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Doctor in a Desperate Land

Why an American has chosen to bind his life to Sudan.

BY JEFFREY BARTHOLET | MARCH 7, 2013

 FP: Water? 

We have two hand pumps: One is in the back, used by patients. One is in our compound, which we use. We also have a borehole with a solar-powered pump that draws water up to two storage tanks on the roof. That comes down and feeds the hospital and our compound. So we have running water in the hospital. 

FP: So the area you are serving, how big is it? 

Maybe about two-thirds of South Kordofan would be our catchment area, and before the fighting, the population of South Kordofan was about two million. The area we serve now has probably 500,000 people -- in the SPLA-controlled areas of South Kordofan. 

FP: How many other clinics or hospitals are in this area? 

We are really the only hospital in the Nuba Mountains. That's it. About an hour away from us is a large clinic, run by the German Emergency Doctors. There's no doctor there. Besides that, just small clinics scattered about. Sometimes they have drugs, sometimes they don't. 

FP: You are the only trained doctor in the whole rebel-held area? 

Yeah. 

FP: So tell me about your patients. How do they get to you? 

Some take seven days to walk, some five days, some three days. Some will start walking, find a passing vehicle [to give them a ride]. It's very difficult: There's no public transportation anywhere [and none of the roads are paved]. 

FP: Are there many cars in Nuba? 

Very few. There aren't really any NGO vehicles left. There's us, the German Emergency Doctors, and Samaritan's Purse. Everyone else is gone. There's no regular transport. [The rebel forces have vehicles.] 

FP: So who are your patients? 

Very few can read or write. During the five or six years of peace, when there were functioning schools again, kids were going to school. But that's all stopped. Most of the schools have closed. When patients sign a consent form for surgery, almost everyone has to give a thumbprint. Very few can sign their names. Our medical staff can read and write English a little bit.

Probably 99 percent of Nuba are subsistence farmers. They have maybe two or three cattle, a few goats. Now there are food shortages, so they're very thin. But traditionally, they are very strong and muscular. They grow sorghum, okra, a bit of corn, some peanuts. If they need money, they'll sell one of their animals or sell some sorghum.   

FP: Malnutrition has been a problem. There have been reports of people eating leaves and roots, or whatever they can forage. 

Before the fighting, we always had malnourished children coming to the hospital. What often happens is that a mother who has a young child conceives, and she stops breast-feeding her baby -- who is maybe a year old. Her belief is that she can't breast-feed when pregnant. So she stops breast-feeding the child, and starts giving the kid poor nutritional food; the kid gets diarrhea, a bit of sickness, and starts the cycle of becoming malnourished. We'd often have five or ten children in the ward in this kind of scenario. Now, in the past two years with the fighting, we see older children and adults malnourished because of lack of available food. Last year, we had people lining up: They would come in the morning and ask us for food in exchange for work. They'd say, "We'll cultivate some of your land, collect you some firewood," whatever. That was something unusual.

We had some extra food. But we had only planned to have enough sorghum for our patients and staff. So it was very difficult. We managed to give them something, at least. Now it's starting again. Whatever they harvested in September is running low. 

Photo by Catholic Medical Mission Board

 

Jeffrey Bartholet is a former Washington bureau chief at Newsweek magazine who has travelled to and reported from over 40 countries and territories.