Pibor... oofda.

In Minnesota, we have a unique expression. When something is a lot to handle, or challenging, or comical in its difficulty, a good Minnesotan will shrug their shoulders, shake their head, and in one big exhale say, “oofda.” In that one word, everyone understands the frustration, exhaustion, and even humor of the situation. In Pibor County, former Jonglei state in South Sudan, there is a similar habit of shaking one’s head, and simply saying, “Pi—bor” with a grin.

In mid-August, Wori, Brian, and I were dropped by a small charter plan on the mud airstrip of Pibor (other team members would join later). August is well into the rainy season, and though the weather was dry when we landed, we knew not to expect it to stay that way for long. Unlike other locations I’ve worked in South Sudan, we would not have a car here. All of our movements would be walking, or perhaps hiring local canoes or boats. So when we were dropped by the charter with the first load of cargo to begin vaccination (the plane would return with another load of vaccination supplies), we were temporarily at a loss for how to move everything to the Intersos base where we would be staying. But fortunately there were plenty of people in the community that were willing to assist us, and after short negotiation we were setting out for base.

The Intersos base was about a 15 minute walk from the airstrip on a dry day. During the 2 months of our campaign in Pibor we became familiar with the route and with walking around the community. On dry days, walking around Pibor is no problem, but the moment even a little rain starts to fall, the packed soil turns to a thick, sticky, mud. When it’s muddy the walking times double. As it was the rainy season, almost every day had least a few hours of rain. Walking through the mud takes practice. I learned quickly that mud can be just as slippery as ice, and that you can nearly dislocate a hip trying to get a boot unstuck from the mud. It took me about 2 days walking in my handy Keen hiking boots to abandon them and switch to rubber gumboots, and even those are only helpful when the water and mud do not go over the top of the boot. I now understand why many people choose to walk barefoot in the mud.

Vaccination in Pibor was more challenging than other locations I’ve worked, and the main reason was that in the rainy season the whole area floods and turns to mud and swampland. Everything becomes more difficult. For example, you want to go to a meeting, you better be prepared for a hike through the mud and wading through rivers. Even a meeting at the governor’s office would have a collection of mud covered gumboots outside the door, and everyone inside would be discussing in their socks.  In other areas we would haul vaccination supplies and portable coldboxes in vehicles, but any vehicle would get stuck in the mud in Pibor. So now we had to make-do with hand-carrying, small locally hired canoes, and a single motor-boat that could be occasionally hired from the Ministry of Health.

Beyond the regular challenges we also had what I considered, "Pibor specific problems" that would make me say oofda.  These Pibor specific problems can be categorized into 3 main groups: boat problems, access problems, and bees.

Let's start with boat problems. During the rainy season the best way to access the different campaign areas is by river. There are local canoes, but using them for some locations takes more time than we have, given our goal is to be back before dark. The best option for the far locations of our campaign was using a motorboat. Unfortunately, at the time of our campaign, there was only one motorboat available for us to use. It belonged to the Ministry of Health, and was shared between the government officials and NGOs which hire it. So not only was the boat very busy, there was always the chance the a government official may need to use it on the days we needed it. The boat also required fuel and engine oil, which was not available in Pibor, and had to be flown from Juba.

The boat challenge was the river itself. The river is full of long grasses and lilies which grow on the river surface. They float and form clumps, or big rafts of grasses. Depending on the rain, water level, and current, these grass rafts can completely obstruct the river. When this happens, it's not always possible to go around. There were times that we would spend an hour trying to get through a patch grasses, each of us leaning out of the boat and pulling handfuls of weeds out of the way. It was a slow process. The grasses were also very hard on the motor, meaning there were frequent mechanical problems with the boat.

In total, the boat problems made our work tricky. A vaccination program requires good supervision, regular restocking of supplies and icepacks, and there was no phone network in most of the area. This meant, if a challenge with the boat arose, we had no way to inform vaccination teams of the change in plans. Sometimes, the only way was to send a messenger on foot.

The second main category of Pibor specific challenges was "access problems." The area we were planning to cover was vast, and beyond that, most was flooded. This meant even walking was extra challenging. The vaccination teams had to work extremely hard. When we were first trying to recruit staff to work with us, we offered the standardized national wage for vaccination campaigns. Upon hearing what we were paying all 200 people just got up and walked out of the training. Most needed the work, but it’s hard and risky to go to some places. It was a new experience for me to have 200 people walk out of a meeting at once, but the point was effective. And it opened our eyes to the unique needs of this community. With help from the Ministry of Health, we were able to agree with the vaccination teams to make sure the work was fair to all parties.

Distances were far, and often even after a few hours boat ride, we would still need to hike to reach the villages. Some areas, were too far for our team to reach. One area, a team was working to vaccinate, but it was too far from the central cold-chain to bring the vaccine everyday. The only place to store the vaccine and icepacks was in the community. The chief in this village was very supportive of our work, and even agreed to watch over the vaccine and store it in his own tukul.

The final category of Pibor specific challenges is "bees." The base in which we were staying had a large bee hive in the roof of one of the buildings. At first the bees were more of a nuisance than an actual problem. But as our time in the base extended, the bees became more hostile. Soon our team was being stung daily. One day, for an unknown reasons, the colony of bees all came out and swarmed everyone in the compound. Some ran inside, others ran to the river, but everyone got stung multiple times. even the neighbors were affected and had to run.

So with that event, we said enough is enough. A crew of local boys got involved and along with some staff at the base, they set to work removing the hive. This was not the scientific procedure with safety equipment I would expect in the US. Instead the boys decided that fewer clothes were better to avoid the bees. They burned long grasses to try and smoke the bees, and knocked a whole in the ceiling to access the hive. It was massive. Handful by handful they pulled it out of the ceiling. arms and bodies covered with honey and bee stings. They were committed to the work, trying to save as much honey as possible while also removing the whole hive. From where I was standing, they hardly seemed affected by each bee sting. Soon the hive was removed, and we sampled the honey. It was so deliciously sweet. The boys took their share and left a smaller amount for the staff at intersos. They also left most of the larvae, which were thought to be extremely nutritious. According to some members of my team, if you eat the larvae in the morning, you will not need any more food or water for the rest of the day. It may be true, but after my sample, I found that the larvae were significantly less delicious than the honey, and significantly more gross.