The terrain surrounding that hastily-erected refugee camp along Sudan's western border was so flat and vast, Patrick Huff says it was hard to know exactly where he was.
His only real reference points were the setting or rising sun on the horizon -- and a steady stream of refugees trekking barefoot across 140-degree sand away from Ethiopia.
Huff, a physician traveling with a disaster relief team, had been there for only a few weeks in 1986 as the impromptu settlement ballooned to 10,000 people.
Another 200 to 300 would arrive each day, all of them victims of a famine and civil war that had devastated an already-impoverished nation.
They often came naked and without belongings; bandits along the way would literally steal the clothes off their backs, says Huff, who spent much of his time treating severe trauma and tuberculosis.
One evening, around a fire, Huff noticed a fellow carrying what he described as a primitive, four-stringed guitar. It was enough of an invitation for Huff to retrieve a banjo from his bunk.
The two played for one another and even attempted a duet. That's when the man broke a string, Huff recalls.
"If you could have seen the look on his face," Huff says, shaking his head. "Here he is, his only possession in the world ... and he breaks it sitting in a refugee camp."
Huff says he reached into his banjo case and pulled out an extra string to replace it. The man's eyes grew big.
"God put me in the right spot at the right time," Huff says.
He then chuckles: "If this guy had been in one of those United Nations tents, he would have been had."
After building his first banjo in 2003, Huff, or "Doc" to his friends, came up with an approach to the craft rooted in his knowledge of human physiology.
It borrows from the interconnectivity between tissue and organs that allow a body to function, he says. When Huff builds banjo pots from precisely cut wooden blocks, he painstakingly lines up the grains around the circumference.
Sound travels the paths of dry wood fibers, Huff explains. When strummed, the instrument "hums" and gives off a fuller sound than standard banjos, Huff says.
"It's only my own theory," he adds. "But I think it works."
Inside Huff's workshop in the foothills south of Dallas, plenty of physical reminders come together to give a snapshot of a life less ordinary.
Totems picked up in Africa and Central America. A hand-carved sign that reads "Valsetz Rural Health Clinic." An old photograph of him and the other members of the Luckiamute River Band.
Huff closed his medical practice in Polk County in the late 1990s to venture out and treat indigenous peoples in the world's most poverty-stricken and volatile areas.
As a manager for a humanitarian aid initiative, GeoAid, Huff and his family spent 2008 in a Cameroon village creating health and education programs for the local Pygmies.
The recession cut that trip short. And severe bouts of malaria for him, his wife, Florisel, and their three young children made him wonder if it was worth it.
"It's great work we're doing, but can you deal with losing a kid?" Huff, 61, says. "It's good to be home with our skins."
Huff's part-time business of making custom banjos is now a full-time occupation. And instead of some remote corner of the globe, you can find Dr. Livingstone in a rocking chair on his porch, playing an Earl Scruggs tune.
Humanitarian work and tropical medicine are "bad roads, strange travels, sweat and mosquitoes," says Huff, who was introduced to those institutions by the age of 17.
A Dallas High dropout, he enlisted in the Army in 1967 and was sent to Vietnam as a field medic for an artillery company. Huff learned how to sleep through mortar attacks, and treat sick and wounded soldiers and civilians.
"I thought, `I can do this,'" Huff says. "It was interesting stuff."
When the war was over, he did undergraduate work at Oregon College of Education and went to medical school in Missouri. He returned to Polk County and ran a family practice in Falls City for almost 20 years.
The Ethiopian crisis of the 1980s compelled him to volunteer his skills abroad. He tagged along in subsequent years with missionaries and relief teams to places like Iraq during the first Gulf War and Rwanda during the 1994 genocide.
By 1998, Huff decided to commit to developing countries full time, a choice that took a tremendous toll on his personal life.
Huff said he felt it was something he had to do, that his professional career to date had prepared him to "go back and work with indigenous peoples."
It's not for the faint of heart. In 1999, Huff went with Northwest Medical Teams to the Honduran-Nicaraguan border, to treat Moskitian Indians impacted by Hurricane Mitch.
That meant traveling hut-to-hut for 200 miles by dugout canoe, backpack and mule.
"The tropics aren't gentle," Huff says. "The heat and humidity want to compost everything ... it devours.
There was a time when one could escape for a fun weekend in some of Cameroon's "funky" coastal towns, Huff says of his first visits there with GeoAid in the early 2000s.
It's destabilized much since then. Most offshore oil rigs are now flanked by gunboats to protect against piracy, he says.
"They kidnap workers," he continues. "They take them, set them in the jungle without clothes, and let the mosquitoes feast on them until they get their ransom."
Huff and his family moved to Lomie in southern Cameroon in 2008 for a two-year project involving health and education programs. They were there to aid the region's Pygmy population, which had been moving out of the rain forests as civilization moved in.
Florisel, who Huff met in Honduras in 1999 and married later that year, was initially fearful. She had volunteered there before the couple had kids.
"It was good to all be together," she says. "But it's a tough area to live in ... you have to live with guards."
For a while, they resided in a jungle hotel with no running water and undependable electricity. He treated patients at an equally primitive hospital. The kids got to know the local children. His eldest, Natalia, communicated with them in French.
She was the first to come down with malaria, an often-fatal epidemic in sub-Saharan Africa. The entire family was stricken with the disease more than once during their 12 months there.
Malaria causes extreme flu-like symptoms, as well as blood loss and intense joint aches.
"I thought I was dying," Florisel says. "You can't compare the pain to anything, even childbirth."
The Huffs returned to Oregon a year early because of project funding cuts. It might have been for the best, as Pat began to question the motivations for the trip.
"We don't have the diseases back home they do here," Huff says. "There's not many things you have to face daily in the (United States) where you're saying, `are the kids going to live or die?'"
Huff put down his classical guitar and first picked up a banjo in the mid-1980s. He says he became inspired by the sound after hearing a bluegrass band at a wedding.
"I just thought this was real music," says Huff, who still jams periodically with members of the old Luckiamute River Band.
He started making his own instruments in 2003, and devised his own innovations, like the matched-grain pots and an ergonomic "frailing platform" that allows for easier strumming around the neck.
"This is therapy for me," Huff says.
Huff often returned from his travels with boards of exotic woods -- African wenge, Honduran rosita -- that find their way into his banjos. He jokes he has enough that he won't be able to use all of the wood in his lifetime.
Returning to the workshop after Cameroon was "intense" for the first few months, Huff says.
"I realized I've probably seen too much in my lifetime in field medicine, death, dying and tragedies," Huff says. "I don't have that urge to go overseas; it's like I got it out of my system."
Still, "it's been a big life," he says.
For more information on Pat Huff's banjo-making business, Doc's Banjos, call 503-831-1529 or visit www.docsbanjos.com.