The hospital is a lazy ten minute wander down the road that passes in front of the compound. I have no idea what the daily temperatures are but they must be well over 30 most of the time, because its much hotter than Darwin where 32 was often the daily maximum, so unless walking at a very gentle pace, soon enough perspiration drips down your face and into your eyes, your shirt sticks to your back and you long for shadows, clouds or a breeze. I’m told – and accept – that things are cooling down compared to 3 months ago, as the rainy season approaches – in fact its overdue – but more heat than this must be almost intolerable. Rain of course will turn everything to mud and create new problems one of which is dramatic increases in malaria.
The road is wide and dusty with huge potholes to be negotiated at intervals, and after recent overnight rain many are filled with muddy orange water. It is possible to drive to the hospital down this road but it takes as long as walking, because the vehicle weaves all over the place around the holes and if it goes any faster than walking pace bounces about so violently people can damage their spine. At Juba I met a women being sent home early because of exactly that.
The first part of the walk is past roughly walled housing compounds containing numerous dwellings grouped around grey dusty spaces littered with stuff that looks like junk and rubbish but which might not be. There may be clothes on a line, naked or near naked kids sitting about, women working on a struggling garden or washing or cooking on an open fire. Houses would not be the right word to describe these mostly dilapidated mudwalled huts with pointy thatched roof, or else low shelters with a sort of bamboo-like screen for walls and sagging roof. Large trees here and there are the only greenery, apart from small front yard stands of corn, and everywhere is dust and plastic junk, old bags and containers, piles of rubbish and dead leaves, sticks and paper. Dragging himself around in all this on the roadside is a sad paraplegic in rags, using old thongs to protect his hands as he hauls his useless legs about, he is apparently also deaf, and his only language appears to be meaningless noises and groans when people pass. He doesn’t seem to be begging and I haven’t seen anyone ever give him anything so I have no idea how he survives. When I passed him this morning he was asleep in the shadow of a wall, as gray as the dust, dribbling mouth open, and I thought what a relief it must be for him to be asleep and maybe dreaming about anything but this reality. He must hate waking up.
Further on, the road to the hospital crosses a main street which is sealed. Pedestrians are the main traffic on it, but there are a few Tuk-Tuks, motorbikes and lorries, and of course NGO Landcruisers but traffic is very light – most of the time it would probably be safe to wander across without looking to left or right . An occasional horse or donkey drawn cart goes by.
On the other side, within its own walled and nicely gated compound is an impressive brick catholic church, almost the biggest building in the town. Yesterday, Sunday, inside its compound an open sided enclosure facing the church was full of believers who presumably couldn’t fit inside for Mass. The majority religion is some variant of Christianity, other indigenous belief systems and also Muslims, whose curious little sand coloured mosque and green minaret is crammed in among the shops and commercial activity of Aweil Central. Thankfully the MSF compound is far enough away that the 5 am call to prayer is barely audible. We are not encouraged to go to Mass or other religious service, but if we must, for personal reasons, we are requested not to wear our MSF T-shirts, to preserve our neutral secular status. In a place like this you really do wish there was a God and therefore some point in going to church, because people like that poor man on the street could sure do with one. For me the policy of not wearing an MSF T-shirt to church will not be a problem.
The potholes and mud continue past merchants, tiny low roofed shopfronts and flimsy stalls on both sides, and the road seems narrower, because their wares are displayed on boxes and carts and benches out front. Here to avoid walking in mud you might have to wait your turn to step between two puddles. It’s the usual limited variety of mostly chinese made plastic and cheap metal consumer junk, plastic shoes, locks and nuts and bolts, torches, hinges, twine, batteries and cosmetics, as well as tinned milk and fruit, biscuits and rice and a few other food items. Clothes are also on sale. I haven’t seen but have certainly smelled a merchant who deals in dead and dried fish. This street is not the main street but runs parallel to it – on the main street there is a slightly better range and quality of merchandise, there are a couple of “restaurants” and somewhere I can get some sort of a haircut, and “Bookshops” which sell dusty very old text books, books about Nelson Mandela and about English language, and not much else. The main street has some nice shady trees, an area used to park donkeys and horses and their carts, and is quite bustling.
Finally you come to a T-Intersection and the hospital is right in front of you, through its own half closed double gates, another rocky and dusty walled enclosure at least as big as a football field, and a collection of long low buildings connected by covered walkways. Some of them are staffed and managed by the local Ministry of Health , and others , by MSF, and they function more or less independently of each other, though together, cover most of the possible medical needs of the local population. Essentially MSF provides all the medical services needed by babies and children to age 15, as well as women giving birth or with complications of pregnancy. Obstetric care therefore includes provision of anaesthetics and operating theatre staff and equipment. In addition there is an MSF Feeding program for malnourished children – these are kids who are literally starving to death, and the ward is full. Hunger is common here. How embarrassing it would be for us if they knew how many millions of tons of good food are thrown out every day in the west.
So that is the trip to work I shall be making at least twice every day for the next six weeks.