last saturday night, we stood in a puddle around stacked soda crates, a goat sizzling over coals beside us, when the three, buzzed-out speakers in the canteen started to play this song and the same dozen cast of characters that i share my hospital days and compound nights with drifted to the tent, and danced, grinning, mud between their bare toes.

soon, it was only me and one of the departing three for whom the party was held leaning on the red cubes of coca-cola, and we agreed that there was no club in new york city that was better than this one, none where you could dance so sincerely, freed completely from the fear that there might be another, better way to spend your time.

this afternoon, i tried to walk from my outpatient clinic to the ward, and was stopped every three yards by a somali woman who pointed at the baby on her hip before detailing an illness in a language i could’t understand. one of the nurses smiled as he walked by. you’re going to miss being so famous when you leave, he said. i will.

so i nodded my head to the beat of a mother’s wagging finger, and over her shoulder saw the familiar eyes of a woman from the TFC’s (therapeutic feeding center) perilous first bed. i looked into them each morning as she asked me, wordlessly, to do something more, anything. he’s dying, she would say. i know, i know. patience. he’ll make it, i said, only half believing.

now she was moving through the gate’s swinging door, a box with a month’s worth of cups and shawls and mats and plates under her arm. behind, an older daughter carried her happy young brother, newly discharged. his mother and i looked at each other, as we had each day for a month. this time she raised her hand in the air, shook it as she walked past. though i will never be on the field for a goal that 60 000 fans will cheer, there’s no way it could sound any sweeter than the beads did clacking on her wrist.

the credit, of course, was hers and the trip she made back and forth to the jug of ORS so she could pour water in as fast as it poured out, the nurses who took over when she was too tired, the people who gave us money for the tin cup she used. but it is these moments that are so remarkable, that they keep us coming back, are worth all the sleeplessness and latrine running, daydreams of drooping faces, the awkwardness of a home that fits you less well than it did before you left because we get to be witness to the concentrated effect of the human spirit’s brightest part; intention manifested.

i remember once, months and a lifetime ago i watched a lizard track a moth up a wall. as she fluttered from one face to another, the lizard leaped, flew, narrowly missed, and the bug bumped back to the burning light. in that instant, i saw how lizards became birds. not by trying to grow feathers, and not by imagining what it would be like to fly, but by wanting that moth in their mouth so sincerely. the wings come later, but they fit perfectly.

you become what you pay attention to. and what that is, there are no rules, only possibilities. we’re all making it up what a human being is as we go along, moment to moment, and if you’re not deciding, someone is. in that understanding is a scary freedom and the world’s real magic, that as the universe manifests perpetual change, it does it, at least in part, through our imaginations.

intention made manifest. for me, some of it is self evident. msf is the world’s largest medical NGO and despite a teetering financial system around the world where even the most confident economist admits she doesn’t know what’s going on, its budget is the largest in its history, made up almost entirely by contributions of individuals around the world who give a few dollars each towards the idea that reducing suffering, even by a little bit, lightens the weight on us all.

with that money, we mark on maps military movements, to decide if we can get close enough to strike, not with weapons, but with a hospital large enough to accommodate the wounded from both sides, the hundreds of civilians who are drawn screaming into today’s modern version of war. with it, we sit like i did the other day, with a group of new arrivals who walked for kilometres through the desert heat to give up their freedom in dagahaley because it was better here, in this place where camels drop, than where they came from. among them, was a young mother who had delivered just the day before, on the road, a tiny baby, invisible under scarf. it wasn’t until she pulled it aside that i saw him, fragile and new, clinging to her breast. we said to her, we’ll take you to the hospital to rest, and we’ll find room for your husband too, and tomorrow we’ll help you work on tents and food, don’t fear, we’re here, you’re safe. it’s not near as sweet as kissing away the tears of someone you love, but it’s about as close as strangers can get, and if there’s any hope to be had in the world, it is in this direction.

like any optimist would, i deny the aspersion, citing realism. either way, i think we’re slowly winning, and if you’re not convinced, talk to your grandpa who lost two brothers to measles and one in the war, then take a walk down your quiet city street. but as you do, and the thousand dollar computer in your pocket shuffles songs, remember that there are still places where tin cups matter. it starts outside this door, the one with the curtain billowing in the sandy wind, and it reaches to the curb you’re stepping off of.

the work is never perfect, only better. but we try, sincerely, and one day, maybe, wings that fit. should you want to be msf’d, or its equivalent, i’ll write more about how you can make happen in another post. if you want to know why, it’s because we’re gonna win and we have the best parties. so if you’ve got the fire, and the tools, we’ll take you lost, we’ll take you found, we’ll take you running as long as that is how you hit the ground, and it’s in the direction we seem to be going, because there’s still so so many more miles.

most times, people arrive here from somalia with nothing. either it is what they started with, or all that is left when they get to this place where camels can die. with time, they get a tent, and some food, a plastic jug. in the new arrivals area, yellow and red plastic canisters snake in a cue a hundred long as people wait for water. tonight, though, there’s no waiting. it’s everywhere.

the sky is dark, and it hammers so hard on the tin that it drowns the sound from my small speakers. i’ve tethered my curtains to my window’s iron bars, but still, as they billow, drops fly in to\ speckle my screen. i’ve moved closer to the door.

this is the second rain this week and the second this year. the other evening was like this one. from a near clear sky, a sandstorm, dust in your eyes, your mouth, then a sweet smell, like fog, and a cloud crashed down. still, the next day, there were no puddles as proof, just dime sized dimples in the dust.

tomorrow i think there will be, though. the rain lashes. before i ran here, to my concrete room to check on my electric things, a nurse and i stood in the mess, marvelling at the sheets of water and bright flashes of lightning. as we did, a metal sink, sunk in the middle of our yard, wobbled, its edge trembled, lifted, then caught by the wind, creaked over at the faucet. i’m sure we shared the same thought of tents turning end over end, children huddled in the mud.

i’ve raised the hospital on the radio. we’re checking on the feeding centre tents. could be my fault if it’s full of water. today i lifted the flaps so that the breeze would flow through, and fewer families would scatter through the hot yard. from drought to flood. so little middle ground.

the feeding centre is packed. yesterday i discharged three, admitted thirteen. in today’s morning meeting, a nurse confessed he was having trouble keeping track of how many patients there were, packed in the ward, the tents, in the old radio room, underneath trees. we guessed fifty, then walked through them all, counting children, marking their foot with a pen. fifty two. maybe sixty by tomorrow.

the rain’s stopped. it’s just like that, isn’t it?

outside my door, puddles shine. i wonder if tomorrow the water truck will be spinning, up to its axles in mud and the people who were, just minutes ago, watching the edges of their tent tremble and lift, will be under a tree, hands on their brow, until they can’t leave their kids alone anymore at home and decide instead to gather some of whats on the ground like anyone would and if that happens, and their children fall sick and fatten further our feeding centre, how tricky it’s going to be to keep track of so many. this time with water, the world answers: be careful what you wish for because you might just get it.

it is just past dusk. the bugs are out, already partying. they’re fast that way. people are splashing their way towards the mess. i’m going to join them. blessblessbless. more soon.

”why not,” the surgeon answered, reclined on a mattress we’ve leaned up against a wall below the razor wire. “i’ve got nothing else on.”

”i can’t.  i’ve got tickets to a concert,” our nurse said. “i’ll try to come after.”

we laughed, then more at the laughter.

”yeah, tomorrow i can’t either.  i’m having a dinner party.”

”i’m playing someone above me on the squash ladder.”

“swimming lessons.”

”ice capades.”

we faded to smiles, our shadows cast perfectly on the cement behind us by the harsh security light.

it is not easy to write about this place.  it is not for a lack of opportunity, for after the work is done, hours of curfew yawn.  it’s not a matter of material; so many stories bear repeating. i struggle because of the sudden, severe beauty that passes so quickly in front of me, words won’t do it. you’d have to follow me through the hot yard where people perch under trees, their children beside them on mats, and we’d pass a boy, his striped shirt stretched over an abdomen so swollen by his liver that he looks like a bumblebee, his mother dabbing blood from his nose as he patiently tries on a rubber glove we gave him, and then he sees us, and with a wide smile, he claps, begging for us to blow more bubbles. Next to him, an older sister and we start at her, feint a grab, and she screams and runs behind the tree where she peeks out smiling fist from one side, then the other.  A cleaner comes over, takes off his hat, extends a long arm, wishes us a good morning in the only English he knows, and we’re not even halfway to the lab.

a tough morning report today.  An infant who I saw before I left last night, seizing and febrile, coughing for days before the mother had the courage to come to hospital, died this morning gasping in twitches.  On his heels, a 3 year old girl arrived  after a week of diarrhea to have her heart stop on the hard wooden bench outside the emergency.

In Europe, is it the same as it is here, the nurse asked? Some things, yes, i said.  Fevers, coughing.  But a child dying of diarrhea, he said? No, no. Never.

I wonder what seeps into our subconscious as we move throughout our days, what dramas work there as we look for something certain in a world that can seem careless.  does it play out in our dreams, or how we live our days? is it what makes home fit so poorly once i get there?  I listened once to a psychologist who supported the notion that we live trying to answer questions we asked ourselves when we were infants, before we could form them into words.   as someone once said, be kind to everyone you meet, for he too is fighting a great battle.  even if its deep underneath.

no word on the girl who i gave my rhinoceros to, and hers.  i was in nairobi last weekend, and tried to find her.  i called the national hospital.  who?  they asked.  a girl.   from dadaab.  she came on wednesday.  i gave her name.  i stayed on hold for almost half an hour, and finally hung up, visions of teeming wards and a weary nurse reading through stacks of paper charts that dropped from the desk.  i’ll find out.  she has my rhino, after all.

though i could do it more, i find that in medicine, like in life, its usually best to let yourself go, to hope deeply, even if it means the pain of it being dashed.  to release, as much as you can, the tiny elastics those pains have placed around your heart because if you don’t, you can forget what its there for, and with that, what we’re here for, this short time on a rock spinning wild and green around one of a trillion trillion stars.

this work is good exercise. you’re asked to give as much to the 35th patient as the first, pull out the elephant (i bought another in nairobi) with the same shock of amazement as the bed before, counsel the mother as gently, so that she can spread the word, and next time she passes a child feverish on another woman’s back, she might give directions to this place.

no rain here. before i left, i would ask the old men when.  “soon,  soon,” they would say. now, they shrug. perhaps another two years.

and still they come.

i returned yesterday, after two days of driving.  as we drew closer, i saw green fade to brown, women’s faces framed behind bright beautiful scarves and soon, we were swerving on sloping sand, fishtailing in the dust.  camels loped behind burnt trees, and between these, miles from each other, houses of rounded sticks. an impala stepped from the brush, sleek as glass. a young boy, six, waved an empty plastic bottle at us, and we stopped to give him all the full ones he could carry.  they fell from underneath his arms as he tried to juggle more, and landed in the dust at his feet.  he grinned, his tongue bright between missing front teeth.

and then i was home.  here.  and when i saw people, they were glad to see me.  glad!  and me to see them.  perhaps that is what makes a home, a place in which you can find your love reflected back.

this morning, i did my daily march down rows of the sick and stick thin, and then to the tents which we’ve pitched to house them because still they come, and i wonder whether this is news anymore, if news needs to be new, or at least heard for it to qualify.  i went back after lunch, and the nurse said to me, quietly, “that boy passed”, the one i spent the morning with convincing his mother to stay, that his best chance was here under our careful watch.

on the day before i left, i took my prized dagahaley possession, a plastic rhinoceros, one that i use to buy the favor of suspicious three year olds, one that replaced the toy elephant that marched off when i left it on the desk and turned my back, the one that children look at, spellbound, having seen neither a rhinoceros nor a plastic toy and which their parents hold up and examine in equal amazement, i gave my remaining rhino to a 12 year old girl who, when i left, was dying of sepsis, and told her about the real animal, how big it was, and strong, and that this one would reminder her of that, and asked her if she would hold it for me until i returned.  she would.

she did. well, her father gave it to me this morning.  she lived, though barely.  she is unconscious now, hasn’t eaten for days.  i arranged for her to travel to nairobi, should there be a chance for better care or x-rays or blood tests or one thing that might be everything, as they pulled away from the hospital this afternoon, i handed it back through the window. i feel foolish now, she’s a bit old for toys, but i could think of nothing more to give, and i wanted to give everything and sometimes its like that.

so that’s the news.  there’s so much more, but i don’t know where to start, or if i did, how i would ever finish.

it’s the end of the day now.  9 pm, the dagahaley midnight.  i’ve poured water on my cement floor, so that it might cool.  an evening wind, like clockwork, has picked up, and is picking up the grass from my roof.  i’ll read some, and go to bed soon.  i’ll lie there, until the day unclenches itself, and i fall into the dust of the next one.

see you there.

this song just shuffled on.  lullabye.

i sat there, smoking, and thinking about smoking, watching my breath trail away with the wind. i had started by having a cigarette only on saturdays. wednesdays and saturdays. and since fridays were pretty much little saturday, those too. now, at the end of each day, i buy one “sportsman” cigarette from the canteen, climb the steel ladder, dangle my legs through the aluminum bars, and gape at the wide outside beyond our barbed walls.

children play football, their kicking scrum disappears in a cloud of sand until the ball emerges with a pock, and the players race after it, their footstrikes smoking on the flat ground. in the trees, their bright clothes hang on branches, swatches of color caught in a sharp needled net.

beyond, camels amble through the barren trees, bend their long knees to take a single leaf that the other may have missed. goats move past, sweeping the ground for the same mistake, moving in mass past our gate, a bleating army, the cloud of dust settling with their trailing yells.

a car in the distance bumps between trees and past donkey carts, filled to bursting with lucky passengers, destination unknown. above, a sliver of a moon, and near it, a glinting planet, hundreds of thousand kilometers distant. the wind reaches me, finally, and the red of my cigarette glares harshly.

pling…..pling…..pling.  someone on the steel ladder.

a hand, then a head, then a hope-you-weren’t-looking-for-some-quiet-time, look. of course not, come on up. the more the merrier.

the thing about the deep desert heat is the true pleasure you take from the laziest breeze, a tingle of delight spreading from the hairs on your arm to the nape of your neck. such full experience of things that might otherwise be ignored when your familiar register is taken away. the slightest wind, a piece of orange, or 30 seconds of quiet, watching the world.

soon, there are seven of us, starfished on our backs, watching the stars blink into black patches of sky. someone brings up a tray of cheese left behind by some journalists, another some chocolate. we talk, and smoke, and wonder what to say next that is not about work when here, that is all there is.

I wrote this for my parents who said that I should spend some time describing for young doctors what life is like here. it is like that. you find ways to get through, and even though they might not seem particularly special at the time, they are, and they keep you coming back.

the rest are details (room four metres by four metres on whose walls I’ve drawn pictures of birds, more than a hundred people in similar rooms, some sharing, it’s never quiet, food’s made for you, camel every dinner, breakfast always thin pancakes and fried dough, your clothes are washed and dry in the sun, squat latrines, shared showers, radios crackle all over the compound, and you live for your work, and outside of your room, you never get a moment of privacy except, sometimes for those 30 seconds, watching the wind whip the earth into spiral shapes all along the water tower).

I have had a tough time sleeping lately, and by lately I mean the last few decades.  After a couple of years of success, things have worsened here, and i lie in front of a blowing fan blowing blowing sand, and watch circles’ seams twist into impossible scenes in the blackness behind my eyes.

Yesterday, I passed by our maternity ward and saw a crowd of people pushing themselves in. I used a line privilege unavailable outside of MSF projects to cut the queue, and wedged through the wooden door to find several women sprawled on a concrete floor slick with chlorine.  34 women in the ward, labouring, and the staff hurried, harried, from one to the next then back.  A concerned group of elders came to the hospital later that day, worried about our capacity.  Keep sending them, we said. We’ll deliver them all.  Better here than the bush.

“This is where the people come out”, Annie Dillard wrote in reverence, from the delivery floor of a hospital.  So too in Dagahaley, blue or bloody, screaming or silent, one after another, life effervesces through women into the cold, clear air, and so it goes.

If the earth was a ship carrying humans, pregnant women would be our most precious cargo. That is why those of us  care to compare health statistics between nations look to maternal mortality first. It tells us where our fastest leaks are. Countries like Somalia lose women, and the life that bubbles through them, a hundred times faster than a country like Canada.  a hundred times more.

(figure: proportion of maternal deaths/1000 population, courtesy of worldmapper)

I left the crying chorus in maternity for a more familiar one in the pediatrics ward.  I moved slowly down the growing rows, and listened to my translator recite each mother’s rolling woes, then edge slightly closer to her child who had never taken her suspicious eyes from me.  i would talk to her like and adult, though she might be only one.  ”pleasant weather we’re having.  a bit hot?  agreed. me, i like the cold.  you?  no preference?  what do you like?  sleeping.  i get that.  eating?  no kidding. me too!  how’s that going?” and if our conversation goes well enough, i can pat my stethoscope from the bed, to her knee, then her mothers wrist, to where it belongs on her rail thin chest and its fast beating heart. bumpbumpbump.

i don’t have any kids, but i get it.

halfway down a row, i came to a woman with one blind eye, her globe white where the dot of her iris once was.  i sat on her bed, and she set her child in front of me.  he was in no condition to cry. ass I turned his lolling head to the side to search for nodes, I noticed a necklace of carefully threaded white buttons ringing his neck.  i held it between my fingers. she smiled and said something to my translator. she shook her head.  the family was so new, from so far away, they didn’t speak Somali.

It didn’t matter. I knew what she said. She loved this one so much, that she saved what she could to get buttons better used for something else, and made him this so it might keep him safe.  I said I would do my best.  she nodded.

I’ve heard it said, from people at home, that women here, because they have ten children and lose 4, must suffer the loss less deeply, that they get used to it, their love hedged like a bet.  These people haven’t sat in front of rows of women fanning one child, the rest hungry at home, or with the woman in the maternity who delivered a tiny, tiny child, small as a bird, and who was angrily refusing to stay in hospital where he might be fed.

She sat, resolute, arms crossed and adamant, until I said how hard it must be to have walked so far, in such heat, with so much hope inside her,  to now be sitting beside it, watching it fade, and her eyes became glassy with tears.  it was no abdication of love, but generations of hard truths of the land she came from, and she was taking her baby back to her stick house to die.

life is precious cargo, even here.  Especially yesterday. Bunch of people came out, in dagahaley, hope manifested, all healthy, and today, is quiet so far, a third as many new humans as yesterday.  we’ll see if we have become victims of our own success, if all of our entreaties to send women to the hospital, day or night, have worked.  if it is a trend rather than a solitary spike in birthday parties from a particularly amorous may night, we’ll put up tents while we build another ward.  better here, on the clean chlorine floor than in the blackness of the bush.  this is a beautiful world.  may the people that come into it live to see it through their bright eyes.

from some of JR’s work in kenya.  beautiful.  blessings. j.

www.youtube.com/watch?v=utVmzUGbgYI

i have left dagahaley, for two days, to the nearest town.  it is as hot, as dusty, but there are people, a broken pool, a room with air conditioning.  i am in it right now, and ive made it so cold that icicles dangle from my exhalations. my left foot, frozen, fell off when i hit it on the bathroom door and is thawing on the balcony.  i have set the thermometer to zero kelvin, and need to finish this before it reaches it, and molecular activity stops.

the best thing, beside the plummeting temparature, is that i can take a walk. after sitting in my room for an hour, i took one towards the nearest barber.  it was a few hundred metres before the freedom felt comfortable, like i wasnt breaking the rules, accustomed as i have become to the last month’s circles.  in the chair, the barber took the most delicate care, and i payed him double despite the jutting hairs.

who do you work for, he asked, shaking the hairs from his sheet. the UN?  do you live in dadaab?

no, i told him,  dagahaley, my whole team, in the camp there, with the refugees.

tell me, he said, what is it like?

well, i said, fishing the shillings from my pocket.  yesterday, before i left, a nurse told me that 142 new people arrived after a month in the desert with no rain. some had lost everything on the journey, even had their clothes taken from their backs, and were naked. they had risked it all  to get to dagahaley.  and to your country, the first safe place they may have ever seen.
thank you for the haircut.  it was just what i needed.  he nodded
thoughtfully, and took my money.

i walked back in the hot sun, thinking about what else was lost on the long, dangerous way.  about my country, canada, which takes as many refugees in a year as dadaab might in march as my countrymen think only about what is lost, never fully what is gained.

i have been outside of the project for a day, and it feels like a month.  i think it is that i get to decide what i do with my next minutes, so the ones that approach are unexamined, unplanned, fresh, full.

those 142 people, they’ve given that up for a different kind of freedom.  a dismissal of fear.  of watching their children die, or of their husband disappearing for good this time, when he takes the goats to graze on the disappearing grass, two days away.

but here, they get free medicines, i hear people say.  free food, too. free tents.  school.

yes, everything’s free, i say. everything except them.

today, however, i am free and am going to exercise it in the best way, by lying down in bed and sleeping some more.  maybe some room serv….ice……oh..tempe..r…a..t….u. r..e…..f…a…
.l…….l…….i……n.. ….g……… …m……u……s……t
……..p….  …..r……..e……….s…………………..s……….end.

A family of cats lives in the cupboard where we store the mosquito nets. During the hot afternoon the mother lies outside of it’s door, panting, just beyond her mewling children’s sweeping paws.

Yesterday, as I was leaving for the day, a young girl was dropped onto a still warm stained bed sobbing sweating, crusts of infection tracking from her ear.  Her head was torted so fully to the right that her eyes looked behind her. and she pushed mightily on that ear, trying to get straight enough to repel me better but could not. This morning she was sleeping, her head still turned, but the fever gone.  Minutes later, I watched through the wire as she walked beside her mother in a trailing orange scarf looking sideways at a tilted world.

I turned to the woman in front of me,  twenty,  and asked her why she was not breastfeeding her baby. She became bashful and turned away. She doesn’t because she’s already pregnant again, the nurse said. It’s still ok, i answer, but this battle is one I’ve yet to win.  How many children does she have so far? The one in her stomach is her fifth.  Five? So young. How many will she have? Many, many, his answer .

And you, i ask him. How many children will you have? Ten, he says. Ten? Yes.  My heart is too big for any less. I have too much love.

The next in line is a breathless girl, old enough to be in the hospital alone, her mother at home with the youngest. I sat beside her and placed the bell of my stethoscope on her back.  As I listened, her hands trembled bravely.

A father pushed through the door carrying his dangling dehydrated daughter, in his fingers a card marked “urgent” that matched the look in his wide eyes. He paced back and forth past rows of beds, not knowing which, if any, was his. One of our staff, in a smart shirt,  took the paper from his hand and said on  she’s for the feeding centre and pointed him out.  No, I said, he’s walked enough. For now we’ll let him lay his dying daughter here.

Today, when we walked to the ward we were met with a chorus of cries from 31 patients, their mothers and sisters wrapped in scarves and bright dresses, stretched on beds below blue mosquito nets waving hospital cards over their bare children.  Beside the first, a sad family stood, the cleaner beside them, patient as charon, his beard dyed henna red.

They knew not their new home nor the right ground for the dead, lost from weeks walking, sharing the boy on their backs,
the sun high overhead.

So we wait for a car to ferry them to their new, bare ground: one patch for a house of sticks another for the quiet blue bundle between them.  Behind my desk, the cat arches herself from the behind the cupboard’s cracked door, lands softly, stretches on the dusty brown floor.

where to start.  so much happens in a moments infinite breadth. during the medical meeting a glimpse through the wire of a woman hanging her bright scarf on the branch of a tree, and then a bird swoops smoothly into the frame in and the world is born new again.  it seems no matter where you find yourself, you are always in the middle of your story,  the landscape racing away in even distances at all sides, like future and the past.

our medical meeting informs us, each day,  of the night’s events, patients added to our census, coughing and feverish, or subtracted, their body loaded onto a donkey cart at first light.

the bird wheels away, and she turns to watch it fly.

“maternity….twelve admissions…..nine deliveries…”

the afternoon before, i left a child huffing and breathless on a  plastic bed, his parents beside him. he had fever for days before his  mother took him to the health post, the clinical officer there taking one look at his shaking frame before calling a car to take him to the hospital.  i was returning from the lab when i saw the land-cruiser enter the hospital grounds, fast and bumping, and seconds later, the driver was trotting across the yard towards my ward, the boy cradled against his chest, arms and legs dangling.

“….one mother has failed to progress, and will be taken to theatre…”

he was four years old, previously well, until he caught a fever. seizures started yesterday.

“….adult ward…five admissions….four discharges…”

he was unconscious when he arrived, and you could feel his hotness before your hand hit the skin.  his malaria check was negative, his  blood sugar normal.  we cooled him with tepid water, gave him intravenous tylenol, but the convulsions continued.  his body didn’t move much, exhausted from all the shaking, but you could tell the seizures from his eyes, the way they looked up and to the right, just over your shoulder, like he was seeing something you couldn’t.

“…one death…total patients in the adult ward….17….”

we eventually sedated him enough that his seizures stopped, giving his brain a rest from the electrical short circuit that if perpetuated, would scar it, maybe already had.  his breathing became regular, and his lids closed. if you pried them open, the irises stared dully forward.  we moved him to the bed nearest the front, and set him resting on his mothers lap.

“….pediatrics ward….”

i went back a few minutes later, and someone was trying to give him milk while he was on his back.  no, no, i said, taking the cup, shaking my head.  he’s too sleepy.  and when he wakes, you sit him up, so he doesn’t choke, like this.  when he’s sleepy, leave him on his side.  do you understand?  i turned to the nurse beside me and said, make sure she understands.  he nodded.  the next time i checked back, the child was sputtering, milk bubbling from his nose, his breaths coming in jags.

“….seven admission…”

he worsened over the next two hours.  i sat on the edge of the bed, with his worried mother, shaking him when he stopped breathing, trying to figure out what to do.   he needed a ventilator to let his small ribs rest, but we have none, nor was there one nearer than nairobi. i decided to to take him to the operating theatre and intubate him, suck what milk i could from his lungs before it got pushed to the edges, suffocating him further.    i explained to his mother that there’s a chance it might make him worse, and only a small chance it would help.  it was, however, a chance, and it’s what i would do if it was my fathermothersisterbrother, and its the only thing i can think of that is doing something besides hoping, each time, that when he stops breathing, he starts again.  she agreed, and when the OT team arrived, we removed him from his oxygen.  she took him in her arms followed us across the hot, blowing yard.

“….five discharges…”

an hour later, he was lying on his side, back in the pediatrics ward. we removed only a few teaspoons of milk, and watched, our hearts in our throats, as he coughed and coughed and coughed when we removed the tracheal tube, our flutter settling with his heart rate.  now, back on the plastic bed, oxygen whistling into his nose, he was breathing easier.  not as fast, not as ragged, no pauses.  the truck was calling for me to come to the gate.  it was near curfew.  coming, i called into the handset, and left him, huffing, beside his mother.

“….deaths….”

comeoncomeoncomeon.

“….zero…..total patients in the pediatric ward…24…”

i left the meeting and walked to the first bed.  he was there, eyes closed, working, taking it from the top with each breath, but alive,  still in the middle of his story.  he remained there when i left him again last night, eyes closed on his blue bed.

we do what we can when we’ve the chance.  sometimes, in places far away from the world’s eyes and priorities which seem more focused on 3D TV’s (it’s almost like the real world!) than half breathing refugee kids, it’s not enough, but the trick is to not let defeats diminish the verve for trying honestly each time, let motivation to rise, again and again, as new as each moment.

compounds up.  coffee time.  happy new day.

i considered kissing it, but couldn’t remember if frogs were only princes disguised, or if there were a princess or two in the mix, similarly cursed.  i  decided against it, to spare the awkwardness.

(poof).

“oh.  hey.”

“hey.”

“…..”

“……”

“i didn’t expect that.”

“i’m sure. to be honest, i didn’t either. when i saw you go in for the kiss, i was gonna say something, but, well…..”

“you were a frog.”

“right.”

“not a great place to be a frog.”

“tell me about it.”

“not much water around.”

“hardly at all.”

“…..”

“…..”

“well.  i guess i’ll get going.  i should probably get back to my kingdom.”

“sure.  and i should….finish rinsing off.”

“soap can really dry your skin out.”

“definitely.”

“…ok….”

the door creaks open.

“hey….uh…frog prince.  my sarong’s outside on the line, if you need some clothes.”

“actually, that would be appreciated.  when i make it back home, i’ll send it back with some jewels or a goblet or something.”

“don’t worry about it.  and hey, sorry i wasn’t some damsel or whatever. i kinda forgot that the frog thing was, like, a dude thing.”

“yeah, we’re pretty much all guys.  the girls usually get put to sleep, or held in a castle.  that kind of thing.”

“noted.  anyway, good luck.”

“you too.  thanks again.”

“no problem.”

“bye.”

“see ya.”

(fade)

i rinsed off, and creaked the door open a crack.

“you sure you want to do this buddy?”

he bounded out, hopping in the dust towards the middle of the compound.

i’m told, that an hour after the first rain, the night is so loud with the jubilation of their croaked calls that you can’t sleep.  these days, it’s silent.  no rain, none for months.  some mornings, there are clouds, but by noon, they are burned off by the sun’s blaze, harmless things.

last week, i visited the new arrivals’ area.   in a midday heat of 40 degrees, an acre of plastic jugs, yellow, red, white attended to by women and children who had heard of a possible water delivery.   we stepped out of the truck, and into a crowd of children, each trying to hide behind the next, then getting pushed to the front in a churning cycle of curious eyes.  i tried to read them for the dull daze of sickness, or starvation.  i knew, though, that those children would surely be in the homes of sticks we had just passed, a hot breeze flapping the plastic sheets above their bed of rags.

i ran into one of our nurses crossing the compound yesterday, and she told me that she had brought water and soap to ten more people who had just arrived, and that tomorrow they would get food.  not today, though.  no food today.   a leader of the nearest camp block put a call to the other refugees to contribute what they could for the newest citizens of one of the world’s fastest growing communities.

6000 last month, more expected this one, most arriving with no food, nor water, nor shelter, to find none, a weekly call going to those who have anything, to share it with these strangers.

and yet, this place, with all of its nothing, is better than what they left.  some say its market, barely a blink, is the biggest they have seen. and the most peaceful.

i talked to a man who has been here, in dadaab, for twenty years.  “i have no plans to go back,” he said.  “everything is here.  my friends, my children. one day, though, perhaps my sons and daughters will return.  where did you say you were from?  Canada? yours is an amazing country.  you take many somalis.”  he smiled and shook my hand.

i dry myself off, open the door.   i walk behind the shower.  the ground behind it is dry.  no sign of the frog.  i listen.  the drone of a distant television.   above, the clear night sky sparked with stars.

i take my sarong off the hanging line, and walk towards my room.  in the corner of the compound, the frog pushes himself into the smooth dust, deeper, sand dry on his skin, the showers splashes a memory.   far below, in the baked earth, he waits, saving his voice for a kingdom yet to come.

today, i love my job.  i love it despite taking the picture of a young girl’s hands, clutched around her head, cradling herself, exhausted.  “can i take a picture of her feet?”, i asked her mother.  “its for medical students to see what happens when people starve”.  yes, she answered, if you can get me a basin.  it’s to wash her clothes.   i don’t have one, and they’re so dirty.  and if you have any money…

yes. take it all.  and the basin too.

it’s what i felt like saying, but i didn’t.  in that way, i am diminished.

degahaley new arrival.

i did get the basin.  i asked after it for hours, and eventually it came.  this afternoon, her daughter, who hours before lied cradling herself in washed out fatigue, stood in damp clothes, renewed from the food we dripped in, her hips at a jaunty angle.  she looked at her brother, then her mother, a parent already at five years old.

today i love my job because it helped me remember something important.  today it was that i have a chance, if i open myself more, and each time more to what is offered to me, i leave improved, both of us closer to the quick of what it is all about.  it’s like a good friend of mine taught me about improv.  you say, “yes, and…” and they say, “yes, and…” and yes, and yes, and yes.  and so it goes.

catch me tomorrow, though, and it might be different.  but each time it is, less than before.  good night.  sweet dreams. bed time.  yesssss…

it’s still blowing in, through my mesh window, out my open door.

back in the heat and the dust.  i arrived last week, by road from nairobi.  i am working in dadaab, home to 300 000 somalis. more come every day, fleeing not only the chaos of their country, but a worsening drought that saw last november’s rainy season shortened to one day.  tomorrow, i will sit at a wooden desk, looking at the rows of mothers gently dripping milk into the tube that runs through their child’s nose into his stomach, as another is lead into the ward, her child barely a bump beneath her black burka.  she will unwrap him,  set him in the bucket of our gently swinging hanging scale.  he will cling to the sides, mewling weakly for support, as his mother and i  glance at the scale’s jittering hand.  5.2 kg at 14 months old, more a robust birthweight than a fighting one.  we’ll lead her to a bed at the end of a long row, one more mother with mouths to feed at home, but this one too weak to last much longer.

this is a challenging mission.  not simply the medicine, nor the context, the world’s largest refugee came and its most forgotten, but also because there is no little life outside of the hospital and compound.  while it will take resolve to last through to missions end, the lack of freedom and its congruency with the population we are here to serve is not lost on us.  the people here are not allowed to move, nor vote, nor work, nor farm.  they live between a freedom they can’t abide, in sight of one they are not afforded.

i wake up at 2 am every night, as the power cuts out and my fan grinds down.  sweat starts to bead, and i push through the mosquito net.  dust falls onto the sheets.   i grope for my headlamp, click it and step outside. the compound, usually full of the activity and noise of the 70people who share it, is quiet and dark. the wind, violent earlier, has calmed.    stones crunch as i walk towards a chair in the centre of the yard.  i sit down, click off my light, stretch my neck back. above, stars are scattered in the blackness, thousands of distant jewels.  somewhere, in dadaab, someone is looking at the same ones, staring at the open space above, hoping that if you can free your mind, even for a moment, with it, goes your soul.

more soon. love.

For more, read the full media release : Fighting in the town of Abyei: MSF treats the wounded

this morning I left my apartment in Kensington market in a hurried flurry of jangling keys and last minute grabs, the chaos of the hasty departure tempered by the cool certainty that the neither my clothes iron nor the burner of the stove were on. in the four weeks since I have been home, I have used neither. not once.

stepping off of the plane from sudan was like stepping onto the moving belt in an airport; things quickened immediately. I started working in the emergency room a few days after, and my cellphone started accumulating messages. I would wake up from a night shift at 3 on Saturday afternoon to a text that said, “party at 4. wanna come?”, and within minutes, I was all jangling keys and hasty grabs. after so many months of no movement, I can’t get enough of it.

my life is frenetic. ours, probably. its pace is unrelenting. when I landed, I jumped on the first speeding moment I saw, and it’s inevitable, unstoppable momentum carried me through time like a heavy ball bearing. in the weeks since I have been home, it has taken the enforced spatial celibacy of an airplane seat for me to write something for the blog that I loved so much.

the contrast between my life in sudan and the one here is complete. it is like someone took the grand tape loop of my life and cut out six sudan months, then glued it together again. it hasn’t missed a beat. the coming home jubilee is like the going away one. my friends are the same, my job the same, my apartment the same.

am I? I can’t tell. I think my friends would answer yes. overbusy, packing and unpacking, an overarching interest in Frisbee and wanting to do more things than i can fit in. outside seems ok. inside tI don’t know. I haven’t taken the proper pause. there is a hard spot right here, right where andrea pointed when I came back from the hospital that one time, when I stood in the kitchen leaning against the dirty counter trying not to think, she pointed right at it, and it sits there like a stone.

amidst all of the ‘how wuzits” it is rare to get a “how are you?”. that’s good. I don’t know. mostly i think i’m ok, completely unscathed, business as usual. then I write a line or two about standing in the compound kitchen, and I can feel the trickles of sweat on the back of my neck. and that stone.

I haven’t been able to go back through the blog yet,except to read the latest comments. I have not been ready to live the Technicolor reality of it. i will. over the next week. I must. I have the chance to write a book, and want to get started. i want to find what i left behind.

so that’s my latest and last news. I haven’t told many people. I don’t want everyone to know. i feel shy about it. posting the news
seems different. maybe it’s because i feel more comfortable with those of you who have read this far into the story, people who might be less likely to ask, “so, how was it?” because they know. and also because i want to say thank you. for helping me think that it might be possible.

as it is, the book will come out on doubleday in early 2009. it will not be the blog. it will be different. the blog was a living thing, kept alive by everyone who read it. if it was printed and bound it would become inanimate, frustrated, lifeless.

the book will be more careful, I will have more time to write about things I had only seconds for in abyei. I am excited for it. not just for the chance to write, the chance to spend moments in quiet thought, and not just for the chance to find what i left behind, but also for the change that will be necessary in my life to make it manifest. it will mean less last minute rooftop parties, but also less jangling keys and last minute grabs. less slippery ball bearing minutes and more slowness.

for now, I need to rely on this blue seated airborne tin prison in order for me to pen you a letter. though grateful for it, I will be happy to see it go.

below me, 30 000 feet, Manitoba’s parcels of land bound by white gravel roads and green looping belts of rivers. I will be in Alberta soon. I haven’t seen my brother in a year. his wife is about to have a baby. we will play Frisbee and talk about how he feels about it. he is the only person I know in the world who likes Frisbee as much as me. later, I will travel north to where my grandparents live. I have heard that my grandfather has made a map detailing every moose my family has hunted over the past 60 years. I hope to go walking with him in the forest and learn more about it, and more about where I am from. and for the first time since abyei, I will find some slowness. may it stretch a bit towards forever.

so, some of you I will see on the street, or at the next jubilee event. the rest of you I will see in spring 2009. until then, I hope the world is kind to you and the moments you love most, last and last.

time and called the friend who had offered
to come pick me up. he was surprised to hear from me. was it today i
was coming home? really? he would be right there. after he finished his
beer.

i hung up the phone and put my bag back down. what was i doing here?
to whom did it matter if i was in the city or in my tukul, sweating.
only me? i supposed that was all we could hope for, that all we ever
really had was our one self. i called him back, said thank you, but i
wanted to take public transit home. it seemed like the right thing.
time to think, a slow unveiling of the city. he said ok, but i should
call him when i got to the market. i handed my customs form to the
officer, Nothing to Declare, and walked through the sliding door. in a
crowd of people i saw greg. he was waiting for me in a mullet wig and
old school blue bell bottoms.

“man. i can’t believe you fell for that… i thought i blew it with
“after i finish my beer” … …yo, let’s get out of here… …people
have been staring at me for, like, an hour.”

we drove back through the city. so familiar. the same straight
roads, the smooth whir of traffic pouring into traffic and out again.

“i won’t ask you how it was. but i will ask you something else. how
do you feel about going to a pool party? yeah, right now. straight from
here. i’ve got some extra shorts. a towel. everyone will be there.”

we went. my other plan was to lie on the floor in the dark of my apartment and feel disoriented. this seemed better.

we walked up the stairs to the radisson pool and snuck in the side
door. bam. faces. fast faces of people i know. flashflashflash. like
bulbs popping in my eyes. friends, my best ones, but this time not
stuck in the still photo memory of my imagination, but moving in real
time, doing real things. picking up a hamburger, diving into a pool,
standing up from their chair, walking towards me, hugging me. someone
had attached my brain to an electrical wire.

it was a mirror image, projected upside down. everything was in its
right place, but it didn’t fit. whatever it was before, this round
thing that i was a part of, seemed broken. i didn’t just want to sit
outside of the circle, i wanted to stand against the railing.

i leaned out over it and looked at the boats dotting toronto’s
harbour. i didn’t know how to start. an acquaintance came up behind me,
clapped me on the shoulder, then shook my hand.

“so…. how was your trip?”

flashflashflash.

“um. yeah, it was… uh…… good.”

******
p.s.

http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2007/08/12/MNLHREC18.DTL&type=politics

I am writing this in east berlin.  it is raining softly.  the skies, however, look like they are about to clear.   there is a hum of traffic from a nearby street.  from my balcony I can see four silent statues, perched on the roof next to mine, staring, dark with soot.

I go home on Wednesday.  I don’t know what I am supposed to do there.   there is some type of beginning, but I can’t see it, not yet.

the rain has stopped.  the sun.  here it comes.  blinding, brilliant.

some type of beginning.  my thoughts are heavy with it.  I am nervous.  I remember the last one so well.

I remember its excitement, its inevitability.  I had spent years placing circumstance onto careful circumstance until they formed a fine point, and I knew exactly where I was.  all I had to do was step onto a plane and into an exact thing.  the openness of what lies ahead is uncomfortable.  it doesn’t feel like it fits as well.  it is too loose.

last october, I was waiting to go away.  I had done my training with MSF in germany, and was waiting for my mission.   I was sitting outside of an office at the university, waiting for a meeting with the director of the international health office, a friend.  my cell phone buzzed in my pocket.  it was the HR officer for MSF’s toronto office with the first offer of a mission.  he asked me if I would consider darfur.  he said it would be a skeleton team, only men for reasons of safety, and the security would be tenous.  we would likely live in tents, move when we could, and try to access populations that were difficult to reach. he told me he had done a similar mission before and almost left early because of stress.   would I go?

my friend came to his door and waved me in.  I asked the HR officer if I could call him back.  yes.  tomorrow?  yes.

I sat in the meeting and watched my friends lips move.  I could not focus on what he was saying.  I nodded, laughed occasionally, but my mind was roiling.  tenuous security.  reasons of safety.  is this what I wanted to do?  I had always known that this was a possibility, even hoped for something like it.  i said that this was a time when I would go anywhere, do anything, that I had no wife and no children and no debt, that if there were a time to take risks, this was it.  I not only said that, I had worked hard for that to be true.  but now that I could see it so clearly, dangling so closely, i was uncertain.

I left the meeting and got on my bike.   I pulled onto dundas street and started to head home.  when I arrived to to my house I kept riding. i turned down alleys and back streets full of leaves until I arrived to the shore of lake ontario.

why was I doing this?  what was I trying to prove to myself?  to everyone else?  that I could take it?  that I was intrepid and brave?  my direction and decision that seemed so clear an hour before now seemed so insistently serious.  I liked things the way they were.  it wwas the best.  my days were full of friends and excitement and beautiful things.   what was I hoping to gain, what might i lose?

I returned home, feeling the true momentum of where i was for the first time.  I walked upstairs and sat down at my desk and turned on my computer.  the cursor blinked dumbly.  no answers.  I started to go through old emails, from friends, from family.  I found one from my friend Michael.  it was from a commencement speech by joan didion.  it was this.

“I’m not telling you to make the world, because I don’t think that progress is necessarily part of the package. I’m telling you to live in it. Not just to endure it, not just to suffer it, not just to pass thru it, but to live in it.  To look at it.  To try to get the picture.  To live recklessly.  To take chances.  To make your own work and take pride in it.  To seize the moment.  And if you should ask me why you should bother to do that, I would tell you that the grave’s a fine and private place, but none I think there do embrace.  Nor do they sing there, or write, or argue, or see the tidal bore on the amazon, or touch their children.  And that’s what there is to do and get it while you can and good luck at it.”

I called the Toronto office and said I would go.  I said, like before, I would go anywhere.

it didn’t work out.  the mission was too aggressive for a first missioner, no matter how willing.  three more came up before abyei.  finally, in January, I received an email that said, “sudan?”.  and then, suddenly….

and now, just as suddenly, the end.  from that beginning to whatever this next one will be.

it is particular to each epoch that its people consider theirs the most important, their power and responsibility unique.   for us, however, it is true. and it is not just because we are fighting over diminishing energy supplies in a warming world, or because we are facing epidemics of obesity at the same time as we struggle with famine.   ours is the most important because we won’t be around for the other ones.   for us, this is it.

I realize that some of the people who are reading this are considering doing a similar thing, either with MSF or in another way.  of course, not everyone needs to practice medical humanitarianism.  you simply have to use what you know to effect the change in the world you most want to see.   I do not consider a moral overstatement to say that because each of us has a role in making the world, we must take some responsibility for what it is.  accept it or change it.  why not.  live like you have been granted your deathbed wish to do it all over again.   the grave is a fine and private place.

I used the analogy of the old black and white television before.  i had one when i was a kid.  downstairs.  once you turned it off, it went from a bright flurry of beautiful blurred hurried stories, flashflashflash, to a bright white dot, brilliant in its intensity and focus, then slowly fades to black.  it is how i think about the difference between life and death.  one minute we are bursting with energy, atp popping off like kernels of corn, everything a million miles an hour, and the next we are concentrated to a singular point that grows fainter and fainter until it finally disappears.   the good part is that life continues on just as brightly elsewhere.  just not my version.

like this blog.  I am struggling because I don’t want to end it.  I have developed such a deep affection for this, I don’t want it to stop.  the problem is there are other versions, people working to perfect a window into another part of the world that deserves attention.  they can use your support.  it was invaluable to me.  let’s help them. check out the other msf blogs.  i will.

I am humbled by the people who have taken the time to read this, and to all those who wrote me.  I have written before that when I was at my worst, this helped me through. I am particularly grateful to msf.  not just for allowing this forum, though that too, but for all the other reasons.  for allowing me to feel in the company of friends, for meeting me at the airport regardless of country and time, and most of all for assuming the difficult mantle of caring for people who would otherwise be doomed.  even through the controversy about this blog, I knew that most of the criticisms were rooted in a concern for the men, women, and children we work for.

particular thanks go to ken.  brother.  I don’t know what I would have done without you helping me out when times were toughest, for making this blog possible, for trusting me.  and to avril, your support was unflagging.  thanks to my family, my mom, my dad, my brother.  you didn’t miss a beat, not one.   bro, i knew that if I ever needed you to, you would turn your car around in the middle of the road and head to the airport without grabbing your toothbrush (which you should have done).  and to the people whose packages made it me in the dusty desert.  may I return the kindness some day.

when I was leaving last year, suffering through false start after delay, people were wondering if I planned to leave at all.  some suspected me of fostering sympathy in order to perpetuate parties.  that was partly untrue.  one of my friends even took to calling the long series of departure events my “going away jubilee”.

the coming home jubilee has started in earnest.  berlin is simply its first stop.   the soft stop date is Halloween, though if I can keep up the momentum through November and dovetail onto the Christmas/new year’s season, it might end in early 2008.  i hope my friends are well rested.

before I end this post, I wanted to offer an apology about the blog.  as much as I wanted to write the story of sudan, I never did.  the story of the country is complex and requires a lesson in its history since independence in 1956.  this was not my story to tell.  it can be found elsewhere.  like all things, if we hope for change, the only way to recognize its machinery is to inform ourselves.  it allows us inform our government as they ponder bills on our behalf, it allows us to be conscious of the support we give to Canadian companies who act in our name around the world.

alrright.  that’s it for me.   it is dark.  the statues are just silhouettes and behind them, berlin shines.   let the jubilee begin.  good night.

i picked my way through, binning many. torn, frayed jeans, worn thin by a scrubbing stone. the sheaf of papers necessary for traveling in sudan. a broken skipping rope. i came to a black plastic bag and could not remember what it held. i opened it and pulled out two sandals. once black, they were now red with dust. they seemed from another time, ancient, an anachronism. i put them back in the bag then repacked them.

i talked to a friend on the phone for a few minutes the other day, and he said, surprised, “well, you sound ok.” i wonder how he expected me to sound, if there was a fear that i had changed into someone he wouldn’t know.

i have changed. i am now a seven foot tall asian woman in her late forties. i suspect this will be the most surprising to people who know me as a medium sized man in his early thirties, but it has its advantages. concerts are one.

the other ways are less obvious, even to me. i suspect that most of us who go through with their first mission do it for several different reasons. one might be a perceived social responsibility. others are excited to see the world, others excited to test their mettle. i would say that all of us secretly expect the experience to change us. it does. you don’t feel it as much until you land into the perfect mirror of home and the friends you have left there.

i was standing in the airport line last winter, about to leave, and talking with my friend matt on the phone. he asked me why i was going. why really. part of it, i said, was inertia. i built my career towards this point, the one where i step off the plane and into something a little less comfortable. it was like climbing the ladder of the tall diving board; there is only one way down. personally, i said, i want to understand the world better. to find my true place in it. to do that, i want to be close to not only its beautiful, comfortable parts, but also its hardest, most difficult ones. it is easy to convince myself of my own happiness when i am whizzing around toronto on my bike, answering phone calls from my friends. but remove this. all of it. instantly. then who am i?

it is a similar lesson that working in downtown toronto teaches me. i finish a shift at st. mike’s and during it i see a homeless, helpless, who has had alcohol poison his life, and seems destined to die in a shelter, grizzled and filthy. a schizophrenic woman deeply addicted to crack, confused and screaming, a prostitute assaulted by her pimp. everyone who works these kinds of days leaves them and must find a way to be a friend to their friends, a son to their parents. i learned it on my bike rides home.

i succeed. mostly. but whether i do or not, on those bike rides, i see the world as it is. at the zero point. the good things, the hard things. there is no fooling. i don’t think it makes that first Frisbee throw in the park any sweeter. but it does whittle everything else away until only its true value remains.

so, part of it, amidst a dozen other worthwhile reasons, was a chance to better approach the world and see it as it is, a way to unblind myself from the millions of circumstances and possibilities that distractingly dangle dazzling in front of my eyes.

i am not sure if that is how i sounded when i spoke on the phone with my friend yesterday, but that is how i feel. unblinded. the true value of a conversation with my brother, the chance to move freely, to be in a warm house full of friends, the exact worth of these is reflected clearly back. and because of that, i better understand my place in the family of things.

somehow, miraculously, there is a life-size space for me in the world, and one for each of us. it could be otherwise in a million ways. i’m glad that, at least for now, at least for these days, i know it. sadly, there seems none for my frayed jeans. nor my chin up bar. the dusty sandals, though… i’ll make some room.

abyei is still real. i am positive. i know that right now, as i type this, the people who remain are working their way through familiar struggles i have left behind, that the call to prayer will happen soon, that someone just looked at the thermometer and is scanning the sky hopefully for clouds. it has collapsed into a tiny white dot, but it is still too bright to forget.

time is different here. hours are eaten up by little tiny minutes, almost instantly. they just disappear. days too. in abyei, time felt thick like molasses. each action was deliberate, even the small ones. eating food had a slow importance to it. this is dinner. now i am done. i will go to bed.

the days since have been like water. bright, clear, diaphanous by comparison. so many mini things have happened, but their inertia is different. i don’t know how many times i have eaten today. or quite where i have been. i could tell you if i thought about it, but i am not likely to.

since i last spoke at you, i have left sudan and passed through geneva for my debriefing. i am now in amsterdam, considering ending my relationship with some parasites. you have to understand, it is not them, it’s me. there are some things i have to figure out on my own.

the debriefing in geneva was interesting. aside from the usual talk about objectives, accomplishments, and future plans, there was considerable discussion about my blog, and about blogs in general. there are some who feel that they hide the slipperiest of slopes, that they are akin to voyeurism, a commodification of the MSF experience. others, like myself, are convinced that its immediacy and combinations of media allow a story to be told in a new, powerful way and that there is a benefit in their telling. the more people who know about abyei the better. the more first time volunteers who understand what it is truly like in the field, the better. the more of our family members who know we are alive, who get a chance to feel like they hear from us every day, the better.

i am not sure what will come of it all. it is true to MSF’s spirit that there will be a heated discussion that will give way to cool consideration, and finally firm into a resolution. i can read the wisdom on both sides, and hope to participate in the dialogue.

i can’t speak to all the merits and demerits of blogs, but i think i know why they work well; they are personal, immediate, and available. they make a window in the world, and when they are at their best, it is almost clean. though i can for the first time, i haven’t looked back through mine yet. not quite ready. too many little mines, memories that need to lose some of their colour before they are recalled.

because i did not have easy access to the internet, i wrote post to post. i never got a chance to see this as a larger thing, if it manifested any particular themes. i wanted to tell the story of abyei as someone who came to it knowing nothing, and then found himself woven into it. i wanted to tell the story of MSF, an organization that manifests a particularly pure version of the humanitarian spirit we all carry around. and, most importantly, i wanted to make more real a world that is happening right now, just now, at this very minute. someone just set down the thermometer, and scanned the sky. no clouds. no rain today. good for the hospital. the roof on the feeding centre has started to leak and the mothers are complaining, threatening to leave. it is important to know not just because it provides perspective, not just because the contrast makes us realize we have the tools to do something about the world we live in, but also to remind us that we are doing something about it. we could just use more hands. maybe yours.

there are other missions. dozens of them, going on right now. people are waiting for visas, passing through customs, counting days until their R&R, coming home. my experience was not remarkable. there are forty others like it right now, some harder, some easier, some longer, all different. i once said MSF is a treadmill. one person gets on, runs for six months, and it is someone else’s turn. maybe its more like the major leagues. dozens of teams, hundreds of games, a thousand people criss-crossing. but the multiplication is dizzying, so i just focused on my small corner because it is the only one i know.

a friend of mine came to visit me in amsterdam yesterday. we drove around in the rain and looked for tennis courts. he asked me what it was like, sudan. i didn’t have much to say. “intense”, i said, “not quite over.” still that bright, burning spot.

I tried to have a simple conversation with the driver on the ride here, but I couldn’t manage. Every thought was short circuited before it verbalized, my neurons a crossed jumble of sparking wires. It was then I realized that my brain had already left, maybe even the day before. Right now it is floating in an ice cream pail on some customs officer’s desk in Amsterdam. Every now and again he adds another warm mugful of vegetable stock and St. John’s Wort, and keeps an eye out for the zombified expat walking around the terminal bumping into pillars while looking at all of the lights.

I will catch up with it. For the time being… bzzzz… bzzzz… crossed, sparking wires.

It took me 48 hours to leave the field. It was a rush to the finish as I received my travel permit just as the plane was arriving, then flew off to the southern town of Rumbek to wait for a connection the next day. Rumbek is Abyei in twenty years. Wide streets with mature trees, green, calm, a large colorful market. I was enamored. This is the Africa I remembered, or at least imagined. People waving hello, children walking to schools in uniformed rows, smiling. This was life as I knew it.

I went for a run in the morning, and waved hello to chidren, even raced one on his bike. It was idyllic. I was about half way through, running on a beaten trail that flanked the side of a road. I made room for a bicycle to pass me from behind, and for a man approaching from the opposite direction. The bicycle wobbled past. As the man passed opposite, he drew his hand back, as if to strike me. In it he held a sapling, as thick as my finger and three feet long. We stood there, him poised, me nervous, waiting. A full moment passed. He laughed, and kept walking.

The spell was broken. I did not fit in. It was an illusion. No matter how well integrated I thought myself, this was not my place either.

I am wondering where that place is now. Yesterday I received an email from a friend who did his first mission last year, and he said that sine his return, he feels uneasy. He is waiting to go away again.

So much left unwritten. There are a million things. I wanted to write about the Casio F91-W, how it is the watch for all developing world traveling needs, reliable and unglamorous. I wanted to tell you about my grandfather, how he used to skate on the thin fall ice, often breaking through, and track diving muskrats to stun them with a quick blow of an ax handle on the frozen surface of the lake, then sell their fur for pocket change. I wanted to tell you about the food in our mission, how we would not call it by its name but by it’s color:

“What’s for dinner?”

“Guess.”

“Umm….yellow.”

“Nope.”

“Ummm…red and brown?”

“Nope…black and brown.”

“Shit. I hate black and brown.”

“Yup.”

I wanted to tell you how some of the women in the hospital, the mothers of the children in the TFC, wrote and sang us a song one day, wishing us strength. I wanted to describe better the team, Franck the logistician who I would trust with my life, Maurizio and his calm, wise ways. All these things, untold. And many more. Alas.

I am leaving with some misgivings. Most importantly, the visa has been slow in coming for my replacement, so she is delayed for a couple of weeks. I am to start work in August and cannot stay. I would have liked it so much more if I could walk through the Abyei hospital with the cavalry, and leave the keys to it in her capable hands.

Second, in some cruel, twist of fate, I already miss Abyei. How can that be? There were weeks that I longed for a reality that was anything but the one that hit me when I opened my eyes. Now it is strange to feel so untethered, to not have the responsibility and privilege to constantly improve something so worthwhile.

I will write some more posts, perhaps with a different frequency, as I see how well the next places fit.

I suspect more thank you’s will follow as this winds down, but my gratitude for those of you who have been there throughout this blog, to encourage, to learn, to bear witness, is so profound that even the best words cannot capture them. There were days where I bent down to enter the logistic tukul and sat at the communications computer still bent from all the weight of the world outside of it, and I would receive an email that contained comments from so many of you. When I left the tukul, it was on a thousand tiny clouds. A source of strength and inspiration when it was wanting the most. Thank you.

Oh, the flight boards. I just looked back over the post, and I capitalized everything for the first time. Huh. Imagine that. Will send word once I meet my brain again.

Soon, suddenly, not Sudan.

www.youtube.com/watch?v=oBmIzjXy9rQ