Text by Daniele Bellocchio
Pictures by Marco Gualazzini
The hospital of desperation
Ciad, a former French colony, gained independence in 1960 and, following the proclamation of the birth of the Republic of Chad we know today, the history of this African nation has been characterised by autocratic governments and continual war. The actual president is Idriss Derby, in office since 1990 following a military coup, and the country is one of the poorest in the world: 183rd on the list of 187 countries on the Human Development Index, with 80% of the population living under the poverty line, 9% have access to adequate sanitary services, and only 48% have the use of drinking water, illiteracy is above 50%, the average life expectancy hardly exceeds 53 years of age, and the rate of infant mortality is one of the highest on the planet.
Today the nation, located between North Africa and Sub-Saharan Africa, is facing also the most complex humanitarian crisis in modern history: the desertification of the Lake Chad, whose surface has decreased by 90% is respect to the size in the 1960s, and the Islamic terror cell Boko Haram are uniting to make the region lake region one of the most oppressed regions in the world: according to data from the Ocha (The Office of the United Nations for Humanitarian Affairs), the humanitarian disaster has resulted in 2.3 million refugees, and 10 million people living in need and 500,000 babies suffering from malnutrition.
An unforgiving light dazzles an disorients travelling along the road that leads from N’Djamena to Bol, the main coastal center: anything to do with man is an enemy of this land. The water is miracle and the thirst is constant, food is a mirage and hunger is ingrained into this place, the emptiness is a prison without any possibility of escape, with the sentence being that of pain without any respite. And then the wind: sheer violence, that can drive you to madness, uninhibited and able to attach anyone that it meets on its path, taking away air like a noose around the neck.
Crossing the Sahara you will meet only a few villages, absolutely silent, mute sanctuaries of tragedies, necropolis of the living. A few dry shrubs, camels, cow carcasses, goats and very few people are all that’s there. There are people, those that cross, that drag their bony bodies, moving like shadows. Just by looking at them it is possible to understand the crisis that exists in this place of silence and this continued abandonment is killing off humanity.
The village in the desert ends in Bol, a village of six thousand souls. A road of sand, huts of shrubs and straw mattresses and some shacks that sell some groceries and bottles of mineral water that are worth their weight in gold. Then there is the house of the Imam, the police station, the Mosque and the only hospital in the whole region. It is here that one begins the descent into the abyss. It is the starting point for understanding and to immerse yourself in a pain that contaminates, which imposes the responsibility to be of assistance, turning other people’s pain into our own.
There are slums so isolated that they have not been reachable by the indignations of the media, by the presence of social positions and the slogans of resentment. “We don’t have local media a no international groups ever come here to report on what is happening. This is the only hospital in all the region and there are only three doctors. Do you understand? Three doctors for the entire region.” Giving this angered speech is the hospital’s general director, Dr. Youssuf Saleh “The people are dying of Aids, of malnutrition, of tuberculosis. We like in the red zone; the arrival of the Boko Haram jihadists has exacerbated the already critical situation. The world knows about what’s happening in Syria or Yemen, but not what is happening here. A drama is going on without anyone noticing and time is running out: NGO’s, European governments, international donors are need to act. Coming and see: this is an emergency that needs your help.”
The doctor’s words prophesise what is feared to soon happen. Crossing the threshold of the hospital, we see the patients packed into every available space where, in the small room occupied and filled with the stench of urine, blood and vomit, in the sand courtyard or the floor of the corridor.
A mother, making use of all available resources, moves a fan, trying to ease the pain of her daughter crippled by a disease, in the maternity ward a newborn is laid in the arms of her mother after being born while lying on the ground, and then there is Ousman Abakar, who at 11 years old is in a coma caused by meningitis: and his father, sitting on his bed, holds his son’s shaking hand, trying to keep him still, to keep him quite while attempting to ease his pain.
“Everything is missing: equipment, vehicles and personnel. Additionally, with the arrival of Boko Haram the situation is becoming even more devastating. The problems with which we have always had to come to grips are made even more difficult through the addition of new problems we have never faced before.” These are the words of another doctor, Mahmat Hassan: “The rapes, the kidnapped children, the psychological trauma. This doesn’t even include the effects of HIV. 7% of patients are HIV-positive, the misery, the continuous displacement of people and poverty have caused an increases in the rate of prostitution and spread of disease.” In finishing she collects in the most intimate parts of her memories, forming story of pure tragedy which she gives voice with great effort, in order to the prevent these stories from being forgotten: “A child saw her father slaughtered in from of her eyes. Then she was raped by Islamist militants and contracted HIV. She had ingested nails in order to commit suicide. I operated and today she is under treatment. These are the type of stories I am confronted with every day.”
Among the patients are the brothers Mbokoiy and Chari Aumi. Two fishermen who defied army orders to leave the islands and for this, while they were lifting out their trawl nets, they were captured by regular Chadians, who tortured them and accused them of being jihadists: hanging them with their arms tied behind their backs for a week, before eventually releasing them when it was clear that they were simply hungry fishermen. Now Chari has necrosis in his arms and Mbokoiy, was the victim of an amputation, today he was lying down between the sand and the mosque.
It is a disturbing snapshot into a place where the hungry are tortured because they are guilty of their own needs, where the defenders of the Patriarch make fear the antidote to terror, jihadists are trying to destroy humanity in the name of God for whom they have renounced everything and the stories of the innocent, with their names, their expressions and their faces, which are disappearing under a blanket of sand and oblivion.