PaanLuel Wël Media Ltd – South Sudan

"We the willing, led by the unknowing, are doing the impossible for the ungrateful. We have done so much, with so little, for so long, we are now qualified to do anything, with nothing" By Konstantin Josef Jireček, a Czech historian, diplomat and slavist.

A Man for All Seasons

By Paul Baak
When statesmen forsake their own private conscience, for the sake of their public duties, they lead their country by a short route to chaos. Robert Bolt, A Man for All Seasons
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February 23, 2018 (SSB) — On a dusty road at Hai Referendum, a Toyota pickup came to a grinding halt as if the driver had just seen a garbage truck parked in the middle of the road. But no, there was no vehicle coming in front. In fact, no car had passed on this road before his, since that morning.
Although it was a sunny afternoon and the weather was scorchingly hot, a woman stood by the roadside. She’d walked for hours before she reached Hai Referendum heading to Mia Saba. When she saw the car coming in front of her, she stopped and desperately waved at the driver to slow down. When the car had stopped, she moved nervously closer to the driver’s window holding back tears in vain. One glance at her face told the driver she was not only inclined to cry but she’d probably been crying for some time. Her eyes were swollen. She was a skeletal figure. So emaciated. Exhausted. Weak. Her face was streaked with perspirations.
Besides her haggard look, her body was apparently shivering with fear. She looked so worried like someone whose world was quickly ticking down to an end.
“Mama, what’s the problem?” asked the driver in local Arabic, his voice filled with fear believing that the worst might have happened.
“It’s my child. My only child,” she replied amidst repressed sobs, and tears ran down her cheeks profusely. In her arms, a child – about four years old – was partially wrapped in patchy, ragged sheet of cloth. His legs dangled lifelessly beneath her left arm. The driver, a robust, good-looking, 29-year old fellow of average height, was too scared to ask further questions.
To assuage his fears, the driver opened the door, sprang down from the car, pulled back the cloth and inspected the child’s face. What he saw made him anxious all the more- the concave eyes, dry mouth, and pale skin.  He reached for the pulse. He detected no beats at the temples. He wanted to jump to conclusion but he couldn’t bring himself to it. He tried again, this time placing two fingers on the inside of the child’s wrist over the radial artery. A dull throbbing reverberated through his hand. He got a tentative assurance that the child was alive. And something needed to be done quickly. And quickly was the word.
The driver was about to reassure the mother that her child would be alright when he saw her head slightly tilted over her left shoulder, her grip loosened up on the child, her eyes rolled, her body lowered helplessly in a slow involuntary descent.  Shocked, the driver quickly grabbed the child with his left hand while extending his right hand to get hold of the mother. He pulled her towards him so that her face rested over his chest while his left leg propped up the child. Holding both of them firmly on either hand, he slowly stooped down to help lay the mother on the ground so that he could take the child aboard the car. Inside the car, there was an assortment of documents on the passenger seat. He quickly stuffed them into glove compartment. He laid the child carefully at a corner of the seat leaving some space for the mother.
He beckoned a passer-by to come and help him carry the insentient mother into the car. The middle –aged man, unsurprised, came over and helped the driver after which he made one remark as he walked away.
“If this is your mother, you need to give her some food before you take her to hospital.”
The driver looked at the man quietly as he watched him leave.
“Thank you,” he replied.
With a quick whisk, the driver drove the car in a semicircle and headed in the opposite direction towards Mia Saba. His mind raced over various locations for the nearest clinic.
In Mia Saba, Kondial Medical Centre was the only reliable clinic in the area before fighting disrupted its operation in 2013. Most of its medical personnel were believed to be at UNMISS Camp with their families, some of them lost their lives while others fled the country altogether as a result of the conflict.
YDK clinic had been hit hard by economic crisis which was exacerbated by hyperinflation. The clinic was forced to lay off some of its staff. Essential drugs were out of stock so they offered only limited non-specialist prescriptions and Malaria rapid diagnostic tests (RDTs) services. The last time the driver visited with his ailing brother, the owner of the clinic had lamented that they would close if the dollar exchange rate continued to surge. It was getting more and more difficult to import drugs, reagents and medical equipment, he muttered with discontent. That time the dollar was trading at quarter the current rate. So the clinic had probably shut down.
In retrospect, virtually all the clinics around Hai Referendum, Mia Saba, Gudele I &II, Mangateen and Suk Libya, were either out of business completely or struggling in a YDK-like status. Only a few pharmacies could be found sparsed in these areas.
Going to Juba Teaching Hospital was out of question. It was considered as a place where you took your loved ones to watch them die without meaningful services. And if anything, the hospital had only one important service – there was always a pickup to carry dead bodies to the cemeteries. Not many people would go there if they had any alternative at all. Some residents regained their faith in that hospital when a sprout of mysterious grass, in the shape of a crucifix, was discovered one morning in front of the psychiatric ward. Lots of people, in euphoria, converged on the scene to feast their eyes on what they believed to be a lifetime miracle or a sign of supernatural presence at the hospital. The grass, against all hope, withered and so did the excitement it mustered. It was a fallacious instance of wishful thinking, so the driver thought.
He negotiated a corner and cast a glimpse piteously over the insensate mother and her child. The mother had not regained consciousness since she collapsed, but the driver was hopeful that her pulse was beating. He believed she was seriously sick. Or did the hot sun dehydrate her? She looked obviously famished when he saw her. Could this situation have been avoided if he had rushed to the nearest shop to buy her some water and edibles when he first noticed her condition? That could have re-energized her and she wouldn’t have collapsed. He became bitter with himself for his aberrant lack of discernment. He shook his head remorsefully.
The car screeched to a halt at the main gate. The car honked in quick, loud successions to signal to the security guard there was an emergency. The gate pried open. The driver swept into the premises, parked haphazardly in the alley, got down from the car, and ran quickly towards the Emergency Unit. It wasn’t his first at Lou Medix, a hospital which was always inundated with emergency cases of all sorts. Victims of car accidents, severe cholera cases, individuals dying from high blood pressure, sugary, diabetes, hepatitis B, victims of “unknown gunmen” and other crimes – all needed urgent attention. It was an overwhelming job with daily and frequent calls for emergency help from all over the city. The personnel were few or they would never be enough.
Two minutes later the driver emerged with two teams of uniformed personnel pushing stretchers behind him. One team took the child and whisked him off into the building via a smaller door on the left while the other team stretchered the mother away through the main door on the right as the driver closely followed them. A receptionist told him to wait in the lounge. Lots of people sat restlessly, while others were wandering anxiously, in the lounge floor. He perched nervously in an empty spot opposite the emergency room. His eyes were fixed on the door.
Suddenly, he realized he didn’t have cash on him and an idea came to him at the same time. He got up and was about to leave.
“Mister, you’ll need to be around to provide necessary information and clear admission charges because doctors won’t go ahead without this, just for your information,” the receptionist told him politely.
The driver thanked her and assured her that he would be around and things would be taken care of.  He exited. On seeing his car, he realized he parked carelessly and wondered why the guard didn’t alert him. There was barely any enough passage for other cars. The guard noticed the error and smiled – not with joy but with pangs of shame. There were dozens of preoccupied drivers who had squeezed through the narrow passage but none of them complained. When the gate opened, three cars entered and two cars left before the driver’s turn came. He knew he needed to be back in time. Just in case the hospital would need anything.
The ATM booth was empty at KCB main branch in Buluk. So there would be no delay for the driver. It was one paradox of the financial crisis. He inserted a cash card into the ATM machine, dialed some digits and held his breath while transaction was being processed. After all, KCB was the latest bank to have shut down most of its branches across the country due to financial problems, so anything could happen. Payment was not guaranteed; not even with a debit card which would bounce sometimes in mysterious ways like “Oops! time out!”, “Service not available now”, “I’m being serviced” or “insufficient funds” (even when requests were placed within limits of the account contents). There were apparently genuine reasons for concern. But, much to his relief, the machine set the cash free for the driver.
No sooner had he stuffed the cash into the wallet than a ringtone came from his jeans trousers. He quickly fumbled a tiny Techno mobile from the pocket and glanced at the screen. And lo, his eyes bugged out like a child who had seen a ghost licking at the coals. It was a rare call from the most extraordinary caller, the Managing Director of Juba Rams Co. Ltd. The fact that the MD, of all other superiors in the company, had to make the follow up call himself underscored the importance of the matter. Standing between the ATM booth and his car, he furrowed his brow and activated the call.
“Am I talking to Jackson?”an authoritative voice came.
“Yes, sir, Jackson with you,” he replied remembering the smirk on his boss’s face when he handed him two sealed brown envelopes and other bound documents in the office that morning.
Jackson left the office at 9 o’clock but he hadn’t completed the mission he was sent to do. The mission was twofold – getting the car fuelled at Nile Petrol in Jebel and delivering some documents to Dr. Kawal’s office. But the latter hadn’t been executed. What would he tell his boss? Would he tell him he was still queuing for fuel at Nile Petrol station? No, he thought, it would be false information because his car had been fuelled and he had left the station, albeit after standing for six hours in the queue. Perhaps honesty would be his best policy as he was not disposed towards lying regardless of possible consequences.
“Jackson, I’m disappointed to learn that Dr. Kawal is still waiting for you at this time” the MD complained in a matter-of-factly manner.
“Yes, sir I’m in….” he wanted to complete the statement when the voice on the other end interrupted.
“And that means the documents have not been signed and delivered, right?” he interjected.
“Right, sir, I encountered a very emotive situation on my way to Dr. Kawal’s office. I stumbled upon a starving mother with a dying son. I had to rush them to hospital. Both of them lay unconscious at …,” Jackson sounded less business-like much to the irritation of his boss whose voice had suddenly changed in anger.
“Listen, Jackson, you’re telling me nonsense! Nobody is interested in your ‘starving and dying’ crap of stories. Remember you’re hired to run a profit-making business not a charity. You don’t seem to appreciate how important it is to have these documents signed and delivered today. Now listen carefully, I don’t care about your whereabouts or whatever the hell you may be doing now but it’s in your best interest to be at Dr. Kawal’s office in the next ten minutes. And mind you, once this chance slips away, your behavior won’t have a second chance,” he threatened and hung up.
Jackson stood undecidedly for a few seconds or so before he proceeded to his car. The gravity of the situation staring him in the face. His boss was notorious for firing as soon as he hired. It took Jackson quite some time to secure the job with Juba Rams. And it was just a little over one month after his probation period. If he lost this job, it would be hard to find another one soon.
Despite this fragility, Jackson was a man with ‘belligerent’ conscience. Nearly every issue pitted his conscience against the puzzles of ethics. Now he had ten or five minutes to decide whether to embark on his business trip and save his job or to go back to hospital to help the mother and her child. Mathematically, time would elapse before he could reach Dr. Kawal’s office.  And going to Dr. Kawal’s office meant that he wouldn’t get back to the hospital till the following day. It was going to be a lengthy business, and he knew it well.
Caught in the moral dilemma, Jackson would have to call on his moral conviction. The purpose of life, he argued, in fact more subconsciously, was to be useful. And happiness was in what one had to give rather than what one had to gain, continued the moral argument. It was this belief, common amongst average South Sudanese, which accounted for the country’s indestructible social cohesion.
The car honked noisily at the gate again. Jackson checked his watch as he headed to the lounge. It registered half past five. His heart was in his mouth as he waited for any information the nurse might have left with the receptionist.
A nurse emerged from adult’s emergency unit. “Are you the man who brought in the two patients, a mother and a child?” she asked.
“Yes, madam, are…are they ok?” he responded and inquired, his voice faltering with anxiety.
“Well, it’s too earlier to tell, but we’ve put each of them on a drip. START assessment shows the child is in critical condition while the condition of the mother is fairly stable though” the nurse explained in a failed attempt to reassure the man whose anxiety had deteriorated. The medical personnel had quickly carried out Simple Triage and Rapid Treatment – START- to evaluate the severity of the conditions of the patients and they needed to tag them immediately. She therefore wanted to collect personal information from relatives of all patients who had just been admitted.
“Do you think the child will be alright?” the driver asked imploringly as he remembered the sadness on the mother’s face when she said it was her only child. “Surely, the life of the mother depends entirely on whether her child recovers or not,” Jackson contemplated.
“Hope he’ll be ok. Please, we’ve got to tag the patients. What’s the name of the child?” enquired the nurse.
“I don’t know the child’s name,” Jackson replied apologetically.
The nurse looked at him unbelievingly and continued.
“Ok and the mother’s?”
“I don’t know too, I’m so sorry,” he responded gently.
“But I thought you were her brother, I mean, a close relative,” the nurse wondered, apparently surprised given the anxiety the man had shown and how worried he looked. “Surely, he must have special relation to the patients,” the nurse seemed to say to herself.
“No, I am not a relative. I found her holding the child in her arm, crying helplessly by the roadside at Hai Referendum. Perhaps she comes from Kuirjik, one of the villages about 15 km away from where I met her,” Jackson narrated the story to the skeptical nurse.
“You mean that mother ever walked any distance today? She looks too weak to walk an inch. Anyway I’ll use your name on both of their triage tags for identification until the mother regains consciousness,” she remarked and turned away to talk to a number of other people before she returned to the room.
Over the counter, the receptionist placed a contact form and a bill for admission charges and signaled for Jackson to fill in the form, settle the bill. When he was done, he asked if there were other financial obligations he might be required to attend to. The receptionist answered in the negative but pointed out that further costs would occur upon further investigation and patients’ management.
It didn’t take long before the nurse came into view again and asked Jackson to enter the consultation room. Jackson had his heart jumped into his mouth once again when his eyes met the doctor’s. He occupied a guest chair and reached across the desk to shake hands with Dr. Kimo. He looked out for any assurances from the doctor’s face but he couldn’t make sense of his countenance. A clean wall of three- faced privacy screens separated the consultation room from the exam room, so he couldn’t see the patients. Dr. Kimo was well-known to many Juba residents for his compassion, competence, empathy, commitment and trustworthiness.
“Mr. Jackson, I understand you helped bring two patients to hospital. I also learnt that you’re not a relative to them; neither do you know where they come from. That’s very kind of you,” he stated calmly and in a way, more appreciatingly.
“Yes, thank you, doctor. Are they fine?” Jackson asked.
“Well, the mother is severely dehydrated. Her condition is aggravated by severe deficiency of basic nourishments. She was clearly at the verge of starvation. It could have been very difficult for her to make it through another hour without assistance. We have to put her on a drip for rehydration and intravenous nutritional therapy because she can’t take anything orally now given her current conditions. But we will carry out further examinations though and I’m hopeful she’ll be fine”, Dr. Kimo explained with an aura of a practiced professional.
The child had severe gastrointestinal symptoms including diarrhea and abdominal cramps, which manifested in vomiting and dehydration. Being apparently choleraic, he was also diagnosed with severe protein-energy malnutrition of marasmic form. His condition was still critical. Statistics on cholera mortality rates were grim. The doctor said the number of cholera cases had plunged to thousands in the last six months at Lou hospital alone.
Cholera and starvation posed major threat to lives across the country. UN reports estimated that more than 1.25 million people were on the brink of starvation that year. More than half were in Central Equatoria region. Cases of cholera were reported at about 6,870 including 174 deaths in 2017. Most victims were women and children living in Protection of Civilian sites in major cities and rural areas.
When Jackson came back the following morning, he was happy to see that the mother had fully regained consciousness. She was seated at the edge of the bed on which her son lay.  She was able to recognize Jackson and told him she was fine. When Jackson examined the child’s face, he noted promising improvement.  He breathed a sigh of relief and glanced at the mother who smiled shyly, having observed encouraging change too in her son’s condition. In her right hand was a triage tag with the name Rita written on it. Another tag hung above the child bearing the name Loki.
“Is your name Rita?” Jackson asked
“Yes, I’m Rita Lopaye and my son is Loki Gateri,” she replied.
“Ok, I’m Jackson Dimo. Do you’ve any relatives around so that I may call them for you? I mean, where is your husband?” he asked and noticed sudden change on her face.
“It’s a long story my son, it’s a long and bad story,” she said remorsefully, as if she was responsible for whatever happened to her family.
Jackson didn’t want to press her further. Perhaps she was understating the horrendousness of one of those harrowing, may be, tragic stories common to most families across the country. He handed her a polythene bag packed with various types of juice and canned foods which the doctor advised him to buy for her. He dipped his hand into the pocket, pulled out three bundles of notes of South Sudanese pounds, and handed them to Mrs. Rita. She looked up to see Jackson’s face.
“Jackson, you saved our lives. I don’t need anything more than the life of my son. I’m very grateful for all your help,” she said with feigned contentedness. Jackson was convinced that she had no money and apparently no relative to support her.
“No, you’ll need to pay daily in-patient charges. I’ve cleared the bill for today but I guess there’ll be long-term stay charges. I’ll come back to see you in the evening,” he insisted and put the money at the edge of the bed. He reassured her that Loki would be alright, bade goodbye and turned to leave. Before two steps the mother called after him.
“Jackson, you’re a Good Samaritan. May you live to save million others,” she exclaimed, her hands folded close to her chest like a supplicatory Buddhist nun.
“Thank you, mom,” Jackson replied with a wide smile, the hallmark of a man of enduring conscience he had become. It was as if things were just fine for him. But he was determined not let anyone know that he was issued with a dismissal letter first thing that morning at his workplace. He would never let her know about it at all. As for the dismissal, he had expected it given the MD’s call and subsequent threat the previous evening.
Nonetheless, Jackson always believed that the rightness of his action depended on the amount of pleasure it tended to produce in relation to the amount of pain it tended to prevent. He mightn’t have saved ‘million others’; but for him, nothing was more conscionable than getting the mother and her son out of the jaws of death. It was a choice he made without qualms.
***

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