Letter from Darfur: Desperate Measures
Credit: Marco Di Lauro / Getty Images

As I buckled my seat belt, it struck me that flights to war-torn Darfur sure had improved since my last visit. In April of 2004 I'd flown to the overrun cities of Nyala, El Fasher, and Geneina, Sudan, in a rickety, propeller-driven Russian transport plane. The preflight checklist seemed to consist of the pilot and copilot barking at each other before throttling up. ("No fire!" "No smoke!" "Hit it!") Those were the early days of the world's largest humanitarian crisis.

Now the flight had a touch of civility to it. A Kenyan crew served water to the doctors, nurses, and other aid workers as they labored feverishly on their laptops. Flying with aid workers is always a lesson in efficiency. Every single person on the flight had either a computer open or papers stacked on the tray table. In front of me sat a breathtakingly beautiful Dutch volunteer physician, Petra, one of the 15,000 humanitarian aid workers now in Darfur. Two years ago, only a couple hundred of the toughest were here to help. Now a small army of determined professionals like Petra had answered the call, and their determination reminded me of my early humanitarian experiences in Africa.

When I was a young medical student in Sierra Leone in 1974, I lost patients every day to diseases that could have been treated with a course of antibiotics or antimalarials back in the States. Meanwhile, near my quarters lived a 75-year-old Peace Corps volunteer who went out every few days to put in a new drinking well in some needy village. With my training, I could only comfort the sick as they died. By seeing the larger threat, this volunteer was saving scores of lives with each well he installed.

Since then I've tried to see things as that 75-year-old did. Stepping in at the right point can make all the difference, and I wanted to try to do that here in Sudan. After Rwanda, President Clinton apologized on behalf of the international community for not acting quickly enough to protect the refugee camps. Sudan is looking like another apology in the making. I was filming a television show with cameraman Kevin Broad, and I'd set my sights on telling the story of Darfur and its people through the eyes of International Medical Corps (IMC), a group of physicians who race to provide medical care and training during international disasters. IMC began in 1984 when an American ER doc sold his house to start an emergency medical program in Afghanistan, and today it enjoys the favor of the U.S. State Department because it's less politically outspoken and more technically accomplished than comparable groups. The IMC doctors are nothing if not devoted. In 1992, in Somalia, I witnessed an IMC physician roll up her sleeve and take a pint of blood out of her own arm to save a little girl's life.

The town of Geneina, on Sudan's western border with Chad, is within a few hundred miles of the Sahara, and as we descended toward the dirt runway the small details came into focus: brown buildings and scattered single trees amid an endless landscape of rock and dust. We emerged into a breathtaking blast of bright sky and dry heat. Beyond the waiting jeeps encircling the plane, the place was still firmly in the 15th century. I watched two men ride donkeys past a smattering of low whitewashed buildings at the runway's edge as passengers marched off the plane to extricate their bags from the pile on the ground where they'd been thrown.

At its core, the Darfur conflict is based on an ethnic division. In 2003 two local rebel groups, the Sudanese Liberation Army (SLA) and the Justice and Equality Movement (JEM), both composed of African Sudanese, began a bloody rebellion against the Arab-dominated Sudanese government. The government allowed militia groups to sweep through Darfurian villages in search of SLA and JEM rebels, and indiscriminate murder became common on both sides – 50,000 to 80,000 dead by the summer of 2004, an estimated 200,000 dead today. As the UN prepares to send in a peacekeeping force, against the protests of the Sudanese government, Darfur is pocked by random violence: government troops and government-backed militias fighting multiple rebel groups, Chadian rebels and Sudanese rebels and bandits on cross-border raids against Chadian government troops, rebels and bandits sacking aid convoys for supplies, and unaffiliated thieves stealing NGO vehicles and equipment. Geneina is a melting pot of aid organizations, military personnel, and profiteers, and it takes a practiced eye to identify the various jeeps full of khaki-clad armed men flashing through town.

A peace treaty between one rebel group and the government went into effect this past May, but several other groups refused to sign, so the region is teetering on the brink of all-out warfare again. The African Union force, some 7,000 soldiers from various countries, is stretched too thin to handle it and, shortly after my trip, announced its intention to withdraw. Geneina sits squarely within the danger zone, and when we got there the UN had imposed a stage-four alert status for foreigners on the ground. Stage five is immediate evacuation. When I arrived, my name, along with the names of every aid worker and foreign official in Geneina, was attached to a particular seat on a particular plane, ready at all times to get us the hell out of there.

The scene at the airport was like Saturday night at a drive-in: a fleet of Land Cruisers idled near the plane with their drivers and greeters, each with a large logo on the door: imc, msf, save the children, wfp, un. As passengers disembarked, old hands hugged one another and newcomers looked around anxiously for their rides. Meanwhile, we got into brief trouble with a group of government officials who'd spied Kevin's photo equipment. For months, reporters had been barred from Darfur; most were stuck in the capital, waiting for permission to come here. My application had been expedited because I'm a physician, but letting us loose with a camera seemed to the officials a sure way of losing their jobs; we would have to return to Khartoum. Then I opened my laptop and revealed a shot of myself with the casually dressed and unusually cheerful-looking president of Sudan, Omar Hassan al-Bashir, at his house in 2001. The official in charge broke into a desperate smile, bid us a sudden welcome, and ushered us politely out the door.

Geneina is a collection of compounds, each protected by head-high stone walls, owned by well-to-do farmers and businessmen and rented to various aid organizations. They reminded me, inside and out, of the Alamo. We walked through the gates of the IMC compound, our base for this visit, as the midday sun began to slide toward afternoon. A Kenyan nurse gave us a tour of the spartan camp, clean and well-swept but coated with windblown dust at the end of each day. A single, low building stood at the center, with sandbags piled high to afford ready protection from any attack. Linens hung on clotheslines, and piles of supplies were stacked all around.

In Geneina thieves are the primary threat: rebels with a side business trafficking in stolen goods, Arab militias, or organized bands of unaffiliated robbers. IMC's crates of medications had been moved inside the lone building to protect them. NGOs were losing vehicles and supplies to armed bands at an alarming rate. Even high-level diplomats were arriving only to find their cars had been stolen and more than a dozen aid workers, mostly Sudanese, had been killed since May. Transporting anything overland, an aid worker told me, was a guaranteed way of losing it. As a result NGOs were moving food and supplies by air.

Settling down in my small bedroom, I worked through a typical Darfur evening routine: kill bugs, set up mosquito net, stare at ceiling, kill bugs, wait for temperature to drop to 105. The faint sounds of fighting – the familiar pop-pop of AK-47 fire, the occasional soft boom of an RPG round – lulled me to sleep, despite the thick evening air. Two years earlier I'd slept in an iron shipping container. At least this time I had windows.