Beginnings

By John Jefferson

I’ve done a lot of traveling since I have been in my mid-20s and most of the time I found that when I got to where I was going, it was a bit of a letdown.   Maybe it was the anticipation or the elevated expectations of what was to come, but often the best memories were of the road to and sometimes from the destination.  In many ways this mission to the people of the Nuba Mountains of Northern Sudan was this way.  Though our goal was critically important, how we got there and the circumstances under which we did became a story in and of itself.

Humble (and improbable) Beginnings

Returning from a church-planting mission to Yei, South Sudan in April of this year, the last thing I expected was to be returning to Sudan on a mission of mercy five months later.  Paradoxically, that’s exactly what happened.  After reading a NY Times opinion piece about a brave woman who took up an abandoned machine gun position and started firing, without hitting anything, before running into the bush to escape marauding Government of Sudan (GoS) soldiers, I was intrigued by the fact that the border war between the two Sudans had escalated into a regional conflict involving the Nuba Mts. (S. Kordofan) and Blue Nile, as well as Darfur.  Not that I didn’t already know at the time that the Doro refugee camp had been bombed recently and there was fighting, but it had escaped me that the conflict had escalated to the point where civilians were being targeted, and starvation and malnutrition threatened a large percentage of the population.  I read Nick Kristoff’s account in shock and horror about the living conditions of the people remaining north of the border in GoS territory and wondered why there was no response from world governments or NGOs.  I’d just been in Southern Sudan, a few hundred miles from the conflict zone, and didn’t even realize the severity of the situation.

I decided to email all my missionary friends and find out what kind of efforts were being made to get food and humanitarian relief to the people, not only in the refugee camps, but those in the Nuba Mts. The responses I got set off a chain of events that led to the formation of what is now called the End Nuba Genocide project, involving representatives from the humanitarian, human rights, academic and faith-based communities, all with a focus on Sudan and the ongoing crisis in the Nuba Mts. (as well as other embattled states under the rule of Omar al-Bashir, President of the Republic of Sudan, and the man responsible for an estimated 3M deaths through war and genocide).  As things unfolded, it became apparent that there was a well-planned, intentional program of direct and indirect murder of a people by their own government, resulting in a severe food shortage situation throughout the region.  This was keenly felt in the Nubas where there were at least 300-400 thousand internally displaced people, and another 400,000 food insecure remaining in their villages or nearby.  Aerial bombardment and raids by GoS-backed militias had prevented the people from planting and the rainy season was approaching.  The only solution was to bring food in ourselves, so we set out to do just that.

The conference calls began in June, and soon the team was putting together the pieces to begin a fund and awareness raising campaign.  Logistics and gaining intelligence of conditions on the ground were nightmares to work through, but as time went on a clearer picture of the situation was developing and target dates for launch of the first food mission were being set.  By mid-August, with the rainy season upon us, the team determined it could wait no longer having raised enough funds for five tons of nutritive foods and made all the necessary contacts to move the cargo at least as far as the closest refugee camp to the border. (Taking it on faith that our Nuban contacts could help us get it beyond that point, or the Lord would make a way where there wasn’t one)  On 9/11 we set out for Africa, uncertain as to exactly how we would get to the affected areas and not in the least in control of the elements of time, distance and weather conditions, all of which were only vaguely known beyond the border.

Back in Nairobi

So the team is out of Yida in Southern Sudan and is enjoying coffee and food at Java House in Nairobi. They will be returning to the states on Monday, three days early. Can not wait to hear the stories and see pics!

A refugee from the Nuba Mountains wanders through… | LightBox

A refugee from the Nuba Mountains wanders through… | LightBox.

I will be searching around for photos and post about Yida. Here is one on Time’s Lightbox blog

Nuba Mountains and Southern Sudan

A couple of months ago my husband came home ranting like a lunatic about what was happening to the people living in the Nuba Mountains. Since the split between the north and the south, there have been documented and many not-officially-documented accounts of bombings in the Upper Nile area and the Nuba Mountains. One of these events occurred back in November of 2011 when a few of my friends were in the area trying to evacuate the people we had been working with for years when they had to take cover from the low-flying Antonov planes which were dropping bombs. The relocation project turned into triage and emergency care.

Most recently the Nubian people have been enduring the same treatment and are cut off from food. Starvation has caused many to flee to refugee camps in Southern Sudan which are now over-crowded. Refugee camps harbor disease, which proliferate quickly on the malnourished, and do not have adequate food supplies to provide enough to all. My husband was incited! He started making phone calls to see if he could find anyone who would help him get aid to the Nubians. A small coalition was formed and an even smaller group was sent. They are currently on the ground in Sudan and as far as I know in the Yida Refugee Camp with the food that was purchased with our fundraising efforts.

The last I heard from him was 12 hours before his flight to that particular area but we figured  communication was going to be nil. The rains have made the area around Yida like a swamp which only exacerbates all the issues already mentioned. I do not have pictures yet to share but I did find some on another site from July 2012. I have included the link. It is such a beautiful area! Please keep this small team in your thoughts and prayers and I will update as I am updated.

http://darkroom.baltimoresun.com/2012/07/yida-refugee-camp-surges-past-64000-in-south-sudan/#1

Darfur: With Red Dust and Sweat

Last Day

We rose early (6 a.m.) and packed up what was left of our gear, and headed to the airport, the dirt strip in which we arrived almost two weeks earlier. We soon found out via satellite phone that our plane would be 2 hours late which turned into 3 hours and then maybe not at all due to some sort of mechanical failure; a part needed to be replaced. Because of the extra time we now had, we stopped at a hotel in Wau to enjoy of all things pasta.  As we sat at the table, a man who looked to be eight feet tall (no exaggeration) entered the dining room and rushed straight to the loo.  He turned out to be the ex-NBA basketball player, Minute Bol, who stands at 7’6” tall.  We introduced ourselves to him and found out he had suffered from nausea as a result of being on the plane.  We talked about our work in Sudan and found out he too was very active in the Southern Sudan, where he was born and stayed until he was “discovered”.  He told us about the violence that erupted in the last few days in the city of Tonj a few hours away in which many people were killed and maimed. It served as a reminder of the past and an unfortunate portent of things to come in this nation of many tribes and tongues that do not always speak the same “language”.

After many hours, sodas and debate about the wisdom of getting into a tin-can-with-wings-that-needed-a-new-part, we finally made our way to the Wau airstrip and boarded our chartered plane on our way back to Kenya covered with red dust and sweat. The interesting thing about flying out of Sudan into Kenya is that the local Kenyan airport Wilson closes at 7:00 p.m. and therefore the plane must arrive before then or reschedule for the next day. With our mechanical delay, our departure had been pushed back to the point of really needing to be postponed until the next day, in addition there were reports of tremendous thunderstorms in Nairobi which would make the trip a bit longer and a bit more dangerous in such a small plane. However, the doctor had scheduled his flight to the States from Kenya on the same day we left Sudan and felt it was imperative to try to stay on schedule. We discussed all the options with the pilots who thought we would be pushing it to leave so late but who decided they would be willing to try.

True to reports, the thunderstorms were massive, and the plane bounced and rocked more than I ever had been as a baby on my mother’s lap. The red dust which had dried during the first two-thirds of the flight, was reactivated by fresh sweat from my efforts to hold the plane in the air and sure enough, we were too late to land at Wilson Airport. Our amazing pilots made some calls and were granted permission to land at Jomo Kenyatta International Airport. After the 5-hour flight, and landing the very small plane in between the large airbuses, I found myself walking through the international terminal laden with bags.  Our ragamuffin group must have been a terrible sight for those waiting for international fights but I did not care. We had made the trip, we had landed safely and I was on my way home held together by red sweat in varying stages of dry and “bushed” from another African adventure.

Darfur: The Road Home

Day Nine

The morning greeted us with heartfelt goodbyes with those whom we had become quickly attached. We were beginning a new journey, the journey home.  As we pulled out of the compound for the last time, and turned away from the river and those that lie beyond, I couldn’t help but notice that we had a new companion, Sadness.  Are we really leaving? Is it really over? Even though we had seen over 900 patients and immunized 1350 children, had we done all we could; had we done more than we should?  Had the small drop of love offered into the world’s barrel of need been enough?  There were two hours of dusty, bumpy road in which to meditate before we would reach Billy White’s compound and our true final night in Sudan.

In the afternoon we visited three families from a branch of the Presbyterian Reformed Church in America that had been ministering in the area for almost a decade and were now running a radio program.  It was amazing to see this “tribe” of white people in the middle of Southern Sudan, living much like the Africans around them except for a few amenities provided by solar power and some modern conveniences such as refrigerator.  Though their ministry was growing slowly, they were impressive in their fortitude and commitment to follow God’s call to the mission field.  It was humbling to know that kind of commitment is only born out of a true desire to seek God’s will, and not Man’s.

I decided not to set up my tent but instead to sleep outside on a cot under the canopy of the African night. The weather had been nice; there had been no mosquitos and I didn’t want to halt the gentle breeze with the barrier of a tent wall. I found myself melancholy pondering the last few days, my life in general and what was to come next…  I woke up several times in the night listening to the crunch of the goats walking by just outside of the compound walls on a search for food, the generators buzzing noise, the sound of a distant baby crying, the occasional time-illiterate rooster crowing, and the general sounds of Africa shifting with slow effort in an attempt to settle into a peaceful sleep.

Darfur: What If?

Day Eight

Today was a day like no other for me. I had studied the human body and its functions for over three years; these pathways had been mapped out on lined white paper for me to learn more often than I care to remember. I understood how the brain was signaled to life, how muscles were triggered to move and what ordered the functioning of glands but today was the first time I had closed my eyes and instead of seeing those memorized pictures of static activity, I could feel the dynamic neuronal circuitry commanding my body.  The electrical impulses surged across axions provoking neurotransmitters to jump out across the synaptic gaps filling chemical receptors on the other side, quickly clearing out and rushing on their way to initiate the “fight or flight” response in strong pulsating fashion. The surging power coursed through my central nervous system then to the periphery; the numb tingling sensation of adrenaline, an aphrodisiac to the nerves, excited my heart rate, badgered my blood pressure to climb, weakened my quadriceps and suddenly bathed in sweat and battling nausea, a thought emerged from the pounding hum of racing blood cells, “we are lost”.

Haliid Abedell is literally in the middle of nowhere 50 Ks inside the border of Darfur. It was almost insane that anyone, let alone us, would want to come out here in this dry and weary land, attempting to navigate the brush to a people very few had heard of, but we had our reasons; the Colonel and Darfuri rebel commander wanted to forge closer ties, the doctor and nurse wanted to reach the unreachable, and the literacy program director wanted to plant a seed in the Rizeigat people. Following the pick-up truck loaded with soldiers carrying RPGs (rocket-propelled grenade launchers), 60 caliber machines guns, and AK47s, we realized that our American passports and even South Sudanese visas meant nothing; we were at the mercy of Darfur, our guides, the trackers and any random janjaweed that stumbled upon us. What should have been a two-hour ride through blistering hot back country bush took three and a half because we lost the “road”, a road I never spied to begin with. Stepping out of our vehicles while the trackers searched for evidence of our path was when I had my neurological epiphany. After twenty minutes or so, we crammed back into our vehicles and followed what was thought to be the way.

By the time we arrived I was pretty wiped out from my persistent heightened state. You see I’m a “what if-er”; what if we get lost?, what if we can’t find our way back?, why are we going further if we can’t find our way back?, what if I am faced with spending the night on the Darfuri desert floor without the zippered protection of my tent from the arachnids?, what if i never get to go home again and feel the amazing sensation of cold water slipping down my esophagus?, what if I never get to tell my mother I love her again?, what if… “what if” never happened but man was I tired from worrying about it and I still had a long day of clinic to go evidenced by the massive number of people milling around. Where did they all come from? We hadn’t seen anyone for three and a half hours. We were greeted warmly with open arms and lamb stew. You see, hospitality runs deep in this culture and they feel it is an honor to have us visit them so in recognition of this honor, they presented us with a special meal and there was nooo way we could turn that down without offending them no matter how late we were or how many what-if’s I could come up with..

Clinic was very difficult in this location. First, we had arrived late (and had to eat a meal first) which meant that clinic would be cut short so we could get home before dark and second, the chiefs in the village insisted we set up camp inside a hut rather than outside under a tree in the breeze. I have already explained the issue with privacy here and this inability to participate in group health (or nosiness) was just not going to be tolerated by the masses; the villagers desperately wanted to see and be seen by the doctors. Though a line had been formed outside the hut from the doorway, it wasn’t long before the people lined along the outside walls in an attempt to peek inside. They pressed in on all walls, poking their fingers in through the weave, shredding the thatch to make peep holes. It seemed that at any minute the swaying walls would cave in and I would be buried under sheets of dried fiber.  When the determination and curiosity could no longer be restrained, they started to storm the doors. Order was barely maintained. It was intense. At this point, I heard one of our men suggest we move the trucks closer to the clinic so that when the time came to close shop we could make a quick exit in case the unseen people took issue…(here go the synapses again, ugh). What if I just kept working… I kept working.

One particular man I helped had burnt his hand gathering gum from the Sudan gum tree. The burn was at least a month old and his hand was contracted. He could not extend his fingers, I couldn’t even extend them for him. His skin was badly charred and in the debriding process it came off in chunks. He was such a stoic man and insisted it didn’t hurt but I could tell it did, the fixed facial expression of tense control gave him away. I worked as gently as possible often assessing his pain but the reply was always the same, a stern nod which translated to, “I am fine, continue.”

After this, I looked up and noticed that the doctor and his translator were gone. My translator (the Colonel) was distracted but before I could inquire he jumped up and said to me, “Come on, I think we better go, something happened.” Oh my goodness! For real? I grabbed my stethoscope, backpack and water and ran to the back of the hut following closely behind the Colonel, my heart racing as I thought I was running for my life. Suddenly we came to a halt, there on the floor was an 8 month pregnant woman crying with the doctor hovering over her. She had not felt her baby move in three days. I knelt down beside her but neither the doctor nor I could find the baby’s heart beat. I placed my hands on her swollen belly, and suddenly become overwhelmed with empathy for this woman. Losing a baby is difficult enough but living in a society where having children is the vehicle for gaining status, for gaining respectability, this was going to be especially difficult. I caught her eye and as she placed her hand on mine, we cried together. The Colonel returned (I didn’t even know he had gone) explaining he had  found someone who would arrange a ride for her to the hospital five hours away.

We continued to work for a couple of hours more seeing a few hundred people in total, before the time came for us to depart. Departure was rather uneventful but we did leave from the back door (with the Chief’s consent). The hut walls were riddled with holes and quite a few villagers were left unseen. That has got to be the hardest part of field medicine for me, walking away when there still exists a line of untreated people who may never again see a clinic. I am often the person in the truck with my necked craned backwards staring intensely at the villagers as if my projected thoughts could launch spontaneous mass healing. I know I can’t help everyone in the world, I can only help one at a time, but couldn’t I have more time?

Driving home in the waning sunlight surrounded by soldiers I found my “what-if’s” were gone. The route home didn’t appear to be the same one from which we arrived but what did I know? Of course, this left me to believe we could get lost but I couldn’t muster the energy to worry anymore, what good did it do anyway. Instead, I leaned back in my seat and watched the low-lying Manzanita trees whisk by wondering what music I would score for this melancholy moment during this scene in my life’s movie. (Yep, I watch too many movies.) However, before I could decide we came to a stop and what I saw shocked me to no end; there was a young woman wandering through the bush, still two hours from the closest village. How did she get here? Why did she come out here? Why was she alone? One of our translators went out to talk to her then brought her to the truck. She was severely dehydrated, and confused. We helped her in the truck, and continued on our journey home. We slowly rehydrated her along the way and guess what? I found one more what-if… What if we hadn’t come by?

Darfur: Women and Children First

Day Seven

Fully recovered, I (and my husband) returned to the village on the river, set up in a different part of the massive compound and again started seeing patients.  By this time, it was known we would see the sickest women and children and that’s who primarily showed up along with men having legitimate illnesses. The Dr. remarked that he saw more unique conditions during the past week than in his whole career; the effect of being somewhere that had seen few, if any, doctors, ever.

Not sure what this. The child was neurologically intact and fontanel was closed.

Umbilical hernia.

What looks like a protruding vein is really a worm.

A cut finger that received no medical treatment.

A jaundiced, malnourished child

Notice the “mud” on this child’s head. It is fairly common for the parents to make a paste out of mud or dung then cover the infected area in hopes it will be curing.

 

 

Darfur: A Wedding

Day Six

I spent the day in bed with my husband watching over me as the rest of the team traveled deeper into Darfur and set up clinic without us.  Though depressing to say the least, it turned out to be a time of rest, reflection, and recognition of the fact that this was God’s mission, not mine, and its success depended on Him and Him alone. When the team arrived at the new location the villagers were preparing for a wedding so hundreds more than usual were present and therefore, more people received medical help. Due to my absence, I will just post their pictures.

 

Darfur: Please Don’t Let Me Fall In!

 Day Five

Working with the Arab cattle herders on the north side of the river presented new challenges, and much consternation on my part I might add, since their system of social hierarchy came into conflict with the concept of “triage” (seeing the sickest first).  When the elders and chiefs were given the opportunity to select those that would be seen by doctors first, a list of names was produced that was more of genealogy of the leading families than anything else. This was not the first time I had experienced this having worked mostly in Northern Sudan (Arab culture), but I can say that increased exposure, diminishes my tolerance.  The men eat first, drink first, and get medicine first, no matter how sick their wife(ves) and children might be. There are a few exceptions but I will say VERY few.  Since we are not there to impose western culture or liberate the women (how I want to!) we adhere to their leadership and most times, within an hour or so we start seeing the women and children. However, this day was different.

The line of men seemed not only to be extremely long but in fact seemed to continually grow. Then after a couple of hours of seeing mostly relatively healthy men whose issues were all too common for men their age, I looked up and realized the next man in line had already been seen. He was here for some other ailment (that could not have been very important or he would have brought it up the first time) and my tolerance drew to a very sharp and drastic end. I put my stethoscope down and just sat there. I figured I needed to take a few deep inhales and slow exhales before I said anything as I wouldn’t want to overly shock the Arab people with my Italian temperament. (Sanity does reign occasionally!) The trip member who was in charge of communicating with the village leadership saw that I had stopped and inquired. My exact words? “I am done.” Huh? I heard. “I am done helping these healthy men while the truly sick sit on the wayside waiting for who-knows-when until they can be seen. At this rate they could wait until dark.” The doctor eyed me, evaluated the situation and said, “I think now is a good time for a water break” and clinic came to a halt. After much animated discussion, it was determined that the women and children could be seen but we needed to finish seeing the men. I suggested that we line the men up in front of me and I would hand out ibuprofen and explain that there was nothing we could do for their prostates while the sick saw the doctor. It was a good plan and it worked, we cleared the men out fast!

 

Not sure if I yet mentioned this, people in Sudan do not line up, they crowd around and they do not give any room for privacy. In fact, I have had other women in the crowd answer the questions for my patient. HIPAA would surely go into cardiac arrest here. Once the women discovered they would be seen they descended. The number of people around me, touching me, and leaning on me, sticking their hands in my pockets, was suffocating, literally, as they cut the air flow which had been a gentle breeze bringing a bit of relief in the 105 degree heat. Fortunately I had my husband as my “body guard” and he initiated a western style line with a numbering system which was to be adhered to or one would leave without an “appointment”.  Oh, he was strict but he poured on the charm and the women finally consented. With order restored and the breeze once again licking my nape, I worked dutifully until the end of the day.

We saw many typical complaints: pneumonia, upper respiratory infections (URI’s), worms, and skin diseases. There were quite a few cases of parasites contracted from the river and a few children born with disabilities. We came across some issues we couldn’t diagnose, not unusual in a day of tropical medicine. Overall it turned out to be a good day and we finished around 6 p.m. After I saw my last patient, I stood up to stretch my legs and the thought crossed my mind that maybe I didn’t feel quite right. As I stood there trying to decide if I really didn’t feel well or if I was just a bit dehydrated, it hit me. Suddenly I was sick and it was coming on fast! I ran for the hole-in-the-ground latrine surrounded by woven mats I wasn’t sure reached the ground and began to dispose of fluids by every means possible, bright chartreuse colored liquid. Straddled over the “mounded” hole with my head between my legs, a most unnerving picture came to mind, it was from the movie “Slumdog Millionaire” and inwardly I began to chant, “Please don’t let me fall in, please don’t let me fall in.”

Well my behavior earned an appointment with the doctor, a shot in my rump roast and a ride in the front-seat of the truck on the way home. It’s certainly one way of getting ahead in line! Needless to say, I went to bed, drowsy from medication, and exhausted from all that chanting.