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.


Hi: I’m a nurse writing for Healthline.com in the US. A distressed person in Somalia has been corresponding w. us & I am trying to figure out how to get him/her some help. MSF seems the best place to start. Here are some links to my posts. Maybe you could ask a Somali colleague to comment on the posts? Anything would be appreciated. Thanks for all your great work. all of you. jc
http://www.healthline.com/blogs/health_observances/2007/06/world-refugee-day-bleak-picture-for.html
http://www.healthline.com/blogs/healthline_connects/2007/06/global-healthbeat-somalia-country-of.html
The world you speak of has many differences when compared to the world I waltz in. Then again, it’s similarities are strikingly similar. Experation dates: we are tagged with invisible ones. Some from malnutrition, and those in the Western world, from lonliness. As you know disease takes many forms. Behind it lies the spirit, the pit of the nectarine, the essence of the person locked within its shell. A place medicine can not touch, as it takes other elements of humanity to spark it. These elements differ from person to person, but it trickles back to well being. The well being of the person is not enough, it has to be the family, the community, the town, and the nation. Interconnectedness. A concept that has been long forgotten, neglected the way those in the western world neglect the troubles plaguing those you aid. On the streets of Toronto straight faces pass me by, black suits, and a latte in hand. Luxury at the cost of poverty elsewhere, no wonder people can’t crack a smile. Whatever brews in our coffee cup has had an impact. The food on our table imported from China, makes a difference. The hundreds of wars being waged in Africa are associated and possibly fueled by our own government. If not ours, then our neighbours. Here I sit, in Thunder Bay, never having heard of Abyei, but knowing that I’m connected and responsible, in some way, Thomas King once said, the truth about stories is that’s all we are. Once you set a story free it becomes karmic. I can forget all that you have written, pass it on to others, internalize it for safe keeping, or do something about it. That is the beauty about writing. The impact of it is far beyond our comprehension. Keep writing. Your writing is a vessel that carries your readers into the pit of our nectarines. This journey activates us.
great post
Hi, That part of the job must be so difficult. I am interested to hear that the little girl is still in hospital. I wish I could help her. I would like to adopt her but unsure if it is possible. I remember her parents were nomadic, I imagine she has been forgotten by them, what does her future hold? I don’t know if you can answer these questions. I don’t think it is wrong to ask them or to care or be interested. We are all on this earth together and unfortunately most of us have conveniently forgotten about the suffering of the less fortunate. We are too wrapped up in emails, blackberries and other daily grinds. I often wonder what would happen if all that went away in a flash. Please let me know if there is anything I can do to help her in any way.
Georgina
prepared for the best
complete survival
Inshalla