today.

feb 26.today, i woke early, determined to run out of town and find a bit of space in the flatness that surrounds abyei. at 630 am, the sky was still dark. as I ran, past the trucks and buses leaving for El Obeid or Khartoum or Juba, full upon full of beds and blankets ontop of beds and blankets, dawn happened. but the sun never rose. not past the meniscus of dust along the horizon. a windstorm had lifted the sudan sand, and it covered not only my tukul and abyei, but the wide sky. by 8 am, the sun was only a gauzy ghostly hole, the color of beeswax.

outline_sudan.gif outline_africa.gif

today, when I was doing rounds this morning, and I was figuring out what to do with a young boy who developed a fever after a run with measles, a boy who I had already stuck a chest tube in his side and two needles in his back to try and drain a large collection of bacteria, as I was deciding whether we should stick more things into his chest or send him to another hospital or if he was going to die, and just as I was hearing that today, already looking like bones glued together, today he started refusing food, I looked down and beneath his bed was a butterfly, white wings with black mosaic, struggling to right itself on the floor but spinning in circles and circles, broken.

today, a whole rash of measles. twenty patients in the last week or so. I had it as a child. so did my brother. I have no memory of it. all I have are pictures about how miserable we both looked. I have no idea why we have these pictures. perhaps in some kind of memoriam of how sick we were, but more likely, we just sat still for more than 30 seconds. people sit still with measles because they don’t want to move. there eyes get infected, their skin flakes, there fevers are severe. measled. miserabled. that’s how my brother looked in the pictures, and that’s how these patients look. but we make most of them better. and we are organizing a campaign to vaccinate thousands. they are some of the sickest people in the hospital. you learn early on in the refugee business that if you have thousands of people together, the first thing you do, before plastics sheets and protein, the first things is to vaccinate against measles.

today, on our rounds, stopping by the miserabled, we found two girls who came in on the same day: achol kwol, and his friend, kwol achol. though we set up a measles tent for this latest surge, people refuse it because it is too hot. sudan sleeps outside these days. achol and kwol were not exception, but by moving around, they had lost their hospital cards. “which are you? achol or kwol? achol? no? kwol? which? achol kwol? the other?” by the time we were done, they were as uncertain as we were.

today, a baby died about ten minutes after coming into the hospital. she was dirty and covered in grass. the family came from far away, and asked if knew somewhere nearby where they could bury her. i said I did not. they thanked me and left.

when people I see in the hospital talk of where they are from, they answer in days. “three days away”, some say.

people here make small cuts in their childrens faces, and as they grow, their scars form elegant angles. they look beautiful. and severe.

I admitted a boy from two days away who had such severe dehydration that he tried to suck on my stethoscope as I listened to his heart. today he is better. he gained a kilogram in 16 hours. from 5 to 6.

there is a little girl here who the staff are so fond of that I think they are delaying discharging her because they would miss her too much. she is always between your legs, and crawling onto your lap. if it comes to me, I am never discharging her either. her mother stays happily too, as thrilled as we are to have someone so delighted so close by.

there is a falcon that sits on my tukul and pierces the afternoon with his high whistling cry. before they knew I was coming, they fed him bits of meat and named him james.

I must return to the hospital. already, it is a well worn path. I am going to take some pictures in the next few days, and send them so you can see what I am talking about, of abyei and some of the miserabled if they agree. if not, then of the hospital.

I am sorry I haven’t updated in the past few days. trying to find the time is occasionally difficult, as is sitting inside when it is 44 C. I believe that you can sign up for RSS feeds that tell you when something is new.

and, of course, if someone is reading this, tell me if something is new with you. no details are too banal. I am hungry for them.

About James Maskalyk

James Maskalyk is an emergency physician and, when not in the field, lives and works in Toronto. His first mission with MSF was in Abyei, in a small hospital on the still contested border between North and South Sudan, and his blog from there became a book. He is in the field again, working and living in a refugee camp in Dadaab, Kenya, home to 300 000 displaced Somali people.
This entry was posted in Emergency Physician, Kenya, Refugee camp. Bookmark the permalink.

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8 Responses to today.

  1. Andrew Tyler says:

    Hey James,

    I was enjoying my second-last evening in Toronto before heading out to Liberia. A long walk along the ravine — never dark, but quiet at least. Been imagining for weeks how to explain -30 to people who’ve never seen 10.
    Your writing is evocative and personal; I appreciate your candor. Sounds like you’re well-loved back home, but I hope you feel equally appreciated, at least from time to time, there. You should: it’s important.
    Take good care, and keep writing.

  2. Derrick Chang says:

    Hi James.
    Unbelievable. I was initially jealous to hear about your adventures but after your Feb26th blog I have no desire to do what you are doing. Scary and inspirational at the same time. Same old sh** here at work. Too many people with paper cuts demanding MRI’s. You ain’t missing anything. All the female nurses are missing you. If that made you smile then its absolutely true. I be thinking about the heat you’re enduring while I’m playing hockey. Take care dude.

  3. Robert Hubbard says:

    Hello James! I represent the St. Mark’s by the Lake Anglican Church Outreach and Justice Team. We are located in Tecumseh, Ontario. We read a couple excerpts from your blog at a fund-raiser for MSF. The stories you tell are quite compelling and everyone enjoyed hearing you via the World Wide Web. Many thanks from all of us for your generous efforts on behalf of justice for all.

  4. Rachida from the Montreal office says:

    Hey James,

    That’s so nice to see that you were able to commit to a long mission with MSF. I enjoy reading your blog as I enjoyed reading your journal a couple of years ago.
    Take care.

  5. Agnes says:

    James,
    I am reading your blog and am awestruck by what you have committed yourself to doing. The description of the measled… pretty vivid.
    Here in Toronto there has been a snowstorm which has dumped about 5 cm of snow. Seeing all the snow drifting and blowing makes it hard to imagine such stifling heat. Take care.

  6. George says:

    James,
    Not a lot…travelling to Vienna for the ECR next week…pretty warm in the Netherlands…compared to Toronto of course :). I made a major switch in technology last week…PC to Mac….a lot better, although not too many PACS running on Mac. Particularly since I owe you some tennis play time and be certain I’ll keep my promise, I joined a local club here and I am trying to move so I get in shape a little by the time you get back. That’s pretty much it for now!
    Stay safe and take care.
    George

  7. Laren says:

    Well buddy i’m going to be in toronto next week if you can make it back for a day or two, in the meantime i’m just killin time watching curious george with eva. By the sounds of things you might want to consider a new travel agent. Be safe, say hi to falcon james for me.

  8. Suzie Bisson says:

    Hello James,

    Thank you so very much for sharing your jouney. It helps me to stay motivated with the PhD program. Wanting to finish early as I am impatient to join the international humanitarian community. Snowing in Calgary…again! It seems that it would be impossible not to get attached to these brave and courageous individuals. Take good care!

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