Land Mines Shatter Limbs and Lives in Sudan

LOKICHOKIO, Kenya —  The spindly Sudanese boy with two strands of beads looped around his neck doesn’t remember the explosion that hurled him through the simmering heat.

All he recalls is waking up in his uncle’s arms in the desert, his right leg throbbing. He grabbed for his foot and got a bloody handful of splintered bone and tangled muscle.

Goch Bol, who thinks he is 9 or 10 years old, is one of the 26,000 people the International Red Cross estimates lose their lives or limbs to land mines around the world each year.

A conference of 90 countries drafted a treaty in September banning antipersonnel mines. But the world’s largest nations--including China, India, Russia and the United States--say they will not sign the pact in December.

The campaign against mines received a high-profile boost from Princess Diana, who had urged “a total worldwide ban” before she was killed in a car crash Aug. 31.

More than 100 million active mines are scattered in more than 70 countries--one for every 48 people on the planet, the Red Cross says. At least 1 million mines are buried in Sudan, the vast majority on the desolate plains of the south where civil war has raged for 14 years.

Mines wound civilians like Goch much more often than soldiers--just 13% of mine victims are wounded in combat. Most of the rest are mutilated while working in fields, fetching water, herding cattle or, as Goch was, traveling.

And mines don’t respect the end of a conflict.

“Even if no more land mines are planted, the ones in the ground now would keep us busy for the next 30 years,” said Dr. George Kundert, a Red Cross surgeon working at Lopiding Hospital in Lokichokio, a dust-blown town near Kenya’s border with southern Sudan.

In Sudan, battles have pitted north against south, Muslim against Christian, black African against Arab African. More than 1.3 million people have died from famine and fighting.

Those who survive grisly wounds and festering infections must wait up to two weeks for a rescue plane to fly them to Lopiding, which is the biggest Red Cross hospital in the world.

With a staff of 18 foreigners and 107 locals, the hospital cares for up to 580 patients in a cheerful compound on a hill shaded by thorn trees and brightened by bougainvillea.

Although AK-47 rifles and land mines wounded most its patients, beds also are occupied by a hunter whose head was crushed by a hippo, a boy with a thigh crushed by a camel, and many children bitten by snakes and hyenas.

Goch arrived last March 8, two weeks after the mine mangled his right leg. By then, what remained of his foot was swollen, stinky and oozing pus.

Most mine victims do not live long enough to get to Lopiding, said Kundert, who is the hospital’s chief surgeon. They die from the severity of their wounds, blood loss or gangrene that occurs because mine explosions blow debris deep into tissue.

Even when damage is beyond repair, some Sudanese refuse amputation until a maimed arm or leg becomes so putrid that even they accept it is useless.

Daniel Odhiambo, the hospital’s physical therapy director, said southern Sudanese especially resist hand amputations, fearful of being stigmatized because Islamic law decrees a thief’s hand must be cut off. However, Sudan’s Islamic government in Khartoum jails thieves and does not amputate hands as punishment.

If a patient puts his thumbprint on a permission form, Kundert amputates with swift, sure cuts. First he makes an incision through the skin--carved in curves so the tissue can be sewn into a neat pouch around the stump.

Then he cuts deeper into the muscles, tendons and nerves to sever healthy tissue from infected. Reaching the bone, he uses a saw, which is more of a toothed wire. A few minutes of back-and-forth tugging under a stream of water to cool the blade, and the limb is gone.

What remained of Goch’s foot was amputated in his first operation. In seven additional surgeries, more slices removed recurring infections or trimmed bone that was growing faster than the boy’s muscle and skin.

Despite his injury, Goch is cheerful and active. On crutches, he races around the compound, chasing friends, peeking in at the laundry room, checking the kitchen to see what’s for lunch--cabbage, carrots and rice today. He turns a scrap of paper into a pinwheel that twirls in hot blasts of wind.

Goch has become leader of the kid pack at the hospital, deciding what they’ll play and how.

His father was killed in fighting in 1991. His mother is back home in Bor caring for two younger brothers. He is not sure what he’ll find when he returns to southern Sudan, nor does he understand the war that cost him his leg.

“They’re just fighting and fighting. All the time fighting,” Goch said.

It is left to his grandmother, Rachael Achung, who cares for Goch at the hospital, to be angry and to worry about his future.

“As the world said, we should have no more of these horrible mines,” she said. “My grandson has been left an invalid.”

About 80% of Lopiding Hospital’s patients are war wounded. The soldiers among them affect bravado.

Morhumhai Manaseh Ayawa, 24, lost his left foot. His attitude: It’s the price you pay for liberation.

He and other soldiers expect to be treated as heroes when they return home--to rest under shade trees, sip tea and play dominoes.

Others scoff at plans to ban mines, arguing the problem in Sudan is not mines, but the war itself.

“If there is a war, then there are mines and there are bullets and there is shelling,” said a young man who insisted on anonymity. “You have to stop the war--that’s the problem, not land mines and other weapons.”

Kundert said he has never seen a woman proud of her war wounds, as the men at least pretend to be. “It’s a disaster for them. They worry, ‘How can I deal with my children, my garden?’ ” he said.

On average, one of every 5,450 Sudanese is an amputee, but most of the victims are in the south.

At the hospital, tall, thin men hobble about with missing limbs. Draped in hospital-issued pink cloth, they get used to crutches and artificial arms and legs.

They listen to music from a homemade stringed rababa, sing and dance. They play raucous games of dominoes, slamming down the tiles they hold in long-fingered hands.

Manyat Manyuon is angry--he wasn’t a soldier and wanted no part of Sudan’s war. Returning home from a cattle camp, he stepped on a mine. His left leg was blown off where the hip joined the thigh, and his right calf and scrotum were damaged. He nearly died of tetanus.

“I cannot do anything, even with a prosthesis. I need to be able to walk two to three days to tend my herd,” Manyuon said from his hospital bed. “I am so very angry. I don’t understand these things that are happening in our country.”

When Goch’s skin is toughened by deep massages to his ice-numbed stump, he will go to a bright yellow workshop decorated with a smiling face where as many as 485 prostheses are made each year.

There, director Benedict Masika will make a gypsum mold of the short lump below Goch’s knee. He will drape the model with a hot, malleable sheet of high-density plastic.

The cooled cone will be bolted to a plastic joint that will work as an ankle, then a plastic foot that moves pretty much the way a foot should.

With the artificial limb, Goch should be able to walk fairly normally over Sudan’s rugged terrain. Sticky mud will be his biggest problem. He will need about 15 new prostheses as he grows up.

Waiting impatiently for his turn, Goch often sits on a bench outside the workshop watching enviously as others slip on their new artificial limbs.

The head nurse, Palina Asgeirsdottir of Iceland, said the Red Cross has considered providing counseling to the wounded, “but the people take care of each other.

“They talk, they sing, they play games together,” she said. “It’s more like it used to be in our old days--each family takes care of its own.”