01 April 2008 Comments
The helicopter approached the burnt and abandoned town of Seleia. The MSF team exited the fuselage on the rocky pad and watched the helicopter take off. It was a strange feeling landing in this community without curious greeters, no vehicle to load equipment into, no animals, no local colleagues… just the wind as the sound of the helicopter fading away. I think it was especially strange for those of us who had spent a significant amount of time in the community. Three months ago when we were evacuated, I expected to return to a more stable community still full of life, happiness, “industry” and fun. In stead we carried our medical equipment through evidence of dwellings, and yards looted and burnt to the ground.
As we approached the town center we found two local women who had returned from being refugees in Chad. Each of them had a baby on their back. The MSF medical assistant spoke to them and learnt that everyone was staying around the military base for safety. On the way to the confined Seleia camp I noticed some holes in the ashes where people likely retrieved the food which they buried- for most this was not the first time they have been attacked and forced to leave everything valuable behind.
The returnee sample of Seleia resettled with only woven grass walls for shelter, a few items for cooking and something to collecting water- some of which I recognized as our medical equipment. I’m glad some medical items ended up in worthy hands. The small grass walls were huddled together for protection, exposed to the open desert, nestled next to the military base. Knowing what this population had been through, I was too impressed with their resiliency and innovation to pity them. I don’t think anyone from a western lifestyle can comprehend what it is like to start again in this way.
Approaching the living area people seemed too busy or perhaps tired to yell out the usual comments that every foreigner to Sudan hears. The population was mostly women and small children; apparently it was too unsafe for many men to return. As we started to settle a clinic area around a tree people approached, then crowded around. It was so great to see some familiar faces again. A few of our staff had returned: One of our guards, the woman who used to clean the operating theater, her infant who would ride on her back while she cleaning, and our translator. As expected they were not themselves. There was not enough time, and too much going on to catch up with them as we set up a table under a tree for medical consultations. Dr. Eric typically works in the emergency department of a teaching hospital in Iowa - this old school desk under a tree in the desert could not have been a bigger contrast. I left Issag and Eric to see the patients and I made my way back into town to inspect the medical facility and the MSF living area.
The only items left in the inpatient area were 2 intravenous poles with the solution bags, and tubing. No beds, no tables, and no one really knows what happened to the patients. The tent part of the operating theatre was missing- medical equipment and waste was spread all over the place- there was no point in collecting an inventory. I could not find a single item to contribute the makeshift clinic in progress. Items I didn’t know were valuable were taken such as: light sockets, hinges, and doors, screening… everything. Jean the logistician was able to find a biohazard container that we were able to use. Jean stayed in the compound and burnt all the medical records and hazards, then later joined me at the clinic set up.
Beside the consultation table I sat on a plastic mat, cleansed and dressed some of the physical wounds of the population. As time went on people acted out their story to me and explained what happened in their local dialect. I was able to pick up a few grim details of what they told me, I wish I had a translator. Though there were some serious wounds, I think a lot of people just wanted recognition, to be listened to, and maybe reassured. One elderly lady was listening in as I was trying to teach the patients about wound care such as what to do with the dressing material, cleaning, etc. Later she declared that it would be her role to teaching people (in a way they could actually understand) how to care for their wounds so that I could continue with the dressings. This woman also went through the crowd and brought a few people to me who needed attention.
I wanted to stay, I felt obligated to become part of this welcoming community again but it was too unsafe at night. The afternoon was coming to an end and we soon had to close our clinic table to return to the landing area. I went through the crowd to determine if there was anyone who was too ill to wait for our next visit. I thought I found everyone such as the women laying on the ground, the baby with the fever, but other sick people still presented themselves to the clinic table, as we had to leave. I hope we were able to attend to all the serious needs.
I watched the burnt town of ashes get smaller out of the helicopter window. Strangely, I felt a sense of reassurance that people were still functioning, being progressive, and doing everything they could to regain themselves. Again, people like me should not mistake the optimism and resiliency of a community with the reality of their troubled state.
I used to be a little baffled by the psychosocial interventions MSF would initiate. I thought that psychological interventions were more of a developmental, rehabilitation project. It was comforting to read the blog of the Canadian psychiatrist Steve who is working on the Sudanese/Chad boarder (sorry I don’t have the specifics, my internet access is few and far between). My Seleia friends who are still refugees need all the motivation and clarity they can get- it is easy to loose faith in outside parties. The more displaced populations I visit, and burnt villages I assess, it becomes clear that it is not so much the NGOs that get a community functioning again- it is more the human spirit.