Editor’s Commentary: We received a large number of essays but Mia’s was one of the first that was universally accepted by all the editors. Descriptive, evocative, with a touch of humour it highlights some of the most complex issues that humanitarian aid workers face – who are we helping? How? What good are we doing? How are we perceived? How do we engage with other cultures and how do those cultures perceive and engage with us? It’s a brilliant piece and we hope you enjoy this sneak peek. 

 

Built to Carry Thirteen

by: Mia Ali

I am four hours into my six hour car journey from one end of the sprawling state to the other. We started late, as usual, the need to fuel and provision our Toyota Land Cruiser taking Wani, the driver, by surprise as it always does. A dozen last-minute errands were suddenly deemed crucially important, and the pulsing sun was high in the sky when we eventually left the compound. We need to reach our destination before dark, so we’ve skipped lunch and my resulting headache is making me surly. I could make it better by drinking some water, but what goes in must come out, and there’s no privacy for a woman at the side of these roads. The occasional bush calls tantalisingly, but the fear of mines overcomes the insistent call of my bladder.

The combination of the heat and the constant jolting of the cratered dirt road is lulling me to sleep, and I fight against the closing of my eyes. It’s best to keep alert, in case of an attack. I shift in my seat, trying to keep myself awake, and I wince as I peel my sweaty legs off the vinyl seat.

Out of the open window I can see miles of open scrubland, barren and harsh. The dry, orange dust is everywhere, coating the car, the back of my throat and the inside of my nose with its pervasive, metallic smell.  Wani and I ran out of things to say three hours ago, and the only sounds are the noise of the engine and the occasional crackle of the radio.

There are no clouds in the sky – it’s the dry season; there will be no clouds for at least another two months. The sun beats down mercilessly on the few animals and people who have to eke out a life in the dirt. Every so often, a village flashes by, breaking the monotony. Children, naked or draped in bedraggled, once-white vests, stand in front of crooked mud huts with pointed grass roofs and stare open-mouthed as we pass. Men and women idle under the shade of a tree, on the ground or, if they’re considered important enough, on broken plastic chairs. It’s too hot now for any activity, so they sit and watch the goats and chickens scrabbling in the dirt.

The slowing of the Land Cruiser alerts me to the fact that we’re approaching a barrier. It might be a pile of dirt or rocks, or perhaps a grubby length of string suspended between two sticks. These obstacles are easily avoided, but it’s polite to stop until you’re given permission to pass. I squint into the distance and see a man at the side of the road, flagging us down.

There’s only one reason someone flags you down at one of these barriers, and that’s to get a lift. And who can blame them, in this country where only the super-rich have cars? A villager might be lucky and get a lift in a minibus taxi or a passing car, but the likelihood of breaking down in these ancient relics, totally unsuited for the terrain, is high. In contrast, numerous well-maintained INGO 4x4s sail past, one or two staff inside a car built to carry thirteen.

But they rarely stop. I rarely stop. I’m too busy helping beneficiaries to help the people by the side of the road. I comfort myself with the fact that I’m not allowed to, for security reasons. What if the car is in an accident and the passenger gets hurt? What if you inadvertently pick up someone who is persecuting the people you’re supposed to be helping? What if your car is commandeered at gunpoint? What if?

So we leave them at the side of the road, in the blazing sun, no way to get where they’re trying to go. How many people have I left, I wonder? What do they think of my organisation? I know what they think of me. I see it in their eyes as I explain I’m sorry, it’s a question of insurance, if it was my choice, but my hands are tied. Their hopeful smiles fade; they look down, spit on the floor, turn away even as I speak. Some have raged – more than once we’ve made a quick and nervous getaway while a drunk soldier rants and waves his gun around, eyes hidden behind dark sunglasses. Because even the soldiers can’t get transport here; the destitute army can’t pay their wages, much less move them round the country. They seem to have no problem arming them, though.

Wani is muttering under his breath, his eyes on the small group that has now gathered at the side of the road in the distance. I surreptitiously lean on the door lock with my elbow, clicking it into place. I glance over my shoulder, making sure that the lock on the back door is down. On one of my early missions, I made the mistake of not locking the doors. The first time we stopped at a village, twelve people clambered in uninvited and it took us half an hour to get them out again.

There have been times when I’ve not been able to refuse. Times when I’ve been senior enough, in a small organisation with less stringent rules. There was the wizened old lady, sitting in the scorching midday sun by the side of a large, muddy lake in the middle of the road. Cars that hadn’t made it through the mud lay scattered around like broken teeth, some teetering on two wheels, other nose deep in the murky water, engines flooded. How long she had been stuck there, I didn’t know, but I did know she’d be stuck there for hours, possibly days, if I didn’t give her a lift. Her grandsons begged me to take her, not asking for themselves. I think this is what persuaded me in the end. She didn’t speak English, and she and my driver had no common language. I insisted that she sat in the front and spent the next three hours in a mimed battle of wills over whether she would wear her seatbelt. We came off the road twice, branches from the bushes crowding the road whipping in through her open window. After a backward pirouette through another water-filled hole in the road, she finally agreed to wear the belt, hooked loosely over her right arm. When we reached our destination, she scuttled out of the car and disappeared into the bush without a backward glance. Remembering her ancient face, I wondered what would have happened if we had crashed and she had been injured. What kind of trouble would I have been in? Roadside beatings were not uncommon at crash sites. I didn’t give any more lifts after that.

We’re approaching the group by the side of the road now. Behind them is a low concrete building surrounded by trees. We roll slowly past a sign:

Primary Health Care Unit

Built with USAID Funding

From the American People

I idly wonder what the American People would think of coming to this clinic. Wani’s face is solemn as we pull up. He clearly has an idea what’s going on, and I could ask him to explain. But I’m tired and hot, and I don’t have the energy to deal with this. With any luck, the group won’t speak English and they can explain their issue to Wani, who can rebuff them for me. I force a bright smile as a tall, well-rounded man in cheap suit trousers and a shirt approaches my side of the car. There was once a time I would have started this exchange by asking what he wanted. I long ago realised that nothing could get done until the pleasantries had been completed.

“Good Afternoon, Madam!” His face is pleasant and his expression hopeful.

“Good Afternoon!” I reply. “How are you?”

“I am fine, Madam, thank you for asking. And how are you?”

“I’m good, thank you.”

I wait as he greets Wani in a local dialect. Unfortunately, after a brief moment, he turns back to me. I suppress a sigh.

“Madam, I am Simon, the Community Health Worker for this clinic.” He gestures behind him at the squat concrete block, no bigger than the reception of my doctor at home. Two splintered wooden benches outside the doorway constitute the waiting room, shaded for at least some of the day by an acacia tree. I know that inside, the unpainted concrete walls will hold a couple of fading, curled posters secured with browning tape.

Do Not Get Sick! Wash With Soap!

Condoms – Put On Your Boots Before You Score!

There will be a peeling wooden desk and a couple of dirty plastic chairs, one for the Community Health Worker and one for the patient. Anyone who comes with the patient will have to stand. An ancient examination couch will be tucked in the corner. The clinic’s store of drugs, such as it is, will be held in a metal filing cabinet. There might be a dusty fan on the floor, positioned to give the Community Health Worker and his patient some comfort. But it will never have worked – there is no electricity here.  Perhaps patient records are kept – if so, they’ll be handwritten and filed on the bookshelf behind the desk. But nobody ever asks for this information, and patients rarely come back for follow up appointments. So maybe they don’t waste their time keeping records here.

“A lady is here, with her children,” says Simon. Again, he gestures behind him, but my view is blocked by a cluster of people. “She has brought her son here; he was sick with malaria.” He looks at his shoes and shakes his head.  “She should have brought him many days ago, when he started to get sick. She went to the witchdoctor and he told her not to come.” He meets my eyes again. “She is not educated,” he explains. He looks into the distance and my eyes follow his gaze, squinting into the glare of the sun. “She walked here this morning, it took them many hours. By the time he got here, he was vomiting badly.” He leans into the window, and I flinch backwards from his expression. “I tried to give him medicine, but he couldn’t keep it down. He needed the injection, but we ran out of supplies many months ago.” He rocks back on his heels, silent. I wait for a moment, but it seems he has finished. I turn to Wani, confused. He looks down at his hands, and not for the first time I feel his embarrassment at my ignorance; at having to explain the obvious to me.

“The boy is dead,” Wani says.

A fly is buzzing behind my head, and as I listen to it, I start to hear other sounds. The low babble of voices. A crying child. A woman, wailing.  I don’t want to turn back to the window. I lower my voice.

“What can we do?” I ask. Wani shrugs. What can we do, indeed. What can we do in this vast, sprawling country, where our money, our time, our efforts are absorbed like a rain drop in the dry season. We push the futility of it all to the back of our minds by making ourselves busy, always planning, reporting, emailing, meeting, driving past people by the side of the road. Nothing we’ve done has helped this woman, who has lost her child in this barren place for want of a simple and inexpensive injection.

“Does she need a lift?” I ask Wani. He won’t meet my eyes. He knows that this is forbidden by our organisation, and he knows that the choice – and the consequence – is mine.

“Does she?” I ask again. He nods, still not looking at me.

I turn back to the window. I can see her now, sitting on the splintered wooden bench, head bent over a bundle in a white cloth, which she clutches to her chest as she rocks back and forth.

“Where does she need to go?” I ask Simon. He is taken aback for a moment. He must have been expecting me to make my excuses. The thought makes me feel ashamed. Ashamed for all the times I’ve made them.

The woman climbs into the back of the Land Cruiser and Simon passes her the white bundle. I can see the boy now – he looks about two, the same age as my sister’s youngest, although he could be older; children here are malnourished and tend to be small for their age. He looks like he is sleeping, and I can’t tear my eyes away from him. His mother is still wailing as Simon helps her daughter, who looks about six, up into the car. She is holding a baby girl, and shoots shy glances at me. I smile at her, and her gaze darts away. Simon climbs in and we set off, Wani staring ahead at the road, his expression grim. I sense his disapproval but I don’t understand it.

“Our clinic is supported by the government,” says Simon. “We haven’t had a drugs delivery for six months and we haven’t been paid for the last three. I will continue to work until the supplies run out. After that…” He shrugs. “We don’t have any transport. I try to get to the communities whenever I can, to teach them about sanitation, and common diseases. But they prefer to go to their village witchdoctor; they don’t trust Western medicine.” He gestures towards the woman, who is keening loudly. “They come to us when it’s too late, and then they blame us for the deaths of their children.” He turns and barks a local word at the woman, who immediately stops her wail, rocking and humming as tears stream down her cheeks.

“It’s ok!”, I say. “Leave her be.” Simon looks at me, the friendliness gone from his eyes. He starts talking to the woman in a language I don’t understand. There are around two hundred local languages – it didn’t seem worth learning just one. His tone is harsh, and the woman shrinks backwards into the seat. Wani joins in. I look from one to the other. Wani sounds angry.

“What’s going on?” I ask him. He looks at me, then back at the road.

“We are telling her that she should have brought her son to the clinic earlier. Then he would not be dead.”

For a moment, I wonder if I’ve heard him right. This woman, who lost her son less than thirty minutes ago, is being told that it is all her fault. How could anyone say such a thing to a grieving mother? I should defend her, but the faces of the two men look hard and alien and my courage fails me. I look at her, wishing there was something I could do to comfort her. Wishing I had learnt at least one language. She is still rocking, rearranging the white cloth around her son’s head, which flops backwards across her arm.

Death is common in this country, where a girl is more likely to die in childbirth than to finish primary school. But most of the time, I can treat it like an abstract concept. I can pretend that mothers here don’t feel the death of a child like mothers back home. I wonder how my sister would feel if she lost one of her girls. I wonder how she’d feel if someone told her it was her fault; I wonder how her other children would feel. The baby starts to cry, and her elder sister shushes her expertly.

We are approaching a village now, and people are emerging from the trees and huts to meet us. As the woman gets down from the car, her keening resumes and other voices join hers. A tall man in tattered shorts and a thin, buttonless shirt takes the dead boy from her arms. He doesn’t speak and his face is resigned as they walk away together, untouching.

The girl, forgotten, climbs down with the baby. I don’t want this to be her life. I search for something to give her, and find a shawl that I brought from home. I hand it to her, and she takes it, confused. Then she is gone. In the months and years to come, I will imagine her wearing it at school, her head bent over her books, or laughing with her friends.

Wani and I are left on the road, watching the backs of the villagers as they disappear into the trees. There is nothing more for us to do here.

We drive on in our empty car, built to carry thirteen.