Aid is a business. The experience in the Southern Sudan showed that the complexity of our work required aid agencies to be as effective in planning, management and execution as any product-producing business. There is no place for mere good intentions when these fine motives are not backed with administrative competence.
In the Southern Sudan I began to understand the ethical dilemmas we face when we try to deliver humanitarian aid in a war setting. Two opposing perspectives are in operation. One wants power and control, even possession, of people. The other wants empowerment and the abundant life. This clash of world views is volatile and dangerous. Resources are wasted. People die.
I Don't See Anyone Breaking The Law
Flying from Kenya into Sudan was illegal, so our journey involved a little sleight of hand. Our flight plans showed a route to Lokichokio in northern Kenya, but our actual destination was Kapoeta, 115 kilometres further north on the other side of the Sudanese border. Rebecca Cherono, our director in Kenya, had discussed our program with the Kenyan First Secretary and the government was willing to give us every assistance. The relevant people simply turned a blind eye.
It was hot, dry, dusty and very windy when we arrived in Kapoeta. The soil was sandy and the vegetation sparse. Thorn trees and scrubby bush were the dominant plant life. It was cold in the evenings and in the mid-thirties during the day. We guessed we were between 1,000 and 2,000 feet above sea level.
It was April, and the rains were predicted to come in May and last until September. Roads would then quickly become impassable.
Soon after that the air strip, a cleared area beside the main street, would become too boggy for use.
Kapoeta was built by the British sometime around the turn of the century when prospectors discovered gold. Now the town was an apparently unplanned cluster of ruined buildings. A ghost town with people. There were no roads, although there had been some attempt to mark road edges with bricks and stones. There was no central water system, no electricity, no sewerage or sanitation system. At the edge of the town, a few thousand people lived in a slum of tin, wood and grass thatch.
A Hospital In Name Alone
And there was the hospital.
If ever there was an overstatement, it was to describe this rag-tag collection of walls and floors as a >hospital'. It consisted of a few stone buildings, many without roofs, three newer brick buildings constructed by an aid agency as wards and a child feeding centre. There was hardly anything which distinguished it as a medical facility, save the patients -- a few hundred sick, emaciated and wounded people huddled together in darkened rooms full of dust that blew in all day long.
The hospital had 450 in-patients when we were there. It served alone as a medical centre in an area containing a million people. The only doctor said he usually had a 1,000 in-patients, although others reported a similar number to 450 two months earlier. Those in need of aid are likely to exaggerate -- the end justifies the means.
There were few beds. Patients rested on blankets on the dusty floor. The operating theatre was in the only building with glass in the windows, though not all the windows. The wind and dust howled through one side of the room. Out of a mess of rusty surgical instruments only a few were serviceable, and these the doctor sterilised in an autoclave heated over an open fire. Hypodermic needles were reCused after boiling.
The pharmacy was a disorganised jumble of medicines crowding the room.
The doctor was also seeing 200 to 250 out-patients daily. He said he would like someone to build and equip a proper operating theatre, but his dream seemed unwise. The main need here was for diagnostic work and primary health care. With so many patients to see every day, there was little time for surgery. If someone needed advanced care they could be transported south overnight by road to the Red Cross hospital in Lokichokio.
'If they are too sick to make the journey, there is probably not much hope for them anyway'. said Dr Dan Carlin, an American medical adviser, matter-of-fact.
Malnutrition and gastro-intestinal problems were predictably the most significant presenting problems. Dan had some concern about the quality of diagnosis in the hospital. We saw many children with severe malnutrition, one of whom was described by the doctor as 'having a cough'. The brittle, orange hair and the puffed limbs and shiny skin spoke to me, even as a non-professional.
The doctor had to treat war injuries and the occasional exotic problem, but mostly it was malnutrition and complications from that. Malaria was common and so was tuberculosis. Recent reports suggested these TB cases were really AIDS. I worried about all those hypodermic syringes being sterilised by boiling over an open fire.
In a newer building was the feeding centre. Inside were a few metal dixies for cooking up a mixture of water, Unimix and Soyalac (these shipped in by World Vision) and plenty of bowls for dishing up. World Vision had supplied them too. There was one water pump beside the feeding centre. The town had two other pumps some distance apart.
Out In The Bush It Was Worse
We were told there were twenty-two camps surrounding Kapoeta. We saw one, called Matchi. It contained a few thousand people. We met some newcomers who sat in a tight, quiet group under a tree. All the children were malnourished, with maybe twenty per cent by Dan's estimate in the most advanced stage of malnutrition. He thought nearly all could be saved if the food could be distributed from Kapoeta and proper feeding regimes maintained. One child in the group was too far gone. A few weeks at most was Dan's prognosis.
We had heard stories of people walking for months and found these stories confirmed. One woman said she had walked from an area near Wau, well to the west of southern Sudan. It had taken her a year. She had moved from place to place, always moving on as conditions became more desperate.
The people built circular huts of sticks and grass. A good 'long grass' hut would last two or three years, we were told, but these would last only months. The more people came, the further out they walked to find building materials from the local vegetation. One man pointed to a distant mountain range showing where they were going now. 'For a strong person', he said, 'it is about three hours walk. Most people take more than a day.' A stream of women entered the camp about three o'clock with loads of sticks, grass and leaves balanced on their heads.
As was normal, the camp was located where it was because water was nearby. A dry river bed yielded water by digging down about two metres. When the hole got too deep, they moved upstream. The river bed was pock-marked with earlier endeavour.
The water was cloudy and brackish. Dan reckoned malaria infection was guaranteed given the swarms of mosquitoes by the river.
A Film Star Brings Great Expectations
Audrey Hepburn, in her role as UNICEF ambassador, had visited this camp a few days before. She had complained that there was no food in the camp, and we found the same. This was hard to understand because there was lots of food in Kapoeta, twenty minutes away by vehicle. We asked when the last food delivery had been. 'April 1st' was the reply -- seventeen days before.
An official accompanying us from Kapoeta pointed out that the policy was to deliver a large supply and replenish it when it ran out. It was not clear whether supplies had run out, but we did not see any evidence of grain stores. Nevertheless, the condition of the people suggested that they were receiving some nourishment, probably from private stocks retained from an earlier distribution.
We were shown the base of a new grain store which the camp administrator humorously described as 'Great Expectations'.
It is fair to say that the food situation in the camp was not clear to us. We felt there were signs that the food supply being sent from Kapoeta was insufficient. One of these was the extent to which people were eating the leaves of the thorn trees. We saw these leaves being carried into the camp and prepared for cooking. It was not clear whether this food was intended to supplement the food supplies because they were insufficient, or because the nutritional balance was enhanced by the addition of the leaves.
Different Agencies, Different Methods
Later, back in Kapoeta, Leo Ballard, World Vision's Africa relief director, spoke firmly to Commander Lam Akol of the Sudan People's Liberation Army (SPLA). Akol was the number three man in the SPLA and had come with us on the plane from Nairobi. Leo urged him to get food to the camps. Leo could not understand why a Toyota Land Cruiser had not been dispatched with an interim supply.
Despite these hiccups, it was very encouraging to see that World Vision aid was getting through. There had been news reports that gave the impression no aid was being delivered. This was false. Of course, while World Vision supplies had been arriving safely by truck, UNICEF/WFP had not, until the day we were there, managed to get a single truck into Sudan. But they had been successfully airlifting food into some areas. The Kapoeta storehouses were full.
We were glad to feel so confident about the way World Vision was working in this theatre of need. Leo and his team were extremely well regarded. I was proud to count them as colleagues. Norwegian People's Aid (NPA) was an excellent partner. I enjoyed the 'can do' approach to the work and the obvious results.
The UNICEF/World Food Program (WFP) effort was another story. Bad luck and bad organisation seemed to characterise the UNICEF/WFP effort at the time, certainly in Kapoeta.
The night before we arrived, the first UNICEF/WFP convoy into southern Sudan of fifteen trucks rolled into town. Each truck was adorned with large UN symbols on the bonnet and doors and a blue UN flag attached to the front like a diplomatic vehicle.
The Media Rules
I was surprised to see UNICEF/WFP in this area of the country. It was not clear that the local leadership, which wanted World Vision and NPA to be the only agencies working in this area, had been consulted. There were other places where we could not work without a substantial increase in resources, and there it was practical to spread the effort. Given the already packed condition of the storehouses, in Kapoeta further convoys here were superfluous just then.
But we discovered that this convoy was heading further east to Torit. Accompanying the convoy in four brand new Toyota Land Cruisers were the officials and the media -- a five-person film team from Germany who had followed the food aid every step of the way from Copenhagen, and a three-person UNICEF film crew. The convoy was headed by a man named Gerard, a Lebanese who had previous experience in Chad.
This gallant band descended on the surprised Sudanese after having cooled their heels in Lokichokio for forty-eight hours. Permission to enter Sudan had been at first refused by Sudanese offended by the way the Germans had been photographing local women. Most women and girls unselfconsciously dressed naked from the waist up, but, like people anywhere, they would prefer to dress up to receive guests or be photographed. How would you like to be photographed in your gardening singlet and shorts?
But the Bureaucracy Can Overcome It
Our interpretation of what happened next was this:
Faced with the sudden influx of media demands, the SPLA in Kapeota could not cope.
They invented a coping mechanism -- official passes.
They simply asked UNICEF/WFP for their official passes.
Since no-one had heard of such a procedure until moments before, naturally UNICEF/WFP could not produce the required documents.
This was resolved simply by the passing of time sufficient for the SPLA to produce some official documents, and at eleven the next morning videoing began. By this time, Greg, our own video cameraman, and I had managed to find someone who would say yes, we too could start shooting.
We had been walking around the hospital with the doctor when the UNICEF/WFP show got under way at the pharmaceutical store. Suddenly, we were asked to desist and wait until they were finished. Dr Dow, the official designated to cooperate with people like us, could not be in two places at once.
By mid-morning, the UNICEF/WFP convoy was ready to roll, and so were the cameras. Like a precision driving team, the convoy left under a panoply of blue and white. The film crews remained behind to record the dramatic departure.
Leo Ballard watched the show with obvious disgust. 'Never seen so many bloody flags', he commented. 'What the UN should do', I said prophetically, 'is spend a little less on flags and a lot more on protecting aid supplies.' This was later to become common place in Somalia and other places.
Returning With The Wounded And Dead
About noon, the UNICEF/WFP convoy came hurtling back into town. They formed up in a circle, wagons-against-the-Indians style. The drivers were very agitated. The lead truck had been blown up fifteen kilometres down the road. An accompanying military escort had 'disappeared' and the rest had high-tailed it back. They wanted to dump the grain right there and go home.
It had been clear for a long time that neither the SPLA nor the Sudan government forces shrank from attacking food convoys if they were intended for the other side. The SPLA attacked a UNICEF/WFP convoy heading towards Malakal on the same day we were in Kapoeta.
The local army chiefs arrived to say that the firing had merely been over-enthusiastic 'celebrations' over the SPLA victory in Bale the day before. Just soldiers shooting into the air. They urged the drivers to go back to Torit and get the supplies delivered.
The drivers would have none of it. They wanted assurances that the road was safe. Talk did not reassure them.
At this point, Leo decided that a convoy of WV/NPA trucks, which had arrived just before we landed, would not go on to Torit as planned but would off-load. It was interesting to see the difference between Leo and Gerard in the way they handled the situation. Leo felt that, in a crisis, it was important to act. 'Even a bad decision is better than no decision', he opined. Thus, by the time the UNICEF/WFP convoy got moving again, the WV/NPA trucks were efficiently unloaded and long gone back to Kenya.
At four o'clock two wounded men from the earlier convoy shooting were brought into town. They were a clerk of the Sudan Relief and Rehabilitation Association who had been shot in the side, and a Kenyan driver shot in the foot. The driver reported that his truck, the lead truck of the UNICEF/WFP convoy, had been hit by a rocket-propelled grenade and blown up. Two SPLA soldiers in the escort were also killed.
The popular theory was that the attackers were Toposa, a local tribe who were marauding convoys and towns, taking advantage of the unstable situation with captured weapons.
The clerk died within thirty minutes. At this news, the UNICEF/WFP drivers dropped their truck tail-gates and started to dump the grain in the middle of the road. Mutiny. Gerard tried to reason with them, but they had had enough.
'They're going to be real happy if it rains tonight', commented Dr Dan laconically as he watched the sacks being piled up in the open air.
Finally, SPLA military men persuaded the drivers to drop the remainder of their loads in the storehouses and they blazed off, right over the precious grain they had already off-loaded. It was, for me, a final, sickening sign of a relief program in a mess.
Later, left alone in town with an injured driver, Gerard wrote a message for me to take out to his boss in Nairobi requesting a plane to help him get the wounded man out. Gerard said that this would be the one and only try for UNICEF/WFP at trucking in supplies. After this, they would stay with air-lifts.
'It's very expensive', I commented.
'Yes, but when you add all this up', said Gerard, looking around in a way that summed up the day's disasters, 'this is also very expensive.' I restrained myself from commenting that it didn't have to be done quite this way.
Is There A Better Way?
Prima facie, it seemed that UNICEF/WFP had been carried away by the legitimate need to put southern Sudan onto the world's political agenda. But they could not match plans with outcomes, rhetoric with action. What we experienced leant weight to the view that the more agencies working in the area, the greater the security risk.
The UNICEF/WFP approach had been to set up a 'big program', using their own personnel, their own trucks, their own camera crews, and so on. I wondered if a better strategy would be to network many smaller agencies, like World Vision and NPA, who had experience and track records in aid delivery using local resources. It was amazing what could get accomplished when no-one cared who got the credit.
Have We Missed The Plane Home?
It was getting late and our plane had not arrived. Within a few minutes we would pass the decisive moment. Although it was still light in Kapoeta, it would be too dark to fly our plane into Nairobi by the time we got there. Fifteen thousand feet is the minimum for night flying in the Rift Valley, and our unpressurised plane was not equipped for such giddy heights.
The idea of staying overnight in Kapoeta without food or blankets was not too distressing. After all, the local people stayed here. Nevertheless, we indulgently began to contemplate the warm rooms at our Nairobi hotel.
With ten minutes to go before it was too late, we set off to walk to the airstrip. We found the plane already there, 'Twig' nervously pacing up and down wondering where we were. He had come in unheard on a wide circuit. He had been waiting an hour.