The professional staff was constantly changing as doctors went home and new ones came, and we were assisted by local volunteers, many of whom were internally displaced persons, IDPs, themselves.
Our current roster consisted of six doctors, a dozen nurses, and a dozen aides responsible for the emergency care of the eighty thousand residents of this camp. Yes, eight zero, followed by three more zeros.
All the doctors here had had to compete for an assignment with Kind Hands. We wanted to do good in the world, and yet very few doctors signed up for a second tour. It took only a couple of weeks for the enormity and the futility of the job to set in.
Ten minutes after being roused by Jemilla, I was in the operating room, scrubbed in and gloved up. The sole light source was a halogen lamp hanging from chains over the operating table, powered by the battery in Colin’s Land Rover.
The boy on the table was a very small four-year-old who, according to his mother, had wandered too close to the chain-link boundary and had been struck by a bullet to his chest.
Sabeena, our irascible and irreplaceable head nurse, her long braids tied up in a colorful head scarf, was wearing scrubs and pink Skechers left to her by a doctor who’d gone back to Rio.
By the time I arrived, she had efficiently swabbed the child down, anesthetized him, and laid out clean instruments for me in a tray. As I looked him over, Sabeena gave me a rundown on his vitals.
The child was bleeding like crazy, and, given his small size, he could barely afford blood loss at all. I saw that the bullet had gone in under his right nipple and had exited through his back, just under his right shoulder blade. The boy’s mother was standing there with a tiny new baby in her arms, her tears plopping onto the contractor’s garbage bag she wore as a sterilized poncho over her rags.
English was the official language here, and, although probably sixty tribal languages were in use, plain English was understood.
I asked, “Mother, what’s his name? Tell me his name.”
“Nuru,” the woman said. “My God. My little son.”
I said to the unconscious child, “Nuru, I’m your doctor. My name is Brigid. Your mommy is here, too. Hang tough, little guy.”
Sabeena wrote Nuru’s name on a strip of tape, wrapped it around the boy’s wrist while I did a FAST exam with our portable ultrasound. There was so much blood still coming from this small boy, I had to find out if the bullet had gone through only his chest or if he also had an intra-abdominal injury.
I looked at the ultrasound.
“There’s no blood in his stomach. That’s one good thing, anyway,” I said to our head nurse. “Maybe the only good thing.”
Sabeena clucked her tongue and shook her head. Then she hung a bag of blood and threaded an IV needle into the boy’s vein while I considered what to do.
It was my call. It was all up to me.
I had recently finished my residency at Johns Hopkins and had volunteered with Kind Hands thinking, like almost everyone here, that I knew what to expect. But the books and documentaries that had inspired me to come here had given me only the slightest inkling of the reality of South Sudan.
Since 1983, the normally dire, antithetical-to-life conditions had gotten worse, with the country now divided and its people and their villages, families, and livelihoods shredded by genocide.
The number of displaced persons in South Sudan continued to swell. Food shortages, a lack of potable water and medicine, contagious disease, killing floods, and droughts had been compounded by gangs of murderous teenage boys and actual army militias doling out unspeakable violence.
And now I stood in an operating room that was bare to the bone. We had two standard operating tables, six beds, a few shelves of expired medical supplies. Instruments were sterilized in pots of boiling water hanging from bicycle handlebars positioned over the fire pit outside the back door. Along with the car battery, we had a small, noisy generator.
We made medical equipment with tire pumps, duct tape, and cotton jersey. I could do a lot with an empty coffee can and a length of plastic tubing.
This was it, the real hell on earth.
Everything here was desperate and chaotic. Except that right now, the radio was plugged into the generator. The Red Sox and Yankees were playing at Fenway. David Ortiz was stepping to the plate with two outs in the bottom of the ninth. The score was tied, 3–3. If Ortiz could somehow get hold of one, maybe Nuru, too, could go deep.
I had hope.
Chapter 2
ONLY MINUTES had passed since I met my young patient, Nuru. Sabeena was bagging the child, and I had determined my course of action, when my colleague, Colin, came up from behind, saying, “Step aside, Brigid. This kid could drown in his blood.”
Dr. Colin Whitehead was a late thirty-something, tireless, bright, frequently cranky surgeon who had left his practice in Manchester, England, to come here.