First Trip to the POC

Wednesday, 8/10: We head out early – 7:00 – on my first trip to the POC (the Protection of Civilians camp – basically, a refugee camp inside the UN compound in Juba). We have a full roster of surgeries to complete before 3:00, including a skin graft and an “exploration” of a post-surgical abdominal wound that is looking pussy and bad.

As I have been told, and will soon come to agree, the worst part of the day is the trip to and from the POC. Thirty minutes plus, out towards a sort of volcanic hill on the outskirts of town, some of it on paved roads, and some of it on the most god-awful, pitted, rutted, washed out dirt roads imaginable. One of the things you pick up rather quickly in Juba is that no one is 100% certain of the security of anyone there, including expats and aid workers. Members of one of the MSF groups in town were pulled from their vehicles and beaten in mid-July, and NPR just ran this horrific story: http://www.npr.org/2016/08/15/490112607/western-aid-workers-among-those-attacked-by-soldiers-in-south-sudan). So I find myself wondering – if some threatening situation arises, what, exactly, are we expected to do? I mean, you can’t go more than about 5 miles an hour on some of these roads! Kind of does away with any extra measure of security you tend to feel that being in a vehicle gives you….

Our way leads, first, through town, on routes lined with apparently bustling businesses, mostly in low-slung stuccoed buildings. We pass the University, which I gather is still operational, and presents a bit of an oasis behind its rock fence (Tennis courts! Playing fields!). We then have two possible routes: one that goes through a central market but, on the other hand, also goes by the grandiose, unfinished concrete gate fronting the main SPLA (army) barracks – not necessarily a place you want to be if tempers flare. And the other that may be the worst thing calling itself a road I have ever driven on. Either way, we head out past the little statue of the man with a bow and arrow and into less developed parts of town. It took me several days to notice it, but at some recent date this appears to have been a new, rich suburb. Although the land all around is scrubby and overgrown, there are a number of very large, expensive looking “villas” along the way, and even something that looks not far from a Southern California subdivision – although whether these are inhabited or not is hard to say. A favorite spot along the route: The bent and rusted sign of the Juba County Recreation Center. In front of what appears to be a derelict fuel station. We remind ourselves daily to make sure and get a membership.

At last, signs of the UN base come into view – razor-wire-topped fences; beefy white people out for a run. We are greeted by a large contingent from a private security force, who check everyone’s ID, log in the vehicle, do an undercarriage examination for bombs, etc. – a more serious check-in than one often gets at these “security posts.” Then it’s through the extremely heavy, presumably truck-proof gate, into a garden land of tidy apartment blocks and lawns and bungalows with screened porches, the residences of the various UN personnel. (Well, except for the very large contingent of Chinese troops. They appear to live in a village of shipping containers. With air conditioning, at least!)

We’re not staying here, however. A 100-meter drive brings us to yet another gate, this one flimsy, made of two-by-fours and chicken wire. Beyond it is the POC, an expanse of white-plastic-tarpaulin huts squeezed together between narrow dirt lanes. As I understand it, its administration is more or less independent of the UN. Troops do come in to take up defensive positions in the many foxholes and bunkers whenever unrest is in the air (the POC is pushed up against a long section of the perimeter fence, and thus fairly vulnerable to people outside). But decisions about the daily functioning of the camp appear to be made by a separate governing structure, as we will later find out.

The history of the POC, as I understand it, is this: In mid-December 2013, fighting broke out among troops in Juba that, from the beginning, had an ethnic (Dinka vs. Nuer) cast. Almost immediately, the fighting spread from the barracks to the streets, with (as Juba is a majority-Dinka area) Dinka groups going around actively looking for Nuer, soldiers or civilians, to kill. The accounts are harrowing, with people hiding under beds for hours or days, and the streets littered with corpses.

During this time, anyone who was able to apparently started moving toward the UN base – not because it was set up as a refugee camp, but simply because they thought they might have some measure of protection there. And – although the UN has not always been effective in protecting civilians, in South Sudan as in the former Yugoslavia, etc. – the fleeing people were allowed onto the base where, in short order, a refugee camp of tens of thousands of mostly Nuer people sprang up. It has been there ever since, and was the place to which, during the violence in July, many Nuer again instinctively fled. Thus, it was a good place to find and treat injured Nuer people, who may not have found a welcome at other health facilities (more on this in a later post).

The camp we are headed into is “POC 1.” Not by any means the only refugee camp on a UN base, either here or elsewhere in the country. One of the other camps here – POC 3 – is actually situated next to but outside the base (I got a glimpse of it one time when we took a drive around the compound). This must make it even harder to protect, and, indeed, I gather there were cases of attacks on POCs during the July violence, where both civilians and UN personnel were injured and killed.

We drive past the flimsy chicken-wire gate, and past the some of the ubiquitous trucks that deliver water to the POC, onto the road along the camp’s perimeter. Wherever people are, can commerce be far behind? One long stretch of the road (Dave calls it “Rodeo Drive”) is lined with what I guess are shops – mostly full of (very good-looking) vegetables, but also including some other items. How, exactly, people bring the stuff in, to this fairly fortified camp, is a mystery to me, but there you are. We also see things suggesting that at least some of the (many) children are able to go to school, and certainly see evidence of the sorts of sanitation and hygiene problems that must plague any camp like this. All in all, though, and from this road that runs along the outside (I never have occasion to go any deeper in), it looks ramshackle but solid – not pleasant, but not destitute or chaotic or frightening, either. (Perhaps I have arrived at a good moment – I think there were serious food shortages a month ago, and, certainly, a lot of women were assaulted when they left the compound to look for food at that time.)

We pull around, in a long “U,” to the second in a line of three Quonset huts. One of our crew starts the generator, and Dave and I head to the back, along a corridor running through the wards housing the surgical patients, separated off from each other with the same white plastic tarps. Here, we change into scrubs, abandon our shoes for OR clogs, and I head into the corner of the tent that holds the operating room. My home for the next five days.