Former Army Ranger Josh Webster Reflects on Pibor Surgery

I once had a naive notion that most of the villages of Southern Sudan were going to be very similar. This was not based on any sort of preparatory study of the area, mind you, but upon the general layout of the few villages and towns I had been to thus far. In the three weeks that we had spent in Sudan we had visited a small village and a small town that were roughly 25 kilometers apart. The people had looked similar enough almost everywhere with little exception. They were usually tall, thin, and had very few tribal markings.

I really had no grasp on the differences that could develop over the distance of a few hundred miles. The reason for this is because although the two areas weren’t very far apart, an invisible line separated the region into two distinct tribal areas. The area we were in was populated by Dinka, and the area we were headed was populated by the Murle. The Murle were of similar stature as the Dinka, but they had extremely elaborate body decorations. They scarred their skin with charcoal which left raised patterns. These patterns often surrounded the entire upper body and were accompanied by beaded head-dresses and gauntlets on the women. They were remarkable to behold and reminded me how much can change over so little an area.

The topography changed as well. Shortly after arriving at Pibor we started referring to it as “Scorpion Camp” with the same secrecy as one might speak in hushed tones about ‘Fight Club’.

1) The First Rule of Scorpion Camp is you do not talk about Scorpion Camp

2) The Second Rule of Scorpion Camp is YOU DO NOT TALK ABOUT SCORPION CAMP!

You get my drift…

The barren, cracked clay that is the earth in Pibor allowed perfect passageway for those little buggers to crawl out of at night and wander throughout the compound where we slept. They appeared just after sundown and came in groups of three to five at a time. At first it was exciting, then it became tedious, until finally it was downright terrifying. The scorpions had free reign and often roamed between our feet while we sat around and disinfected our drinking water. The true test of manhood became who would wear flip-flops at night.

It was in this scene that I began assisting in operations for the Murle tribe that lived in Pibor. A woman had a large hernia on her belly that needed to be fixed, and I asked to be involved in the surgery. I had been in the Operating Room dozens of times, and I have assisted in cleaning wounds, anesthetizing patients, placing airways, and manipulating broken bones. Never before had I taken lead on a wound closure as I was preparing to do that day. The hernia reduction went well, and I prepared to suture the wound closed with the help of my Sudanese Clinical Officer, Dr. Ajak Abraham.

Since I had done a good job with the hernia closure, I was allowed to begin working on the removal of two small ganglion cysts that were lodged inside of a young mans forearm. With direct oversight from Dr. Ajak I proceeded carefully into the surgery. I used local anesthesia to numb the area, and after checking distal function of the limb I opened the arm.

I’ll save my readers from the specifics, but the operation went off without a hitch. I closed the wound with suture and checked to make sure the young man had full movement and feeling in his arm. To my surprise, he quietly examined the bandage, flexed his hand a few times, shook mine, and left. As he walked out of our mock operating room he smiled a bit and buttoned up his long-sleeve dress shirt with his newly healed appendage. The others had joked earlier in the day that his shirt was pink, but I had defended the well dressed Sudanese man. “Its cool”, I said, “Its salmon”.

This was truly operating without the extravagances of an American hospital. The candidates weren’t perfect, the gear wasn’t optimal, and the environment was unforgiving. In summation, it was unbelievable. I’d do it again in a heartbeat.

Josh Webster
Former Army Ranger and Air Force Pararescueman “PJ”

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