Doing a world of good (Page 2)

Since its founding in 1971 by a group of French doctors who wanted to ensure the right to medical assistance for all individuals, Médecins Sans Frontières has also served as a witness to political, economic and religious conflicts, and the resulting suffering inflicted on innocent populations. The private organization now operates in 80 countries and has a staff around the world of 10,000. The charter of MSF, which all volunteers must respect, affirms that it will remain neutral, that it has the right to intervene and that it wants complete freedom of movement and access to endangered populations.

PHOTO: IAN BROWN

Marie-Eve's first long-term project took her to Abyei, a town in the government-controlled area of southern Sudan. The objective of the mission was to reopen the hospital and to provide health care services in a town where there was no doctor. The area included about 10,000 residents and another 10,000 or so refugees from the nearby war zones. Marie-Eve, a nurse and an MSF logistician, together with local medical staff, quickly had the hospital unit running again. They then faced the enormous task of trying to control epidemics of measles, cholera and borelliosis.

Many displaced people arrived at the hospital after weeks of walking through the woods with very little food or water, and no access to health care services. Many had contracted malaria and pneumonia. Some simply collapsed as they arrived.

"We had a small feeding centre operating within the hospital. We were able to treat everybody, the displaced as well as the people living in the town, and by doing this we showed it was possible to treat without discrimination, one of the principles of the Charter of MSF."

Unfortunately, when the rebels of the Sudanese People's Liberation Army encircled and attacked the town of Abyei, the MSF team was forced to evacu-ate to the capital city of Khartoum. "We had a bunker, which was basically a hole in the ground, so it was not enough protection. The hospital was located between the police and the military compound — two military targets — so there was absolutely no security for us. But leaving the people and local medical staff behind is never easy."

Governments can also create difficulties for the staff and the distressed populations they are trying to reach. When Marie-Eve left for Burundi in November 1998 as National Medical Coordinator, the relief program's goal — with the backing of the government — was to decrease the mortality from diseases and epidemics. Working in one isolated province, the team supported the local hospital and set up a therapeutic feeding centre for severely malnourished children, along with four supplementary centres for moderately malnourished children. There were also frequent outbreaks of malaria.

At the same time, in the capital city of Bujumbura, MSF ran and supervised another nutritional unit as well as a surgical centre. For Marie-Eve the responsibilities were numerous. "Part of my time was devoted to curative work. I was also on call for surgical emergencies. During the intense phase of the therapeutic feeding centre, I would do rounds. The rest of the time I followed up on the different programs, checking the quality of care given in the MSF structure. I measured regularly the effectiveness of our actions through evaluations, data analysis, and training of national and expatriate staff by providing technical information to the health workers. I was also the contact person between MSF and the Ministry of Health in Burundi, which meant attending meetings to clearly communicate our course of action."

Toward the end of the mission, the political situation in Bujumbura worsened. In order to control rebel activities, the government decided to force the people living in the hills around Bujumbura into camps. The MSF team struggled to combat malnutrition and disease among the 300,000 displaced people, but with severe restrictions imposed on their freedom to move around the camps, MSF had to make a decision. "For ethical reasons and lack of effectiveness, we decided to suspend our work at the camps after two months of intervention. It was not quite accepted by the government, but we were not making a big difference in the well-being of the people regrouped. We could not have any impact on the quality of life," she says.

But as one mission ends, another has already begun. As you read these lines, Marie-Eve will already have moved on to her next assignment. She will be learning a new language, adapting to a new culture, and once again saving lives in a town relieved to see the bright red and white flag of Médecins Sans Frontières soaring high above the hospital. This time in Baku, Azerbaijan.

			STAFF SURGEON AT MONTREAL'S QUEEN ELIZABETH HOSPITAL FOR 30 YEARS, NOW RETIRED. JOINED MSF IN 1996. SERVED IN: HAITI, BURUNDI, ETHIOPIA. The contribution made by Fred Wiegand, BA'56, MDCM'60, MSc'64, to MSF missions has been mainly as a trauma surgeon on four different assignments, and he has, he says, "loved every minute of it." He adds that his volunteer work has given him "absolutely indescribable gratification. The patients show such remarkable courage, resilience and gratitude, you come to realize what a profound honour it is to be their doctor." Wiegand wryly says he has first hand knowledge of some of the suffering faced by the people he and his colleagues treat in developing nations. "I got malaria during my MSF mission in Haiti -- the nice thing is you feel so badly, you actively hope you won't be alive the next morning, never mind worry about getting better!" Fred Wiegand on assignment in Ethiopia in January of this year. Wiegand says his "heart leapt" when the unexpected Nobel announcement was made, and adds that the work of volunteers and the thousands of local employees truly deserves the recognition. "Not only have I become extremely impressed with MSF as an organization, but it also attracts high performance individuals who are a delight to work with and live with. In addition, MSF consistently carries out meaningful projects in a timely and very cost-effective manner -- no wonder they won the 1999 Nobel Peace Prize. Some people feel that 'ideals' by definition should be unobtainable -- but in my experience MSF actually makes them happen. "In my view, and in the view of many others, providing international monetary aid (i.e., government to government) to under-advantaged nations has been largely discredited; nevertheless, I still believe in international medical aid, preferably non-governmental (i.e., grass roots to grass roots). And that's where MSF shines!"