Dispatches from the Edge: A Memoir of War, Disasters, and Survival (9 page)

The mothers watch you enter, watch you come and go as you please, the color of your skin, the camera on your shoulder, the only entry pass you need. In the twitch of an eye, they’ve scanned your clothes, your eyes, read your intentions, your ability to help them. They don’t beg; they know you’re not here for that. They see the camera, the notepad; you can do nothing for them right away. Maybe in the long term you can help, they think, so they’ll let you take pictures; but, really, they don’t care. Their needs are immediate. Liquid. Food. Nutrients. Now.

Inside the compound, just beyond the gates, in the admissions tent, Dr. Milton Tectonidis examines a two-year-old boy clinging to his mother’s breast.

“He’s quite dehydrated,” he says about the boy, gently pinching the skin of the child’s left arm. The boy’s name is Rashidu. His eyes are wide, and he looks right at Dr. Tectonidis.

“Usually in a kid you look for sunken eyes, and skin that doesn’t come back, skin that stays folded,” he says, barely pausing long enough to glance up. “In a malnourished kid, however, it’s not a very useful sign. Because they’re so scrawny, the skin always stays like that.”

In his native Canada, Dr. Tectonidis might be mistaken for a drifter. His long hair is unkempt; his tall, thin body swims in the white T-shirts he always wears. He has worked with Doctors Without Borders for more than a dozen years, and in as many countries. He’s treated tens of thousands of children, perhaps hundreds of thousands. He’s lost count of how many he’s saved.

“The very bad ones are in such shock, they don’t look at you like that,” Dr. Tectonidis says, smiling at Rashidu’s unblinking gaze. “But he’s weak, so I’ll keep him here.”

The tent is crowded. About forty mothers with children sit on wooden benches waiting to have their children measured and weighed on a giant scale that hangs from a bar. The mothers say nothing. Only the children make sounds—coughing and crying, crying and coughing. A constant cacophony.

Dr. Tectonidis doesn’t wait for Rashidu to get weighed. There’s not enough time. Cradling the child in his arms, he takes him straight to the intensive care ward.

The UN had been warning about food shortages in Niger for months, but who pays attention to press releases? In this television age, nothing is real without pictures: starving kids, bloated bellies, sunken eyes—Sally Struthers stuff. Warnings don’t get headlines, crises do. Malnutrition sounds so bland. Famine? Now that’s a showstopper. The problem is, Niger isn’t suffering from famine—not yet. Adults aren’t dying, just thousands of kids. It’s a food shortage, a hunger crisis, severe malnutrition—none of which will get you a spot on prime-time TV. The BBC was the first TV crew here; we came second. Most American networks don’t even bother to show up.

“We saw it coming in February,” Dr. Tectonidis tells me later. “We sent out a press release saying, ‘Watch out! We need free food and free health care.’” February. Now it’s July. Help is just starting to arrive.

“Maybe it was the tsunami,” I say. “People unable to focus on more than one crisis at a time.”

Dr. Tectonidis shakes his head. “It’s always like this,” he says. “The less politically important a country is, the longer the delay.”

According to Dr. Tectonidis, the UN wants to raise a billion dollars for a reserve fund. That way, every time there’s an emergency they don’t have to go around begging, and exaggerating the scope of the problem. That’s basically what they do now. The figure they’ve been using, the one I heard on the BBC—“3.5 million Nigeriens at risk of starvation”—is carefully crafted and somewhat misleading. You’ve got to read the fine print. “At risk”—that’s the key phrase. What exactly does it mean? We are all at risk in some way, aren’t we? If no aid arrives, if no attention is paid, 3.5 million Nigeriens could starve. True. But it doesn’t work like that. Kids start dying, then some reporters pay attention—usually freelancers, men and women looking to make a name for themselves. They arrive first. Their pictures motivate someone from a network to come and do the story. Then more aid arrives. It’s not a perfect system, but it’s what the market will bear. The problem for Niger is that not enough people are dying. A few thousand children isn’t enough.

RASHIDU IS LAID
out on a plastic mattress. In the intensive care ward, there are no sheets on the beds. It’s too messy for that. The room is actually a tent several hundred feet long, with a single row of beds on either side. The mothers share the mattresses with their children.

When a child is severely malnourished, his body breaks down, devouring itself. The fat goes first, then the muscles, then the organs: the liver, intestines, kidneys. The heart shrinks, the pulse slows, blood pressure drops. Diarrhea dehydrates, the immune system collapses. Starvation doesn’t kill the child; infections and disease do. No layer of fat between flesh and bone, nothing to pad the pain. His little heart simply gives up.

I’m standing by Rashidu’s bed, watching doctors work to save his life. I feel useless, a bystander, doing nothing to help. I check on the cameraman, make sure he’s getting tight shots of Rashidu’s scared face. I think about how to incorporate Rashidu into the story I’m writing in my head, the one I need to get on air in a few hours. It all feels so stupid. More than stupid—it feels inappropriate. I’m a shark picking up the scent of blood. This little boy is dying, and there’s nothing I’m doing to help, just taking pictures of his misery. I hold his tiny foot in my hand. It’s swollen with fluid.

“It’s water in the tissues,” Dr. Tectonidis explains. “Sometimes it’s only in the feet, sometimes the hands, sometimes even around the eyes. It’s called kwashiorkor, and it was first discovered in Africa in the twenties, but it’s been seen everywhere since, even in the concentration camps in World War Two.

“I think we’ll get him,” Dr. Tectonidis says, inserting a tube into Rashidu’s nose. “We’ll give him fluid, give him sugar right away. Just a little, because their heart overwhelms quickly. And we’ll give him antibiotics. And milk. If he makes it through the first day or two, you’ll see him running around in another week.”

Rashidu is crying, but he has no tears. In his eyes there is only terror. He lies on his back, arms outstretched. He is naked and shivering. He looks like a tiny, wrinkled old man. When he cries, it sounds like a baby bird being smothered.

I ask the cameraman to make sure he’s getting the audio levels right.

“JOURNALIST, YES? HELLO.”

The voice was young, enthusiastic. I couldn’t see who was talking, however, because when the pickup truck swerved to a stop in front of me, it had kicked up a cloud of dust that quickly surrounded me.

It was September 1992, and I was walking along what I hoped was the road into Baidoa, nervously chewing the inside of my lip, a habit I’d picked up from my brother when we were both little. I’d been in Somalia for less than an hour and was already lost.

If I worked for a major news organization I’d have had a vehicle waiting to pick me up when I arrived. But I wasn’t working for anyone, and had been too intimidated to ask the relief workers at the airstrip for help before they drove off.

I’d noticed the outline of a pickup truck heading my way, trailing a large cloud of dust. As it got closer, I made out at least two Somali men in the back cradling AK-47s.

“Oh, good,” I said to myself. “Alone on a road, with gunmen.”

When the truck stopped and the dust had cleared, I saw a young Somali man walking toward me.

“Journalist, yes?” the young man repeated. He was wearing an oversize white T-shirt with
I’M THE BOSS
emblazoned on the front.

The boss was Saiid. A student in Mogadishu before his country imploded, he now made a living off starvation. He and his friends bought some guns, rented a truck, and offered one-stop shopping to visiting journalists: translation, transportation, protection. It was a package deal Mike Ovitz would have been proud to have put together. Around his neck, Saiid wore a pen from ITN, The British television network. He said he had just finished working for them. Technically, this gave him more journalism experience than me.

“Whatever you can pay would be fine,” Saiid kept insisting, which threw up all sorts of red flags, but he was adamant—and he had all the weapons—so I climbed into his truck, and off we went. On the windshield he’d taped a bumper sticker:
I
SOMALIA
.

At first the town was a blur of brown—brown houses hidden behind high brown walls, mini forts barricaded from one another. On the main street were stores and cafés of corrugated tin, nearly all of them seemed shut down. People, some little more than skeletons, shuffled along or sat staring vacantly from behind soiled rags.

Gunmen careened around corners in pickup trucks, horns bleating, rarely slowing for the starving, who scurried out of their way. In one truck, a boy of perhaps thirteen sat atop sandbags with an olive green grenade launcher resting on his shoulder. In another truck I saw what appeared to be an improvised cannon.

There were no traffic lights, of course; the biggest guns got right of way. We had only two AK-47s, so we ended up braking a lot.

“Why don’t you carry a gun?” I asked Saiid, seated next to me in the truck’s cab.

“I don’t carry a gun because I’m an educator guy,” he explained. “Educator guys don’t need guns.”

Saiid’s philosophy of survival was simple. “I aim for myself,” he explained. “It’s not hard here. I’m living well.”

I didn’t really know where to begin, but I figured the hospital would be a logical start, so I asked Saiid to take me there. A sign out front warned those entering not to bring weapons inside, but no one seemed to pay much attention to this rule. In the courtyard, several Somali men squatted, cradling their guns, their long sarongs hiked up around their knees.

“Do you think it’s okay if I go in?” I asked Saiid.

“Of course,” he said, not understanding my reticence to barge into an operating room. “You are American.”

There were two rooms for surgery. Neither had running water or electricity, so operations were performed only in daylight, which came through an open window across from the operating tables. On the floor, a plastic bin overflowed with bloody gauze bandages and refuse. When I entered, I saw a young American medical assistant bent over a shirtless Somali man with multiple wounds on his legs and a bandaged arm.

The medical assistant’s name was Raymond. He was a twenty-eight-year-old volunteer with the International Medical Corps, an American group similar to Doctors Without Borders. Raymond was not a doctor, but in Somalia that didn’t matter. He was American, had medical training, and, most important, was here. That was enough.

He was Southern, handsome in a Tom Cruise sort of way, appealing as much for the attitude and accent he swung around as for his looks. Dressed in blue surgical garb, he wore a medical kit bandolier style around his shoulder. He’d been in Baidoa for three months and apparently was used to reporters barging in on his operations.

“Look, I don’t snivel about what I can’t take care of,” he said, examining the man’s open wound. “I do what I can do and don’t worry about the rest. I don’t have any nightmares. The floors are filthy, we have no running water, there’s puss all over everything, everything is infected, everything. It’s one of those things you never really know what it’s like till you’re actually here yourself. I mean, intellectually you can figure it out, but it’s one of those things you need to be here to really experience. You know what I mean?”

I was beginning to.

Dawn Macray, a pleasant nurse with short blond hair, came into the room. “We had a bomb blast last night,” she told me. “Fifteen casualties. Three died immediately. Today we’ve had multiple gunshot wounds, a couple of knife wounds.”

“Are things getting better here, now that food supplies are being airlifted?” I asked.

“Better how?” she responded. “They’re still killing each other.”

Raymond moved into the next room to help a retired American doctor amputate another leg. The doctor appeared to be in her late sixties and wore a miner’s lamp on her forehead for extra light. The Somali man’s wife was trying to prevent the amputation.

“Look, I’d like to save his leg, but we can’t do that,” Raymond explained, as the Somali hospital administrator halfheartedly translated. “I’ll tell you what, we won’t cut off the leg, we’ll just clean it up, but if he dies, it’s her fault.”

After this grim possible prognosis was translated for her, the man’s wife stopped yelling, and shrugged. The amputation didn’t take long.

“Everything’s a challenge,” Raymond said, as he moved to another patient. “You don’t have enough supplies, you don’t have enough equipment, you don’t have enough time. You’ve got too many wounded, and a lot of them, you can’t do anything for. You’ve got an infected leg, the bone is dying. If we were in the States, we could do something about it. But we can’t do that here. You do the best you can with what you have.”

When I came back to Baidoa several months later, I asked at the hospital for Raymond, but they told me he had gone back home. No one would say why.

IN THE INTENSIVE
care ward of the hospital in Maradi, Niger, a four-year-old boy named Aminu lies on a bed. He is just a few feet away from two-year-old Rashidu, but is barely visible beneath a heavy wool blanket. Aminu whimpers softly. His mother sits on the bed slowly waving a fan over him to keep the flies away. Her name is Zuera and she is remarkably beautiful—high cheekbones, night black skin, and two small scars, parallel lines on either side of her face. They are tribal markings that were cut into her flesh when she was just a few days old. In some other place, she could be a fashion model, but one of her legs is deformed, twisted from a childhood bout with polio. She walks on her own, but with a slight limp, a small imperfection. In Niger, however, it makes her undesirable because she’s less able to work. She is married to a grizzled old man, with whom she’s had three children.

“Her parents were probably relieved someone would marry her,” a nurse says in passing.

“Aminu came in with severe kwashiorkor,” Dr. Tectonidis tells me, lifting part of the gray blanket off the boy’s tiny body. He cries softly at the sudden exposure, but allows Dr. Tectonidis to examine his blistered flesh.