wfn.org | ELCA - A LONG WAY TO KURMUK

[Worldwide Faith News <wfn@wfn.org>]

While the famine is getting worse in Sudan's Bahr al Ghazal Province, the
situation has improved in southern Blue Nile. Sudanese aid workers, defying
a government ban on relief work and some of the worst roads in Africa, have
turned a looming famine into a managable food crisis.

By Nils Carstensen
Kurmuk, Sudan. July 1998.

"Let them fall"
     Willie takes a quick step sidewards and looks on as two 300 litres
diesel drums hit the wet sand with each their muted but heavy THUUUMP! 
     For a moment the men gathered around the tractor remain silent as they
try to catch their breath. The late evening symphony of croaking frogs and
chirping crickets engulfs the group. All torches have been switched off and
the river crossing is bathed only in the monochrome silvery light of a
hazed but almost full moon. There is hardly a wind and the day's heat is
still sticking to the ground.
     Willie wipes the sweat off his forehead and puts the cap back on. He
is 28 years old, wears a T-shirt, which was white when he started out this
morning, and a pair of black jeans. His face is concerned and there is
authority in the voice as he speaks.
     "Leave the sick guy on the trailer. Everybody and everything else has
to come off."
     It's past ten in the evening and they have been trying to cross the
stream for three hours. Flat on their bellies and half submerged in water,
they've had to dig the tractor out after three failed attempts. They've
built a track of large flat stones through the river and up its banks. The
stones had to be found and carried from along the river and the nearby
bush. All along mosquitos have been feasting on their half naked bodies.
     It is the fourth time they're stuck at a river crossing in a day's
drive. What should have been a four, or at most six hour trip, has so far
lasted 13 hours and they are still only half way to their destination - the
town of Kurmuk in eastern Sudan.
     The three women passengers and their children all get off the trailer
and wade across the low flowing stream. The problem is not the level of the
water but the weight of the tractor and its trailer in the wet loose silt
and sand of the river bed.
     Some of the men have started talking about giving up for the night.
This is the last attempt, if the tractor cannot cross with the trailer all
emptied, they'll have to wait for the next day and a small miracle in the
form of a passing truck which can pull them out. 
     "Khaliffa, get ready on the tractor. Everybody else pushes."
     Khaliffa, stripped to his underpants, gets in the drivers seat and
very slowly he lets the tractor roll a few inches backwards before he
releases the clutch and hits the accelerator. The left rear wheel starts
spinning and mud, sand and water is thrown in a cascade at the pushing men.
Then both wheels catch on to something solid and the tractor starts moving,
jumping and dancing out of the low water, up the black muddy bank and it is
in the clear with the men stumbling and falling in the darkness behind it.

Black cotton soil
     35 minutes later and while driving through a swampy area the left
wheel again hits softer ground. This time it is the infamous "black cotton
soil" and nothing can stop the tractor from sliding and sinking sideways
until its body sits on a patch of solid ground while the left rear wheel is
spinning senselessly, halfway buried in mud and water.
     Down and out and even Willie knows it this time.
     "Khaliffa, Abdullah, the sick man and one of the guards can stay
behind. The rest of you take a few necessities and come along. The next
village is not far away."
     After some 20 minutes walk through the night they reach the first
roadside huts of a village at the foot of a small but almost perfectly
rounded hill top. At this time of night, all is quiet in the village. An
accompanying member of the Sudan Peoples Liberation Army (SPLA) goes
searching for the local chief and returns a few minutes later with the
message that the visitors are welcome and can stay overnight in the guest
hut right next to the road. 
     The women and children settle into the hut while the aid workers among
the group pitch a couple of tents. For the remaining men, beds and mosquito
nets are borrowed from the chief.
     Half an hour later the Southern Cross and the moon is looking down at
a very quiet camp site at the village of Barbaras in Sudan's Blue Nile
Province, not far from the border with Ethiopia.

A nightmare
     As Willie Omoro gets out of his tent the following morning he is
greeted with a mug full of hot sweet tea - courtesy of the village chief.
Willie is the team leader for a group of Sudanese and Kenyan aid workers
who run the only relief operation in the parts of southern Blue Nile
controlled by the rebels of the SPLA. 
     A dozen or so children from the village have gathered around the
visitors. They are between two and seven years of age and most of them are
naked. All of them have the pot bellies,  swollen faces and reddish hair
common in children suffering from prolonged malnutrition.
     Like their parents, these children are displaced from the neighbouring
province of Upper Nile and have settled here while fighting continues in
their home area. Some of them have been displaced for more than one year,
and their situation is why the aid workers are on their way to Kurmuk.
     Willie and his colleagues represent a consortium of church agencies
including the Sudanese churches, Action by Churches Together (ACT) and
Caritas Internationales. They are delivering assistance from international
partners to more than 30.000 internally displaced people from nearby Upper
Nile Province, along with a larger indigenous population equally stricken
by 15 years of civil war and decades of general neglect by the central
government in Khartoum. 
     On this early morning, the aid team again faces an enemy almost as
troublesome and difficult as the civil war in their country: The
combination of a very poor road and the rainy season, which for four to
five months every year turns any movement of goods into a nightmare. 
     And all they have at their disposal is the small red Massey-Ferguson
tractor and its trailer which now can be heard approaching their camp site.
A group of men from the village has been up with the earliest light of the
day and they have helped Khaliffa and his co-driver Abdullah dig and push
the tractor out of the cotton soil ditch, where it spent the night.
     The tractor is carrying fuel supplies from  the aid project's base
camp to the town of Kurmuk some 100 kilometres up the road. In Kurmuk,
several hundred tons of relief food and some essential supplies of salt are
waiting for fuel before it can be moved on for distribution in different
parts of the area. Rains and roads permitting.
     A large truck that was  used to help distribute food has been stuck at
yet another river crossing for five days now. And despite numerous rescue
attempts using trucks and tractors borrowed from the SPLA, its front wheels
are still halfway burried in sand and mud. It got caught in one of the many
small and unassuming streams which within hours can swell to roaring rivers
as rain water from the Ethiopian highlands feed into them. 

An eerie silence
     Shortly after 8 a.m. the tractor and its passengers are back on the
road again. This morning the sick man seems to be a bit better, and he is
sitting up in the trailer. He's a local health worker, about 35 years of
age and his wife and two children are accompanying him. 
     As the trailer's movements on the rough road trows them back an forth,
the sick father tries to comfort the smallest child. Yesterday he was
delirious and could not even recognize the children and tried to beat them
up. Nobody knows what is wrong with him - a case of cerebral malaria maybe?
     Once they reach Kurmuk the doctor there will have to try diagnose his
illness. In his home village nothing could be done for the sick health
worker.
     The landscape they are driving through is one of small mountains,
pointed rocks and black and reddish brown boulders which stand out in the
midst of a large bushy forest. 
     Gum arabic producing Acacia trees are abundant but nobody seems to
utilize them. A simple gold mine, which until recently was explored and
exploited by a Chinese consortium working with the blessing of the
government in Khartoum, is lying dormant as well. The Blue Nile Province is
known to be rich in gold and other minerals.
     They drive by villages where all grass and mud huts have been burned
down and even the few stone buildings seem dilapidated and abandoned. There
is an eerie silence and absence of human activity when the tractor quiets
down for a break.  
     Some few hundred meters from the road lies the ruin of an old stone
building. In the 1860's this was the home of a Funj Queen remembered now
only as "Amna". She settled in Blue Nile to trade in slaves and gold with
the Arab traders further north. She, like the Chinese gold diggers 130
years later and the numerous Northern Sudanese traders and administrators
who took control of the area in the mean time, may have done well for
themselves but seem to have left little behind in terms of development.

Neglected province
     The SPLA has been fighting for control of southern Blue Nile since the
mid 1980's. They captured it in 1987 - only to loose it again in 1992.
Since 1996-97 the SPLA has relaunched an offensive in southern Blue Nile
which so far has been militarily successful. But the renewed fighting has
sent much of the indigenous population fleeing along with the Sudanese
government forces as they withdrew to the north and west. Many have also
run into neighbouring Ethiopia where tens of thousands of them now remain
in a refugee camp.
     In their huts and villages displaced people from the Mabaan area of
neighbouring Upper Nile Province have moved in as they had to flee fighting
which broke out in their home areas. 
     Everybody and everyone seems to have been uprooted in this remote and
neglected part of Sudan. Only very slowly are people of the indigenous
Uduk, Barta and Funj tribes of Blue Nile coming back to re-start their
lives as the area at least for now seems secure with the front line pushed
some 80 to 100 km to the north and east. 
     Eight months ago an unknown number of children died of hunger in these
villages. Inhabitants and visitors then spoke of an unrecognized famine.
Now malnutrition remains widespread and common but nobody dies of hunger in
the villages reached by the aid project. More than 1,000 metric tons of
maize along with protein enriched biscuits for the kids have helped turn
the disaster into what Willie Omoro now considers a "manageable food and
health crisis."
     Sixty-five tons of seeds and more than 14,000 tools along with
agricultural education have ensured that many of the displaced will have a
first harvest by August.
     As the small red tractor and trailer slowly make it through the bush
it may not look like much when compared to the air drops of the UN's World
Food Programme in other needy parts of Sudan. But this is the only aid
project in the entire southern Blue Nile and for as many as one hundred
thousand people, it has helped make the difference between famine and a
modest harvest, between health and disease. 
     For some it has meant the difference between life and death.

Too little food
     As the tractor makes a stop at the village of Dem Ansour, Willie calls
for an improvised meeting with six of the local chiefs. Sitting under a big
three, 50 year old Nyaka Lida speaks his mind while the other chiefs nod in
agreement.
     "So - yes the local people here let us work in their fields and we do
get food from the project. But what about drugs for our sick children?
There are none. And the food we get," the chief shakes his head vigorously,
"it is too little for us. It is rather for feeding chicken."
     "Our project," Willie counters after having listened to the elder man,
"is not the United Nations. It is from the churches and we cannot, and will
not, keep handing out food to you. We are only here to help you become self
reliant again. In about a month from now you will harvest your own crops
and from then on we will only help the weakest children with food. The rest
will be  food for work.' We need to free some resources so we can start
assisting in health, medicine and education."
     The discussion goes on for another half hour. The chiefs talk among
themselves and in the end chief Nyaka Lida speaks again. 
     "We may have been chased from our ancesters' land, but we have never
been dependent on anybody. Not the UN nor the Arabs (local slang for
Northern Sudanese). We always depended on agriculture. We don't know much
about schools either. But we welcome what you say about schools and
medicine. And although we may not believe you right now, we may come to
believe you, bit by bit and as we see things happening!"
     The chiefs' disbelief is deep as it is rooted in experience. No other
aid organisations, be they international NGOs or any of the agencies of the
United Nations have so far been willing to assist the people in Blue Nile.
     This is not because there are no needs, but because southern Blue
Nile, like the Nuba Mountains or the Inghesena Hills further west of here,
are contested areas in terms of the Arabic versus African cultures, the
religious conflicts and the rivalry over natural resources which lies at
the root of Sudan's 15 years old civil war. 
     Because of such sensitivities the government of Sudan will not allow
humanitarian organisations to work southern Blue Nile. By blocking aid the
government in Khartoum hopes to achieve in Blue Nile what it has achieved
in other parts of the country controlled by the rebels in SPLA: depopulate
the areas by starvation and force people to flee. 
     In practise all the politics means that Willie and other aid workers
are here illegally. Aid has to be brought in discretely using complicated
means and so adding to the trouble caused by war and bad roads. The
ceasefire, which has been declared for a period of three months in other
parts of Sudan in order to facilitate relief work, cannot be counted on in
Blue Nile. If anything goes really wrong here Willie and his collegues can
trust only the tractor and  eventually their feet to get them out of
trouble. 

Local hero
     After 36 hours on the road the tractor passes by the ruined military
barracks which marks the beginning of the town of Kurmuk. 
     Greetings of "Keef ?" (how are you?)........ "Kwais, ana kwais, el
hamdu lilah. Khef inta?" (Fine, thank God, I'm fine. How are you?) is heard
over and over again as they drive through town. Finally the tractor stops
near the hospital and next to an empty field used by some youngsters for a
late afternoon game of soccer. 
     Children and adults gather around to look at the newcomers, hear word
of a friend down the road or simply for the attraction of somebody
arriving. Kurmuk seems at first sight to be a quiet town of some 5,000
inhabitants, securely set between high hills and next to a small river
demarcating the border with Ethiopia. Not only is the setting beautifull
but the hills and the closeness of Ethiopia help keep the Sudanese bomber
planes and helicopter gunships, which terrorize other parts of the war
zone, far away.
     The warmest greetings of the day are exchanged half an hour later when
Willie meets with a local collegue - Dr Ivonne Atar. The 37-year old doctor
shows up straight from the hospital where he has been working since early
morning.
     Apart from being happy to see Willie and the team, Dr. Atar is also a
very tired man. He has had to attend to some 200 out-patients in a day.
Monday is market day in Kurmuk and people from remote villages flock to his
consultation when they are in town for the market. 
     Though hired by the relief wing of the SPLA, Dr. Atar is part of the
same project as Willie. With support from ACT and Caritas members worldwide
the project pays all expenses related to running the hospital, the medicine
and other equipment for the hospital and a few health clinics in villages
in Blue Nile.
     As Dr. Atar realizes that the tractor is not carrying any supplies for
the hospital, Atar is visibly disappointed and Willie has to reassure him
that supplies will arrive soon.
     Soon in Kurmuk usually translates into weeks or months.  Still, after
a little while the  doctor starts organising for dinner, bathing water and
accommodation for his fellow aid workers. However short he may be on
supplies at the hospital, or at home for that matter, this is the Sudan and
hospitality is a time honoured virtue. 

Better amputate than loose the patient
     Kurmuk hospital is housed in three rows of low stone buildings. The
walls were painted white in some distant past but the roofs of corrugated
iron sheets have recently been repaired and patients and equipment are dry
even during the heavy down pours of the rainy season.
     Beds are rare in the hospital after the looting which usually
accompanies fighting in towns and villages in Sudan. Looting too accounts
for the absence of X-ray equipment, any trace of a laboratory and, even
worse, the lack of a generator. The town of course has no power supply.
     Yet Dr Atar handles more patients here in a week than other doctors
would see in two months. He has just discharged 20 in-patients and is left
with 103 patients in the wards - most of them with battle injuries. On top
of that anywhere between 90 and 200 out-patients call on his consultation
every day.
     The hospital serves both civilians, wounded SPLA soldiers and
Prisoners of War who require medical treatment. 
     Kneeling down next to a 17 year old soldier with a broken leg, Dr Atar
remembers how he, less than two months back, received 86 wounded soldiers
from a battle at Wadega. They all arrived within just a few hours.
     "Working alone like this, I have to quickly sort the patients out
according to urgency and then deal with the worst cases first. On this day,
and mainly because the wounded arrived here soon after the battle, I did
not have to do any amputations. Still I worked non-stop from three in the
afternoon until the next morning around nine o'clock. The worst problem I
have had with wounded patients is if they get Tetanus. There is no
electricity so I have no cold store for Tetanus anti-bodies. I've lost
three patients because of that. There was nothing I could do to safe their
lives. Nothing."
     Dr Atar continues to another ward and sits down next to a middle aged
woman lying on a blanket on the floor. She has had a part of her left foot
     "Mines. It is always the land mines. This woman went looking for
fire wood and came too close to the former barracks. Before they fled
the army mined the place."
     The doctor inspects the bandages and asks the woman a few
questions, then he moves on to attend to another mine victim. This one is
a soldier who stepped on a mine during the recent battle for Ulu in
nearby Upper Nile.
      "I don't know what it is with these mines, but if you don't
amputate all that has been exposed directly to the explosion, it just rots.
So it seems better to amputate than to risk loosing the patient's life," Atar
explains.
     "But I have to work very fast. Because we only have limited
capacity for anaesthesia, I have to finish any operation in 30 minutes."
     Right now the doctor's greatest worry is lack of dressing
materials. "We should have antibiotics and other medicines enough for
......say three to four months. But I have next to no bandages and
dressing materials left. I have to ask the patients to wash and clean their
bandages and then use them again and again. This is a real problem
considering the number of war wounded we have on top of what
happens to people because of normal accidents."
     During his one year in Kurmuk Hospital Dr. Atar has not only seen
patients die or loose limps, he has also seen some near miraculous
recoveries.
     "Yesterday I discharged a boy of four years, Idris Shawish
Payak. He was shot right in the forehead during the fighting for Wadega.
But incredibly enough the bullet did not damage his brain. As he left the
hospital yesterday with his father, the skin had healed over the entry
wound, but he still has this striking big indent in his forehead."
     "Another strange case is John. He is a Prisoner of War and he
had been shot in the throat. When I got him, his body was completely
swollen by infection but after a few days on antibiotics, I could operate
on him. And somehow the bullet had entered the throat, worked itself
down into the chest and backwards toward his back. I found the bullet
behind his scapula - his shoulder bone."

A feast in Kurmuk
When Dr Atar volunteered to come to the hospital in Kurmuk about one
year ago, he left a good job at a well run hospital in Egypt. Here he
works extremely long hours and has to do without all the technological
back up and specialized colleagues, other doctors take for granted. He
has also had to go for up to seven days with out proper food. Still he
says, he is happy to be home in Sudan working for his own people.
     That evening local leaders in Kurmuk decide to honour Dr. Atar,
Willie and the other visitors with a rare occasion. A goat is slaughtered
and roasted over open fire. From across the Ethiopian border, otherwise
unseen drinks such as cola and beer are organized and the evening
turns into a small feast.
     The community's gratitude to Willie and not least Dr. Atar is
obvious. Just as obvious is their concern that the project should close or
that Dr. Atar decide to leave. On a couple of occasions local leaders
have tried to introduce the good doctor to suitable young women in the
hope, that he may end up marrying and settling for good in Kurmuk.
     In a country run by a fanatic Islamic government, it is note worthy
that while the doctor is a Christian, the young women, discretely pushed
in his direction, were Muslim.
     So far though, Dr. Atar keeps his options open.

Back on the road
The next morning Willie, Khaliffa, Abdullah and a new group of
passengers bid Dr. Atar farewell and thanks. As they pass by the
hospital, they see the sick health worker sitting on the ground with his
back against the wall of the food store. His eyes seem lost somewhere
amongst the leaves of the tall Niim trees above him.
     Heavy rain drops starts falling and 20 minutes later they are in a
mess. Rains pours from above and big chunks of mud and sand are
thrown at the passengers from the tractors rear wheels.
     After a while they stop for and pull a large green tarpaulin over
their heads. Then the red tractor moves on with everybody but Khaliffa
and Abdullah in hiding under the green plastic. 
     While trying to keep the tarpulin in place over the trailor, Willie
worries about getting back to the project's base camp and the air strip in
time to receive the next plane load of supplies. This time hopefully
including the dressing materials for the hospital.
     As the rain clouds close in on them, Willie realizes that there will
soon come a time when even the red tractor can no longer make it. The
people of Blue Nile will be isolated until the roads dry up again in
November, but Willie is equally confident that most people can make it on
their own.
     Seeds and tools have been distributed in time and around the huts
and villages maize, sorghum and vegetables are growing. By August the
first crops will be ready for a modest harvest.
     Given a minimum of peace, security and aid, the famine that
claimed the lives of the children here just eight month back, can be kept
at bay in southern Blue Nile.
     The supplies to the hospital is a greater concern. Rains and roads
will decide when they can next make it back to Kurmuk. A trip may last
only eight hours. Or it may - as it happened to Dr. Atar a year ago - last
12 days with a good part spent on foot.

                            -- 30 --

For photos to go with this story please follow the links from the ACT Web
Site (www.act-intl.org) to the Photo Oikoumene site.

ACT is a worldwide network of churches, including the Lutheran World 
Federation, meeting human need through coordinated emergency response.