Dr. Geelhoed journal entry 20 Feb 2011 (part 1)

Series: 11-FEB-C-4


FEBRUARY 20, 2011

I have tried to get up as the roosters were crowing, and had hoped to take a short run along the road on which SALT is located (The Center for Serving and Learning Together). This road goes to Akobo, which is much closer than Bor which is eight hours by road away and through the lands of the hostile Dinka Bor. It is closer still than Juba which is two days by road, ten days if one is driving cattle to be sold there to finance the trip. It also goes through the land of hostile eastern Jonglei Dinka, and a few Nuers. In fact, in any direction, there are groups with which the Murle have picked fights and continue to do so, so they are landlocked with no major town or markets. They have less reluctance to go to Akobo since it is near the Ethiopian border—the escape route a number of them have taken to get out of the area as almost all of the Lost Boys did who were taken to Cuba, meaning Ajak and all the other Lost Boy doctors. The Lily River here is only flowing until March and then it dries up so one can cross it right where we are watching the small boys using seine nets to catch fish without removing ones shoes. The Lily River, when it is flowing goes up to the Sobo River (the one filled with crocodiles which the Lost Boys had to cross to get to the refuge of the Ethiopia to establish their camps, and then cross back over with great carnage and loss of life when the Mengistu Government of Ethiopia fell and the new government of Ethiopia allied with the GOS turned on the camps of refugees and enfiladed them. The Sobo River originates in Ethiopia and flows to join the White Nile at Malakal, the seat of the Upper Nile Province where we work at Old Fangak.

I got a chance to learn a little of the area and had mapped out a running route near sunset last evening when I tried also to clean up by dumping a bucket of water over my head as a “head shower.” As I walked into the slanting rays of the tropical sun, Rev. Oruzu saw me in my walk and came to join me. He pointed out the cleared land around SALT, and a number of SALT partners had joined in trying to educate the population, particularly a group resettled in huts nearby for a conflict zone in which the Murle were over-run by opposing Dinka and Nuer in a 2009 massacre in a nearby village called Goma-(hyphenated with a name I do not recognize.) Rev Oruzu and I concur on one thing—he is awaiting the day when there are no more cattle in all of Jonglei State which have done nothing but contribute to the violence and rustling raids among tribes. He is convinced as am I that there is no economic value to the cattle except as currency and as pawns in the struggle of armed competition which was always present in raids as a mark of manhood with spears and prizes ranging from cattle to brides for the opposing tribes. But in the last twenty eight years when automatic weapons have flooded the countryside, every such raid is no longer like a high school football game rivalry, but leads to high body counts in deadly civil war. He says if only the people would recognize that the ground beneath their feet, the fabled floodplain of the Nile, were not denuded by over grazing from cattle and polluted by a veneer of cattle feces which gives a high death rate for children and adults, the people could grow almost anything. “The only thing that would not sprout here in the Nile flood plain are Bones and Stones.” Nonetheless, it is like the settled farmers of the Wild West in the USA versus the pastoralists, a contest never resolved until the invention of barbed wire—and made intense by the inventions of Joseph Colt.

So, there are plots of ground nearby here in which locals are learning agronomy. Since they are so landlocked, there is a big market and people go wild if somehow some fresh mangoes came to the area. But that is not happening often and if a group decided to import fresh vegetables from say, Juba, they would all be rotted by the time of arrival. Besides, the Murle here are so poor because all of their investment is in the economic drones of cattle, they could not buy it. They are reluctant to swap out their cattle, their visible symbol of wealth and prowess in the pecking order. They are trapped by their own mindset.

Adjacent are stands of acacia trees. “Gum Arabica” is the resin that can be harvested from acacia trees and the resin itself is starvation forage for the people—they can eat it when nothing else is available. If they could cultivate some crops in the four feet deep Nile River sediment from annual flooding they could get better nutrition and would take only a lesson in irrigation and tilling. There are floods to well over the knees each year for six months. “Even if you wore gumboots, it would be over the top, and if you did wear them they would be sucked off your feet at every step.” So people go barefoot in the mud—with consequences in trauma from the unseen junk beneath the mud and the hookworms and other helminths that live for this transmissible moment in their own epidemiologic cycle.

Rev. Oruzu knew that I had corresponded with the seminarian intern of the Presbyterian Church Bill Andrus at Akobo since Marguerite Schandebare had linked us up, but that Michael Puitt had also hoped to come to our sessions in MCH to get his own CME with his classmates from Edmonton, such as Ajak. I will go up to Akobo on the next trip, but it is a good thing I am not there on this trip since it is shut down at the time we would have gone by the violence between Nuer and Murle. Now it is possible to go there for this moment since these raids come and go with frequency and everyone is alarmed at the most recent violence and then forgets about them and goes back to the hard scrabble task of subsistence. All of the chiefs know that I am here and everyone is aware that we have even operated. I gave the packet of the Mission to Heal Whistles to Rev Oruzu who will see the chiefs and the commissioner who are STILL sporting my Mission to Heal Bracelets from my last visit wihen they were supplied by Julie Cavallo. Now, through Marguerite Schondebare, the chiefs have a lanyard around their neck with the same “Mission to Heal” logo on the whistle that came along with her story. They are still in a glow of disbelief that the promise has been kept and the redevelopment of the health care system here seems as a work in progress they do not want to jeopardize in any way with any violence.

Rev. Oruzu is the first Murle to have ever visited the USA.

As we walked we came to the one institution that had been set up here by the IRC (International Red Cross.) Would you believe? It is a veterinary station for the treatment of the cattle—a priority ahead of health care for the people suffering in this area who chose to treat their cattle first! I wish we could opinion all cattle here the way a viral infection was introduced into the pest of rabbits in Australia to clear out these vermin!

As the sun set, we came back to the sleeping quarters and furnished our post op patient with food and water and helped him outside to pee as the motion returned to his lower extremities after the spinal anesthetic wore off. He cannot stop smiling and shaking hands and thanking everyone. We walked along the door side of the SALT sleeping quarters where I had once had the reception with 78 sub prefecture chiefs, two paramount chiefs and the District Commissioner, and now have our sleeping quarters which we have modified into our OR. There are fissures in the earth that is hard and cracked. Our light picks out small black insect looking creatures which shrink into small slugs when alarmed. But if one disturbs them they blossom out into full-fledged stingers and advanced claws—Scorpion!

We spotted as many as twenty scurrying scorpions which would dive not the fissures to escape our stomping running shoes so we did not reduce the population of them very much anymore that we have eradicated any cattle! Vermin both!

I went to bed as the generator was still running leaving the laptop hooked up to get the charge restored back after the spellcheck I had run on the Feb-C-3 last night to send out from PiBor through the BGAN uplink. I thought about the laptop later as it was open and the winds picked up. It was stultifyingly hot, and I hoped to get some relief, but the wind was hotter than the still air in the room. It got to be ferocious at times with the plastic water bottles we had not refilled with our pump and sterilizing UV stick were blowing around the yard like bowling pins. A few branches were hitting the pan roof like the downfalls which I am sure are accumulating at Derwood from the winter tree downfalls. It was getting to be ten o’clock and I was hot and awake. I had drunk, like all the rest of us at my encouragement, as many as four liters during the course of the day, and it is odd that none of us have gone out to pee. So, we are desiccating in this Saharan sandstorm “the Waymool.”

Then it hit. First it seemed like a few more twigs had fallen to the roof, then a patter that was gentle. Then at about eleven o’clock, the rain started as a thunder of tattoos on the pan roof as all of us were awake and listened up. Our patient was asking if he could go outside—he was the ONLY one who needed to pee since he had the advantage of IV liters of fluid in the course of his operation whereas we were all content to listen to the thundering chorus on the roof of the corrugated iron. It was over very quickly, this bizarre rainstorm in the sand swirling Saharan Waymool, and the ground was pocked but not wet since the humidity here must be around 4%, so it almost immediately evaporates on contact with the ground. I imagined what would be the case six months from now when such rainstorms continue all day on a saturated floodplain of the Lily river, adding more soil to the ground in the equatorial tropics—an exception to the usual rule that there are no equatorial soils from the half year of baking and a half year of eluting dissolution. It is a weird night. It is in a weird land. The people are maladapted to a way of life that is the only one they know and it is limiting them in their fertility and their mortality from violence. The freak rainstorm that followed the Waymool might be a wakeup call to remind them there is a chance at an agronomy that might more peacefully support them. But pride is a persistent lesion that holds them up as well as gives them a demonstrable cultural uniqueness. It is a kind of stubborn pride to celebrate the uniqueness of a contingent group of people—a final Last Hurrah. Without a transformational change they will not last another generation.

I am now packing up to go off to clinic to see the scores of women who will be coming to complain of infertility—and their cattle they believe will rescue them from it rather than being intimately associated with the cause of this social catastrophe. I believe there may be something we can learn from them about our own consumptive non-sustainable life styles.

Read More Stories