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!