Monday, August 11, 2008

That sounds about right

It is my newfound use of this phrase that inspired someone I work with to inform me that I'd officially been working in South Sudan for too long. It's a phrase that conveys agreement, while at the same time expressing a disinterest in any sort of precision relating to what you're talking about because whatever it is is the norm to such an extent that it isn't questioned. For instance "My flight hasn't started boarding and we were supposed to leave an hour ago" "That sounds about right", or "We're out of tea and there are ants in the sugar" "That sounds about right" etc, etc.

So the question then becomes whether the phrase is an expression of complacency on one hand, or an understanding that nothing can be expected to work perfectly here, so that close enough is often your best choice. I'm not sure to be honest. There's a great song that begins with "One of my friends taught me the most glorious lesson, that in this life there is no need to ever be complacent." If complacency is "smug and uncritical satisfaction with one's self or one's achievements" then perhaps the sentiment I've described is the opposite of complacency. It is the recognition that no matter how hard or long you work, there is so much to be done here that it feels like you're wading through waist-deep mud no matter what approach you take. For instance, Unicef distributes drug kits to organizations that support Primary Health Care Centers and Primary Health Care Units. These drug kits contain all the basic medications needed to diagnose and treat basic diseases, and without them the health centers are essentially impotent. So after months of organizations informing Unicef that stocks were getting low, the kits were finally delivered. All at once. All in Juba. So now you have literally thousands of tons of drugs sitting in NGO compounds because the drugs are, in fact, mostly needed in the field, not in Juba. But the roads are terrible and hiring a charter to fly your tons of drugs out to your site (if your site has a landable airstrip) is incredibly expensive. The UN Humanitarian Air Service (UNHAS) has kindly donated 80 hours of flight time a month to INGOs for shipping supplies. But they won't take anything of this weight or bulk. So Unicef distributed life saving medication in such a way that no one is using them and the medication is sitting on shelves slowly moving towards its expiration date? Sounds about right.

There are many more humorous examples of how this phrase is applicable to daily life here. For instance, " This beer is warm" "Ahh sounds about right", or "There's a goat giving birth outside our front door", "Yup, sounds about right". If nothing else, it just goes to show you how much you can get used to, some of that is positive - like not being phased by everyone you meet saying "morning" regardless of the time of day. On the other hand a friend of a friend told me a story the other day about being asked to name three pivotal events of the past week, one of which was having an AK-47 held uncomfortably close to his temple at a traffic stop. Rather than being frightened or vowing to get out of Juba, he began asking his friends how many lbs/inch of pressure it takes to fire an AK-47, so that the next time it happened he would better be able to gauge how close the finger on the trigger was to firing the gun. That's not normal. But normalizing things that would ordinarily offend, scare or repulse you is part of life. Rats darting out from underneath giant piles of trash is normal in New York City, goats tiptoeing among piles of burning trash is normal in Juba.

Many people have asked me what it's like here, they want to know details about everything from the day to day to the extraordinary. And even after two and a half months I still stand by my original assertion that it's not all the different from many other places I've been. Manhattan it's not, but then again nor is it a place that would be beyond the imagination of anyone. So either I am particularly adaptable, or the world is smaller than we've all been led to believe.

Wednesday, August 6, 2008

A numbers game

It is easy to become accustomed to the contradictions present every day in Juba. Then all of the sudden I remember I'm not only in Africa, but am also in one of the least developed countries in the world, with what is estimated to be one of the highest maternal mortality rates and infant mortality rates in the world. It's estimated because no one has concrete or reliable statistics, and sadly the statistics that do exist must be negotiated with the government before they can be made public. I've been slowly coming to the conclusion that, of the things I have learned so far in school, some of the most valuable have been from stories I've heard from professors or other students. Not that learning the meaning of p-hat and the difference between specificity and sensitivity isn't useful. They are (hopefully) what will help me get a job upon graduation. But it's the stories and experiences in countries, often terrible and heartbreaking, that have really stayed with me.

For instance, to paraphrase a particularly poignant one, we had a professor who works in nutrition and only taught one class but told a story about working in the earthquake in Bangladesh many years ago. He was given a week to lead an assessment of the housing and nutrition status of the entire population to determine the need for aid in the immediate aftermath of the disaster. The only way to access many of the areas was by helicopter so he and a team of surveyors would drop into entirely isolated locations, do a rapid survey and get pulled out again. At the end of the survey they estimated that (I don't remember the numbers here, so these are just examples) 2/3 of the population did not have adequate housing. They determined whether housing was adequate by the presence of walls and a roof, as long as the basics were present to protect people from weather it was thought to be enough. He brought this data back to his organization and they looked at it and saw they simply couldn't meet the need, there wasn't enough money or staff. So rather than let everyone see that the organization was underfunded and couldn't help all the people who needed it, they insisted he change his definition of adequate housing to anything that provided shelter from rain, ie a tarp, a house where all the walls have fallen down that the reports about the disaster that came out of Bangladesh claimed that 1/3 of the population was in need of support.

When you think of it as simply shifting a few numbers on a spreadsheet, it doesn't seem like such a hard thing to do. But when you consider that you're deciding that tens of thousands of people won't have access to shelter and will therefore be more likely to die of exposure and a litany of illnesses, it's shameful. But that is apparently the case with most statistics. I've been told that in some countries infant and child and maternal mortality rates that are reported by many organizations are negotiated with the government before they are released. The rates are decreased or increased depending on whether the government wants to display progress to satisfy one set of donors, or a decline to increase aid funding. It's a sad state of affairs and could make some people lose faith in the nonprofit/aid industry. My reaction is just the opposite. Call me an optimist but I think it can only get better and if nothing else there is a recognition of how important the work of NGOs is, as well as the importance of engaging the local community to make the progress and change sustainable. Sounds like rhetoric to anyone involved in this work, but I actually believe it. And I figure if South Sudan couldn't knock it out of me, maybe nothing will.

Thursday, July 31, 2008


No really. During a break at the health forum I attended today I was told to search for a google group called Jubalicious. At least people here have a sense of humor!

So I made it to Juba after an eventful time in Rumbek. Wednesday was a holiday that marked the 3rd anniversary of the death of John Garang, the former leader of the Sudanese People's Liberation Army/Movement (which is now in power in South Sudan). I went out to a spot close by with people from work since we technically had Wednesday off and the subject of what I've learned here came up. I told them that I have to make a presentation when I get back to school and one of the things I have to talk about are big lessons learned. Several drinks into the day off from work celebration the members of my and several other NGOs came up with the following three things I should have learned: 1. Never offer to help. Everyone in these situations is understaffed and under-resourced, so offering to help can get you in a whole lot of trouble. Prime example: one staff member told of his first job where he heard someone saying they were overwhelmed and he offered to help. They asked whether he knew how to move refugees. He said sure. He ended up directing an armored convoy through an active war zone to load, register and then deliver refugees to a refugee camp. Yes, he helped. No, he should never have been allowed to lead such a dangerous activity. 2. Always bullshit. This came up when I told them that when I arrived at the airport in Rumbek I wasn't registered to be on the flight. The operator told me that it was possible that someone had emailed him, instructing him to "greenlight" me and put me on the flight, but his email was down. I explained that I was sure that was the case and I absolutely needed to be on this flight. So me, and my two super heavy bags (the limit is 1 bag at 15 kilos) got on the flight without paying for a ticket or for my extra weight or bag :) 3. Always assume things will go wrong, as opposed to assuming things will go right. This is completely contrary to my nature, I'm an optimist and like to believe that things have a way of working out. But here it's best to plan so that, even if it all goes to hell in a hand basket, you can still do what you need to do. I was told this when I asked a staff member if she thought it was a good idea for me to be booked on a flight from Juba that would arrive in Nairobi at 2pm the same day as my 6pm flight to Dubai. Generally that would be fine, international flights tend to be more reliable than domestic flights (which almost never leave on time, if they leave at all). But, as she explained, my organization will fly me in a day early, pay for a hotel and a cab to and from the airport, so the hassle is theirs. Whereas if I miss my flight to Dubai it becomes my problem. So on that note I have 12 more days left in Juba, rather than 13. I must be learning.

Also there are new pictures up if you're curious:

Sunday, July 27, 2008

On the Road Again

As much as Mvolo has embodied slow summer days and lazy afternoons, it's now all coming to an end relatively abruptly. I got an email on Saturday from our Country Director asking me to present the research methods and findings from our survey at the upcoming Juba Health Forum. The Forum is on the 31st of July. This means that I have to fly out of Rumbek on the 29th because the 30th is a national holiday (the 3rd Anniversary of John Garang's death). We currently have an electrician from Rumbek visiting who needs to return on Monday, which means I'm leaving tomorrow! After spending time counting down to countdowns and doing some waffling in my love/hate relationship with Mvolo, now I won't even have time to say good bye to many of the people I've gotten to know here, which feels like such a shame.

Given that I have about 2.5 weeks left in South Sudan total, I wonder where I would prefer to spend them, in Mvolo or Juba. It seems like every upside of one place is a downside of the other. For instance:

Plumbing - Mvolo doesn't have any.
Juba has indoor plumbing, but the water that pours over you in the shower is straight out of the Nile (into which our indoor plumbing empties itself).
Winner? While I'm not a fan of latrines I think I'll take a bucketbath with clean water over a shower with who knows what in it any day.

Food - Mvolo's food is basic, beans, greens and rice for lunch and dinner every day. Very little variety and if I eat out it just means a different kind of beans. But breakfast is usually yummy with something fresh baked. Plus there's oatmeal!
Juba - Much more variety, equally greasy but yummy food at the guest house. There are places to go out and get other food which is exciting. But it also means I'd be spending money which I never do in Mvolo.
Winner? I think it's a toss up. If it were forever I'd vote for the food in Juba, but I've been eating rice, beans and greens twice a day for two months, two more weeks wouldn't kill me.

Living - Mvolo is serene, it's cooler and it's quiet and it's beautiful. I love the birds and the lizards and being able to run or walk in a straight line for as far as I want. The sunsets are amazing and the air is so much cleaner than my ny apartment right near the George Washington Bridge. I am, however, covered in bug bites. I don't know if I've ever had this many. It's also very isolated here, even with all the internet chatting and my colleagues around, I still feel it. And the mouse that keeps me up at night is getting on my last nerve. There is nothing he won't chew and nothing that makes noise and rustles that he won't sift through at night. grrr.
Juba is hot. Really hot. And dusty and dirty. Instead of chickens and goats you have sick dogs and burning trash. But then again there are people, lots of people. And there aren't bugs in the bedrooms. Running is more of a challenge but still doable.
Winner? I think it's going to be Juba. I think long term I would pick Juba. But in the interests of not having culture shock when I meet Doug in Dubai or when I make it home to Washington Heights, I figure spending the next 10 days getting my sanity back and seeing friends in Juba sounds like a pretty good plan. Because after all, although I've been working 50 hour weeks for nothing, I'm technically on vacation :)

I think I could play this game with just about anywhere. There are always benefits and drawbacks of everywhere and I think these past couple months in incredibly rural Mvolo will help me make it through another year in New York City. More updates to come from Rumbek and beyond.

Tuesday, July 22, 2008

Where are you going?

Many years ago a friend of mine explained to me why he liked walking to school after a snowfall. As he walked to school he would leave his footprints in the snow, marveling at the impressions laid out behind him, then as he walked home in the afternoon he would look for his shoe prints, to see if the marks he had left that morning were still apparent.

The other day I did the same thing without even realizing it. I went for a run down the one road here. It's about the width of two cars, the dirt is bright red and it is filled with potholes big enough to swallow a small goat. It had rained the night before so when I was on my way back I noticed my footprints in the mud. I could see where I'd weaved and jumped to avoid puddles and and sprained ankles. It was also very apparent that mine were the only shoe prints with a nifty tread design. The mud was full of deep tire tracks from the huge trucks that rattle by all day and most of the night, there were some hoof prints from goats and the occasional prints of bare feet left by the kids tending the goats.

It dawned on me then why I get the reactions I do from the drivers of trucks and motor bikes, as well as people in the community when I jog by. The most popular reaction is simply to return my wave and smile. Closely following that is a perplexed expression, shrugged shoulders, maybe a little head shaking. Then there are those who stop, they ask me where I'm going, after trying to explain that I'm just running for fun, that nothing is wrong, no one is chasing me, and no thank you I don't need a ride, I continue on my way, and they hang on to their confusion. I had one man stop his enormous truck, jump out and start waving his arms and shouting at me in Arabic. After a moment I got it across that I had no idea what I was saying, but his copilot managed to explain that they were coming from Somalia and he wanted me to take his picture so I could show it to people in America. Presenting my empty palms I apologized profusely and he shook my hand until he wore himself out and was on his way.

I pass two clusters of tukuls on my run, (as there's only one road and I've been instructed to run in only one direction, I know the scenery pretty well) and in one of the clusters is a set of kids who run out whenever I come by. I stop, shake lots of little hands, then try to explain that I'll stop and play on my way back. But at they sometimes want to run after me in their flip flops I want to yell "Stop, you don't have the calories to spare!" And that's what it is. The idea that there is so much food that you have extra calories to just throw around to go for a run in the heat is a completely foreign concept here. Exercise might just be the most pretentious thing I do here. It's like flaunting all the food we have to eat in the compound. But then again my running has gotten other people who work in my compound to get out walking which is a plus, because between the isolation and stress, plus the food drenched in palm oil and long days staring at our computers, we could all use a little exercise. So we walk together sometimes, generally to the only white tree which is about 25-30 minutes down the road. I get teased about keeping up because several of the people I work with come from nomadic or herding tribes. But then when I run I'm by myself, and on those long lazy Sundays when there is no power and I've already finished a book, written in my journal, painted a picture and contemplated going back to bed, I just run. As far as I can, and it just happens to be towards Juba (the future site of my departure from Southern Sudan). Eventually I get tired or a little bored and I walk back, sometimes through rainstorms if my timing is bad. My sojourns take me to the same place every day, but provide me with a great outlet for my Larium jitters (hey it's better than mefloquine induced psychosis...) and the other things that make me not feel like myself. So while my running could be described as culturally insensitive, I need it. Because if nothing else, after a long hot run, I feel alive again, and I feel almost the same way I do after a run in New York. Tired. A little wheezy from the exhaust. And generally slightly delirious and happy. I figure I'll take what I can get.

I've got about two weeks left in Mvolo, then I'm off to Rumbek for a few days, then Juba from there. Then finally to Nairobi and off for a whirlwind tour of Dubai and Abu Dhabi before coming back to New York on August 26th. Thanks to everyone for keeping in touch, it's been more helpful than you know, and keep it up! I'm going to be gone for a little over a month more!

Wednesday, July 16, 2008

I am the master of my infinite patience

This is my new mantra. I repeat it in my head while breathing deeply. (I feel like the guy in Fight Club who is reading books that describe the experience of organs in the first person for some reason. "I am Jack's raging bile duct" "I am Kate's racing heart and urge to yell at someone") I started saying it when I would fight with the internet here. It's a satellite so if it's rainy or windy, no internet. It's the rainy season. I play a lot of solitaire and remind myself to be patient. Then yesterday we drove through the thickest bushes and deepest muddy puddles you can imagine for at least 1.5 hours to get to Kombi to survey their kids. The school was entirely empty. There weren't more than 10 people in the whole town. The tukuls that make up the health center (that we fund and pay 3 staff members) were padlocked shut. No survey. But it was okay, because we did get to survey Kulu which was on the way back. Skip to today. We drove to Mayewe. Long drive. Hot day. No kids. Again. Apparently the teachers had gone to Mvolo (where we had just come from) to collect their salaries, so the school was closed. Deep breath. Patience. Drive home. Spend limited survey funds to pay per diem, but get no work done. News from Mvolo and MOEST (Ministry of Education, Science and Technology): Some teachers have gone home. Some have not. Unlikely they'll reopen the schools this week. Two weeks of vacation to follow. I have about 4.5 weeks left in Southern Sudan. So the next two and half weeks not used for the survey is a pretty intense setback. Luckily the next county over, Wulu, is finishing their vacation this week, so hopefully we can survey them while we wait for Mvolo to come back. Deep breath. So now I've got some time to work on data entry, finishing up the revision on the School Health and Nutrition curriculum I've been working on. It'll also be nice to not squish 13 people (!) into a Land Rover for hours on end. But after a visit from the country director earlier this week I've got my plans set for the final weeks, ironed out what my deliverables are etc. And although I'm only technically half way through my three months that I'll be gone (two weeks of vacation after my work is done!), it feels like the summer is beginning to come to a close. Every day that the country director was here, he asked me what I'd learned that day, and there was always something new to tell him. The new type of disease presentation, new explanations for why there is so much fear/hatred for the Dinka in this area, new ways that bug bits can swell up and hurt/bruise/bleed! All sorts of mind boggling things. More pictures are coming, check out the ones that are there now at if you haven't seen them yet. More soon.

Friday, July 11, 2008

A plane landed in Mvolo!

Well almost. After a long day of surveying and pricking little kids we were waiting in Mvolo center for a ride back to Domeri (where our compound is) and we heard a huge rumbling. What happened next was right out of the movies. Every single person in the store, in the town, ran outside and stared up at the sky. We hadn't seen the plane but it was sure flying low, could it be landing here?! A mass migration began, first with little kids running towards the airstrip, little girls with baby brothers and sisters on their hips and older kids whizzing by on bicycles. Then the adults started to wander over in groups, continuing their conversations but obviously curious to see who had come to what has been described as an "unlandable" airstrip. A crowd gathered, everyone was pushing their way to the front to see what exciting people and things might emerge from the plane. But then the news slowly spread through the crowd and back to the town. The plane hadn't landed, it was just flying very low and had continued on to Rumbek. What was almost the biggest day in Mvolo didn't end up amounting to much, but it was amazing how foreign the sound of a plane was to me after only 6 weeks away from the big city.

All wasn't lost though because USAID had made a visit to the town earlier so everyone went back to playing with their new toys. Radios! And not just any radios. Blue radios about the size of half a loaf of bread cut lengthwise. They come with batteries installed, but also have a hand crank and a solar panel. They receive in AM, FM and SW1 and SW2 which I've never actually heard of, but are the only frequencies we get here. The funny thing was that everything from USAID says "USAID - From the American People" on it, so everyone was joking and asking me if the radios were really from me. USAID has sponsored a couple radio programs in Sudan and they are apparently giving out radios to make sure people are able to listen to them. I got the scoop on one program when I visited the USAID compound in Juba and talked to the Education Officer. She said that they had a program that broadcasts classes for grades 1-4 every day. That way even when there are places with less teachers than they need, no teachers or untrained teachers, the kids can still learn if they listen to the broadcast. And I figure it also helps if adults end up listening to the broadcasts since it's estimated that 80% of the population is illiterate, it can't hurt! We've been visiting more and more schools here and although I admit we seriously disrupt classes by taking out students in P3 and P4, it seems like school isn't the learning environment we wish it was. With most schools taught all by unpaid volunteers, and the volunteers generally untrained with little access to resources for curriculum planning or even working with children it's no wonder that the education is relatively rudimentary. Check out this BBC article about a town we've already surveyed! (I was very entertained to find factual errors in the article, things I know from being here!)

We've got a week left to finish the survey in Mvolo County before the kids go on break for a few weeks, so this week will be a big push, and after that it's on to managing all this data! I'm more than half way through my time here, and thanks to everyone who's been in touch with me so far, it's a huge help to have people to talk to, or to entertain me with stories from home. On that note please check out the addenda I'm going to add to a few blogs. I've gotten some good comments and additional info about some of the things I've written about from discerning readers. I love that people read these entries, but also remember that I'm claiming to be neither neutral nor an expert. I'm merely an observer and I am very aware (as are all of you, I'm sure) of all the biases associated with my experiences and my perceptions of what happens around me.

Saturday, July 5, 2008

Wondering where I am?

Maybe that's a bit self centered :) Maybe you're not wondering at all and figured I've been working away interviewing ankle biters (children that is, not mosquitoes or black flies) and having meetings in excruciating heat in tukuls. Though generally true, not the case lately! I've only had limited access to the internet for the past couple weeks, so here's a general life update and I'll get back to the more well thought out posting a bit later. I'm working on a baseline survey on children's health and nutrition status and knowledge and after recalculating the sampling frame at least a million times we've finally got everything going and we had the training and got the sampling started. I was nominated to be the one to prick their fingers and take blood samples to test them for anemia. Given that a lot of little kids in very rural towns already cry and run away when they see me, going after them with a needle and a wacky machine that checks their blood didn't exactly help matters. But, after months and months of pricking my own finger to teach people how to check their blood sugar and doing diabetes education I was quite the pro and only one girl cried so hard I couldn't prick her finger at all :) We're sampling children in primary 3 and 4, but because of movement and conflict and not attending school at regular intervals among other things, the kids in primary 3 and 4 range from about 8 or 9 up to 16. And the interesting thing is that those are only guesses because none of the kids know approximately how old they are, let alone their exact birthday. Plus many of them are malnourished which leads to stunting and delayed puberty so even estimating their ages is hard. So with interviews, physical exams and sample collection we've gotten through three full schools and still have quite a ways to go.

Last Friday morning we left before the sun rose to drive from Mvolo to Juba which is about 8 hours by car. Most of the time is because the roads are absolutely horrendous despite attempts to keep them maintained and avoiding the potholes is quite the task. On top of that we had a full car with one person coming down with malaria and another throwing up every 30 minutes with car sickness. Not a trip I'd like to repeat! I then spent the weekend in Juba which was quite fun since there is another intern (Arpan) based there. She was in Juba for about a year in 2005(?) so she gave me a grand tour and also knows many people still living here so I finally got a look at what the ex-pat scene is like as well as what's outside Hai Malakal (the area of Juba where we're based). I spent Sunday at the USAID complex (where there's a swimming pool!) talking to ex-pats and hanging out and meeting people which was a lot of fun. Hearing the stories of everyone working for different NGOs and UN agencies was fascinating, as was hearing the perspectives of the newly arrived versus those who had been here for years.

Then on Monday almost everyone in the agency headed to Addis Ababa, Ethiopia for a retreat. We stayed at ILRI (International Livestock Research Institute) which was nice and not filled with animals like I imagined :) The retreat sessions were a bit like a recap of many of the classes I've taken at school, so it's good to know I'm learning the right stuff, plus it's amazing seeing everything that goes into supporting the people who are in the field implementing programs. Judy and I (another intern from Columbia, based in Pagak) got out to explore the city a bit which was exciting, Addis is a pretty cool and I'd definitely like to go back. And of course the food was amazing, everyone was surprised that I'd had Ethiopian food in the states, but the funniest thing of all is that when Judy and I were at Emory together we actually used to go out for Ethiopian together. Small world. I have some great pictures and photos of traditional Ethiopian dancing which is like nothing I've ever seen. I'll get them uploaded soon! We flew from Addis to Juba on Friday, but unfortunately I was the only American left in the office because a number of people are off at meetings or on leave. Arpan and I headed out to a local place called Bedouin Bar where there was a big barbecue and american music and a bit of dancing. They were projecting American movies without sound and somehow the ones they chose to best represent America were Black Hawk Down, Saving Private Ryan and Pulp Fiction. It was definitely a fun 4th although I was quickly reprimanded when I suggested trying to make our own fireworks (people said that everyone would think it was fighting. i was only kidding anyhow!). But it was lots of fun. I realized that this was my 4th July 4th that I've spent out of the country. I was arriving in Paraguay, picnicking and water fighting in the Dominican Republic, summiting Mt Kilimanjaro and now traveling around East Africa and hearing stories about life in South Sudan from veterans of hardship posts around the world. But I must say, there's nothing like watching fireworks in the states, maybe next year :)

Thursday, June 26, 2008

The Revolution Will Not Be Televised

According to BBC news, the latest news here is that the government of South Sudan is going to start actively disarming citizens. The twenty some odd years of war left a country full of guns. Not handguns, but rifles, some even semi automatic and automatic. If you read the article (linked above) it explains that they've attempted a voluntary disarmament program, but very few weapons have been turned in. The last time they disarmed groups, those disarmed were left defenseless against others who kept their weapons, leading to hundreds of deaths. So this time they're taking weapons by force.

I beg to differ. Although pictures of the government disarming civilians who live in tukuls (mud and grass thatched huts) may look good as an international news blurb, it's far from the biggest thing happening. Google Abyei, South Sudan. The town was burned to the ground in May, people are fleeing by the 10,000s and maybe a week or two ago the "joint" government of Sudan and South Sudan said they were sending in a coalition force of troops from both sides to quell the violence. However, I appear to be living on an important supply road and have a front row seat to a small fraction movement towards Abyei. Last weekend a truck from an international NGO stopped to rest near our compound. The driver told someone I work with that the NGO is already setting up camps to care for the wounded that they anticipate from the upcoming fighting and possible outbreak of civil war. The driver had a truck full of emergency medical supplies. Then today as we were driving to Mvolo military truck after military truck whizzed past us over the potholes. The immense impact of what I was seeing was overwhelming. The government of South Sudan appears to be mobilizing its troops, and is sending trucks full of boys, men and many many weapons to Abyei. I am not an expert, I am merely reporting what I've seen firsthand, but the peace agreement that was signed in 2005, after decades of war and over a million deaths, appears to be hanging by a thread. The U.S. government recently pulled out from talks that were aimed at making the peace agreement work. They said that it seemed like no one wanted peace. I guess it depends who you ask. The men who continue to wear military uniforms because the power and prestige of war have defined their lives might like an opportunity to command their peers again. But the children we've been interviewing for the past few days need stability more than anything. I haven't compiled the data yet, but easily more than half the children have moved in the past 7 or 8 years, when asked why, phrases like tribal clashes, internally displaced, death of parents, and to flee the flighting rolled off the tongues of babes. I don't know what will happen here, but for the sake of the development and progress of the country, and for whatever generation eventually sees the end of the fighting (if that day comes) and is faced with the daunting prospect of moving forward, I hope that peace comes sooner rather than later.

And in case you were wondering what they're fighting about, some say it's land, some say it's religion, some say it's politics, but at the center of it all Abyei is surrounded by oil fields.

Wednesday, June 18, 2008

Think about the last time you were sick...

I mean really sick, with something infectious. None of that stuffy nose and cough type thing. What was it? The flu? Strep throat?

What if it was tuberculosis? Or malaria? Or leprosy? Or river blindness? In the short time I've been here I have seen more people with diseases that have been entirely or mostly eradicated from the North (or the West, however you like to phrase it) than I can count. After seeing a blind man making his way along the main road by himself with nothing but a stick, it was explained to me that river blindness has left 1/4 of the people in villages nearby blind. One in four people. Take a minute to think about that. If 1/4 people in the US were blind how would it impact our capacity to run our government, let alone our economy. Here the river blindness is thanks to the Mvolo river which runs right through town and creates a nasty swarm of black flies during the rainy season, which is right around the corner. I was given medicine which apparently protects me from river blindness for a year, but what about everyone who can't walk into the health center and get what they want for free (since their NGO supports it)?

So if 25% of the population has river blindness, and the leprosy rate is somewhere between 10 and 30%, and 70% of the world's remaining burden of Guinea Worm is in South Sudan, not to mention the worms crawling around in the bellies of most kids (ring worm (okay it's a fungus, still pertinent) is particularly obvious as you see kids with black hair with white polka dots), the micronutrient and calorie deficiencies of kids and whole families. The list goes on. Where does that leave the people living here? There is development under way and with immunizations slowly becoming commonplace there are less disease outbreaks, and the menningitis and measles outbreak that occurred last year was contained relatively quickly with the efforts of NGOs, the government and the community. But even so, the impact that ill health can have on development has never been more apparent. Consider that many micronutrient deficiencies can lead to slowed mental development and mental retardation if not corrected within the first years of life, or that anemia makes children and adults alike tired, think more slowly and have less energy for daily activities. You have a huge proportion of the population that is entirely absent from productive activities because of their health. So, as many workshops as you do and as much capacity as you build in the community, the physical capability of the population is severely limited by its ill health.

I'm not offerring any solutions here, mostly because I think that many of the possible fixes for the situation are already being implemented, it just takes time. Education for instance is so crucial, but with an education system that's been mostly absent for 20 years, you've got teachers with a 4th grade education teaching the 2nd graders. But as education improves, and access to healthcare and health literacy improves, I think the situation with diseases that we have preventions and cures for will continue to get better.

But then there's nodding disease. Ever heard of it? That's because it only exists in South Sudan and no one knows what causes it. It mostly affects young children, causes seizures that make the children look like they're nodding, and leads to mental retardation, and then as it progresses is almost 100% fatal. A few people are studying it, google it for some more in depth info. But I've visited schools and looked at the rosters and you see so many kids listed as "nodding" or having "fits". So if you've got all the issues listed above, plus anywhere from 5-25% of your children will have retarded mental development or will most likely die, it's just one more giant pothole in the pathway to development.

So, for anyone who wonders what on earth I'm doing in South Sudan, it's doing the first survey in memory of the health status of Southern Sudanese children in this county. And hopefully, as with all data, it will be put to good use, will move and inspire donors and other organizations, and all the other big things I imagine happening. But at the very least, the kids here won't be invisible anymore, because someone will have documented what it's like to live here.

Friday, June 13, 2008

Sometimes I Eavesdrop

But eavesdropping seems a little harsh, I personally prefer to think of it as listening to a conversation that I'm not actively participating in. Yesterday I went to visit two schools in Mvolo county, both of which are receiving support from my organization, and one of which will be part of my project. I went with a driver, the education officer from my NGO, the education officer from our local partner, and a member of the Ministry of Education. Over the many hours of bumpy roads filled with puddles and potholes, I listened to them talk about everything from the division of labor by gender to interpretations of the war and the current manifestations of the peace agreement. I think the tidbit that stuck with me most has to do with cattle grazing.

Both North and South Sudan are made up of a number of tribes, all of which are full of subdivisions. The Dinka are some of the most well known people, partially because of their statuesque build and partly because of their involvement with cattle. For as long as anyone (in the truck at least) could remember, the Dinka had been starting inter-tribal clashes by taking cattle from other tribes, who would then take the Dinka cattle and fighting would break out. Some tribes have now gotten out of cattle raising all together in attempt to avoid the violence, although they are the poorer for it.

The SPLM/A (Sudan People's Liberation Movement/Army) is currently in charge of South Sudan, the politics of which are complex and way beyond the scope of my experience. But needless to say, after the temporary division of the country into north and south with the peace agreement, the commanders of the SPLA are now some of the most powerful people in the country, and because they are powerful, they have cattle. Now these SPLA commanders have hired the Dinka to help raise their cattle and bring them to graze. So you've got Dinka herding the cattle of army commanders through the land and fields of subsistence farmers who barely grow enough to eat as it is. But no one stops them, because the cattle belong to the army, and the army has given the Dinka AK47s to protect their cows. And so the cycle of hunger, poverty and violence continues.

Just one of many anecdotes from the car ride, I could go on for ages with more, but I figure if I don't keep these reasonably short then no one will read them! After many requests, the link to my pictures is if you'd like to see where I'm living and who I'm working with. I'll have more about the project I'm working on (a baseline survey for a School Health and Nutrition intervention) next time, as many of you have been wondering what I'm actually doing here. :) Take care and thank your lucky stars for indoor plumbing!

Monday, June 9, 2008

Eating Beans with my Fingers

At the midway point of the 8 hour drive from Juba to Mvolo yesterday, we stopped to switch vehicles and to have something to eat. Two bowls were set in front of me, one with ugali (a lot like white polenta) and one bowl of soupy beans. I'm used to Ethiopian food where you have injera to help you pick up the different dishes, but eating beans with just my fingers was much more difficult. As I got started I looked around and tried to mimic everyone's method of scooping the gooey food, then sliding it into your mouth and licking your fingers. The whole experience mirrored my impression of Sudan thus far, a little more difficult than usual, slightly nonsensical and new to me, but generally fun if nothing else!

I am now in Mvolo and will be here through August, except for a possible side trip to Ethiopia for a bit of training. Our compound is about 9 miles outside Mvolo town, and so I haven't been there yet, but apparently there isn't much to see, much less buy. The compound is huge compared to the Juba compound, with two guest houses and several tents to stay in, a big office building and chickens running everywhere. My room is home to lizards and moths and apparently the occasional scorpion and mouse. The generator runs in 4 hour spurts throughout the day which makes an early morning bucket bath that much more difficult because it's in the dark, but also makes sure you never show up to work early!

When the full staff is here (including drivers, cooks and cleaners) I think there are probably about 12 people, but much of the program staff is always on the road, so it's down to about 6 of us at the moment. I am working on the School Health and Nutrition program, and am trying to get a huge baseline survey going, which is pretty difficult since the program manager is in Yambio at a donor meeting. Tomorrow I will be going into town to meet with the local officials as well as to see the schools and meet the teachers and the health center I will be working with.

I am one of two Americans here, and most of the staff speaks basic English, but I speak almost no Juba Arabic, which means the conversation is halting and slow so far. That being said emails from home are definitely appreciated and I will do my best to keep this blog updated in case anyone is interested in what I'm up to! Pictures will be coming along shortly, but after a bit of a snag in Juba, I'll only be able to post pictures of Nairobi and of Mvolo. Happy Summer!

Friday, June 6, 2008


I have been in Juba since Wednesday, but still haven't managed to get much of a feel for the city. After reading conflicting reports about the size of the city from home, I can say that tales of how expensive it is are true ($20 for some toothpaste and ramen noodles) and I'm still not sure exactly how many people are here.

I am staying at the "guesthouse" with most of the rest of the staff, and work at a compound closeby. Those two buildings have been my entire orientation to Juba as I'm not allowed to go beyond them by myself, and generally need to be driven anywhere I want to go. I've spoken to friends from school interning with other organizations who are staying in "hotels" (most often tents" in other parts of town, and those basic accomodations range from $150 to $200 a night!

Everyone I work with has been very friendly so far, and they're all surprisingly good natured consideirng that they work and live together. The staff seems to be mostly Kenyan with a few other expats, and a couple Sudanese and other East Africans. I will be working a few hours from Juba in Mvolo, a smaller town about 2.5 hours from Uganda with a population that I've seen estimated at about 26,000.

The rain I'd been promised has just begun, and I've been warned that I could get stuck in Mvolo because the roads turn to mud because none of them are paved. There the conditions have been described as more basic, but everyone has said the local people are very kind and receptive of our programming.

I'm heading home for dinner now, but I'll be sure to send more updates later and when I get to Juba!