A Search for Humanity

I was asked why a doctor working with Doctors Without Boarders would write. Why, when books, magazines, and newspapers are already congested with the grievances of world conflict? To add to this ocean risks being lost inside the cesspool, beaten and plundered by roaring, vicious waves, and finally dissolved into yet another forgotten piece of crucial information. There is already material for people to read should they wish to be educated on the subjects of genocide and inaction in the twenty-first century. No, for a doctor operating in a war zone, twenty-four hours are not enough for the sea of wailing, helpless victims of senseless violence; there is no time for quill and ink. A physician, whose words are better used to comfort the families of slaughtered children, whose ears have gone deaf to cries of anguish, whose arms have felt the slow vibrations of saw against bone and the final crack of the limb falling from the body, deserves no place among the countless others reporting from the crumbling corners of the globe. Why should she write? Her voice is not needed as much as her skill. What does she wish to accomplish through simple words and pages? What can she say that has not already been said (and ignored)? Does she only seek recognition in the arena of human rights activists, a pat on the back for her sweat and blood and tears? 1

No. The doctor swears to Apollo, Asclepius, Hygieia, and Panacea to work for the good of their patients. She dedicates her hands, mind, and body to the art of medical practice. Was it not Hippocrates’ intention for physicians, who swear to uphold his creed, to assist all in need through medical means? Isn’t a doctor, whether working on the front lines of a major human catastrophe or within the confines of an office, only obligated to fulfill the specific guidelines set down in that sacred oath? I think not. A physician operating in a war zone has an obligation not only to the patients she sees while there, but also to bear witness to the atrocities taking place. She does not serve for a glorified station among her peers, nor does she wish congratulations for the services she has rendered. Rather she works to fulfill her burning desire to help the helpless and halt the senseless violence corrupting society.2

I first saw Mihad standing in the corner of an image flashed hurriedly upon a projector screen. There, almost as if by mistake, she was the only life visible in the desolate desert landscape. The haste with which the slide was changed perhaps was meant to remove the significance of the image and to focus our attention on the mass graves, the weapons the Janjaweed preferred as their methods of inflicting misery, the villages set ablaze, the horrific wounds left in the wake of an attack. But Mihad’s face was instantly engraved upon my mind. The painful lines of malnutrition stretched their fingers across her naked chest, threatening to peel skin from bone and leave only a scarred carcass of the beauty this child once possessed. Our promise of, “Never again,” had been forgotten. The great nations of the world had failed to halt the genocide in Darfur. And now I was being sent to mend those unfortunate enough to be along the route the Janjaweed chose to take.3

The next morning I flew to Agok, the internationally displaced person (IDP) camp that Mihad had fled to after her town was destroyed by the Sudan People’s Liberation Army (SPLA). It didn’t take me long to find the little girl, who was standing at the front of a group of orphans. I gave her an encouraging smile and walked over to introduce myself. Her timid nature was soon overtaken by her desire to become friends with this white woman from America. With little ado she offered me her small, bony hand and took me on a tour of the camp.4

The sights I saw in this wretched place left me wondering if there was any hope for the goodness of humanity. Emaciated bodies floated by as if they were spirits already. Some stretched out upon the dusty ground appeared dead, and it was only upon closer inspection that I realized that life still breathed from ribs that burned with the effort. Genocide hung in the air. Like a dirty blanket it covered the blameless with its own denials, and with a gasp I realized the many lies we had chosen to believe because we did not wish to see it happening again. When emotion finally took hold of my chest and twisted the breath from my lungs I stopped to comfort children whose tears had flowed dry upon their hollowed cheeks. My touch seemed to register no more than the flies that rested in the sticky corners of their eyes. Mihad turned and waved, inviting me to walk again among the dead and almost dead. She knew this scene well, for she had already lived through the rest of the world’s ignorance.5

I am a doctor, not a writer. I have saved the lives of many with only the most basic resources against a backdrop of war and despair. I have seen people die, from massive wounds, disease, and the loss of hope and the will to survive. Like many, I carry with me the ghosts of my limitations, the effects of my decisions. The memories haunt me: the ones I couldn’t save, the ones I killed. The dead pile up around me, they overflow the graves dug to hide them from sight. Some are victims of irreversible injury, others are the inexorable casualties of the system - the physician’s mistakes swayed by erroneous calculations, bad judgment, fatigue, and bad luck, the result of faulty or absent equipment, or the simple victims of time. There is only so much medicine can do in the war against death and despair. Its weapons are limited, its resources strained.6

The pen, however, can strive to close the gap between medicine’s success and failure. Through writing doctors can initiate action. With words our voices can bring life to hearts unmoved by the struggle of those on other continents. Our accounts of the horrors we face can educate those blinded by distance and ignorance and catalyze a reaction by individuals, groups, politicians, governments, and the world. Peace is obtainable; it is time we stand up against injustice and fight for the rights innate to all people.7

The second day I was in Agok a group of refugees flooded the camp. Listening to their pleas for the lives of their relatives, and the apparent confidence they had in the small group of doctors, I quickly got the feeling that someone had told these people that my team and I were miracle workers who would be able to save the endless stream of traumatized and dying victims. I could only hope they were right. My first cases were two brothers. Both had been shot. The less wounded boy had carried his badly injured sibling on his back for five days. I knew immediately the second child would not survive. His wounds were severely infected, his breathing labored and raspy, his heartbeat weakening with each passing second.8

After twenty minutes of futile attempts to save him we declared him dead and moved on to the first child. Hussein had been shot in his left arm. With immediate medical attention his injury would have been easily treated. Unfortunately, this had been unavailable to him and now the putrid stench of gangrene radiated from the blackened crater in his flesh. Grimly, I told him we would have to amputate the limb in order to save his life. His face showed no emotion, he only nodded and followed us to the operating table. We saved ten people that day. We lost four.9

In Darfur I walked through a circle of hell Dante himself could not have imagined. This world of war and medicine has taught me of the cruelty of man. It has showed me fear, pain, and despair in their rawest forms. It has given me irrefutable evidence of the urgency of the crisis in Sudan and of similar crises throughout the world. It has infused me with a burning level of frustration and anger that before I would not have thought possible.10

I have been witness to unimaginable cruelty, subjected to utter helplessness in the face of injury and disease, and shared in the suffering of the innocent against the heartless and corrupt. With my own eyes I’ve seen the resiliency of the human body, the strength of spirit that carries an oppressed people forward, the love and compassion that can exist between strangers. Some might ask me why I write. Others will question how I could not. How, after what I have seen, could I not try in any way possible to bring this knowledge and experience back with me, and to share it with the rest of the world? I cannot remain silent.11

I do not write for myself, I write for Mihad, Hussein and his brother Anour. I write for the people of Darfur. I write for humanity. Doctors in conflict zones have the first and foremost responsibility of providing medical aid to the sick and injured. But our responsibility does not end there. We return from these regions as witnesses to astonishing crimes, and we have an obligation to share that information with all who will hear it. Individual efforts to bring urgency to the case for Darfur’s victims can do more than weak reprimands by uninterested nations. One outspoken witness to such atrocities can rally thousands, hundreds of thousands, even millions of people against the cruelty of the Sudanese government and their Janjaweed rebel forces. Perhaps then, with the voice of the multitude behind us, we can initiate action against the government of Sudan and end the genocide in Darfur.12