The following are impassioned excerpts from the personal journal of International Medical Corps volunteer nurse Kelly Suter. She went to Malakal, South Sudan at the height of the civil war in the beginning of 2014 and she recounts her days interacting with the refugees and displaced people of Africa’s newest nation.
Kelly Suter, RN holds a newborn baby at International Medical Corps' primary healthcare clinic at the refugee camp in Malakal, South Sudan.
What I have learned so far about South Sudan and particularly Malakal is saddening. The country is only two years old and is in the middle of basically an ethnic civil war. While there are many tribes in South Sudan, two main tribes are at the center of the conflict- the Dinkas and the Nuers. In general, the Dinkas form the government army and the Nuers form the rebel army.
Let me give you an idea of what the city of Malakal has been through. On February 18th, the rebels attacked the city. After seizing control, they began murdering every Dinka tribe member they could find (and if they couldn’t tell what tribe they were from, they murdered them anyway). They looted and burned homes, city buildings and everything else in sight. The teaching hospital was destroyed- the patients raped and shot in their beds. For many nights after, in a drunken stupor, they went around looting, burning and murdering.
I have seen pictures of war and its devastation, but experiencing it first-hand driving to the UN base is beyond what words can describe. The smell of rotting flesh, vultures surrounding the half eaten dead bodies that are scattered about, homes, hospitals and churches razed to the ground, the eerie silence of a once peaceful and thriving city; the brutality and inhumanity of it leaves one unable to muster any feeling outside of nausea.
We are running a primary health clinic and a reproductive health clinic (the midwife delivered a set of triplets yesterday!) The reproductive health clinic also offers rape counseling and treatment. When the fighting first broke out, the population of Malakal fled to the UN base or went into hiding. There are many pockets of people still hiding in the bush, unable to make it to the UN base safely. Recently, the rebels found a group of about 9 women hiding in a church and raped 5 of them- the youngest being about 12. The reproductive health clinic was able to offer these women both psychological and physical care.
As expected, gender-based violence has been a huge issue here in Malakal. I took care of a 15-year-old girl named Julia yesterday. She had attempted to return to the city to collect a few of her belongings with her mother and baby sister. A group of rebel soldiers found them and separated Julia from her mother and sister. She was locked in a room and raped repeatedly. That night, she was able to escape and made it back to the UN base. As of yesterday, Julia’s mother and baby sister were still missing. She remained composed as the doctor and I took care of her, but her trembling body gave way to the fear she truly felt. I reached out and took her hand cautiously, not sure what her culture indicated as an appropriate form of comfort from a stranger. Julia immediately grasped my hand with both of hers and started crying. I stayed close to her until she calmed down and was ready to go home. Unfortunately, she is only one of many similar incidents.
The clinic continues to see about 250 patients a day, though that number will increase when the fighting does. Today we had a sick little 6 year old girl arrive and attempt to register to see the doctor. As with any child that is alone, we asked where her parents were. She told us that it was just her and the little brother that she is taking care of- they have no idea what happened to their parents in the chaos. Luckily, there is a “protective” team here that looks for and manages “unaccompanied” children. Currently the unaccompanied children are living in a makeshift home in the logistics base (the part of the UN base where the UN and aid workers are living). They treated the little girl and then took her to find her brother. She will probably now be placed in the logistics base until a relative or parent is found (if they are still alive).
While we are very limited in what we can do at the clinic due to security and logistics, I have found that many people are simply starving for attention, for a sliver of hope, a kind word- to know that they have not been forgotten by God or the rest of the world. Yesterday, walking down to the clinic with an armful of supplies, I came across a two or three year old sobbing hysterically. He was looking up at one of the UN helicopters that flies, quite low, over the clinic routinely. He was terrified. I walked up to him and just started patting his back gently. Without knowing me, and despite being obviously taken aback by the color of my skin (or so I am guessing) he stopped crying, put his arms around my leg, and hid his face there until the helicopter passed. When I finally stopped patting his back, he just sat there looking up at me and smiling. Eventually, he took off running to join his friends. I can’t provide food for him, I can’t protect him from a bullet, but I could comfort him and make him smile. It’s moments like those that give me the courage and motivation to continue.
International Medical Corps' primary healthcare clinic at the refugee camp in Malakal, South Sudan.
While eating dinner, there was a large explosion that caused the building to shake. Almost immediately, our radios started blaring the instructions we all hope not to hear,
“All UN and NGO staff, please get to the bunkers immediately.”
Everyone was up and moving within seconds. After about 40 minutes in the bunker, we were given the all clear. Apparently, the government army was firing rockets and mortar bombs at the rebels and miscalculated. While they were still a ways from us, the UN wasn’t going to take any chances that the government would try again and miscalculate even more. We found out the next day that it actually came very close to taking out the oil station that lies just outside of Malakal!
A portion of the next day was spent in the bunker before we were given the all clear. Once cleared, we gathered the clinic staff and set to work putting together triage and first aid stations- expecting to be flooded with causalities. Not a single soldier came to the UN base for medical care. The UN reported later that the government army used their tanks and rockets to “clear the way” prior to entering the city. The rebels apparently took off running the moment the government’s heavy artillery showed up- hence the lack of casualties! No one was injured in the UN base and Malakal is now under government control.
That night, the entire camp celebrated the defeat of the rebels until early in the morning. The following morning thousands of people were gathered near the gate- singing and dancing- as they waited for the gate to open and the first opportunity to return to their homes without fear of being shot. Since then, our clinic numbers have dropped as IDPs spend most of their days bringing their personal belongings back from Malakal or fishing at the river.
I wish I could tell you about each and every one of the people I have met here- their lives, their struggles, their triumphs, their will to survive in horrendous conditions. The blind woman who lost her husband and toddler to illness and now carries her infant as her four year old guides her by the hand. The 7 year old girl who pushes her grandmother in a dilapidated wheel barrow all the way to the clinic because she is too weak to walk. The grandfather with arthritis and hunched shoulders, who can barely walk himself, who carries his grandchild to the clinic because he is sick with Malaria. The mother that lost her child because she couldn’t make it to the clinic in time and gave birth on the side of the road. The boys that give each other high speed rides in an old suitcase or the kids that taunt the UN soldiers until they are angry and then take off running and laughing. From the outside, it is so easy to classify them as 20,000 IDPs- to make them a number that is only one of many. The longer I am here, the more I can see them for who they are- dignified individuals who have learned to stand tall in life despite the weight of the world on their shoulders.
My time here in Malakal has come to an end. It feels like yesterday that I stepped off the UN flight in Malakal- wide eyed and wondering. I can’t believe a month has already come and gone and now I am starting my journey home. Leaving is definitely bittersweet- I am happy to go home, but as with Haiti, a part of my heart will always remain behind.
It is difficult to remain neutral after seeing the suffering of thousands of innocent people who have been subjected to unspeakable horrors at the hands of both the rebel and government forces. The rapes, the murders, the destruction of homes and livelihoods- the blatant disregard of even the most basic human rights. Just a few days ago the government army kidnapped a young boy just outside the UN gates. No one knows if he was murdered or forced into the government’s youth army. He will most likely never be seen again. Then God finds a way to remind me that love is unconditional. It doesn’t pick sides, seek vengeance, harbor anger or withhold kindness to even the most hardened of hearts. Recently, a high ranking government officer was at a hotel bar- the same hotel that we use for staff members who are in Juba for a day or two before leaving for the field. He was intoxicated and started verbally harassing one of the NGO staff members. The owner of the hotel- in very diplomatic fashion- asked the officer to leave and not return. The following day, the officer came back. He humbly apologized for his behavior. With his head cast down he went on to explain,
“I have been in the army since I was ten. I don’t know any better and I don’t know anything else.”
It is so easy to forget that even the greatest perpetrators were once the innocent victims in this conflict- many of them children that saw destruction and death, that lost family and friends, that had to choose between a lifetime of desperation or life in the youth army. While their actions are inexcusable, the reminder that they are wounded and suffering as well helps to lessen the distain I feel towards them.
The most difficult part about leaving Malakal is leaving my local staff. I have come to know them, appreciate them and care about them. One nurse in particular was hard to say goodbye to. His name is Thomas. In the beginning I had trouble being patient with Thomas. While he is an intelligent man, his writing and reading skills are subpar. It took a lot of time to teach him anything- though once learned he never forgot! Thomas is a very humble man with a constant smile and an uncanny ability to see the needs of those around him. He never left the clinic until every staff member- including myself- was done with work for the day. If it wasn’t something he could help with, he would talk or simply sit silently and patiently so that staff members wouldn’t have to walk out of the clinic alone.
When I said goodbye, Thomas grasped my hand firmly and said,
“Please, don’t forget me.”
In the US, we use that phrase haphazardly, but in Malakal it is a desperate plea. It nearly broke my heart in half. I wish there was some way that I could have conveyed to him the fact that his face, his kindness and his plea could never be forgotten.