Nuba Mountains Journal: The War through a Doctor’s Eyes

 

Editor’s Note: Dr. C. Louis Perrinjaquet M.D., MPH, volunteered for a month last year in the embattled Nuba Mountains of Sudan. In this guest blog post he reflected on the experience and shared excerpts from the travel journal that was recently returned to him.

It is a strange new phenomenon to watch the conflict in Sudan’s Nuba Mountains unfold in near real-time reporting by satellite, Skype, and email, to see military buildup with new roads leading into civilian areas, evidence of indiscriminate bombing, even a captured Sudanese Armed Forces’ drone showing GPS data of civilian populations used to direct the Antonovs bombing them.  

Watching these reports has been particularly painful since getting to know these places and some of the people that inhabit them. I’m a medical doctor based in Breckenridge, Colorado, and for several weeks each year I volunteer in medical clinics in hard-to-reach communities, most often in Nepal and Honduras—typically places cut off by poor infrastructure, poverty, difficult terrain. These challenges hamper access to Sudan’s Nuba Mountains as well, but there’s also something far more sinister at play: the terrorizing campaign organized by the Sudanese government, targeting its own citizens, and the intentional blockage of humanitarian assistance to ensure that hunger attacks those who the bombs miss. I cared for many men, women, and children who were the victims of this senseless violence.

I don't want to sound overly dramatic, but this is a life-and-death situation on a grand scale.

Last October rebels took my travel journal as I boarded an arms shipment plane to leave Nuba. Through a long chain of handoffs, my journal was returned to me this spring. Some of the entries are graphic and hard even for me to read. I did not write this with the intent that this would be published, but I feel obligated to do so if somehow it brings help to the people of the Nuba Mountains. The world must not ignore or become complacent about the ongoing suffering there.

October 2011

...difficult to arrange flight from Juba into Nuba Mountains because Sudanese Armed Forces keep finding out about flights and bombing landing strip as the plane tries to land...

Oct. 8 Mother of Mercy Hospital in Gidel. Horrible “Antonov” wounds, at least one child dies of malnutrition every day, osteomyelitis (chronic draining infection of exposed bone).

Oct. 12 Heard my first Antonov. Dr. Tom Catena pointed it out over sounds of fans, anesthesia machine, oxygen concentrator, and people talking. “You hear that low rumbling sound?”  Then back to surgery. … many children dying of malaria because of lack of medicine because of “denial of access of humanitarian aid” war tactic of Sudan government.

Traction pin placed through young man’s tibia for femur fracture when Antonov bomb blew off his left buttock. Eight of us worked to construct a two-piece mattress to allow access to dress the wound. Now he has to lie on his back in traction, and the nurses have to get underneath him to clean and dress the massive wound down to pelvis, whole left buttock gone.

Oct. 20 In Togor (3.5-hour drive north of Kauda) Abass, the clinic administrator: “No medicine. No gauze. Solar fridge needs battery, kerosene fridge not working. No truck for transport.” Monitoring children under 5. Advising people from outside this area to travel to refugee camps in South Sudan [city of] Bentiu, many days or weeks walking. Also has inpatient ward, but only one person now because of bombs; people are living in rocks and caves nearby. Staff is working for free since May [2011]: 13 staff, including two guards and two cleaners.  

In Sabat. Visited the Nuba Community Clinic, a nice set of buildings, well maintained. No patients, no medicines, no supplies for months except a few packets of oral rehydration salts, so most patients just come for referral or guidance on where else to seek care, which everyone knows is too far away if you are sick.

Oct. 23 In Kurchi. Everyone is friendly, cheerful, and alert to sounds of Antonovs in the distance. As soon as we arrived they showed us where the holes we are to run to are if we hear planes. “Snakes, bombs or bullets.” May be bitten by snakes if run to caves to avoid bombs and may meet bullets if leave the area for help. I get a walking tour of the area. “My father died of hunger,” the man said with sadness, but no more than if he’d said, “My father died of cancer or a heart attack.” I’ve never had someone tell me their father died of hunger.

Oct. 25 In Gidel at noon. We left Kauda at 8 a.m. Finished rounds with Dr. Tom then assisted removing rotten, decayed baby three weeks after ruptured uterus. Opened abdomen, foul gas blew out like opening a tomb. The baby skull came out in pieces... I plan to donate blood for 15-year-old woman with two-week old ankle injury “blown out from Antonov.” We’ll amputate tomorrow. … I just gave the nurse named Monday all my dental instruments, some I’ve had for more than 10 years. Monday said he agrees to stay and work at this hospital and use these tools at least 15 years, until he retires.

We just finished amputating a guy’s right leg below the knee. He has spinal anesthesia [and] couldn’t feel pain, but [he] was awake and talking about home though the sounds of sawing though his tibia that shook the whole table. 

Oct. 26 No bombs or bombers today. Donated blood again, something concrete I can do.  I removed five fingers from four peoples hands. As leaving dinner, SAF soldier from yesterday’s battle was found and brought here by SPLA-North. He had gunshot in and out of his thigh, shattering femur, not bleeding, good pulse, fever—probably from malaria and not the wound. Tom plans to put in traction pin tomorrow. Lots of people in courtyard shouting about this enemy soldier but SPLA-N who brought him asked he be treated well. 

Oct. 29 Yesterday we amputated 15-year-old girl’s right leg above the knee. Her ankle had been struck by [a bomb from] an Antonov. The second unit of blood I donated was running in her arm as I filed smooth the freshly sawed end of her thigh bone. She felt no pain. The spinal anesthetic worked well for that, but she was wide-awake and we made eye contact as I looked over the surgical drape to make sure she was OK. Sorrow and relief. After the rounded stump was cleanly wrapped and the surgical drape lowered she raised her head to see her future and her lifeless leg lying on the operating room floor. I tried not to project my own sadness onto her own emotions. 

I am overwhelmed by the injustice suffered by these innocent people—“The enemies of Omar al-Bashir,” as Dr. Tom refers to his patients. 

“Doc PJ” Perrinjaquet M.D., MPH, spends most of his time in his family practice clinic in Breckenridge, CO. The seasonality of work at a ski resort allows him to volunteer in remote areas of the world such as Honduras, Nepal, and Sudan in the spring and fall. He spent the month of October 2011 volunteering in Sudan’s Nuba Mountains.

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