Six months in Sudan equals a lifetime of change

Posted November 17, 2009

By Krista Goheen

Dr. James Maskalyk speaks to students at the Faculty of Medicine: photo by Calvin Sun

Doctor James Maskalyk lives his life according to an overarching principle: if you have the chance to see the world and make a difference, well, why wouldn’t you seize that opportunity?

This dictum may seem simple enough, but Maskalyk’s own decision to eschew stability to spend six months working in Sudan seems a bit bold, brave, even crazy to people who spend their entire lives working toward that very thing.

“I have, I suspect, an enthusiasm for work that takes me far away from the comforts of having a home,” he says. “But I choose it willfully because the work is its reward; the experience is its own true gift.”

Maskalyk is, in his own words, drawn to the hard parts of the world, a passion sparked by an elective spent working in Chile’s public health system, while he was enrolled in medicine at UCalgary.

“It was an important part of my career as I learned how much pathology and disease is contained in poverty.”

An emergency room doctor at St. Michael’s hospital in downtown Toronto and assistant professor at the U of T, Maskalyk accepted a temporary posting with Médecins Sans Frontières (Doctors Without Borders/MSF) in 2007, an international medical humanitarian organization.

The six-month position took him to Abeyi, a small contested border town in Sudan.

Measles patients in a separate ward of the Abeyi clinic in Sudan: photo by James Maskalyk

“You’re on the plane and you pass over this little patch of huts and it’s so hot and so dry and in your medical mind these pictures tell you a thousand words: people are going to be starving,” remembers Maskalyk.  “They can’t grow any food, there are no animals, there is no water, no irrigation, no power lines.  And so you start to anticipate the problems you’re going to see.”

The problems he saw were vast.  The MSF team tended to a population infected with diseases like malaria, meningitis and tuberculosis–diseases that were made worse by a lack of immunization, clean food and water.  It was also a starving population facing a measles epidemic.

“Two patients turned to five; five became fifteen and that’s when I realized that we were in trouble. There was an epidemic and the population hadn’t been immunized,” he says.

Within a month, he and his colleagues had 150 patients, all of them with measles, in a hospital meant to hold 60.

The MSF team also dealt with a host of other trauma not exclusive to third world countries, but not entirely familiar to many in the Western world either: food shortages, malnourished children and those affected with HIV, women dying from childbirth, civilians and soldiers wounded by gunfire, and the constant threat of war.

“In Canada I work in a medical system where there’s a greater capacity to say I can offer the best medicine in the world and mean it,” Maskalyk says. “But in places like Sudan and Cambodia I have to do the best I can, and when it doesn’t work I feel like I didn’t live up to my end of the bargain.”

The team was faced with few resources and an overwhelming need.

“At the time you try to make peace and do the best you can. And you can rationalize it and build up a certain amount of layers, but it’s still spiritually and emotionally difficult to be surrounded by the sorrow that inhabits that loss of life.”

In an effort to understand his own experiences and to bridge the distance between Sudan and the life he left behind, Maskalyk started chronicling his experiences in a blog.  That blog turned into a book, Six Months in Sudan.

“I knew that if I could tell the story and make what I experienced seem closer, I could change things. The knowledge that people suffer so much and the heaviness of that truth is inside of me.”

Through his writing, Maskalyk says he has gained a greater understanding of his work and why it’s important.  Now he’s  sharing that knowledge with medical students, most recently in August at UCalgary Faculty of Medicine.

“As medical students, there’s that wonderful truth that you can really enunciate what you want to see in the world through your actions,” he says.  ”The privilege that you have been given to understand the world is unique and has the opportunity to encourage personal change and perhaps, with time, societal change as well.”

In some regards, articulating his experiences has given Maskalyk a greater sense of peace, though he admits he may never make complete peace with it.  Although he physically left Sudan some time ago, the country, its people and the work he did there stays with him.

“My title, Six Months in Sudan is disingenuous,” Maskalyk says.   ”My engagement in Sudan and talking about it is much longer; it lasts a lifetime.  And the only real truth I see in the world, unfortunately, is that we have to leave it at some time. The rest of it–what you do with the time that you’re given–is really up to you.”