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From Alaska with love: Aid helps African clinic recover from fire

For the last four years, in the remote village of Old Fangak, South Sudan, a health-focused team of Alaskan volunteers have labored long and hard beside steadfast community members. The focus of their combined effort is the construction of a humble medical clinic.

Editor’s Note: Jon Waterhouse is 2012 Ecotrust Indigenous Leadership Award honoree and a National Geographic Explorer. Through his international Healing Journey, he has connected with people around the world, including the people of South Sudan featured in this post, which first appeared in NatGeo’s Explorer’s Journal.

By Jon Waterhouse

A December 23rd fire in South Sudan prompted a fast, steady and miraculous aid response.

For the last four years, in the remote village of Old Fangak, South Sudan, a health-focused team of Alaskan volunteers have labored long and hard beside steadfast community members. The focus of their combined effort is the construction of a humble medical clinic. A disease called kala-azar (visceral leishmaniasis), often referred to as Black Fever, has ravaged the area for decades and in 1989 Dr. Jill Seaman (featured in the January 2013 issue of National Geographic Magazine) arrived in Old Fangak. She began developing a treatment process for this deadly and indiscriminant disease and has tirelessly administered care to thousands in this vast land – without running water or electricity.

There are no adequate buildings in Old Fangak in which Dr. Jill can perform medical procedures, so the construction of the clinic has been attended with a great deal of anticipation. Traditional African dwellings, called tukuls, are abundant in Old Fangak but they are built on dirt and constructed of sticks, mud and cow dung – not so ideal for performing surgeries. There is a very old colonial building still standing, built sometime during British rule, but not much in the way of maintenance has occurred on the structure over the decades.

Adding to the difficulties of providing medical care in Old Fangak, access to clean water is limited. During the dry months the dirt is hard like concrete, which makes well-drilling efforts in the village during the ‘building season’ problematic to say the least. Just another aspect of the challenges faced by the volunteers. As far as the rest of the year, Old Fangak is located in the Sudd, the largest swamp in the world, so when the rains begin, there is only mud. Deep, sticky mud.

Many surgeries and treatments over the years have been delivered in tents and under trees.

I remember when a man who had gouged his eye 2 years prior received word of Dr. Jill and made the 3-day trek to Old Fangak to see the legendary doctor. His damaged eye had adhered to the lid and was permanently open, infected, swollen and painful. He stated he had not slept in the 2 years since sustaining the injury. The surgery to remove his eye lasted for 10 hours amid the buzz of flying insects attracted by the light of Jill’s headlamp (which looks just like mine from REI.) When the patient awoke after surgery he was astonished to be rested and free of pain, and was eager to return home. Dr. Jill all but tied him down to keep him overnight to monitor his post-op condition but he had cows to tend and the walk home would take another 3 days. So off he went. This is typical of the patients seen in Old Fangak. I can see Dr. Jill bidding him farewell, shaking her head, shrugging her shoulders, and watching him walk off across the savannah toward home. Yet his unexpected departure offered no reprieve in the doctor’s busy day. For every patient seen by Dr. Jill in a day, hundreds more await. The numbers are unfathomable.

So with the new clinic in place, access to a higher standard of dispensing treatment for her patients was finally close to being realized, and the new clinic was near enough to completion that it could house the supplies and medications used in Dr. Jill’s daily efforts.

The clinic’s creation in this little known region of Africa has been arduous. It’s location in the Sudd makes cross-country travel to and from the village impossible. Many might naively imagine that with a Range Rover, a load of fuel, and a spirit of adventure you could simply drive the roughly 900 kilometers (550 miles) from Nairobi to Juba, refuel then break a trail the remaining unknown number of kilometers (perhaps 500?) to Old Fangak. But, alas, there is no road to Old Fangak. Aside from the lingering effects etched by decades of civil war, the terrain hosts a series of natural obstructions. Wet and dry riverbeds, deep ravines, rocky outcrops, large patches of acacias (or mokala – tall, bushy trees with huge thorns) and mucky, green wetlands around water sources might imply that Mother Nature herself is rebuffing the presence of humans there.

Take a look on Google Earth and see for yourself (or even just Google Maps). Even with the cost of fuel hitting around $40 per gallon at one point, trust me, if it was possible to drive to Old Fangak, we would be doing it.

Our only options in delivering building materials and medical supplies are by plane and boat, but unless you pay the exorbitant cost of nearly $10,000 to charter a small plane, the process is unreliable. And though a narrow branch of the White Nile River nears Old Fangak, trained boat mechanics are scarce, so simple mechanical issues also impede river travel. Sadly, basic boat operation and safety is not always taught or practiced and precious lives have been lost on the river during the building of our clinic. River travel can be unsafe for several other reasons as well. Dangerous wildlife is always present, and add to that the fact that any boat carrying building materials or cargo might eventually come under the gaze of someone who believes that cargo should belong to them, so there are also heavily armed threats.

This clinic in Old Fangak has been a long time coming, and the hope it has brought is immeasurable. Volunteers have paid thousands of dollars out of their own pockets to get from Alaska to Old Fangak and have used their own resources including their annual vacations building this clinic, working with materials and supplies donated by generous individuals from the United States.

I could go on, but I think you get my drift. It has been an arduous labor of love. So you can imagine the overwhelming heartbreak Dr. Jill must have experienced as she typed an early morning email (sent via INMARSAT) on Dec. 23rd to her partner in this grand effort and the director of the Alaska Sudan Medical Project (ASMP), Dr. Jack Hickel, describing how a fire in the wee hours had ravaged the clinic. Thankfully, no one was hurt. But in addition to a large inventory of medical equipment, supplies, our meager solar power system, and other necessities, an entire year’s worth of the expensive kala-azar treatment was lost. The shock that this tragedy could occur after so many had given so much to make the dream of the clinic in Old Fangak a reality was almost too much to bear. All who have given so selflessly to bring this thing to life were stunned.

Jack was stunned, too. As he re-read the email and attempted to fully understand what had occurred, his wife, Josie, made a call to the pastor of their church in Anchorage. December 23rd fell on a Sunday and the morning service would be starting in an hour. That morning, the pastor told of a tragic fire in South Sudan, and of the incalculable efforts by Alaskan volunteers to improve the lives of the grateful Sudanese people there. By the end of this Sunday sermon, the offering plates literally overflowed… to the tune of almost $15,000. Their outpouring of care and concern for the people of Old Fangak – strangers in an African village with whom this congregation has never had contact – was astounding. I am truly in awe of their gracious generosity.

Word continued to spread through the Alaska Sudan Medical Project team. I have to admit that upon reading the email, I, also, was momentarily grasped by the emotion of shear gloom. All that work! But when I hung my head and relayed the news to my wife Mary, her first response was, “We’ll contact the gang at National Geographic right now.” … Yes! We knew that through the many channels there, more good would come. I felt pretty hopeful as I sent out a group email and soon spoke with my close friend and fellow NGS Education Fellow, Dr. John Francis, aka the Planetwalker. John made a call to TIDES (Transformative Innovation for Development and Emergency Support), a Defense Department research project based at The Center for Technology and National Security Policy of the National Defense University. From there, after several conference calls and much logistical strategizing between  John in New Jersey, myself in Anchorage, and several key players in between, we could see a giant ball starting to roll.

TIDES swiftly assessed our needs and contacted Solar Stik, a provider of portable power solutions serving government, defense, commercial and individuals across the globe. Since our solar powering units were destroyed in the fire, Solar Stik immediately assembled a replacement system many times more powerful, proficient, and robust than the one we lost, complete with the detailed training necessary to utilize their advanced technology. DHL Global also came to the rescue and nobly volunteered to ship the valuable cargo free of charge. Vital logistical assistance was provided through the remarkable US Africa Command, one of six of the U.S. Defense Department’s geographic combatant commands. TIDES then contacted Samaritan’s Purse, a non-denominational Christian organization that provides help for those in need around the world. In an incredible gesture of generosity and humanity, Samaritan’s Purse not only offered an almost immediate replacement of the cherished kala-azar medication (and the supplies necessary to dispense it), but assurance that they would deliver the shipment to Old Fangak within just a matter of days.

We were floored! Since the fire, our ASMP guys on the ground – David Kapla in Old Fangak and Jason Hahn in Nairobi – have worked around the clock. They have paved the way for all of these incredibly charitable organizations to assist ASMP and Dr. Jill in getting the replacement medicines and materials to where they need to be. My hat goes off to them both as they have been tossed into a truly awful circumstance and have handled it with selfless efficiency.

This fire was indeed a tragic turn for us, but the flood of good prompted by the disaster has re-energized us beyond imagination. We are pulling through a tremendous challenge with a greater understanding of how many are standing beside us in this effort, and our crisis is now a source of hope and inspiration for everyone involved.

I believe I can speak on behalf of ASMP and the people of Old Fangak in offering a special ‘thank you’ to John Francis. Without his call to TIDES, we would still be in a state of crisis with little hope for a quick recovery.

To learn more about this project, the organizations who have helped, and the wonderful people behind them, please visit these websites:
facebook: Alaska Sudan Medical Project

UPDATE 1/23/2013: Dr. Jill just relayed to us that amid the flurry of aid and response to our clinic fire, WHO (the World Health Organization) actually got a shipment of kala azar meds and supplies to Old Fangak so quickly that her patients never missed a single dose! Awesome! WHO’s presence in South Sudan has been a Godsend for Dr. Jill, ASMP and other relief organizations there. We are truly grateful for their unfaltering presence and assistance as we work to improve health and living standards for the many who call Old Fangak and its region in South Sudan home.

Jon Waterhouse is the executive director of the Yukon River Inter-tribal Watershed Council.