Editors Note: Elizabeth Karman is a member of Christ Church who works for Doctors Without Borders/Médecins Sans Frontières (MSF), and is currently posted to South Sudan where she works to improve access to quality healthcare.
On Maundy Thursday, I was sitting in a muddy airstrip, cursing the sky.
I had been visiting a tiny hospital in a very rural area of South Sudan. It was an area where distinct and isolated people groups live nomadic lives just as their ancestors have for millennia, moving with their animals. Due to deforestation and climate change, the area fertile for hunting and grazing was getting smaller every year, forcing families to travel further to find quality land. Few services are available in this area, but everyone knows they can access the MSF hospital for free care. I was there with a South Sudanese nurse colleague, to assess the progress of training local nurses, and to make recommendations for improving the quality of care.
We had been camping there for two weeks, in alternating heat and mud, as the sun fought with the rainclouds each day. The work was fruitful, but we were ready to return to the capital, Juba, for a rest and to celebrate Easter. The sun had been shining all morning, but the plane did not come as expected. We later heard that it had been diverted to pick up a critical patient from another hospital. When it was finally on its way, we ran out to the airstrip only to see an ominous black cloud. Ten minutes before the plane was due to land, a sudden and overwhelming storm began, turning the dirt landing strip into a vat of mud. Another plane might not be able to land for a week. If only that critical patient hadn’t needed to be moved! I thought.
Earlier that week, my team heard disturbing news about another hospital to the north in Ulang. Local violence had been brewing nearby for weeks, and on the Monday of Holy Week, it boiled over. The hospital was overrun and looted. Even the small classroom and lab where we taught nurses was destroyed. It took several hours before I was able to contact my colleagues among the displaced staff and confirm that all were shaken but ok. We mourned together for the community. The only hospital in a huge rural area was now gone. If only people could see that hospitals are neutral! We lamented.
I was frustrated. In this year of work in South Sudan, already so many things which my team has worked hard to build up have been dismantled or suspended. National-level political infighting has increased the general sense of insecurity, and localized conflicts had led to evacuations or worse. In updates from my former home in Afghanistan, I could see the work there being threatened as well. Former colleagues reached out with the terrible news that all the mobile healthcare teams we had started, which were delivering free care to women and children in very isolated rural communities, had lost their funding due to the withdrawal of USAID. My colleagues were laid off, the office closed. If only all that work didn’t come to nothing…
When I am working in crisis or conflict areas, I have to remind myself daily that, despite so much being out of my control, there are things that are always within my sphere of influence. I can choose to show people love and acceptance by how I communicate. I can step aside with my Western-educated privilege and ensure my incredibly experienced South Sudanese nurse colleagues have the spotlight when things are going well. And as much as is possible given security restrictions, I can choose to stay, to “be with” even when things are hard (and muddy!)
I remembered that the people experiencing Holy Week for the first time didn’t know how the story would end. Nor did Lazarus’ family know. Why didn’t you come earlier, Jesus?
At 6:30 AM on Good Friday, a logistics officer woke us up in our tents. Could we pack and be in the car ASAP? A plane may be able to land today at another hospital several hours’ drive away. I grabbed a breakfast of instant coffee and day-old rice and was first in the car, praying that this plan worked. The road was beyond muddy, and we made very slow progress. We got stuck several times, but the experience and skill of the driver saw us through. As we left the tiny town behind, we entered an area of bush which was known for exceptional biodiversity of birds. Along the road, groups of hawks and buzzards gorged on the fat termites which had been brought to the surface by the rain. At one point, an enormous and elegant white crane faced off against our car in the middle of the road, raising its wings in an aggressive pose, trying to chase us away. The whole car burst out laughing. We saw a herd of gazelles jumping over the scrub and crossing the dirt tracks in front of us. I realized that because of the frustrating delay, I was now getting a front row seat to a safari that was off limits to most.
It took a long, exhausting day of travel, but we made it back to the capital city by late Friday evening. My South Sudanese colleague was able to surprise his family by being back in time to celebrate Easter together. I was able to finally wash all the mud off and relax. I joined the Christ Church Easter service on You Tube, and prayed along with you.
As for the hospital in Ulang, there is no happy end to the story. Because of choices made by a few, many people will suffer from a lack of access to health care, at least for the time being. The efforts of so many staff- local, regional, and international- have been unfairly cut short. After talking with traumatized colleagues who ran from the destruction, I still don’t have the words to express the injustice of it all. But it is not always my job to name things- I can simply sit and bear witness to the injustice. I thank God that my colleagues in Ulang are safe, and that the work goes on in other places.
As I finish the last few months of my time here in South Sudan, please join me in continuing to pray for peace. For protection for those caught within a decades’ old conflict, and for wisdom; both for the political leaders and the leaders of communities, institutions and organizations trying to mitigate the harm to civilians. I pray for the people who have lost access to health care, and to the local health care workers, who are facing new and frightening challenges.
PS: In the days since writing this, a second MSF hospital where my team has been working, in Old Fangak, was bombed and destroyed. I have been evacuated to Kenya and am safe, but my heart and prayers are with my South Sudanese colleagues.
(Note that all opinions here are my own, and do not represent MSF or any other employer.)
