April 18th, 2007. Night shift.

Hospitals always feel strange at night. Maybe it’s because of the all-shrouding silence, or perhaps because fewer people are around compared to the day shift, but after dusk all hospitals seem to become more “human”. This is especially true at the Salam Center, in Khartoum, EMERGENCY’s hospital in Sudan, which today, after an enormous amount of work, finally began in earnest the activities for which it was built: early tomorrow morning Sunia, a beautiful 14 year-old girl, will enter the operating theater to have one of her cardiac valves replaced.

All of us, medical and technical staff alike, have been eagerly waiting for this moment, and it’s finally here. Excitement runs high, and so does anxiety, the fear that something will go wrong, even if we’ve been obsessively checking and double checking everything for the past two weeks.

Maybe it’s all superstition, but we’re all a bit ‘wired’. This hospital has always--ever since being born as an idea--been under heavy scrutiny from all, particularly from those who never believed it could happen, those who still wouldn’t believe if they didn’t see the pictures. It does exist, and it's a thing of breathtaking beauty. EMERGENCY kept at it, relentlessly, stubborn and courageous, despite the criticism: from the humongous ‘hole’ that was excavated over two years ago to fit the foundations has risen a ‘monster’ of beauty, all white and red, with a lush garden all around, making it all the more striking. And at night the floor lighting plays with the long colonnade, making for a stupefying effect. Perhaps even the on-duty guards are sensing that something is different this evening.

The Sudanese nurses and I go check on Sunia, to see if she’s already sleeping, in her clean bed, in a hospital room that she could have probably never dreamed of before. Tonight is even more special for her: she is the one whom we’ll have to wake up early in the morning, shave, wash, disinfect, pre-medicate, dress with the surgery vest.

She's not sleeping—I wonder how many thoughts, how many worries—and I only manage to ask her “Tamam?” (“Is everything alright?”) in my shaky Arab. Almost taller than the bed, skinny and all, she answers me with a smile. We explain to her that because of the surgery, tonight she’ll be fasting, alas, and skip the 10pm snack of milk and cookies that all patients enjoy, one of the hospital’s four daily meals. Nutrition is of paramount importance to the healing process. Especially here at Salam.

Sunia cannot possibly imagine how many resources, how many people, how many sacrifices were made by many, in faraway places, to allow her to be treated in such a highly-specialized, first class structure like this one, free of charge, according to EMERGENCY’s ethics and mission. She cannot know that thousands of people, this very night, after a day’s work, their day’s work, tired and dealing with the everyday and its problems, having never seen one of EMERGENCY’s structures “live”, are giving of their time and effort, for free, to increase awareness among others, to raise the funds essential to the viability of our many projects.

But I do know, and as I look at her, I get emotional.

Areech, one of my young colleagues, must notice this, because she looks at me and says: “This hospital is very important for our people”.

April 19th, 2007

Dawn comes quickly to bathe our hospital in light. Areech wakes Sunia up, gently, brings her to the medication room, preps her, makes her shower, covers her in disinfectant and gives her the blue surgical vest. I inject her with some sedatives, to calm her a bit: any kind of stress is very harmful to a cardiology patient. The gurney is already outside her door, waiting for the call from surgery.

Jacqueline, her mother, has just arrived: she’s one of our wonderful cleaners, a huge woman whose lips always smile, except for a second when her gaze and Sunia’s cross. We leave them alone, it’s their time. They’ll have a lot of things to tell each other, or maybe not, but surely they’ll be  mportant.

The wait is unnerving: by now the morning shift has began. The whole team is feeling the anxiety... these are the times when we feel close, bound together by this mission and all on the same boat, all part of EMERGENCY: it's what makes this different from all the other hospitals, anywhere in the world.

We try to comfort Jacqueline, but having worked with us for a month, she gets it, and makes us feel her trust in us. One hour behind schedule, due to an unpredictable glitch in the a/c, the call from surgery finally comes.

I walk into Sunia’s room: she understands and hides under the covers; we need mom to dig her out. Sunia gets on the gurney, we cover her with a sheet, and the other patients in the room warmly smile at her, wishing her well for the operation, a beautiful gesture from people who’ve found themselves together for only the past four days.

We make our way along the hallway, which seems endless, we enter the buffer area before the OT, the doors open, lots of masked people, all in scrub-green welcome us, perhaps even more emotional than we are... we look into each others’ eyes for a second, we wish ourselves well, and perhaps even extend to ourselves mutual thanks, for having all allowed this moment to finally come.

Sunia switches to the spotless surgery bed, and I can’t help caressing her face, not knowing how else to give her a bit of assurance. Now it’s time for the anesthesiologists, the surgeons, the perfusionists to take over: we will wait for her return to the ward, as she’ll have to pass through a few days of Intensive Care, where local and international staff will monitor her 24/7, to provide care and stability in a difficult moment.

I can’t wait to see her smile again: tired and pained, perhaps, but with a better future in front of her, thanks to a new cardiac valve. There’s no time to let tiredness set in.

Thank you, to all of you who allowed this long chain of events, leading to surgery, recovery and  rehab, to happen and succeed.

Thank you, to all of you who always believed in this, sometimes clinging to nothing more than a bit of faith.

Thank you, to all of you who will never believe in this, not even if we flew you down here to see for yourselves, providing us with even more motivations.

Thank you, to all of you who, like me, are pained by the situation in Afghanistan, and worry about the fate of our projects there, of Rahmatullah and of all our local staff; we have not abandoned you.

Safe journeys,

Salam Center