My first mission with MSF was to Turkmenistan, where I worked on a tuberculosis (TB) program for one year. Turkmenistan has an endemic rate of tuberculosis, with emerging multi-drug resistant TB. At the time of my mission, MSF had started the first TB DOTS (Directly Observed Treatment Short-term) program in the country. Official Ministry of Health data indicated a significantly greater incidence of tuberculosis, asthma and hypertension specifically in the Aral Sea region. Many experts believed that the increased incidence of certain diseases in that region was directly related to the poor air quality, caused by frequent toxic dust storms, as well as extremely polluted water. Fortunately, with the DOTS program in place, MSF noted promising cure and program completion rates. It was especially rewarding to see previously chronically ill patients with TB discharged home to their families, fully completely cured of the disease.
The following year, I was sent on mission to Zambia to assist refugees escaping war in Angola. Working in a refugee camp setting was completely different from working in the organized DOTS program. I remember one particular experience when I felt completely impotent when a two-month- old child choked on a piece of dried maize. We didn’t have the equipment to assist her and even my effort to perform a cricothyroidotomy was unsuccessful. In the end, the baby died in my arms.
Working with refugees also created incredibly rewarding experiences. The refugees in the camp were kind people, and showed unbelievable strength and hope they would one day have better living conditions. Many were highly educated and hardworking. They rarely complained about their difficult situation: they ate meals of maize, salt, oil and beans distributed by the World Food Programmeme (WFP), they had only plastic sheeting for shelter and waited long hours for their medical consultations in the camp. Most amazingly, I met people who found happiness in their lives despite their poverty, the same way Canadians can find happiness in their own country.
In 2002 I was sent to the Ivory Coast where I worked as a doctor in a primary health- care unit in rebel territory. This was also a challenging setting to work in. In this particular project we were frustrated by the fact that we couldn’t transport patients to a nearby hospital at night due to the tense security situation. One night, we had a patient who presented a complicated intrauterine pregnancy. Due to the night-time insecurity we were forced to wait until six a.m. to transfer the mother safely to the hospital, despite the fact she was at great risk of rupturing her uterus. Although the baby died in the end, we managed to transfer the mother in time to save her life.
There is no doubt that MSF work is challenging: the limited resources in some settings, the insecure climate in others, the long hours of work. Yet one of the great gifts of MSF is the opportunity to meet new and interesting people – people such as the inspiring and resilient national staff and patients, and the volunteers recruited from dozens of countries around the world – and the opportunity to share incredible life-changing experiences while working in completely different cultural settings around the world.
It is a reality that there are countless individuals in this world who do not have access or have little access to health care through no fault of their own. MSF has opened my eyes to how fortunate we are in Canada and has given me a deep awareness of global issues. In the end, you will receive and learn much more from the people you work with than you may ever give them.