After returning to Juba from Addis Ababa, I attended the Medair South Sudan Quarterly Meeting over 3 days. All management on the programs and program support side were in attendance, and that includes me! As I looked around the room, I felt distinctly young and inexperienced in comparison to the roughly 20 others in attendance. I felt unworthy to attend these meetings, wondering what can I contribute the management of Medair’s work in this country? I know it is a significant privilege to sit among these movers and shakers of humanitarian aid, to hear their dialogues, ideas, solutions, and strategies. I do not take this for granted. At the same time, I must recognize that I attended this event because I am in a management position! Somehow, Medair sees me as belonging in this group! This amazes me! I know I must live up to the expectations of a leader, and I know that I have what it takes. I will learn as much as I can from here, knowing that it is all in God’s plan to prepare me to do greater things!
As I was feeling all of this humility, I had to give a presentation. I am proud to report that after years and years of practice classroom presentations, I have successfully given my first professional presentation to colleagues at the Medair South Sudan First Quarterly Meeting of 2012! I presented on Medair’s approaches to health and hygiene promotion (HHP), my team members (the Community Liaison Officers [CLOs]), the funding proposal requirements for HHP (which forms the field activities workplan), my objectives and tasks as HHP Manager, challenges of HHP, and support requested to accomplish the work. My line manager (the Deputy Country Director [DCD] of Programs), the DCD of Programme Support, and the Country Director each told me that my presentation was great! This meant a lot to me because I struggled with public speaking for a long time, and I feel that this is a major stepping stone in my lifelong journey.
After the quarterly meetings, I planned to go to Awerial, the first field location that I visited. I rode in the land cruiser for 1.5 hours to a town in between Juba and Awerial, called Terakeka. There, we met up with another team member to exchange staff between vehicles. Here, I was also informed that the CLO would be returning to Juba because his family had just arrived by barge from Upper Nile State to Juba, and they were all sick. This is undoubtedly a good reason for him to leave the field, but it made me wonder what I would be doing while he was away, since we are partners in our HHP work. We continued by car to Awerial, but on the way, I was informed that I would not be going to Awerial, but rather, I would be mobiling in Caltok with the health team to fill in for Alfred. “Mobiling” is a term used here to refer to camping in the bush. Though it may seem that being in Awerial is in the bush, in fact, it gets bushier. We sleep in tents, bring jerry cans to collect water from the borehole, bring toilet paper in expectation of no latrine, and sometimes bring our dry food supplies with us to have a local woman cook for us, not because we are lazy, but so that we don’t have to bring pots, pans, charcoal, etc. So I found myself dropped off in Caltok to assist with a measles vaccination campaign. My roles at various times included: crowd control (which I hated!), rolling cotton balls, tallying ages of children vaccinated, washing the upper arm to prep for the injection, and unwrapping syringes. We had 2 teams of 4 people and a driver to set up for a few hours in several locations in the area of Caltok over 4 days. I stayed for 2 nights before we finished. We received fresh, frozen vaccine each day from the base and kept them in coolers with freezer packs. In some of the areas, we also distributed Vitamin A supplements to prevent blindness from deficiency of this essential vitamin. It was very interesting to be a part of this campaign because I gained hands-on understanding of the program and its challenges such as quality control, maintaining integrity, treating each person with dignity, and reporting. It was easy for the team to make the injections a priority over the people. This seems to be a common struggle in humanitarian aid where donors have expectations and helping is a job.
I try to imagine what it must be like for these people (especially the children) when 4 people, one being an odd color, come in a big machine with all sorts of odd things, telling them to come prevent a disease for children 6 months to 15 years old, refusing to give to anyone else. Then the people come to the foreigners because they are curious about us, and they see us with sharp needles, injecting some kind of magic liquid that does who knows what, and making children cry and scream in pain. Would you let your child come into our hands? I would be skeptical. However, it seems that many of these people are aware of the disease of measles, they know that it kills (aided by the fact that 7 children have died recently of measles in the area, which is considered an outbreak), and they are aware that there is such a thing as vaccines to prevent disease. Many are skeptical and afraid. Many children scream and cry. Many of the older ones walk away with a smile, happy that the injection wasn’t as painful or horrible as they thought it would be. Some of the reactions are funny, and some have made me very sad. One that made us all laugh was a 6 year old boy who was apparently clueless about why he was standing in line. When the injection was given, he was overwhelmingly shocked that the injection caused pain, and that shock quickly turned to fear. The moment the needle was out, he turned and ran away as fast as he could. He didn’t cry, because the pain was minimal, but the surprise had scared him and he knew he just needed to get away! Some other children feared the injection so much that they fought and kicked and screamed, despite being yelled at, whipped, or slapped by the adults. These cases made me very sad. I know this is how I reacted as a child when I had to get an injection. My mom has told me a story that 3 nurses had to hold me down because of my fear! Now I know how difficult it was for my mom in that situation, knowing the injection was necessary but dying inside to relieve my fears and calm me down.
Yesterday, we first drove 30 minutes further from the main road to a village. We sent one of our team out to mobilize the community to send/bring their children aged 6 months to 15 years to the church to receive the measles vaccine. Everyone knows where the church is, and it is usually central to the community, but I wonder if anyone was excluded because they are not welcome at the church, they do not attend the church, or for any other reason. Though Medair strives to serve all people without discrimination, on the field, some decisions are made out of convenience and first glance at the community, which may compromise our integrity. While we were waiting for more children to come, there were three mothers with their children in the church. We took this opportunity to teach them a hygiene lesson on washing hands. I made the point that many children die of diarrhea and related to them what causes diarrhea, because they said they didn’t know. The mothers said, “So give us the medicine to prevent this”, so I told them that as mothers, they have the power and the responsibility to be the preventive medicine to their children, and this medicine is to wash their own and their children’s hands with ash or soap after defecation, after cleaning their child’s bottom, and before eating. During the lesson, one of the mothers commented that I must be sharing this message with them because one of her children died after having diarrhea. I was sad to hear this, but very glad that she brought this up because it helped make the issue real to them. I felt that this lesson was a success!
Next, one of the mothers told us that there is another village a 30 minute walk away, so we decided to go, in the heat of the day, carrying the small cooler, cotton balls, water, syringes, sharps container, and rubbish bin. Usually when an African wants you to go somewhere, the place is “very near” and when they do not want you to go somewhere, it is “very far”. We wondered how far this village really was, since she wanted us to go there instead of her going to tell them to come to where we were set up. Sure enough, it was exactly a 30 minute walk. I find this quite impressive since she didn’t have a watch and they don’t pay much attention to the time or passing of time in the bush. In this village, we vaccinated more children under a tree, and then called the base manager to find out where the vehicles are and when we can be picked up. He had some bad news: the vehicle that dropped us off got a flat tire, the driver changed it to the spare, and then got a second flat with no more spare. The second vehicle came to its rescue, but on the way, developed a leak in the brake fluid, so it, too was unsafe. He rushed off the phone to find a solution. Medair actually employs a mechanic to maintain the vehicles, but these things still happen… So there we were, in the middle of nowhere, about 45 minutes drive through the bush with no road, away from the main road, running out of water, tired, hungry (we hadn’t eaten lunch yet and it was almost 330pm!), and wondering if we needed to return to the church and find some suitable sleeping arrangements and food. This was contingency planning, but in the end, we walked back to the church, immunized a few more children, and a vehicle came to bring us back to our tents. When we returned to where we left our tents, they were no where to be found! The tents had disappeared and no one on our team had moved them. After talking to several people in the community, we found out that the wind had picked up sometime throughout the day, the tent poles were removed and the tents were carried with mattresses and travel bags inside and piled into the tiny 2 room clinic nearby. Still the day was not over… When the people saw that we had returned, several children from that area came to us wanting to receive the vaccination because they hadn’t attended the previous day when we mobilized in that area. We set up again and were able to use up the rest of the mixed vials of vaccine so that they wouldn’t be wasted.
That night, we were all happy to bathe (bucket bath inside an unfinished building) and eat a chicken stew and kisra meal together. Kisra, also known as paper food, also known as injura, is a sorghum pancake, typical of Ethiopian food and common in east Africa. It was an excellent meal! After dinner, the driver informed me that my name is too difficult to pronounce, so I need a Dinka name. My Dinka name is Akur (pronounced Ah-koo-r), which means a black and white cow. When they explained the meaning, for the very first second, I was a bit offended to be named after a cow, but I quickly realized what an honor it is in this culture because they love the cow so much! Their whole culture revolves around their cows: how many they have, their health, payment for marriage, renewable asset, etc. I wondered, since the Eskimos have so many words for ice, do the cattle herders have so many words for their cattle? In fact, the Dinka language has about 20 different words for various types of cows, mainly by its gender and color. I admit, I think this is much more understandable than having so many words for ice, since there really can’t be much variation in frozen water… Arising from the conversation about words for cow and names that come from them, I learned some other names. The name “Machut” is given to a male child who comes after a child that was born and died already. There is another name for a child whose father dies while the child is in the womb. I would really like to learn more about these naming schemes because I think it will be very insightful to the culture, what they find important, and what they think identifies a person.
After this conversation, I fell asleep, happy to be somewhere known, comfortable and with a full tummy. Around 11pm, the faithful driver woke me up to ask me to hand him the rain fly inside my tent because the rains were coming soon. He happily put the rain fly onto my tent, for which I am so grateful! The rains came loudly and I feel asleep again.