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Being Present

my tukul, the hut that would be my home. Built on a platform elevated on three-foot stilts, each tukul was a duplex, with two 10-by-10-foot rooms. The tukul is constructed of sturdy posts and sticks, covered with a mud and hair plaster on the outside and a sort of stucco on the inside. The roof is thatch over plywood. My room had a straw mat on the floor plus a camp bed made of sticks and strips of hide, latticed like a lawn chair, with a foam pad on top. The amenities also included an insecticide-treated mosquito net and real sheets! Because I was there during the "dry" season, I did not see a single mosquito, but the bed net did keep the bats at bay, or at least a comfortable distance away.

I wondered why the stilts; that question was answered when I heard jackals and hyenas foraging nearby at night. In fact, some of the hide beds and chairs in unoccupied tukuls fell prey to their hunger—though the empty bed frames later made excellent posts for a badminton net. There was no electricity in the tukuls, but a solar panel and storage batteries provided a little light in the kitchen and dining area, the showers, and the latrines. When the power went out, a headlamp was essential. My alarm clock very early each morning was the bleating of goats and groaning of camels in the Afar village just outside our compound.

The expat staff compound was on a small rise and gave us a little view of the vast plain we occupied, toward some low mountains about 30 miles to the north. We could see dust storms an hour before they arrived—a brown wall, sometimes hundreds of feet high. Though an hour gave us enough time to get the shutters on the tukuls closed, the dust still went everywhere.

The sunrises and sunsets were stunning, as was the full moon. With no artificial light for hundreds ofmiles, the night sky was spectacular. I often found myself humming "Lucy in the Sky With

Above, the tukuls in which the Galaha medical staff lived. Below, another young woman in the traditional, colorful garb that many Afar still wear.

Diamonds"—an especially apt song, since a 3-million-year-old Australopithecus afarensis skeleton dubbed Lucy had been found in Hadar, just an hour away.

After less than 48 hours in Galaha, I felt like I'd been transported a thousand years back in time. And I was many thousands of miles outside any zone I'd ever before experienced. Between the oppressive heat and the enormity of the medical problems facing the Afar, I felt like a newly anointed intern just out of medical school.

The workdays were tough. They began at 6:00 a.m. and went until 6:00 or 7:00 p.m., with a break between noon and 4:00 p.m. During the break, we all found a place out of the sun and tried to stay as still as possible, to conserve energy and water. We'd work again for two or three hours after the break, once the intense midday heat began to let up. I started each day with rounds in the inpatient department (IPD), seeing asmany of the 45 to 50 hospitalized patients as possible.

Meanwhile another team, headed by Dr. Paras Valeh, the TB doctor, distributed medications to the TB outpatients.

ur "hospital" compound consisted of several open-ward

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