"So this is how you died. In whispers that you did not hear..."
Hemingway

Journal entry - June 1, 2006

In the quest to remedy starvation there is more than meets the eye. A lack of food can bring an otherwise healthy man to the brink: he may lash out, withdraw, hoard meaningless things, steal, lie, and when desperate, hurt himself or others. His heart shrinks, his blood pressure falls, and his cells break down. You cannot give a malnourished person a hamburger and call it good.

The body's ability to protect itself to the point of destruction boggles the mind.

This morning was rough to say the least. At this time I am not trained to handle urgent care (a grueling practice for both nurse and patient), but there’s more than enough to swallow on the other end. A three year-old placed in my care will be released in less than a week with an extra ration of dried fortified milk and no where to go. Her family is missing.

More adults die in this camp than children.

Does the world hold these adults responsible for having children in a country without means, not taking a moment to fully grasp the lack of education, the violence, the cultural pressure, and when comes down to it, the entropy of a starved mind? It is the adults who suffer due to neglect. They are harder to care for - with age comes pride, resistance and the devastation of loss.

Frances told us of a Somali woman brought to the camp, near death and refusing treatment. Her family had been murdered and she no longer wished to live. When a little girl came up to her crying, she slowly sat up and asked for a comb to brush the child's hair. That interaction, that feeling of being worthwhile, was all she needed to survive.

Still, there is hardly enough for man, woman or child.

This isn't the hot bed of excitement one sees on ER. Not the short news clip or the 20 minute commercial featuring emaciated children too weak to speak of money. Reality show contestants paid to entertain never truly waste away, they only waste our time.

Every night we pack up and drive 20-30 miles to the staff camp. Every morning we return and hope our med tent is standing. Four questions hang heavy in the rushing air.

Is the water contaminated? Will we have enough rations? Has the aid truck finally arrived?

Three questions plagued by the other set deep in the mind.

In a country where more is less, is hope a luxury?