"People are hungry to be brought closer to the world, even its hard parts. I went to Sudan, and am writing about it again, because I believe that which separates action from inaction is the same thing that separates me from my friends. It is not indifference. It is distance. May it fall away."

James Maskalyk set out for the contested border town of Abyei, Sudan, in 2007 as Médecins Sans Frontières (Doctors Without Borders/MSF) newest medical doctor in the field. Equipped with his experience as an emergency physician in a downtown hospital and his desire to understand the hardest parts of the world, Maskalyk’s days were spent treating malnourished children, fending off a measles epidemic, and staying out of the soldiers’ way. Worn raw in the struggle to meet overwhelming needs with inadequate resources, he returned home six months later more affected by the experience, the people, and the place, than he had anticipated.

Six Months in Sudan began as a blog that he wrote from his hut in Sudan in an attempt to bring his family and friends closer to his hot, hot days. It is a story about humans: the people of Abyei who suffer its hardship because it is their home, and the doctors, nurses, and countless volunteers who leave their homes with the tools to make another’s easier to endure. With great hope and insight, Maskalyk illuminates a distant place – its heat, its people, its poverty, its war – to inspire possibilities for action.

“Some of the work in repairing the world is grim, but most of it is not. Hope not only meets despair in equal measure, it drowns it.”


  • “…Maskalyk is a natural, fluent writer…” – The London Review of Books

    Maskalyk is a natural and fluent writer. Based on a blog – the first by an MSF doctor – his writing is vivid, impressionistic and off-the-cuff. Reading it is rather like sitting through an episode of ER. You marvel at the responsibility placed on these brave volunteers, summoned from their tukuls in the early hours to deal with the victims of a marketplace shooting. You shudder vicariously at the pus and the gore, delivered with a just manageable dose of medical jargon. You share Maskalyk’s sense of defeat as he calls time over the body of yet another emaciated Sudanese mother who has failed to survive childbirth, and his sense of release as he unwinds with his equally exhausted peers, gazing at the stars.

    Full review here.

  • “…austere as the Sudanese landscape, this book has poetry in it along with pain…” – The Washington Post

    By Michael Mewshaw

    Given the malign reality of relief fatigue, even those of noble intentions have difficulty dealing with more than one disaster at a time. Mention Sudan and instantly Darfur comes to mind, while the rest of the country, along with the rest of the continent, recedes into obscurity. Yet when presented with an opportunity to serve in the tiny village of Abyei on the fractious line between north and south Sudan, James Maskalyk left an emergency-room post in Toronto and volunteered for Doctors Without Borders. For six months, he delivered babies, did his best with limited resources to comfort the dying, fought a measles epidemic, offered basic maintenance to TB and AIDS victims, and tended to soldiers and civilians wounded by grenades and gunfire. The work, heat, dust and discomfort were relentless, and the dedication of Maskalyk and his staff often went unthanked, even resented. But as he put it, “If you keep looking over your shoulder, waiting for a pat on the back, you’ve missed the point. It’s not about you.”

    That there was something Sisyphean about the task goes without saying. Day after day, the grind continued, broken only by gruesome episodes and rare moments of joy. Maskalyk’s roster of patients would have overwhelmed anyone less committed and less capable of compartmentalizing his emotions. Pregnant women dying of sepsis, babies dying in breech positions, kids dying of shrapnel wounds, adults dying for want of care that the primitive conditions in Abyei didn’t permit — these constituted the existential conditions of life in a war-torn tribal village.

    Maskalyk did what he could to cope. When not too exhausted, he went for a morning run. He paused to admire a sunrise or visit a little girl he fell in love with and considered adopting. He wrote a blog. But this caused controversy. His superiors at Doctors Without Borders feared he would upset the government in Khartoum and get the mission expelled. To his credit, the author never complains, doesn’t despair and never melodramatizes his personal predicament or the overall situation in an area seething with armed militias. Just as he was determined to provide for his patients’ needs, never aggrandizing his role or hinting at heroism, he presents the reader with an unvarnished reality.

    This is not to suggest that Maskalyk ever became numb to experience, or that despite the suffering and harshness that he witnessed he wasn’t sensitive to the dilemma of the people and the paradoxes of his job. He explains why Doctors Without Borders sticks resolutely to its mission and works within limits, but he concedes that “when a family comes kilometers over broken roads, carrying their dying daughter, and they arrive ten minutes too late, when you tell them that no, you cannot help them bury her . . . the knowledge that you are being wise is poor comfort.”

    Considering Maskalyk’s generosity of spirit, his courage and frequent astuteness of expression, it’s unfortunate to have to quibble with some of his narrative choices. In an author’s note, he acknowledges that “the conversations are from my memory and though their words are conjured, the content is not.” But whatever its truthfulness, far too much dialogue sounds stilted or downright silly. To cite just one of example, Maskalyk reports a phone conversation with his girlfriend.

    “‘Yeah, I totally suck. But it’s like . . . a kid dies or whatever, and you’re like, Hmm, what should I do now? I guess I’ll just wait around for the next one.’

    ” ‘Oh baby.’

    ” ‘Yeah. Whatever. It’s cool.’

    ” ‘Doesn’t sound like it.’

    ” ‘It’s okay. Sorry. Didn’t mean to harsh you out.’ ”

    Maskalyk’s writing, like his medical treatment, improves when it depends on close observation and detailed description. “This is what happens if you are a Dinka child [dead at the age of 13 months.] Your father takes a small piece of string and binds your large toes together, to keep your legs closed, then wraps your feet. Your hands are placed grasping each other, and your thumbs are bound. Your fingers are then concealed in gauze. Last, he lifts you onto a piece of colored cloth and wraps you a final time.” Austere as the Sudanese landscape, plangent as a ballad, this book has poetry in it along with pain.

    Michael Mewshaw’s new novel, “Lying With the Dead,” comes out in October. He’s finishing a book about Africa.

    Read the original review at the Washington Post here.

  • “…a moving book, a vivid picture of camaraderie in an inferno…” – The New York Times
    Armchair Traveler
    Published: June 21, 2009

    In 2007 James Maskalyk told Médicins Sans Frontières (Doctors Without Borders) that he would go anywhere it posted him, no complaints. Stints in Cambodia, Bolivia and southern Africa, practicing and researching what he calls “the medicine of poverty,” had not cured his restlessness. He was happy to leave behind a career and a girlfriend in Toronto in order to find out what would happen “when all the insulation between the world and me was removed.”

    The six months he worked in the middle of Sudan, in a village named Abyei that from the air was little more than “a smudge in the sand,” severely tested his traveler’s optimism as well as his mettle as a doctor. His experience of caring for noncombatants trapped in a civil war, recorded first in a popular blog and now in this moving book, are particular to this time and place. But much of the routine misery he describes is the lot of the rural poor in countries everywhere.

    Dr. Maskalyk and his team operate a primitive clinic where patients are sometimes “thrown like matchsticks” from the back of a truck. He had hoped being “so far from somewhere” would at least allow him nights “full of quiet stars.” But the high volume of the Abyei “jazz band” (he uses the term loosely) exceeds the damper of his ear plugs, and the unyielding pace of his job doesn’t allow much time for a doctor to learn about tribal life (mainly Dinka and Misseriya).

    His account doesn’t avoid the inevitable pitfalls of the memoirist. The picture of the changes he traces within himself (“no matter how much I try, I will never go back to being the person I was before I left”) at times crowds out the background of faces in the village. But his honest doubts about an adventure few of us could handle, much less ask for, is commendable. His reports on the internal workings of Doctors Without Borders, a noble organization that depends more than it wants to admit on the United Nations, add another dimension to his vivid picture of camaraderie in an inferno.

    Abyei is a place where everyone endures searing heat, choking dust, rampant disease and the threat of war. For those who call it home and have nowhere else to go, the place pulls and repels. Dr. Maskalyk, too, finds himself torn between his mission and an urge to flee. “I have been in Sudan for three months, but I have yet to fully arrive.”

    As can be imagined, this story does not have a happy ending. The question the author asks — what is his responsibility for the lives of others? — is one that every visitor to an underdeveloped country has pondered, and it doesn’t have an answer.

  • ” …a rich story that gives a wonderful, raw awareness of what we are as humans…” – The Vancouver Sun

    Maskalyk never minimizes that truth, nor does he offer the consolation that he made a difference. There was nothing he could have done to change the reality for thousands. Indeed, Six Months in Sudan is a bleak story.

    On the other hand, it’s a rich story that gives a wonderful, raw awareness of what we are as humans. We are those who suffer and we are those who care and we are those who do our best to help.

    Maskalyk’s commitment to telling it as it is serves to liberate the reader. Our hopes and illusions are stripped away, yet we are left not with despair but with a deeper appreciation and a sense of wonder.

    This is a rare memoir, blending compelling scenes of Abyei with the thoughts and feelings of a volunteer doctor, all done with genuinely brilliant writing. I’m sure Maskalyk is a fine doctor, but he’s an even better writer. Just as in the field blog that preceded this book (see Sixmonthsinsudan.com), his aim is to pull readers into his experience, to make them as much witnesses to the truth there as he was. It is all about intimacy.

    Read full review here.