can take this one.” all the bits of iron that are added to that thick girder, the one that keeps us walking to the next patient, felt like tin. shaky. the whole thing would crumple with her.

so, we take care, i take care. hope for the best, prepare for the worst. this system, however, has certain flaws. staring at the starving child of a blind mother, for instance, should be avoided if possible because then, like now, you can only imagine big, brown unblinking eyes as big as a billboard, and hope does not seem good enough.

before i left for the day, i walked back to his room and crouched beside his bed. “listen”, i said, “i’ve done some thinking. i’m afraid i can’t accept anything less than complete survival. complete survival. got it? so stop this fading away business. alright. i’ll see you tomorrow.”

swallows are back.

a friend of mine, a poet and playwright, says that busy-ness is the death of ideas. i think she is right. when one hurries through his day, it pushes past him in the opposite direction, at the exact same speed. ideas that are born fall behind, recede like signposts in a rearview mirror, forgotten before they can grow into the present moment.

every time i sit down to write something, i think about this. a hundred signposts a day pass me by. i could write about each one for days. a dangling light switch, if i take the time to stop, turns into life without electricity, without the sparks of energy it provides as supplement to a human’s own, to warm bodies and cool food, turns into the necessary ecological footprint of a hospital and the massive quantities of power required to allow a human body to repair itself, that the footprint is directly proportional to the inefficiency of our best technology to replacing the elegant physiology our bodies have developed over millennia, how we need to split the atom to provide the energy for the dialysis that a kidney can silently perform if fed a few apples, turns into the moral turmoil of the nephrologist after he brought dialysis to india, because his country needed clean water more than it did expensive treatment, into the tension between caring for one single human and society at the same time.

a dozen more things just passed by. a butterfly flew into my tukul. a locust is crawling up my wall. the logistician just poked his head in and told me about a new measles case. a visiting cook from khartoum, here to improve the food, walked past. it’s difficult to know where to stop and begin. i have only an hour every few days to pick one, hurriedly type it down in one copy, then send it. the other ones, equally as worthy, move into the past.

it is frustrating. i want to bring you here. to show you. not just to better your understanding of the place, but because it would increase mine. words are twice removed from reality, pictures and videos are too flat, embedded in the past. i want to share a consciousness of the present.

it appears we are working towards that. this blog is evidence. so too google, so too facebook, so too the cellphone buds in our ears. connected. more and more all of the time. none of the means are perfect, none allow us to truly share. not yet. but evolution is a continuous process.

the only thing i am not sure of, looking around the world here and seeing the congruence between people and their environment, is if we are moving towards something new, or trying to regain something worthwhile that we have lost.

i have just finished at the hospital and walked home on the muddy road. the last thing i did before i left was to explain tuberculosis to a patient’s mother. she is from the nuer tribe. her four top teeth are removed, and the ones left on the corners are filed into sharp points. her face is lined with scars, scatters of perfect dots, swooping curves.

i sat with her for twenty minutes, balancing her small child on my knee. he was 3 kilograms heavier than when he i first admitted him, feverish and coughing, to the feeding centre. i explained to her that tuberculosis is a very strong infection, spread by coughing. most children catch it when they are young, from an adult. it lives in their lungs and can make them sick. other infections are not so strong, and can be treated in a few days. tuberculosis needs medicines for six months. every day. if the pills stop too early, the infection comes back stronger, and it is difficult to treat.

she nodded occasionally, never met my eyes, never smiled. my story was difficult to believe. certainly no more likely than the illness being caused by a dark curse on the family. her understanding of the world, and mine, were completely different. we had separate ideas about how it started, about how best to live in it, about what will happen when we leave it. my beliefs would be as magical to her as hers to me. we sat there, our different worlds sharing the same room, our common ground balancing on my knee.

she agreed to continue the treatment. i am not sure if it is because she believed the pills were stronger than the infection or the magic. it didn’t matter to either of us. i showed her how to give the medicines, to dissolve them in clean water, to use a syringe to squirt them in his mouth.

and then they were gone. and so was i. i grabbed my bag, and walked through the gate. as i did, i imagined myself back home. in the emergency room. leaning up against the nurse’s desk to scribble down an order. the bright fluorescent light. the hum of electricity. an overhead announcement. a patient’s call bell ringing. the intern behind me waiting to review a case. a porter saying, excuse me, pushing a patient past. just one live moment.

i understand why they call it shock. that’s what it felt like. two left brains. or two right ones. a mirror image on top of a mirror image, turned upside down. it just didn’t match. if i changed places right now, in an instant, i wouldn’t know where to begin. wouldn’t know whether to sit down or stand up, where i finished and where everyone else started.

i leave the field in about a month or so. i thought i could never get this place to fit me right. i understand now that was never an option. all along, without me even knowing it, i was somehow being fitted.

after ten hours on a chattering road, i arrived into abyei as planned, two days ago. the first thing i did after setting my bags down was to fell headfirst into a fever. i spent my first morning back shivering in bed from my hot welcome.

so, especially to my family, sorry for the delay in news. i thought about writing… well, that is not really true. i thought about thinking about writing, but decided that thinking was entirely out of the question. i was flat, inside and out. 2D. a paper man. i just wanted to close my eyes and hang out in the black thoughtlessness behind them.

today, i am better. at first i was worried i had disco fever, which in abyei, because of its lack of discos, is incurable. i considered lotto fever, spring fever, saturday night fever, johnny fever… pretty much all the fevers, but couldn’t confirm any of them. we simply don’t have the necessary tests, ones that would be readily available in canada. there, let’s say someone has, i don’t know, johnny fever. we just get the johnny fever guy on call, he rolls with that episode of WKRP where mr. carlson decides to rain down frozen turkeys on the thanksgiving parade, and the patient is cured. in abyei, it is much more difficult. the best we could do, if we even made the diagnosis of johnny fever, is to try to explain the episode from memory. it is poor treatment, and very rarely works.

on a hunch, and because of significant previous personal experience, i started taking antibiotics for food borne illness, and today i feel better. i guess i’ll never truly know which of the fevers it was. i’m just grateful it wasn’t disco because there would have been very little chance of staying alive. one spends his last hours in the frustrated contortions of a dance that time, embarassed, has forgotten.

the long ride from kadugli was exhausting, though the chance to see a landscape i had only flown over, was welcome. during the ten hours of driving over rocky red roads, we passed only a handful of towns. it is in one of them, the one where i ate lunch in a mud market, that i likely picked up one of the fevers. another one we passed was home to a hundred people or so. they shared their village with birds, large ones, three feet tall at the shoulder. they landed, evolutionarily, between a crane and a pelican and walked stooped, their heads hanging between their bony shoulders. most of them lingered in the groundwater near the side of the road, trying to siphon frogs. a few of them, however, padded back and forth between houses like hunched old men, as if they were returning to the market to pick up something they missed the first time.

the rest of the journey, except for these few small blinks of people, was through acres of uninterrupted wilderness. the landscape reminded me of that in northern alberta, in the jackpine and the tamaracks. some of my favorite. wide spaces between narrow trees sitting on sand or marsh. occasionally we would pass someone walking with a hoe dangling over his back. from where? to where? we had passed no homes. he was walking for miles, forever.

i thought, was this what the fighting was about? these spaces where noone wants to live, and those that do, have to struggle and struggle just to get a stalk of corn to poke out of the ground? the blaze of the bombs at night, a second before the sound. the bullets splintering the tamarack trees, whining away, frustrated at not finding a human. people running ahead, just ahead of the fighting to where, anywhere, just not here. these marshes? that’s what it was about? here?

sure. part of it. and because of resources. history. politics. because we are war-like. all of these, and for other reasons i will never know. but also over those empty stretches. while there are things in the world worth fighting for, it’s tough to convince myself that there are many worth warring over.

so i was thinking these thoughts as i pulled into abyei, my torn temporary home, still struggling from all of the struggling, and they gave me a fever. them, and that piece of goat from the market.

i am back in khartoum. how? i just finished
waiting for the plane in agok, then the storm, then the middle of the
night flight, then kenya, then back, and it seems like a minute, and
soon i will be back tucking the mosquito net under my flat foam
mattress, handset crackling beside me. time. it can’t be trusted.

my first impression of kenya, when i arrived, was how rich the
people were, at least in the rural areas i passed through. if one
disembarked here directly from toronto, his first thought would be the
opposite: how abjectly poor. a long stopover in abyei changes one’s
eyes. a verdant green compared to abyei’s graying brown. the markets
had fruit in them. people had shirts and nearly all of them had shoes.
crowds of children in brightly coloured uniforms swarmed schoolyards.
infants looked fat, miles away from the fence that so many in abyei are
sitting on, swaying on. i saw mothers holding their child’s hands as
they crossed the road; in abyei, children move alone, their parents far
too occupied with finding food or shelter to provide such attention. i
passed businesses. one made pallets, another sold wrecked cars. in
abyei, for most of the people, there is nothing. they live hand to
mouth in a hard landscape that bears little fruit, they struggle from
season to season, from war to peace. and, when they are sick, they go
to the hospital.

that is where i will be soon.

i spent six days doing very little, mostly thinking about things
other than sudan. i read, rested. one of the books i read was one by
ryszard kapucinski; one of poland’s greatest writers and one of the
world’s best african correspondents. in part of it, he describes
arriving to a town in ethiopia that is suffering from a severe drought.
people lie on the side of the road, their eyes half open, starving.
with that simple sentence, he made the last four months of abyei rush
back. it was the half open eyes of the starving. half open. half
closed. mostly closed. closed.

i sat there, holding the book, and realized that no matter how much
i try, i will never go back to being the person i exactly was before i
left. i can try not to think about it most of the time, and most of the
time, i will succeed. the memories will fade from video to short sepia
snapshots, but from nowhere, a simple sentence will throw all the
hardness forward and with it, that helpless, sleepless, lonely drowning

ache.

i started having dreams again this past week. some of them were
about abyei, and those that were are too difficult to transcribe; full
of war and sickness. but others too. one was entirely about muesli. row
upon row of it. it gave me hope. both for muesli, and for dreams.

i will send word from abyei. i think the airstrip in agok is washed
out, and i will have to be picked up in kadugli, a day away from abyei.
i am looking forward to the drive, to the movement.

i am on my way back to sudan today after the six short days afforded for six months of work. the hardest part about returning is not imagining myself tossing and turning in my tukul, it is resisting the urge to keep on traveling, stifling the desire for movement, refraining from tapping the driver of the crowded mini-bus on the shoulder and asking, “do you speak English? how far can you take me?”

i know exactly how far i will go, exactly where i will be taken. there is none of that freeing feeling, and after a tiny taste, i miss it.

i have been in contact with the field, and things are well. the team is shifting again. a treadmill, msf. my friend, the oldest person in the mission, reto, is leaving. he may be gone by the time i get back. if so, then i am, i guess i should say we (you and i) are the oldest people in the mission. we will have the clearest understanding of what we’ve been through to arrive at the present moment. the people, the seasons, the crises. we’ll know it best. i was told, way back in the beginning, that it would be like this.

so, soon back to work. i am curious what changes will have happened. while i was away, we had a visit from our coordination in Geneva. we had so many questions about the project, its necessary direction, its natural longevity. i suspect i will arrive to some answers, and with them, a more defined sense of purpose. to this point, the unanswered questions were a mire.

i was also glad to learn that a friend of mine has fully recovered from malaria. two nights before i left, he said “i feel warm”. he was. he looked fine. i did a paracheck for malaria, listened to his lungs even though he had no cough. everything was normal, negative. i gave him some ibuprofen, and told him i would see him in the morning. when i did, he did not look fine.

i got malaria a few years ago, when i traveled through malawi. though well supplied with antimalarials, i had stopped taking them. i was staying on lake malawi, at a guesthouse. i remember going to bed with a low grade fever and an ache in my neck. i was neither particularly sick, nor particularly worried. i woke up in the middle of the night feeling incredibly cold. not cold, like a chill that a blanket would solve, but a teeth rattling cold that shook me through. it was like my bones were made of ice, and no matter how many clothes i put on, no matter if i doubled or trebled my thin blanket, i was sucking in all of the heat in the room and turning it out an arctic wind.

i had typhoid once, but this was different. when i was sick with typhoid, i had a fever for days. i felt like a radiator. i could put my hand next to my own skin and feel how hot i was. i glowed. i became a walking desert, delirious with a heat that burned even in my dreams. i felt like i would sizzle through an iceberg. now i was inside one.

this time, i couldn’t tell if i had a fever and didn’t care. i just wanted to be covered in the hottest, heaviest thing in the world to stop the shaking. kapucinski once describes getting malaria in a village in africa where they had no blankets to cover him. they put a wooden chest on him and patiently sat on it until the worst tremors had passed.

i lied there, sweating, chattering, freezing, with three pairs of pants on, not knowing what time it was, and waited for morning. once it was light, i decided i needed to go to the nearest hospital. i staggered into town, and climbed onto the back of a truck headed for mzuzu with twenty other people. people stood aside and gave me the space behind the cab where the wind was the least. it took an hour for me to get to mzuzu and i got off at the first stop. i saw a stand of cars and walked to the closest one. without speaking to the driver, i opened the door and lied down in the back seat. he climbed into the front and turned around to ask me where i wanted to go, and on seeing me, realized he did not need to ask. i remember the look of fright on his face, his wide eyes. apparently, i did not look fine.

he took me to the hospital, opened the door for me and helped me to my feet. he drove away without asking for money, relieved i was now someone elses’s problem. i walked into the hospital, past the front desk, and down a hallway. i found a stretcher wedged in a corner, lied down on it, and covered myself from head to toe in blankets. i got up once to push it in front of a sunny window, desperate for more heat. the rest i don’t remember. at some point (an hour later… more?), someone found me curled up and shivering. they called for the doctor. someone gave me some paracetamol, someone else took some blood. the doctor arrived as the paracetamol started to work, and the rigours settled down. he gave me a bag of quinine. he asked me if i wanted to stay in the hospital. i told him i did not. he told me that he has had malaria fifteen times and that it gets easier. he watched me take the first pills, making sure i did not vomit, then said goodbye. i found a taxi, took it all the way to my guesthouse. i lied there, limp, for two days.

one learns in school, and in books, about a plasmodium viremia – the parasite that causes malaria. he learns that the anopheles mosquito transmits it while she is having a blood meal, that a few tiny parasites from her previous infected victim fall into the new host’s bloodstream. once there, they multiply a millionfold in the energy rich human body. he learns that different plasmodia create different malarias, their patterns of fever are different and unique, so much in fact that one call tell the species by the spikes and troughs of your patient’s temperature. you learn that of all of them, the very worst, is plasmodium falciparum, the kind found in abyei and much of africa, that each year it kills a million people.

you can learn all of that from books. there is something that you can only know by experience. for instance, when someone writes “the plasmodium parasite multiplies itself several million times”, what they don’t know is that with each multiplication, the plasmodium produce a tiny shard of ice and in an instant, you are full of them. they dangle in your bloodstream, turning over and over like little icebergs, until your blood becomes so viscous it stops. you shake yourself to keep it going.

my friend in abyei is fine. he was fine by the next day, like i was. in toronto, if one sees a traveler with malaria, it is an event. medical students flock, case reports written. my one experience was important and rare enough for me to record with incredulity. but for so many people (most?), it is a regular part of their life. this rainy season, hundreds of people around abyei, and millions around the world, will turn cold, then start to shake. if they are lucky and have some access to health care, and they can afford it, they will get a bag of quinine. if the drugs are real, and they are given a proper course, they will be cured. if they are unlucky, they will suffer with it for days, missing work, the opportunity to care for their children or tend their fields. in addition to the human, individual toll, the absence of effective prevention and available, affordable treatment, is a missing rung on the ladder that most nations must climb to pull themselves from poverty. until then, i suppose, most have only the poor comfort that next time, it might be easier.

if one is lucky, he might witness the extraordinary, maybe even the magical. if he sees it just once, he will spend the rest of his life looking for it. and the rest of his life finding it.

today, the sky above was blue. over the meniscus of an ocean turned silty gray by swollen rivers, the rainy season hunched on the horizon, waiting to return. for now, the sun was high and hot, and it burned through bands of thin white clouds. I lied there watching them, trying to determine whether the wind would hold the darker ones at sea, or shuffle them in. I couldn’t determine which direction the wind was moving them. north… no, south. wait. north. the narrow strands of cloud were being blown back, and forth, and back, and forth, stuttering, a glitch, a loop in time. they stayed there, tossed around from side to side, for a minute or more. dizzying. most days have been filled with rain, covered with a gray blanket. today was different, full of light from the start. there are very few tourists in kenya at this time of year, and as such, few opportunities for recreation or conversation. cloudwatching is as good as it gets.

as i was driving to meet my plane last week, i watched the landscape smooth by. between the scrubs of trees were mazes of paths. roads do not matter to the people here. noone has cars. they do not stretch ahead in the distance, not navigable from beginning to end; they are short interruptions in a narrow footpath. when you flew above sudan, the thick strips of gravel were outnumbered by thousands of trails that angled in all directions.

like much of africa, at least the parts of africa that are not yet europe or america, the life around abyei is not linear. it is curved. it moves in ellipses and arcs. the huts are round. the cattle paths meander back and forth. there are no straight sidewalks flanked with edges when one approaches a home, only a gently angled padded approach. in canada we can trace our lives with a ruler. our doors, our stairs, our house, our property, the shortest path to work, to the movie theatre. whenever i arrive home after months away like this, my first thoughts are always, “wow. everything is so square.”

as i have mentioned before, many of the paths in the part of sudan where i work are made by the dinka. they are one of the largest tribes in they south, and make up a majority of the patients that i see in the hospital. easily recognizable, tall and thin with high cheekbones and almond eyes, they are nilotic cousins of the more famous masai from kenya, among the most famous of the dinkas is manute bol who, at seven foot seven, was the tallest player in NBA history. anthropologists wonder at how they preserve their unique height. someone once told me that the dinkas in southern sudan changed weight/height charts for the entire world.

historically, the dinka were pastoralists. they spent their time herding cattle from one grazing area to the other, looking at the clouds and following the seasons. if the unit of human understanding is the story, the story at least in this part of the world includes the cow. they are of the highest worth. they are used to pay a woman’s family for permission to marry. their number is a measure of social status, of power and wealth. they are tended and loved. often, a man will favour a particular cow, befriend it, write poetry to it. on the full moon, some tribes tie colorful bands to the bulls horns, and sing and dance until morning. their songs are about their cattle, so too their dance.

in abyei, there is one large bull that is free to roam about town. his horns are incredibly large, difficult to believe. they are as disproportionate to his frame, mantis antennaes, and very heavy. unable to find equilibrium, his head bobs from side to side.

only after their natural death are cattle eaten, their hide used. while they are alive, only their milk is taken. at adolescence, a dinka boy is relieved of his childhood duties, of which milking the cows is an important one. with an initiation rite, he is welcomed into the world of men, of warriors and with this arrival, the permission to accumulate cattle of his own, and to take a wife.

many of the men who i work with bear the marks of this initiation. on their forehead are deep scars, tracing the brows and meeting in the middle. they are intended to resemble horns. at thirteen or so, after an adrenalin filled night of dancing and singing and homage to ancestors, an elder takes a sharp knife and cuts deep into the forehead of the initiate. he neither cries nor flinches; a jitter in a smooth scar would be a permanent sign of his cowardice. the blood is then wiped away, and his forehead bound. the cuts are deep. i have read that sometimes when a skull is discovered one can tell the tribe it belonged to because of the marks left in the bone.

the man now goes about his business of looking for a wife, perhaps the first of many. someone told me that abyei’s chief prior to this current one, had dozens. he was very wealthy man, with many cows.

i have not found out why some of the people i see have different patterns of scars. intricate serious of lines, dots, circles stretching from their face, down their arms, over their chests. they are remarkable, beautiful and fierce. occasionally, i will see women with such intricate scars, but haven’t been able to glean their significance. i will do more research.

there are other unique, distinguishing features particular to some of my patients, as well as some of my colleagues. some, for instance, have their four front teeth removed. i have seen it both done on the top, and the bottom. others have their teeth pulled to right angles from their jaw. completely perpendicular to their face, they jut beneath their lip. it is thought that it makes women, in particular, look beautiful and fierce.

i remember asking my translator in cambodia why he kept the nail on his fifth finger so long. he shrugged. “i think it looks good”, he said.

an msf colleague, after years in southern sudan, was allowed to witness an initiation ritual, a terrific honour. she described the rending of the teeth, the dancing and ululating that followed. afterwards, they passed around a gourd that contained fresh milk and warm blood. she politely refused.

it is an unfortunate thing that i will not be in abyei long enough, and am unable to mix with its population well enough, to get more than glimpses into the complex patterns of human history and beliefs that surround me. already, one can see that ties to the past are loosening. in abyei, 50 cent shirts are more common than traditional garb. one of the people i worked with asked how much it would cost to have his teeth reinserted. such traditions are relics, part of the past, an old sudan that has no place in a global future. in a proposed version of a new constitution, i read a statue forbidding ritualistic scarification.

as i often do, i wonder what we lose as we drop another piece of human pageantry, another extraordinary piece of our history. perhaps nothing. and it makes good sense to me as a canadian, good rational sense, to not give a fourteen year old boy scars on his face he might be ashamed of fifteen years later. however, i suspect the system that encourages uniformity, that engenders such shame, that puts as arbiter a sensibility that sees differences as deviances, is more to blame than his parents. north americans do not need to look far to see how easy forced integration, borders, and culture is for a native, nomadic population.

however for now, and for the foreseeable future, no matter how many eminem and WWE shirts parade abyei, cows still rule. the dinka are slowly recovering from the turmoil of africa’s largest war, and they are moving with their growing herds to find green grass and to celebrate marriages. change may be inevitable, but here at least, it will be slow.

one last thing in an already too long post (i blame a gray, long day): for those who want to know more about southern sudan, dave eggers has written a novel called “what is the what”. it is well worth reading, but be careful. it spares no detail.

[ More Info : James refers to the book "What is the What : the autobiography of Valentino Achak Deng" - a fictionalised memoir of a young man fighting for survival as a refugee, during Sudan's civil war in the 80s and 90s prior to the current Darfur region conflict.  Click here for a review at the NewYorkTimes and reader/buyer comments from Amazon.com ]

accomplished.

it didn’t take very long. one day. in an attempt to liven things up, I have unsuccessfully tried to find trouble in paradise. there is no conflict, no disease, no problems to solve, no situations to talk yourself out of. I have looked for seediness, for shady characters, and have found none. I have even begged the hotel staff to hunt me for sport. they have politely refused. I figure if I continue to insist, they will do it for pleasure.

and, for the first time in months, my every thought is not of abyei. distance affords me perspective. the difference between circling a storm, and being at its centre. I am able to gather glimpses of a larger world.

again, I am astounded at the ephemerality of time, and how we experience it. each day in abyei is a complete event. nothing is certain. it stretches for a month. I left home years ago. each minute is so bursting with seconds, that the sixtieth is wedged somewhere in the middle. in sudan, my traditional account of time has lost meaning. here, in kenya, in paradise, the day happens before I even notice it. by the time I have breakfast, and walked in the rain, it is afternoon.

i was thinking about my thoughts as I walked into the kitchen in abyei, about how many we have as we carry out the most straightforward tasks. pouring a glass of water, for instance. for an observer, it takes us ten seconds, but inside, it is an infinity. but of course it must be. our concept of the universe, its largeness, it’s distant stars and the black, cold vacuum between, our outer space, is exactly proportionate to the largeness of our inner space. I remember running in the toronto winter and stopping at the tracks in the swirling snow as a train whipped by. I saw the faces of people deep in their own imagination, and thought, “now that is infinite.” a godel’s set.

distance provides perspective. I can see myself two weeks ago, exhausted, how my writing was becoming as thin as I was. I forced it the same way I forced myself through the day. I can also see the project better. I can see the work that I am doing as part of a larger thing.

msf projects trend towards improvement. everyone is committed to pushing in one direction. in abyei, in Khartoum, in Geneva. in fact, from a distance, the progression is remarkable. the project I leave will be better, and stronger, than the one I found. not from my efforts, but the constant inertia of everyone working in concert.

I am glad for whoever replaces me that he or she will have a clearer idea of what we are there to do, and how to accomplish it. they will better see the goals, and how to achieve them, just as I did because of the work of the person that I followed. they will not make the mistakes that I did. they will not take call as often. they will spend more time out of the project. they will work more closely with the community, and understand them and enjoy them more. their sleep will be easier, the food will be better, the communications more consistent, the team larger, the support from Khartoum greater. all of these things are already being made real by the dozens of people piling effort on top of effort consistently on one side of the scale, tipping the balance of the project, and even abyei, towards an easier future.

it is one of the ways that I make sense of the world, to believe that it hangs in a grand balance. but no matter the distance, no matter how much I travel, no matter how much I read, no matter how carefully I look, can I determine which way it tips. good, or bad. success, or failure. hope or despair. I can’t say, and it doesn’t matter. all one can do, if he cares about it tilting one way or the other, is to pile as many efforts as possible, no matter how small, on the side he hopes for most.

I am envious of the person who will follow me. they will accomplish important things that I was never even able to see, and perhaps their tiny successes will push the balance even further. and, I suspect that when they are allowed the appropriate perspective, they will agree that this experience has been one of their most valuable, one they would not change with all the hindsight in the world.

it is raining. I see the gardener peeking through a shrub. oh, there is the concierge, trying to sneak up behind me. it appears my entreaties have worked. the game is on. finally.

after six flights, I am on kenya’s coast. I feel like a poor traveler. after years of throwing my backpack on the top of local buses and bumping from country to country, i have forsaken discovery in favour of renewing pleasures that abyei does not afford. yesterday, immediately after my sleepless arrival, I ate fresh ocean fish in a sour coconut sauce, drank a glass of white wine, and fell asleep on a wide, white bed with a surplus of pillows and an air conditioner whirring above me. 24 hours later, I have left my room only to swim.

for me, traveling is best done on the ground, bus to bus, and planned only when necessary. with the five days out of khartoum that we are given after three months of volunteering, there is little room for mistakes, and only enough time to catch up on one’s sleep. we are allowed to go to five countries for our rest: tanzania, kenya, uganda, egypt, or jordan. we are not allowed to go home, because the familiar gravity of one’s own bed might be too strong to break. my home is abyei, and after a short respite, that is where I will return.

traveling is also best done on the ground because it avoids it in the air. flying is for the birds. for me, putting a hundred humans in a metal cigar and propelling it into the atmosphere using combustion is not a miracle of modern aviation, it is foolish. like we are not only tempting Fate, but we knocked her out with a sucker punch and are holding smelling salts under her nose.

my discomfort with lifting off the ground with a thousand kilograms of gasoline and navigating incredible distances at incredible speeds while avoiding incredible numbers of other missiles with similar trajectories does not improve with the number of times I fly. I fly all of the time. the only thing that has improved is how quickly I accept my inevitable end with every unanticipated click of the aircraft.

(click)

“well, I guess that’s it. I’ve lead a good life. seen amazing, beautiful things. I knew it was just a matter of time. should have taken the bus.”

the flights in northern sudan have done little to quell my belief that I am flying on borrowed time. the other day, as we waited in agok (WFP?), the afternoon clouds started to gather. as is typical of the season, light wisps of cumulus cloud are blown out of the way by their thicker, thunderous cousins who hunch on their flat base, just at the dew point, and grow, and grow, and blow, and rain.

in an hour, in Agok, the sky was shifting from blue to dappled gray as the plane dropped out of it. we had a two hour flight to kadugli, the nearest tarmac landing strip, where we would refuel. we climbed through the gathering wind, our tail waggling from side to side, and flew north. wind whistled through the door behind me. we ascended to several thousand feet, and as we reached the base of the clouds, we bumped against it. bump. bump. as we were being thrown up and down, one of the passengers turned to me and said, “I’m going to get some shut eye”, and I was like, “what? in this tin coffin? fine. you sleep, I’ll use my mental energy to keep the plane aloft.” so we flew to kadugli, our heads brushing the clouds, one of us fast asleep, one of us fast awake. below us, the scorched earth raced by.

after circling kadugli for what seemed like an inordinately long time (”is this normal? they would tell me if there was a problem. I’m pretty sure they would.”), we bumped shakily down. “crosswind.”, the pilot explained as he opened our door. we stepped out onto the tarmac. “umm…”, he said, “refueling takes about 15 minutes, but we’ve gotta watch that, see what it’s gonna do.” he pointed his thumb over his shoulder. lightning sparked in a black horizon. “which way is El Obeid?”, I asked. he gestured over his shoulder again.”

the tiny airport was full of UN soldiers and staff waiting for a plane that, when it arrived, made our plane look like a toy. their’s was big and muscular. ours was made of balsa wood. I joined our pilot outside. we sat, smoking, as the wind gathered, and watched the storm. “what happens if we fly into that?”, I asked, over the shhh of blowing sand. the pilot made a breaking motion with his two hands.

it came towards us, but never hit the airport. we could see it dash the hills only a kilometer away, feel the weight of it on our skin, but it never crossed the runway. after several minutes, the UN plane loaded its passengers, and smoothly lifted off from the runway with a certainty that must have been contagious.

“I think it is blowing itself out,” the pilot said. “let’s give it a shot.”

a shot. perfect. the college try. and if it hasn’t blown itself out, we’ll just….

the storm looked over its its shoulder at us as we lifted off in the wind. we were all bolt awake. we flew, certain, straight towards el obeid. the storm had shifted, but had not gone. by no means. as we lifted past the hills, it stood in front of us, an angry purple bruise. mounds of clouds. flicker. flicker.

a day or two before, I had sat on the veranda in the compound and watched storm clouds roll in on top of each other. I imagined being up there, not in a plane, but just hanging in the mist, feeling the crackle of electicity in the air, looking for sparks amidst the twisting grey fog. perhaps nature had interpreted it as a wish, and was making it come true.

instead of flying into its blackness, we circled back towards kadugli. I could see the jagged silhouette of the nuba mountains as we flew west, away from el obeid, away from the storm and wondered about where I would sleep.

we did not land. we flew past the airport with one eye on the storm, and started to circle its margins. we were never more than a thousand metres away from the rain. when the storm moved closer, we veered away, our balsa plane bobbing in the wind. from my window, behind the cloud of dust the storm had stirred, I watched trails of rain draining onto the sand. (hey, pilot… lightning…. come on, look… to your right… it’s getting closer… what are you doing?… lightning…. does he see it?… no… look…. it’s just there….. he’s not looking…. what?… what are you turning around for? … aren’t there important instruments to be constantly monitored? … …let’s fly closer to the ground…. skim the trees…. actually, let’s just set this bad boy down, and have a good think about this whole endeavour…. all in favour?)

we followed the sun, over the mountains, just outrunning the storm, moving west… west …north a bit… north… west… north… north… northeast… northeast… around it, into a bright pocket of sun. we sailed through white, harmless clouds, and unclenched our hands from our arm rests and smiled at one another. we would be in Khartoum by sundown.

i wonder not why I feel this way about airplanes, only why everyone else doesn’t. there is only one way to fly.

i am writing this in the newly renovated
khartoum international airport. it resembles very much the older, less
renovated version. it is nearly 3 in the morning, and many other
passengers are curling up in their chairs, trying to find space to
sleep. i scan the scene occasionally, looking for a familiar face from
check in, watching how others respond to the arabic announcements. so
far, no movement.

the last two days, however, have been full of it. i left for
khartoum yesterday in a darkening sky, hopped from airport to airport,
and after several hours, landed here. from the frying pan into another,
even hotter, frying pan. on the ride to the guesthouse, i rolled and
unrolled the window several times, trying to decide which was cooler,
the stifling temperature inside the car, or the hot wind. when i closed
my eyes, i could feel with the inside of my eyelids how hot they were.

“does it ever rain here?” i asked my driver. he shook his finger back and forth.

yesterday, i was in agok, waiting for the plane. every so often, a mechanical drone. WFP [World Food Programme]? nothing. mafi. a call came over the radio.

“mobile 11 for alpha bravo… mobile 11 for alpha bravo….”

i answered, “alpha bravo, this is mobile 11, go ahead.”

“mobile 11, we need the car back in abyei for an urgent medical
transfer. can you see if you can get a ride back with someone else?
over.”

“well copied. stand by.”

i walked along the landing strip to an idling WFP car. i knocked on the glass, and it rolled down. i explained the situation.

“oh. it must be from the shooting… …yeah, didn’t you hear? …at
11:30… just now, in the market… …no, no real details… my staff
is standing by at UNMIS [United Nations Mission in Sudan] for possible evacuation.”

when i left, things were calm. i shook hands with my field
coordinator, newly recovered from malaria, and drove out of abyei at
11:25. i rolled down the window, and watched the countryside slide by.
abyei, as it can, changed completely in five minutes.

i was torn. do i go back and help? do they need it? they would have
asked me, right? what if we were evacuating too? is it wise to move
when the situation is unknown, possibly evolving? likely not. and we
could not discuss things over the radio. i sent the driver. i stood by
the air strip, carless and radioless, wondering if my team was ok.

one of my fellow passengers had a satellite phone. it was her staff
that was standing by for evacuation. every two minutes her phone would
ring, and she would update me. news started to trickle in.
ringring.  four bodies.  policeman.  ringring.  the
shootings were non-military.  an arrest gone wrong.
ring.  there was to be no evacuation.  the souk was chaos,
but was settling. so were we.  there were no more rings.  we
sat together, under a grass roof, and listene for the plane.  it
came.

“masaly? get on the plane.”

a day later, and things are calm in abyei, as they are in this
airport lounge. 3:30 am, and this flight is nowhere to be seen. not yet.

ahh, people are standing. movement.

abyei. tiny, rickety place, tilting toward an uncertain future.
yesterday, i watched it fall away and soon, perhaps it will fall
away further, leave me some space of my own.  at least my backpack
is where it feels best, snug on my back, and i am leaving for kenya. i
will send word from there. good night.