Ruby has just arrived in Bentiu, South Sudan, where she'll be working to assess the needs of the people living in a camp set up to protect civilians from the conflict in the region. She shares her diary from day one...
Our tiny six-seater plane makes a smooth landing and we’re greeted by Médecins Sans Frontières / Doctors Without Borders (MSF) staff, struggling to walk towards us, being helped by marginally less sick MSFers. Welcome to Bentiu where a Norovirus outbreak has claimed several of our staff! We help them on board for their flight to Juba hospital and watch the intravenous drips being set up.
Aerial view ©Sandra Downing/MSF
It’s a stiflingly hot day. I’m already covered in sweat by the time we’ve made the short drive to the UN compound. This is a very unusual project for MSF. We have set up a hospital and medical services in a Protection of Civilians (PoC) camp. This is a new terminology that the UN is using for areas where UN military forces can protect civilians at risk of being targeted by warring factions, in this case Government of South Sudan (GoSS) forces supporting President Salva Kiir and the in opposition (iO) forces supporting the sacked vice-president Riek Machar. The political disagreement that started in December 2013 has erupted into widespread fighting, largely following ethnic lines, simplistically perceived as Dinka GoSS versus Nuer iO, all over the country.
So we find ourselves in the unusual position of staying in the same compound as military forces. But of course certain things never change. While the UN staff sleep in air-conditioned containers, surrounded by small flowering gardens, we are sleeping in basic 8-person tents! But integrity can only go so far. We’re taking full advantage of the cafeteria and running hot water!
UN gardens ©Ruby Siddiqui/MSF
And this is a big reunion for me. Two years ago, I was in the initial team that responded to the Maban refugee crisis in the north east of the country. I’m greeted by Vanessa, the medical coordinator during that crisis. Niall the logistician and Adrien the Water and Sanitation (WatSan) technician are also here. And my chum Sandra, the field epidemiologist, has already been here for a month, setting up the community surveillance system that worked so well for us in Maban.
Even MSFers I know from outside the field are here. Ian and I worked on a MSF promotional event at Womad three years ago, Leo worked briefly with us on a GIS (Geographic Information System) project in London, Sara is the personal assistant for the medical department in Amsterdam and Haydn and I have lots of friends in common. I’m looking forward to seeing these guys in a work context. And my good friend Ivan is heading the whole team.
Ivan and I work together in the London office, exploring innovative GIS and technological solutions to epidemiological and field issues. We’ve worked together in the field once before, during the MSF response to the Haiti earthquake. We often respond to humanitarian emergencies in the field but rarely together. It’s going to be fun to work alongside him in the field once more.
I’m here to guide the epidemiological activities here. Sandra is on the last few days of her mission and Bhargavi arrives in a couple of days (for her first assignment with MSF). I need to ensure the community surveillance (the system we use for assessing mortality and illness in the population) is functioning correctly and carry out additional assessments to understand the population needs. We take a tour of the PoC camps, led by Tango David, our outreach nurse, and David, the outreach supervisor. There are five PoC camps. PoCs 2-5 are all located together to the east of the MSF hospital. But PoC 1 is in a separate location, north-west of us, due to the different ethnic make-up (Dinka, Shilluk and others as opposed to the largely Nuer population in PoCs 2-5).
The MSF hospital ©Ruby Siddiqui/MSF
But it’s not just the Dinka and Nuer that are fighting. In fact later on, when we return to the compound, we find a Darfurian trader that has been beaten up quite severely by people in the camps. The Nuer are suspicious of all Darfurians after JEM (the Justice and Equality Movement), a rebel group from Darfur, was accused of supporting GoSS forces.
Tensions are running so high that Adrien even met a man whose arm was broken for having an Arabic (and by local logic, Darfurian) name. This follows the massacre in April of at least 200 people at the Kali-Ballee mosque and Bentiu hospital, the majority of whom were Darfurian traders. Our medical coordinator, treats the trader’s injuries in the hospital and the military police escort him off the camp to relative safety.
We cover all the camps, measuring GPS coordinates for the MSF health post, MSF ORP (Oral Rehydration Points - for children with diarrhoea), nutrition centres set up by other NGOs, schools and water points. We pass a large pond where a UN truck has emptied garbage from the compound. He has managed to contaminate the camp pond with our own rubbish. The Ghanaian UN guards who couldn’t stop him in time are furious. And so are we.
MSF oral rehydration point ©Ruby Siddiqui/MSF
The camp is a sorry sight. People are living in makeshift shelters, open defecation is occurring everywhere and sewage water runs alongside the shelters. We bump into Ian who is working with the WatSan team to rapidly construct 100 latrines in a week. An ambitious target but badly needed.
Ian building latrines ©Sandra Downing/MSF
There is mud everywhere and it feels impossible to stay clean. Especially if you’re a local kid that has just discovered mud slides! We watch the kids hurtling down the slopes on crushed plastic bottles (that we distribute for collection of water from the tap stands!). The laughing is infectious and Ian and I turn to each other and say at the same time ‘I want a go!’
Mud slides! ©Sandra Downing/MSF
And we reach the one destination we’ve all been looking forward to. Bol is a young boy with learning difficulties and a huge smile. His mother died of TB and he has TB too. Luckily we’ve caught it and the outreach team ensures he receives his TB treatment. He was living in what had to be one of the worst shelters in the camp, the roof was falling in and it backed onto a putrid pool.
Tango David rolled into action and within days had arranged for the camp management to repair the shelter. And we’re here to see the final result. Somehow it’s hard to get too excited. The roof has been repaired but it still backs onto the stagnant water. But then Bol comes out with a huge grin on his face and melts our hearts. If he’s happy then so are we.
David complains that I’m walking too slowly. But everyone is about twice my height! I have to practically run to keep up with his long strides! We reach the end of PoC 5. But to exit the camps we have one last hurdle, a muddy slippery slope followed by knee high ruts of clay-like soil.
Crossing the sewage stream ©Ruby Siddiqui/MSF
Entrepreneurial kids have set up a little business by providing gumboots to anyone that needs to pass this hurdle. They’re making a tidy profit. We watch a couple of the Mongolian UN troops chasing a young man that has just passed through the entrance gate to the camps. He’s oblivious to their shouts. They’re all slipping and sliding in the mud. They finally catch up with him and check his bag. He’s carrying hashish to sell in the camps so they escort him out. They’re checking all bags for weapons, drugs, anything that might compromise security in the camps.
And this is just Day 1!