MSF Blog: Chiradzulu part 15
My friend’s brother died this month. He was less than a year older than me. Life expectancy in Malawi is something ridiculous, like 40. Everyone I know here has lost someone in their immediate family. Mother, father, brother, sister or child. It’s madness, and I don’t know how people keep their sanity. Our nurse from California reminded me that we look at our own lives – in our 30’s and 40’s – and think we’ve got another 30 or 40 years left, and statistically that’s probably true. But here in Malawi it’s not. Stalin said a single death is a tragedy but a million deaths is a statistic. It’s harder to think of people as statistics when you know their names rather than their diseases.

The thought of getting malaria or schisto doesn’t seem like such a big deal anymore. It’s leishmaniasis, onchocerciasis, and trypanosomiasis that scare me, not to mention TB and HIV. Life is raw out here, and if you’re not African it can seem too difficult.

Carrying wood on Chiradzulu mountain, photo by Pat Carrick

There’s a word to describe someone who is not African – Mzungu. Malawians say it’s not derogatory, but simply refers to someone who is not black. But I think it means someone who is weak, when compared to Africans. People are strong here, mentally and physically. Women pump water daily, and then carry buckets full on their heads as they walk home barefoot, with a baby on their back the whole time. It’s not just women, as I have seen plenty of children doing the same thing.

There’s a cleared soccer field here in Chiradzulu, and a group of children meet some of us there on the weekend. Most of the time they are dressed in their Sunday-best, but sometimes their bare feet and torn clothes are hard to overlook. Their ingenuity impresses us most. If the weather permits we fly a kite, courtesy of our doc from Pittsburgh. But the kids have offered to show us how to make kites, out of reeds and plastic bags. We also play games. A few weeks ago I played checkers on a hand-made cardboard-checkerboard using bottle caps as chips – Coca-cola versus Kuchee Kuchee beer. One boy, Junior, has this incredible toy car that he made out of wood and wires that has a handle attached as a steering wheel. Another impressive creation is a triangle shaped go-kart we’ve seen the boys riding down the hills of Chiradzulu. Sometimes we expats struggle with the desire to give things to our young friends, but always refrain for fear of encouraging them to ask for more. In the end, they are happy when we spend time with them, as are we.

A school sign in Chiradzulu, photo by Pat Carrick

Still, I can’t stop myself from contemplating their future. I haven’t told them my age, because mid 30’s is considered old. I tell them I’m 19 and they laugh and call me a liar. But I wonder how many will get to be as old as me.

Sandy, from Chiradzulu in Malawi

MSF Blog : Chiradzulu part 14
There is a growing and global lack of health care professionals. Countries such as the USA and France import skilled workers from other countries. But in countries like Malawi, there is a serious brain-drain occurring. Malawi has about 12 million people, and one medical school (since 1991) which, as of 2007, has graduated 254 doctors — ever. Many, if not most of these doctors, leave the country for more lucrative opportunities elsewhere. That leaves approximately 2 doctors per 100,000 people. Here in Chiradzulu, if our MSF doctors weren’t here, we’d have one doctor for the district of 300,000 people.

Of course one can’t blame the doctors, as anyone would prefer an international, better paying position. In Chiradzulu we have focused on task-shifting to provide adequate health care to patients. Task-shifting means clinical officers and nurses take on responsibilities that might otherwise be covered by a physician. More serious cases are referred up, but those with less training are asked to perform tasks where staff are in short supply. Task-shifting isn’t the only solution, but it is helping get medical care out into rural areas where patients might not always have access.

Mauwa Health Centre, Chiradzulu. Photo by Pat Carrick

 It’s not an ideal situation, but MSF is trying to make it work. Sometimes it feels like we’re paddling a boat upstream, especially when we calculate that one clinical officer may still see about 80 patients in a day. For them it becomes part of their normal work schedule, but maybe we should stop and ask what do we accept as normal these days?

 I know asking for a definition of normal can be a clichéd question, but perhaps we can dissect how something becomes normal. Could our impression of “normal” just be a collection of habits? Is it repetition that makes an act habit? My brother once told me that if you do something 12 times in a row, it becomes habit. I’m not quite sure where I’m going with this, but repetition, habit and normalcy seem to be on the same highway. If so, then I think I prefer the slower country roads where you might encounter something different, every once in a while, that could lead to something unexpected. Maybe it starts with opening our minds to the possibility of a different idea – one that we aren’t used to – one that’s not normal.

 How much complacency has set in when we discuss the era of the AIDS pandemic? Do we question the role of our own government’s policies that may be fueling the spread of the pandemic? More than 10 years ago, an editorial (AIDS 1995, 9:539-546) questioned the role of free trade promotion in declining sustainable rural subsistence economies (farming) that leads to more rural poverty and thus pushes people towards migrant industries. This also includes less employment for unskilled work, the kind that women with little education and low status rely on. In such situations, women often turn to prostitution. If you mix increasing migrant work with increasing prostitution the equation quickly leads to more sexually transmitted infections, which then contribute to higher rates of HIV transmission. Pardon the simplification of a very complex issue, but you can see how assuming the “normal” progression of AIDS in Africa may simply be us getting used to the idea of a continent being decimated.

If something is repeated multiple times, do we then take it as truth? Maybe it’s not about doing something different just once, but rather realizing the possibility of ideas that aren’t “normal.” It’s letting go of beliefs, and then sharing ideas. There are 6 billion people on the planet. Is it possible that the other 5,999,999 are doing it differently from you?

Sandy A. from Chiradzulu in Malawi

MSF Blog: Chiradzulu part 13

As the data manager on the team, I’ve learned tons about data management, STATA and staff management. But I’m more amazed at the obscure skills I’ve acquired, like 1) having a sixth sense of where the matches are when the power goes out; 2) cooking for a dozen people with two burners and an electric kettle; 3) driving a manual land cruiser with right-hand drive; 4) saying “Thank you” in a half-dozen languages; 5) finding constellations in the southern hemisphere; and perhaps most important 6) letting go of expectations. I’m not quite sure what my expectations were when I arrived. Somehow “saving the world” seemed a bit ambiguous, but was headed in the right direction. Now, after 6 months, I’m thinking I will have gained more than what I have given.

I am more appreciative of the extended family here. Though people may live with their spouse or parents, their financial obligations extend beyond the immediate family. Unemployment is probably over 50% (statistics are an evasive animal here), so when someone is working, they are often supporting people outside their immediate family. If someone asks for help, you just give – not necessarily a lot, but what you can, because you can. This is an area where I have stumbled a lot. I see many men drinking their money away, so am wary to fund such liquid assets. Meanwhile, prices of food have doubled in some areas, and though we expats may not have cookies or yogurt for a week, I don’t know what my national counterparts are sacrificing.

Shops in the region, photo by Pat Carrick

MSF-France has been in Chiradzulu for over 7 years treating patients who are living with HIV. There are about 15 expatriates, and 150 national staff. The expats come here as supervisors or managers, but most with little or no context of understanding Malawi. Even I have been here for 6 months, speak enough Chichewa to get by, but still stumble over many local customs – and I’m very far from understanding what exactly motivates people. In this setting we expats arrive to supervise staff. Some of us, on top of no Malawi-experience, have little or no HIV experience, while our national counterparts have been treating HIV patients for years – in Africa. But we are here to supervise and manage the program. Of course every new expat who is here for a few months wants to feel like they made a difference – that our time during a mission served a purpose – so we look for some new improvement to implement. We bring our expertise from whichever country we are from and impose our great ideas on these people of whom we are guests. Sometimes we don’t bother to ask our staff what they think. After all, we are the expats/experts.
It’s difficult to be a manager, there’s no one to tell you if you’re doing a good job – or if you’re doing a bad one. I wonder how long we expect to supervise? Perhaps what makes it difficult for MSF here is that it’s a long-term program. MSF is used to working in crisis mode which cannot be sustained for long periods of time. But this HIV project has been here for 7 years, and will probably be here for another 7, at least.

Chiradzulu Hospital, photo by Pat Carrick

Maybe what Africa needs from us first is a willingness to understand, only then can we be understood. If you want people to build a ship, you don’t teach them how to chop wood and build sails, you get them to yearn for the sea. (I think a French writer said that.)

We’re learning how to implement water conservation tactics, not because any of us are big Al Gore fans, but because we’re bracing ourselves for the impending water shortage. The guys on the mission have proposed communal showers.

Sandy, from Chiradzulu in Malawi

Here in Chiradzulu MSF manages the HIV/AIDS program with staff at the district hospital and10 health centers serving a population of about 300,000. We have over 15,000 HIV positive patients in the program and every 2 or 3 months, each patient comes to their local health center or the hospital clinic to be checked out by a nurse or clinical officer and most collect a triple therapy of anti-retrovirals. When the project started in 2001, there was just the hospital clinic and only 65 patients on treatment. Now we see over 10,000 patients every month. MSF sends mobile teams out to the health centers every day. Each time they see a patient, they fill out a form that captures information about the patient’s health status and treatment. My job is to collect that information, process it, and develop statistical reports that are then shared with the rest of the team so they can monitor the program. I spend most of my time in front of a computer, which is kind of sad considering that’s what I did in Atlanta. I don’t know how to make statistics real. By the time I see these patients, they are bytes of data. I don’t know how to explain that we have over 10,000 patients on ARVs in a district half the size of Fulton County (GA); that without these drugs, these people would have little hope for a normal life. How can I explain that an entire continent is being decimated? Even for me it doesn’t seem real. I can’t speak for our clinicians, but I don’t know how they function daily – attending to one HIV patient after another. To find out, I have spent my mornings for the past two weeks shadowing the mobile teams at the local health centers.

HIV patient in Chiradzulu, photo by Pat Carrick.

The numbers and statistics that I tally every month have come alive with my visits. When I count a child who is initiating ARV’s at the age of 13, I see the young girl who came by herself to a health center, sitting alone in a chair, and answering questions from the clinician who feels like it’s an extra burden to meet stable patients who are under 15 every 2 months rather than every 3 months. But she patiently answers questions and then takes her forms and goes to the nurse to collect the drugs she will continue to take for the rest of her life. Or when I count the number of children less than 18 months old whose HIV status is not yet specified, I picture the 8 month old child clinging to his mother, who trembles at any attention from me, and has no idea that in another year, he may be handed a life sentence, just as he is learning his first words.
Meanwhile our database continues to be twice as large for women (men are less likely to access health care until it’s too late – universal problem), and the incidence of HIV in Malawi shows no signs of slowing down. It’s uncommon to have a full staff at work. Someone is either sick, or attending a funeral. In my first month I was told that many of our own staff are HIV positive, and having trouble sticking to the daily drug regimen. I take a multi-vitamin every morning, and malaria prophylaxis once a week. But if I forget either, I just make up for it the next day. Fortunately my life doesn’t depend on my accuracy. But it does for our HIV patients on ARV’s.

Waiting room in Nkalo health centre, photo by Pat Carrick

We know hope is with the next generation, and ARV’s are delivering that hope. On Wednesday I watched a 9-month old get his finger pricked for an HIV rapid test. I must have sent up half a dozen prayers in the 10 minutes we waited for the results. I couldn’t face hearing the clinician deliver a life sentence to a child who could barely walk and talk – fortunately it was negative. He’ll come back for his final test in 9 months, but now that he’s stopped breast-feeding, there’s little risk of transmission from mother to child. HIV positive women on ARV’s are having HIV negative babies. Of course this means they are having unprotected sex, but these children also have a chance at a future. There is hope for the coming generation.

Sandy A. Chiradzulu, Malawi

Being on a mission with MSF has been ten times harder than starting a new job elsewhere, but I wouldn’t trade it for any other. When starting a new job, there’s typically a 6 month period for adjustment, and you don’t hit your stride until half the year is gone. On an MSF mission, you could be handing over your job to a new expat at the end of 6 months. In the time it takes to get adjusted to a position in the States, with MSF you have to come up to speed, do your job, make some kind of improvement, and prepare to hand it off to the next person. And do all of this in a foreign country where you know very little, not even the people you live with. It seems crazy that people sign up for this, but it’s the most worthwhile experience I’ve had. I’ve grown in ways I could never have imagined. I’ve met people who were exemplary role models, and others who weren’t so much, and ended up learning from both. I’ve taught myself things that I never knew how to do before, and then trained someone else. I’ve connected with people from all sorts of backgrounds, and felt their mark on myself. And the whole time, know that what I’m doing is an attempt to make this world a bit better.

Bicycicle Amulance in Bilal, Chiradzulu. Photo by Pat Carrick

Staying balanced has helped, but being open is mandatory. Apart from family and friends, I don’t miss much from home. Maybe a sweater as the weather is getting colder. It’s officially cold season in Malawi, and I am now sleeping with four blankets.

I guess I didn’t time this mission with the circadian rhythms of my body. I left Atlanta just as the cold was starting to lift and the buds on trees were starting to become green. To my body, that meant preparing for longer days, more exercise, lighter foods, and a svelte physique. Unfortunately I’ve thoroughly confused it by moving to the southern hemisphere and now days are shorter, temperatures are dropping, and my body has decided to hold onto as much extra energy as I can consume. Of course this means tighter fitting clothes – for another 6 months. If I go home at the end of my current contract (August 2008), I’d yet again be preparing for winter season in Atlanta. Three winters in a row? No, thank you! That is definitely motivation to extend my mission. Therefore, family and friends, it won’t be until February 2009 that you will see me again in Atlanta, when the buds come around again.
Until then, I hope you have been enjoying the blogs!
Cheers,
Sandy

Who says Friday the 13th is bad luck? I had an amazing day traveling, and though the flight was a bit bumpy, I found Zambia to be what Africa is about, raw and unspoilt.

Yes, the Falls were amazing, and if you make it out there, the only way to see it is by Microlight, the motorized hang glider that flies over the falls and gives you a true bird’s eye view of the natural wonder below. Flying over the falls, unhindered by any glass or doors, you can see how the falls is carving another crack, another gorge to add to the snake-like canyon; this crack that has taken 5,000 years to form, a future ninth gorge in the canyon. It’s another reminder of how little time we have had on this planet. Meanwhile the Zambezi River continues to pour down the falls, spraying clouds of water so high you can see it from Livingstone, 10 km away. Spilling its water into the eighth gorge of the canyon, the river snakes its way into Zimbabwe, leaving behind a trail of water at the bottom of the canyon, a trail that begins with the whirlpool at Boiling Pot, churning the massive volume of water that becomes rapids, the whitewash that continues to sculpt the Nyami Nyami canyon.

Flying over the falls in Zambia

Meanwhile, above the falls, elephants swim across the river to walk across the islands that sit within it. Hippos lazily bob up and down. And people continue to flock here, to jump off a bridge with a big rubber band tied to their ankles, or cross the knife bridge to get sprayed and consequently soaked in seconds, to witness rainbow after rainbow across the falls, to rush the rapids below, or fly in a glider above. It’s our way to touch nature again. To remind ourselves that we are part of this tapestry. And then, to be humbled in the presence of something so magnificent, so spectacular, and so old; to share this awe with each other, we again touch humanity and our commonalities. In the end, as unbelievably breathtaking that vision of water falling, spilling, spraying and churning was, after putting my feet on the ground again and thinking, “Okay, now I can go home,” it’s the people whom I met that I will remember more fondly. Like the French Canadian who came to Africa to learn and practice English, or the German bicycling across Africa in a tandem bicycle (www.bike-together.de), or the South African fisherman walking across Africa along the rivers and lakes living off the land, or the gemstone speculator from Australia who is too restless for domestication, but appreciates the 30 seconds it takes to properly greet someone. And of course the lovely Zambians I met all along the way. Their warmth, bright faces, openness, and friendliness reminded me of home, and I was so happy to return to Malawi.

Zambia is a lovely country. The people are warm and welcoming. I no longer have this paranoid fear which the US exported with me. That’s not African. I ate off the street my last day in Zambia: scrambled egg fried in a vat of oil, along with fried potatoes that were still dripping, huge chunks of white bread with blocks of margarine in between, and a plastic mug of tea that shouldn’t be drunk to the bottom due to questionable sunken particulates. Am just awaiting contracting malaria, then my transformation will be complete.

Shout-outs to friends I met along the way:
Assaff: Hope you find Malawi as warm as I described it. Guylaine: Please tell me if the Zimbabwe side warrants another trip to the falls. Bennie: I hope you put the sunset photos on your site! Innocent, Matinda, Sylvia, Carlo, Fan, Reuben, Stephen and the rest of the staff at ZigZag: Thanks for making me feel like a long lost friend in just two days! Omer: Thanks for letting me win. Steven: The chambo in Malawi is delicious. John: Am still looking for a copy of HoD, but I think my description above is more accurate.

Sandy A.

TROIS SEQUENCES IMAGEES peuvent–elles suffire à tisser l’essentiel de l’histoire de Mohammed (8ans) ?

ESSAYONS…

LA PREMIERE, se situe encore dans ces récits répétitifs d’explosions dont les déflagrations déchirent le ciel et la terre les habits comme les corps ne distinguant rien de l’humain et du reste. Aucune priorité n’est accordée, les morts et les survivants sont traités de la même façon… “le sauve qui peut” n’a pas sa place, il n’est que le fruit du hasard. Mohammed est pris dans ce tourbillon… Il allait au marché avec sa grand-mère et sa sœur… Elles meurent sur l’instant toutes les deux… Il survivra, découvert dans cette fumée opaque et noire qui suit le feu ravageur. Il ne perd pas conscience, seules, euphémisme, ses deux jambes semblent en poussière.

LA SECONDE SEQUENCE me fait témoin de cette histoire et de ce petit bonhomme qui entre en marchant malgré tout, disloqué, il lance en pas de côté ses jambes désarticulées et raides… Malgré ses incompréhensibles enjambés, il garde la ligne droite avec la précision du funambule sur son fil qui rattrape toujours son équilibre.

IL PEUT RACONTER l’avant, le marché… Sa sœur… Sa grand-mère, mais au moment où le réel surgit, il s’arrête m’adresse un extraordinaire sourire et fait avec ses mains un geste de dénégation « je ne me souviens pas »… Il m’interdit par ce simple geste de tomber dans les niaiseries des inconditionnels des débriefings systématiques, d’interroger plus avant.

DE CE TROU du réel qu’il a parfaitement repéré et repéré comme indicible, et hors sens, il en fait son affaire à lui. Cette mise en garde qu’il m’adresse, m’indique sa réponse à lui. Il n’avait rien perdu de la scène creusant l’irréparable brèche, mais sa logique à lui Mohammed, du haut de ses 8 ans, l’a emporté sur la logique de l’événement que tout un chacun jugerait impensable. Il m’invite à faire comme lui, échapper, surtout ne pas s’engluer dans la fascination du dramatique.

LA TROISIEME SEQUENCE devient simple alors, le « c’est comme ça » du symbolique, le fait rejoindre la réalité de sa vie, sa vie d’enfant blessé, il peut dire ses difficultés à marcher, les souffrances des traitements, mais aussi, petite revanche personnelle comment il arrive à jouer au foot…. Il peut rire et pleurer sa sœur compagne de jeux, son regard à l’éclat de ses émotions. Ce qu’il dit, sa douceur mature, et les très belles expressions de son visage sont le gage de sa propre victoire sur la tragédie familiale.

Maryvonne Bargues
Psychiatre Amman juin 08

(Traditional dancers in Chiradzulu during World Aids Day 2006, photo by Pat Carrick)

IN PLACES FRAUGHT with famine, poverty, disease, and war, it’s difficult not to feel as if you aren’t doing enough. Perhaps, rather than trying to solve all the problems, it’s smarter to try and make things just a bit better. It can start with changing ideas.

IT’s CRAZY TO think that centuries of beliefs can be dismissed with an IEC campaign, but ARV’s are having an impact. There’s an MSF video about the HIV project here in Chiradzulu. At the end, it shows a woman, bringing out bottles, canisters and jars, full of herbs, liquids and powders. She is standing on her porch, and dumps each of the containers, one by one, in front of the camera, the whole time explaining how none of the traditional medicines helped her. After she empties the last container, she picks up three white pill bottles and holds them up, declaring that these ARV’s worked when nothing else did. Then she holds out her arms, as if to offer herself for inspection. She proclaims herself fit again; strong enough to collect water, cut wood, harvest maize. She ends by telling the audience that if they are sick, they should get tested, and then get treatment; life can be reclaimed, just look at her. It’s a powerful yet simple message. That’s the best way to dispel myths and superstition. There’s a lot of superstition in Malawi, though it isn’t often talked about. The unknown breeds superstition.

IS IT HUMAN nature to be fearful of the unknown, or is it society that makes us scared? Shouldn’t curiosity be the natural reflex to something we don’t understand? How did fear become the knee-jerk reaction to the unknown? When responding to fear, we tend to hide, fight, runaway, attack, denigrate, demonize. We naturally think that something we are scared of is something bad for us. But if we are always afraid of what we don’t know or understand, then do we presume the unknown is bad for us, or against us? Doesn’t that limit our future, potential and possibilities?

JUST IMAGINE IF we only lived according to what we already knew – that would be like watching reruns over and over. And as much as I love watching season 3 of The Office, I am so looking forward to see what happens in season 4.
Maybe it’s better to embrace the unknown, study it, take it apart and understand it – without judgment.

SOMETIMES I GET irritated when I hear an expat make a quick judgment about someone after a brief encounter, or about our adopted country after a few weeks in the field. It’s not fair and it shuts down any opportunity to learn from each other. If we’re looking to simply put people in boxes – boxes we’ve designed and created from our own biases – we should be ready to sit in one as well.

LIFE IS A discovery, but staying open can be difficult as it requires patience, tolerance, and imagination. Just imagine you don’t know. As soon as you think you know everything, you stop learning. After my first month, our French nurse told me that on a mission you learn a lot, but in the end you learn the most about yourself. I hope I can stay open enough to continue to learn.

I WOULD LIKE to learn how to open a bottle without a bottle opener. Malawians use another bottle, our French logistician uses his lighter, and our administrator from Cote d’Ivoire uses his teeth!

Sandy, Chiradzulu - Malawi

Dr. Khine Myae, a native of Burma, was one of the first physicians MSF sent to the devastated Irrawaddy Delta to provide assistance after it had been battered by Cyclone Nargis. Below he remembers the first few days after the tragedy occurred.

Sunday, 12 May
Everyone on our team sees an average of more than 200 patients a day and many people are in shock or are experiencing trauma. There are confused people still searching for their families, children who have lost their parents, parents who have watched their children drown. In the evenings, I sit with my colleagues and everyone tells what they’ve heard and seen during the day. It is difficult for everyone. We are all tired and we sleep poorly. “I can’t get the stench of the dead bodies out of my nose,” says one of the doctors. She spent a few hours sitting in a boat going through an area where there were many dead bodies and animal carcasses. The smells, the images and the people’s stories together form an overwhelming picture. I feel myself blocking it out. Tonight I went outside for a moment, I didn’t want to hear anything anymore.

(photo by Ewal Warshawski)

Saturday, 11 May
We need to rent more boats. Every day the number of teams and amount of material grows and most places can only be reached by boat. I negotiate with a boat owner. He is a nice guy and is very glad to help us with our work. Just as all the other people here, he has a “I barely survived” story too, he says. “I have a salt-producing business farther up in the Delta and was there when the storm hit. The water rose so quickly—a meter every minute—on the salt flats. I started to swim and could just grab onto the top of a tree. In the beginning, I held on with both arms because the current was so strong. But soon I was afraid that I wouldn’t be able to hold on like that. Then I just held on with one arm and if I got a cramp in that arm, I switched to the other one. My clothes had been torn off me long before that. The water was ice cold and my legs started to cramp. If I relieved myself in the water it was warm for a moment. I was fortunate. I was able to hang on for five hours. Out of my 200 staff, almost no one survived.”

Friday, 10 May
The weather got worse last night. Our team tried to sleep in the supply tent we had set up in the village earlier in the day. But in the middle of the night, it was no longer possible. Soaked to the bone and cold from the storm and rain, we ran to a nearby house. The family that lived there had cooked for us earlier that evening. Everyone there was already awake: the father, mother, children and a little baby. They were frightened to death. Although it was the same sort of bad weather that happens a few times each year, now everyone was trembling with fear. “What will we do if the water comes back again, the panic, all those screaming people? We won’t flee again, this time we’re going to stay here and then we’ll just face dying

Thursday, 9 May
The girl is seven years old. She has a big, ugly head wound from the moment a palm tree fell on top of her. Using unhygienic material, someone gave her emergency stitches. The wound is now terribly infected and she needs more medical help than our mobile team can offer. Her father is a fisherman and they lived in a house by the sea. When the palm tree hit their house, the whole family fled away from the water and headed inland. That saved their lives. The water washed away their house and most of their neighbours drowned. I arrange transportation by motorbike and boat and send the girl with her mother to a hospital further inland.

MALIHA A 40 ANS, veuve, son mari a été tué durant la guerre Irak  /Iran, elle est mère de 4 enfants…

L’HISTOIRE A PLUS d’un méchant tour dans son sac…Maliha fait ses courses dans un de ces grand » mall » , centres commerciaux de Bagdad , où là comme ailleurs la foule se presse, bruyante et animée…Encore une fois et soudainement, le ciel tonitrue, hurle dans un craquement de fin du monde et s’effondre en nuages de feux, pulvérisant la foule de ses flammes dévorantes…le feu illumine ce ciel assassin,  se déploient  ensuite le sombre tourbillon des poussières…les cris déchirants… .le silence de l’effroi.
Le compte “uncomptable” en fait, des morts et des corps disloqués sera à la « Une »  une fois encore, une fugitive image…
 

MALIHA EST DU nombre , très heureusement seule, une de ses jambes est broyée…Quelques temps après des soins précaires des hôpitaux iraquiens qui faute de moyens ne peuvent soigner.. elle sera en chaise roulante.

 QUELQUES TEMPS APRES aussi entrent dans la maison des milices inconnues qui froidement vont abattre sa sœur et son mari leurs 2 enfants de 18 et 16 ans.Elle est épargnée, ravalée au rang de témoin impuissant.

JE VOIS MALIHA… Elle m’apparaît comme « une petite chose »  recroquevillée,  un souffle ténu gémissant sans parole articulée …je ne sais encore rien de son histoire, elle se désigne seulement dans une sourde complainte douloureuse. Son corps entier souffre de partout sans distinction aucune, comme si, seule la douleur pouvait la maintenir dans le monde des vivants, au dessus d’une complète dissolution.

SA MAIN SE crispe sur un mobile( qui je pense la relie à sa famille restée en Irak…) Son regard est rivé sur cet objet, en fait tourne en boucle sur ce portable le film d’horreur des corps étendus, morts, de sa sœur et sa famille.. elle finit par me le montrer, je comprends alors… ..Maliha est restée figée,identifiée à ces images d’horreur et ne peut que se dissoudre en elles… Aucune parole jusqu’alors ne pouvant rompre cette fascination… cela durait depuis  deux ans maintenant !!

 LA SUITE N’EFFACERA pas les drames intimes de Maliha de ce qu’elle a vu dans la réalité,  mais elle est en mesure de s’en séparer de faire passer au dire, ce qui l’englobait totalement, seule maintenant sa jambe blessée est désignée comme source de souffrance ; Elle a retrouvée la liberté de se mouvoir, de réhabiliter  son propre corps.Ce qu’elle me dit chaque jour est de plus en plus habité et animé,  ses mains accompagnent ses récits, elles  se sont libérées du portable, de l’image traumatique qui avait la perfidie de ne pas être un fantasme…. Parler de sa sœur et sa famille, les réinviter dans son histoire a restitué à Maliha sa réalité et un possible futur.

 Maryvonne Bargues    Psychiatre Amman May 2008