Security Briefing

We just had a briefing on the security situation in the country, and I’ve also been listening to what some of my colleagues have to report about what they are seeing in the hospital.

It sounds like Juba (the capital, where the violence recently flared) is in a pretty scary state, even though the active shooting stopped several days ago. MSF has actually started a surgical program there to deal with all the gunshot wounds. Meanwhile, cholera has also appeared – if that gets out of control, it will be a huge problem. And, finally, rape. Apparently, there is not enough food in the UN compounds and other protected enclaves people have fled to. When women leave the compounds to look for food, though, they are being attacked. So barbaric. Did everyone see Zadie Smith’s New Yorker story a couple of weeks ago? It illustrates alarmingly (eerily) well my worst fears here.

There are other problems, too, that one might not immediately think of. For example, the synergy these three things: 1) Many of the aid organizations on which, for better or worse, the country depends have pulled out since the violence flared; 2) The insecurity means that cross-border traffic (and road traffic in general) has come to a halt; and 3) There was a lot of random criminality during the unrest, including the looting and destruction of markets and UN warehouses. The result of all this being that there are shortages of many necessary items, including food, and that inflated prices are being charged for whatever is available. So you don’t necessarily need to be ill or injured to be desperate. (The inflation – which was a problem before the unrest, as well – affects even relatively peaceful places like Aweil. Today, one of the drivers was talking about the impossible prices for sorghum and sugar, and it seems like the South Sudanese pound has lost something like a quarter to a half of its value in the past week.)

The head MSF office (located in Juba) has responded to these and other problems by trying to expand healthcare activities in the most affected areas, using whomever they can pull from existing programs. My colleague, the local nurse-anesthetist, was sent to the new surgical program in Juba three days ago. My workload is completely manageable, however; the bigger problem is in the wards, where they are apparently starting to get malaria admissions at a rate similar to the worst period last year. In a perfect world, we would open more wards – but I don’t know if the present staff can take it. It’s almost 7:00 here, a time when, usually, everyone is getting dinner. However, after the briefing, a large number of folks went back to the hospital to finish their backlog of work.

And then there is the little matter of getting out of here! Truly, it is rather far down on the list of problems, in this particular time and place. But, as a first-missioner, I suppose I can legitimately claim ignorance as a partial excuse for having put myself in a position to be concerned about it. In brief: I would not say that anyone really, truly made it clear to me how fragile the transportation network can get when there is unrest. For several days last week, neither commercial nor humanitarian airlines were flying – if I’d been scheduled to leave then, I would just have been out of luck. And even now, they are trying to keep the number of people coming through Juba to a minimum, to make security easier. Which means that the lovely “logistics” guy – essentially, the guy who keeps the physical plant of the hospital running – who has been here for 9 months and just wants to go HOME, was informed yesterday, the morning of his planned departure, that, no, he would have to wait a little longer. In the briefing, they said he might get out on Thursday, which wouldn’t be SO bad. But, then again, he might not.

I’ve got a whole life planned for when I get back, including a nice visit with my sister (hi, April!) and, it seems, a nice new money job. I really, really, REALLY don’t want to be stuck here for an additional week, or two, or six. It’s not up there with getting raped, getting shot, or getting cholera, but, in my little life, it would really suck. So I will make sure and do a little plotting and investigating over the next few days to see if I can at least minimize the possibility.

On a brighter note, we are very near a huge swamp, so there are lots of cool birds here (see the two herons in the top of the tree?). In the evening, along with the herons, flocks of long-necked black ibises sometimes fly by, and you see trees full of white ibises, too. And of course the LOUD tuxedoed crows that are everywhere. And the huge (wingspans of several feet?) fruit bats. They come out at dusk, and look more like birds when they fly than I would have thought possible (no feathers!). The best way to tell them apart? Birds: Back ends have tails. Bats: Back ends have little rodent feet!

Have good days, wherever you are.