I HATE TALKING WITH SR. ROCIO

I hate talking with Sister Rocio. She tells me about the children she is nursing in the paediatric ward at the Mother of Mercy Hospital in Gidel. Last week was about Kuku, the six year-old boy who fell from a tree and landed awkwardly. Blood was flowing from his ears and nose and, as Sr Rocio explained “that wasn’t a good sign.” After a few days it was obvious there was brain damage but at least he could respond to simple questions and the staff are clinging to the hope that he will get better. Sr Rociothentold me about Leyla – an eight year-old girl who also fell out of a tree and wasn’t as badly hurt as Kuku because she ‘only’ broke both bones in her left arm. Her parents didn’t bring her to the hospital because it’s far from their home and they tried to treat the fracture at home using the traditional method. But an infection set in and after five days they walked the 35 km, all the way to the hospital. The doctor had to remove the whole arm from inside her shoulder because the infection had spread upwards and she would surely have died of septicaemia. “Leyla is in shock”, says Sr Rocio,“and can barely respond when we try to talk with her to tell her she will be okay.”

Amira is so thin and has the biggest sores on her bottom and in her genital area that Sr Rocio marvels how she has managed to cling to life for the past two weeks. “A healthy five year-old should weigh at least 20 kg but Amiraweighs only 10kg – the weight of a two year-old! We have a feeding tube in her but can only give her small amounts. It will take a long time before she gets better – if she makes it at all. And Amira only whimpers a little when we have to change the dressings on her wounds. It must be so painful for her but she endures it.” She explains that a small donation of about $15 to buy fresh meat for Amira from the nearby local market was so gratefully received by her mother that she didn’t have the words to say thank you. “Her face said it all though,” reflected Sr Rocio, “and her mother hasn’t left Amira’s side. I know it is her love that keeps that little girl fighting for life.” 

Why aren’t children like Leyla and Kuku prevented from climbing trees, you may ask? Why don’t their parents do more to ensure that these sorts of accidents are prevented? And why isn’t Amira’s mother making sure that she gets enough food each day to stay healthy and strong? The answers are simple, really. Leyla and Kuku, and too many children like them, are climbing trees because they are hungry. There is widespread hunger in the Nuba Mountains as a direct result of the almost daily bombing raids that camefrom Khartoum during last year’s cultivation period. Hence the majority of Nuba people were not able to grow and store enough food to survive for the year, as they have usually done year after year for centuries. In this season now, several weeks after the end of the mango season, there is only one tree that bears a hard and almost tasteless red fruit. Children gnaw on this fruit and it helps them feel less hungry. Other children and adults are picking the edible leaves that are beginning to sprout on the spiky bushes and eating them raw. Some people are also coming and begging for seeds to plant now that the rains have started as they had long ago eaten the stock normally reserved for planting.

This is a very hard time for people in the Nuba Mountains of Sudan. Whilst there has been a small respite from the Antonov bombings and raids by MiG jets during this 2012 period of cultivation – because Khartoum is ‘busy’ attacking South Sudan and Darfur and Blue Nile – the consequences of last year’s deliberately targetted campaign to prevent the harvesting of the Nuba’s staple foods of sorghum, maize and groundnuts are really being felt now. The ones suffering the most are children and the elderly: innocent civilians like Kuku and Leyla and Amira. Amira’s mother is pregnant and is naturally focussed on preparing the farm: digging and weeding the land for this year’s crops and on having as healthy a baby as possible. Her ten year-old sister is able to fend for herself but Amira’s story is that because she hasn’t demanded food like some children she has, rather too quickly, degenerated to the state of severe malnutrition. She isn’t the only malnourished child that the staff at the hospital are seeing these days.

Sister Rocio is close to tears as she explains that Medicins Sans Frontiers staff in Yida refugee camp are now regularly referring children with complications of malnutrition – and this despite the fact that they are specifically commissioned to provide a supplementary feeding program for the refugee children. The journey to and from Yida is a gruelling one with terrible “roads” pot-holed by the new rains and long waiting periods for a free ride with one of the few vehicles still daring to risk the trip to and from the Nuba. Kaka was referred to Gidel by MSF. “She was literally skin and bones, had a big lump on her neck and despite the feeding program they saw that she wasn’t improving. They also suspected she had tuberculosis, one of the likely consequences of malnutrition.” The lump, however, was cancer and when Sr Rocio tried to find some muscle to give her the first dose of chemotherapy she said: “I could only pinch the thin skin and inject it in the space between it and the bone.” Kaka died the next day.

Many Nuba people have chosen to walk the 205 km to Yida Refugee Camp where food is being distributed rather than risk severe malnourishment. Many now arriving at Yida (and reports are that up to 1,000 are arriving each day and the population has now reached 50,000 refugees) are already weakened and succumbing to the effects of malnutrition. It is a fact that Nuba will die of starvation especially the elderly who are left behind because they cannot make it to the camp. The continuation of sporadic bombing and ‘surprise’ aerial threats, coupled with Omar El Bashir’s adamant refusal to allow humanitarian access to the people of the Nuba highlight Khartoum’s deliberately evil and criminal policy to prevent another agricultural cycle in Southern Kordophan state and so starve many more children, women and men to death. This is a continuation of the genocidal campaign in the Nuba that the regime mounted in the 1990s.

It is vital that the international community pressures Khartoum to immediately cease its aerial assaults on civilians and farmlands, demandfor humanitarian assistance to be provided to those who are hungry and malnourished and particularly to prevent the famine that is sure to be declared when saving the lives of tens of thousands of Sudanese will be too late.

Today when I met Sr Rocio I asked after Kalo who has been her special patient for two months. She had been giving me almost weekly updates about his condition since he arrived with an older woman. They were both victims of an Antonov bomb but instead of the usual injury of having shrapnel tearing parts of their body to shreds they were severely burnt by the radiant heat when it landed near them. Kalo was the worst off and arrived with third-degree burns to 40% of his body. Instead of the beautiful black skin characteristic of the Nuba,Kalo’s skin was a melted mess of white/ red and black/green colours – the latter because the tissue was gangrenous. Sr Rocioonce tried to describe the stench she and the staff endured each day for the two hours it took to remove the bandages, cut away the dead tissue and re-bandage his wounds and said he was one of the most stoic children she had ever nursed. “He rarely cries but sometimes it is too much even for him and when we dress him and then we also cry with him.” Rocio’s face registered the shock of a painful memory with my asking afterKalo. “Oh, of course, you weren’t here on Wednesday.” Her voice softens and immediately tears fill her eyes.“Kalo died. He went into shock and we tried to keep him alive and urged him not to give up but he couldn’t hang on.”

Once again the thought of ‘this is why I hate talking to Sr Rocio’ crossed my mind but as I responded to her sad news I also knew deep down how blessed Kalo was to have had her looking after him. He had had two months of the most amazing love and care from her and he was totally loved into death. I don’t really hate talking to Sr Rocio…I just wish that she ‘only’ had cases of malaria and measles and diarrhoea – at least they are more (but not totally) excusable diseases that children usually get in Sudan.