The Divergent Nature of That Sunday

08:00Road trip to Yuai cancelled.

08:15Learn that our beloved Sudanese nurse/midwife Hellen needs to return to Khartoum for an undisclosed amount of time for personalreasons (a solid blow to the team—we just lost our African Mom).

08:45 Start playing darts with Maina.

08:00Road trip to Yuai cancelled.

08:15Learn that our beloved Sudanese nurse/midwife Hellen needs to return to Khartoum for an undisclosed amount of time for personalreasons (a solid blow to the team—we just lost our African Mom).

08:45 Start playing darts with Maina.

08:50 I am either drunk or was dropped as a kid because nobody should be this bad at darts…

09:15 Canada 2 & Kenya 0 – Maina is worse at darts!

09:20Hear screams of life-halting horror coming from our medical clinic more then 200 metres away.

09:30Learn that a middle-aged man has passed away from unknown causes in our Inpatient Department (IPD).

10:00The deceased is from a village over a day’s walk away, and his wife, daughter and son have no way to remove or dispose of the corpse.

10:01It’s Sunday and we’re short staff, which in this case is the same thing as a short straw.

10:30Nothing in my life has prepared me for this. Flies and fecal fluids have filled the middle-aged man’s tukul. He’s naked and dead and I’m breathing and confused by the simplicity of it all. I can taste the smell of death in the back of my mouth. I keep thinking the middle-aged man is going to move and it scares me a lot.

10:35 Thankfully John Yany (pronounced Yang) and a guard crawl into the tukul ahead of me and roll the middle-aged man onto a stretcher. To be honest I don’t think I could have done it.

10:45Yany, our guard and myself pick up the emaciated middle-aged man, a pickaxe and two shovels. There is only one sandy road and it runs right through the middle of Pieri. Every step is taken with the fear that the middle-aged man is going to fall off the stretcher. We stop about half a km past the market and I’m amazed at the weight of death.

11:00Yany has stopped in the middle of a never-ending pasture. Every effort is made to be as dignified as possible but I feel like somehow I let the middle-aged man down. I quickly remind myself that this isn’t about me.

11:01We start digging beside a couple of the week’s other tragedies. No cemetery, no markers … just mounds of death in the middle of a field.

11:10Maina and six men from Pieri including Stephen Mai, our logistical supervisor, come and relieve me of my duties. (Which for the record are not my duties).

11:15Maina and I pay our final respects and head back to the compound.

11:20A bee attacks Maina and we run like hell to avoid it all.

12:15 Hellen’s plane comes and goes. It’s sad as hell to see her leave.

12:45 Sue gets a call on the radio that a woman who has been in labour for 9 hours is now at the Antenatal Care Clinic (ANC), and ready to give birth! Come back Hellen...

12:50Our amazing 29-year-old Dutch doctor Ortillia and super-star Canadian nurse Sue know that I've never witnessed a birth and want to. Sue suggests that in Hellen's absence they could use an extra set of hands. My first thought is that 1 in 6 babies die during childbirth in Sudan, the highest toll anywhere in the world. My second thought is that I should man up and do it!

1:00Stephen Mai has beaten us to the clinic. The man is everywhere. It turns out that he knows the woman and brought her and the family to the MSF ANC clinic. The delivery room is spotless and one of our few buildings with a cement floor.

1:05-30 The girls put me to work immediately as our regular ANC gang is either enjoying their only day off or on a plane. I sort through keys, grab stuff out of the ANC closet and run to my medical store to grab some extra supplies.

1:35Without the aid of any drugs this woman has withstood a barrage of contractions, and an episiotomy and has barely made a sound.

1:40The mood suddenly shifts when Ortillia calmly mentions to Sue that the umbilical cord is wrapped around the baby’s neck. With only basic medical tools at their disposal, the girls continue their inspired work, while for the first time since arriving I’m grateful that the woman in labour doesn’t speak English

1:41I can’t stop watching Sue and Ortillia do their thing. They are so calm and never once let on that there may a problem. But there is a problem, a huge one.

1:42Ortillia performs some orchestrated moment of magic with her arms and like that the baby appears untangled in front of Sue and its Mom.

1:42Silence surrounds us.

1:42Everyone and everything is soundless. It feels like we somehow stepped into a vacuum. In my mind I start chanting...

Cry… Cry… Cry… Time passes with a glacial sense of speed. Please cry!

1:43For those of you who have heard the first cry of a newborn, you know that there is no sweeter sound on earth. It’s a boy and I’m never having sex again!

Stephen Michael (that’s right Michael) Deng was discharged from our clinic on Tuesday, October 23rd two days after the birth. Mother and baby are doing great and every day that MSF continues to work in Sudan, the odds get a bit better for the next baby.

I don't know how to reconcile the divergent nature of that Sunday. I’ve learned that the Sudanese circle of life is the same as anywhere else it’s circumference is just a lot smaller. I have always had a very difficult time with the concept of life and death. Ever since I was old enough to understand death it has frightened me more than I believe is either normal or healthy. Notorious B.I.G. summed it up best, when talking about Tupac's demise. "Death, there ain't no comin' back from that shit." While I don’t pretend to know if that's true, I do understand that although death is inevitable, sickness and suffering doesn’t always have to be. To that end MSF's work in Sudan and around the world is a tribute to human compassion, and inspired action.

An ode to Stephen Mai: What a guy, that Stephen Mai.

Rarely have I been more taken with a person quicker than Stephen Mai. Mai is my age, 34. He has three wives, and after today ten kids (six boys and four girls), four tukuls and ten cows. Today's addition has been named Maker (A very good Sunday). Four years ago, Mai brought his dying sister to the MSF clinic in Pieri. Our lab technician Sammy diagnosed her with kalazar. Mai was so grateful to MSF for saving his sister's life that he helped rebuild our current laboratory, which is a simple yet solid rectangular building, with a tin roof. Right angles are hard to come by in Pieri as the Nuer people seem to prefer circles to straight edges but our lab is an exception, and there is always a constant line of people having their bodily fluids tested and yours truly has been among them. You'll be happy to know that evidently it only felt like giardia. In four years Mai has risen from the ranks of an MSF guard to our logistical supervisor. He is resourceful, compassionate, dedicated to MSF and maybe the hardest worker I have ever had the privilege of running with.

Some Facts on the Ground:

1)Seven snake sightings since I last wrote. Four of them were baby Red Cobras. We think there’s a nest!

2)Snakes eat frogs and at any given time I have a family of five frogs in my tukul.

3)Constipation is a lot better than diarrhea.

4)Suggested reading on southern Sudan. What is the What by Dave Eggers.

5)I’m currently reading Endurance: Shackleton’s Incredible Voyage (Thanks Billy). It is about Ernest Shakleton’s failed voyage to the South Pole in 1915. For some reason it helps keep things in perspective. Frying is better than freezing and canned beans are a hell of a lot more appetizing than seal blubber and penguin brains.

6)The term “computer bug” was coined when the first computer (The Mark I or IV I think) unexplainably shorted out. After a look under the hood it was discovered that a moth had shorted out one of the circuits, and the term computer bug was born. At this moment there are 4 different types of bugs on my screen and another 3 chilling on the keyboard.

7)Bat pee smells much worse than bat pooh.

8)The going rate for a wife in Pieri is 35 cows to be paid to the eldest male in the female’s family.

9)The Nuer engage in scarification rituals. When a boy enters manhood, six cuts are driven into his forehead from ear to ear. If the scars are crooked, it means the boy moved and couldn’t take the pain. I’ve yet to see a crooked scar.

10)Some women have a tapestry of facial scars that I’m told are actually much more painful to receive than the scared lines. As if there was ever any doubt having just witnessed a woman silently deliver her first child without any drugs.


Salutations from the south,