People are literally dying trying to get here

This piece was featured in The Toronto Star on 13 October 2012.

Below is an early draft that includes a bit more info than the Star’s edited version.

MABAN COUNTY, SOUTH SUDAN – Syrupy mud claws at the thousands of bare feet of those trudging to the nearby market, reluctantly letting go with a wet, sibilant sigh.

Rain-heavy pendulous clouds lurk overhead as men and women, in their shimmering iridescent shawls of viridians and clarets, follow the dirt road that weaves its way through a labyrinth of lush grassland pitted with pools of standing water, pit latrines, and tents that have UNHCR emblazoned on the side in blue lettering.

This is Yusuf Batil refugee camp in the remote northeastern corner of the world’s newest nation.

Colleen Laginskie, a 29-year old nurse from the West End of Toronto, visits with young mother Karima Musa in the camp’s inpatient therapeutic feeding centre.

Musa cradles her baby daughter in her arms.

A hand-drawn poster adorns the tent wall illustrating why it’s unsafe to drink the surface water in the flooded camp – the same water that many of the camp’s residents defecate or urinate in. In light of a recent hepatitis E outbreak, this poster is part of a prescient campaign to improve hygiene in the camp, and to get the refugees using the pit latrines provided for them.

The children in the feeding centre – just one tent in the muddy matrix of the Médecins sans Frontières (MSF) field hospital – are so malnourished their faces collapse in on themselves like black holes and their arms, toothpick-thin, hang limp by their sides.

“Seven days ago I lost my son to sickness,” Musa says. “We walked for three weeks without food, only eating tree leaves and lalock berries, and that’s why he died.”

Musa says her remaining child is also now sick.

“I am so tired and weak,” she says. “I’m trying to breastfeed my daughter, but I just don’t have enough milk because I haven’t been eating.”

The babies in the centre are fed only a weak powdered milk solution, their small bodies too weak to handle digesting anything more substantial.

And to keep malnutrition and related illnesses at bay among the children, Laginskie and her colleagues work 12-hour shifts in very basic conditions.

A rudimentary emergency room was only set up a few weeks ago. Minor surgeries can be performed in the nearby town of Bunj.

Laginskie says up to five children are dying a day from malnutrition – twice the rate that’s internationally recognized as the emergency threshold. In a “regular” emergency scenario, the number of daily deaths would be one to two for every 10,000 children.

But recent MSF figures show that this high mortality rate isn’t isolated to young, vulnerable children. While approximately 58 percent of the reported deaths in Batil have been children in the under-five bracket, an alarming 25 percent have been adults over the age of 50.

Laginskie graduated from York University in 2005 with a Bachelor of Science degree, and has since worked on a casual basis at Toronto General Hospital primarily in the intensive care unit when not working abroad.

This is Laginskie’s second mission with MSF, having previously worked in Ethiopia’s Liben refugee camp.

She says it’s hard to compare the two experiences, but that in terms of sheer numbers, Batil is by far a bigger humanitarian crisis.

“But the bottom line is that in both places children are dying at an alarming rate, and it’s unacceptable.”

Laginskie says that life in Batil, while difficult, is a vast improvement on the conditions the refugees faced in their home communities.

“We’ve heard lots of stories from the refugees of what they’ve endured to even get here,” says Laginskie. “A lot of people haven’t had food and some apparently just collapsed on the way here, too tired to walk, too tired to carry on.”

She says it took many of the refugees up to two months to walk from their villages to the Batil camp – a journey on which they brought little to no food with them.

While walking, they had no choice but to resort to eating leaves and shrubs, or drinking dirty surface water infected with parasites and bacteria.

“People are literally dying trying to get here,” says Laginskie.

Yusuf Batil is just one of four camps in South Sudan’s Maban county, now home to more than 110,000 refugees.

More than 37,000 refugees currently inhabit Batil — a population one-third larger than Orangeville — living in the thousands of white tents that are crammed into the six square kilometre site. Most of the refugees here are from the Ingessana tribe, the same ethnic group as Malik Agar, the rebel leader who is leading the SPLM-North’s fight against the Khartoum government.

The conflict started as a dispute over the oil-rich region of Abyei in the months leading up to South Sudan’s secession in July 2011. This dispute has since spilled over into the northern Sudanese states of South Kordofan and Blue Nile where many fought for the South Sudan’s independence.

But when a peace agreement was signed in 2005, ending more than 21 years of civil war, these two states remained part of northern Sudan, leaving many feeling betrayed and isolated.

The rebel group, banned by Sudan’s leader Omar al-Bashir, has also accused the President of wanting to turn Sudan into an Arab Islamist state where different religions and ethnic minorities are persecuted.

The refugees in Yusuf Batil camp say they fled the Sudanese state of Blue Nile after government planes pounded their homes daily with bombs over a two-month period.

They say they don’t know why this is happening to them; many say they have never even heard of the SPLM-North.

The Sudanese government has continued to deny the allegations of aerial bombardments targeting civilians.

But the refugees who continue to arrive in their droves to the camps in the remote northeastern corner of South Sudan keep telling the same story of being forced from their homes by constant attack from Antonov bombers.

It is now the rainy season in South Sudan, and Yusuf Batil has become an island.

All the roads are flooded or have been washed out completely. The camp is only reachable by plane or river barge.

There is simply no budget to airlift out refugees requiring more serious operations.

Additionally the pernicious effects of forced month-long marches, of malnutrition and disease in the camps, cannot be ignored, nor should they be belittled.

But Yusuf Batil is simultaneously home to a multitude of stories of incredible resilience, of hope, and optimism.

There’s the 10-year old girl Iklas Bashir who says she’s not sad about her village being bombed, leaving her friends behind, or having to eat leaves for months as her family hiked south.

She adjusts her Red-Riding Hoodie in a moment of shyness.

“I was sad I didn’t have time to gather my schoolbooks before we had to flee our home,” she says.

Iklas says she still wants to be a teacher when she grows up. Being a refugee hasn’t diminished that dream.

She’s started to go to the school in the camp so she can learn English. She counts haltingly up to 25, missing an occasional number.

“I’m happy here,” she says. “I feel safe and when the bombing stops we will go home.”

Abdullah Aladi Primary School is one of the few makeshift schools established by Save the Children in Yusuf Batil to provide education for the young children.

For a few hours each day, over 300 children like Iklas come to this large tent to learn rudimentary English and arithmetic.

They have also been taught songs with a twofold purpose: to teach them English but also to drive home important messages.

One song stresses the importance of personal hygiene in the crowded camp. The teacher leads the song, and the children clap belting the lyrics back at him.

“Everyday, everyday / I clean my nose / Every single morning / OK, good, OK / Everyday, everyday / I wash my hands / Every single morning / OK, OK, OK.”

The teachers here have taught the children a second song – this time in Ingessana – with an equally important message.

“Now that we’ve been displaced / Let’s go back to school and study.”

The boys in the room stamp their feet while they sing, raising clouds of dust in the dimly lit tent.

The message is clear – life goes on.

Then there’s 18-year old Hassan Jafer whose family fled their village of Soda eight months ago following weeks of incessant bombings that resulted in the death of his aunt.

Once a week Hassan walks the 49 kilometres – a journey that can take several days – from Jamam refugee camp to Yusuf Batil. He comes here to sell fresh milk, which he buys locally and then re-sells at a profit.

He sells three litres of milk for six pounds – a little more than a dollar.

If he’s lucky, Hassan says he can sell four 20-litre jerrycans of milk in a day.

Hassan spends a couple of nights sleeping rough in the camp before heading back to Jamam.

He travels back to his family there – his parents and five brothers – whom he is single handedly supporting.

Hassan says seeing the sick in the camps has compounded his desire to become a doctor.

That such a weight has been placed on the shoulders of one so young is terrible. But that Hassan has borne this weight so well, showing remarkable fortitude, entrepreneurship and dedication to his family is simply inspiring.

Everywhere you look in Batil, there are similar signs of hope and resilience.

There’s the young boy who’s refashioned a UNHCR tarp into a pair of trousers.

There’s the man in the market whose trade was farming, and yet he has adapted to the new order of things and now has a successful business selling soap, batteries and sorghum at the roadside.

There’s the women chattering and laughing as they pump water into their jerrycans at the borehole, and the men who joke and cajole one another as they play mancala at the roadside.

Frederic Cussigh, head of the UNHCR field office in Maban, says 99 per cent of the refugees want to go home, but that an immediate return to their homes is unlikely given the continuing conditions in Blue Nile.

But he recounts a remarkable anecdote.

Thousands of UNHCR tents were set up in Batil before the refugees arrived in the camp. These were set up in regimented, orderly rows.

When the refugees arrived, they took the tents and re-pitched them in a seemingly random fashion.

Cussigh has to explain, saying he too hadn’t understood what they were doing.

“They were reorganizing the placement of the tents to mimic the layout of their villages back home,” he says.

The refugees even named their compounds after their villages.

Baldog. Jam. Kubnid.

“This is a very positive thing,” says Cussigh. “It means they see Batil as their new home, not just a refugee camp.”

For her part, Laginskie’s three-month mission in Yusuf Batil has since come to an end in South Sudan. She says her sister-in-law was having a baby and that she wanted to be back for that. But she hopes to return to Yusuf Batil.

In reflection, she says it could be the briefest of moments in a day that made the work worthwhile.

“I love when one day you have this child that’s all grumpy in mama’s arms, wants nothing to do with you, won’t crack a smile,” she says. “And then the next day you come in and the medicine’s kicked in and they give you a half smile.”

“It reminds you that things are working, that we are seeing improvements, and that it’s not all glum.”