Brown Bag Lunch: Syria

Earlier there was a brown bag lunch to update the office about MSF's involvement in Syria.  There were three presenters: someone from the field, someone from HR, and someone from the advocacy department.  Syria is not a homogeneous region.  It is filled with rival religious sects, the Sunni being the majority and the Shiite being the minority.  In 2011, Syria erupted in a civil war that is still tearing the country apart today.  MSF was among the first NGOs to respond to the crisis and now has projects run by all five operation centers: Paris, Barcelona, Brussels, Geneva, and Amsterdam.  There are a number of risks that come with having missions in Syria.  It is said that "there is no safe place in Syria."   Kidnappings are common, there have been 20-30 in the past year, and it is not outlandish for MSF hospitals to be bombed or shot.  Foreign humanitarian work calls for a specific breed.  It requires those who are willing to leave their families, travel to a distant country and risk their lives all to save the life of a complete stranger.

Interview: Finance Department

Interviews are not easy! 
Filmed interviews are even harder! You have to prepare the questions, set up the camera, figure out how to work the mic, adjust lighting, and deal with background noise.


Yesterday I had my first interview with Mary Vonckx, the Grant Officer in the Finance Department.  I was really stressed in the hours leading up to the interview, but I think it went alright in the end.  The interview lasted forty-five minutes in all; I should probably trim down my question list for my next interview this afternoon!  Mary was great though!  She is so knowledgeable about the company, far beyond her basic job description.  We talked about what the finance department does, the funding structure of MSF USA, MSF USA's role in the global MSF movement, and what happens in surplus and deficit years.  Through this interview I learned that the finance department does a lot more that simply handle the money.  They have to figure out how to get the money to the field projects, which is not easy.  Sometimes the area in which a MSF project is being conducted is too dangerous or remote to wire money for supplies that men have to get in four-wheelers and drive to the project and deliver the money face-to-face.  This can put the lives of the carriers in serious danger.  This was my first interview of six.  I hope the rest of them go this smoothly!

The Positive Ladies Soccer Club

ARV SWALLOWS

To test HIV positive in an African country means...

...to be banished
...to be discriminated against
...to be abandoned by your husband
...to be beaten and blamed as if you did something wrong

... 'it is the equivalent to being given the death sentence.'

The film, The Positive Ladies Soccer Club, follows the development of a ladies soccer team in Zimbabwe.  Fourteen women, with the help of a male coach, ban together to form a soccer team to fight discrimination.  AIDS is not a commonly understood disease and there are a number of misconceptions that are made about those who are HIV positive.  You cannot catch AIDS.  The disease can only be transmitted through bodily fluids.  You are not at risk of contracting the disease by simply talking to someone who is HIV positive.  Unfortunately, this is not understood by citizens of developing countries, so they turn there backs on those who have the disease.  The women in the film joined the soccer team because they were in need of support.  Abandoned by loved ones, they had no one to turn to.  AIDS is a scary disease and the soccer team gave the women a support group to help each other through this scary time.  They entered the HIV Women's League as the underdogs and brought home the trophy at the end of the season.  "Before people laughed and scoffed at us, and now people follow us where ever we go," said Annafields, captain.  

RED ZONE: DETERMINING WHO NEEDS HELP FIRST

"Today, more than half of the deaths of children under the age of five are due to malnutrition- 6 million per year, 12 children every minute" (Doctors Without Borders Promotional material). 

Malnutrition affects about 200 million children across the world, mainly in sub-Saharan Africa and South Asia where access to nutritious food is close to impossible.  When MSF enters a village, devastated by famine, the volunteers take a MUAC- mid-upper-arm circumference- test using labeled wrist bands, seen in the picture above.

When famine strikes, children are the first to suffer from malnutrition.  MSF's focus on triage- treat those with the worst bodily state first- calls for a quick way to determine who should be treated first.  Volunteers can use the MUAC wrist bands to quickly assess the order in which patients should be attended to.

I was given a MUAC wrist band in my intern packet one the first day and I thought it was fake, because I couldn't imagine a child's forearm being that small.  Seeing this was the first time that I could begin to relate to the work that MSF does, and what the volunteers witness everyday by the thousands.  There is a difference between reading about suffering and seeing it first hand, and not until you experience it does it really become true to you, even though you might have thought it was before.  It affects you in a life altering way.

I'm going to bring back these tests and display them at my presentation so that everyone can experience what I did when I first saw the tests!

Quotes from the field

"This strange, inhospitable, impossible place that is now home for 15,000, 65,000, 115,000 people who had to run here.

I don't think about this a lot, because it seems like an impossible thought.  To try to understand what it might feel like to have no home to go to anymore.  The Ingessana are of their place, very much so.  I can't see it in the faces of the eyes of the people who I work with here, the people on my team who come from the refugee population.  Strangely, they seem happy, in such good spirits.  I'm confused by a lot of my staff actually.  If I was bombed out of my home, I would be shit mad, totally crushed."

-Imran (A MSF volunteer)  

http://doctorswithoutborders.tumblr.com/archive

Quotes from the field

"Medical aid is being targeted, hospitals destroyed, and medical personnel captured."

-MSF President Dr. Marie-Pierre Allié (Humanitarian standstill in Syria)

http://doctorswithoutborders.tumblr.com/archive

Quotes from the field

"I leave with a strange feeling inside; this is something totally exceptional for me, to see a human body in this state [bones splintered, muscles crushed].  To understand the challenges faced by the surgeons and medical team with each ase, to admire their skill, calmness and dedication to doing the best they possibly can for each and every patient.  I take my hat off to them."

-Ben King (Biomedical engineer)

http://doctorswithoutborders.tumblr.com/archive

Quotes from the field

"MSF did live up to its set purpose.  They were a friend, and not just any but one willing to risk the comforts and lives of their volunteers."

-Thanks from Port Harcourt

http://doctorswithoutborders.tumblr.com/archive

Quotes from the field

"I have never seen burn patients like we have had here over the winter.  Often the burn victims are, again, women and children, as the women prepare the meals over open flame stoves and the children play around their mothers.  We often had multiple victims from the same families.  While we do out best, we lost quite a few of the patients to infections or they were simply too badly burned to survive.  All we can do is provide sterile dressings, increased calorie foods, and hydration.  It has been hard to watch, and I am glad this season is pretty much behind us.

Certainly, the most difficult part of this mission, for me, has been the child deaths.  Of course, everyone dies, but I am not accustomed to so many pediatric deaths."

-Georgann (MSF nurse in Afghanistan)

http://doctorswithoutborders.tumblr.com/archive

Quotes from the field

"Life happens to you even when you work in the field.  In MSF you work to alleviate human suffering.  You strive to help and support people as much as possible, every day.  In the midst of this, it is easy to forget that you too are only human, that on occasions you too will need support."

-Minja (A mental health officer)

http://doctorswithoutborders.tumblr.com/archive

Battling a Measles Epidemic in Northeast Congo

Above is a video produced by MSF about a dangerous measles outbreak in the Democratic Republic of the Congo following a malaria epidemic.

Living in Emergency

Today my uncle gave me a project that I will be working on until I leave in two weeks.  I am creating a document comprised of MSF's videos and multimedia, powerpoints, books, reports and newsletters, merchandise, and social media that can then be added to the website under the public events tab.  This addition to the website will allow people to do their own screenings of MSF videos, or lead discussions about MSF's work.  The document is called "Share MSF With Your Community."  Along with creating the document, I am also watching a number of the films on the list to further familiarize myself with the organization.

I just finished watching the first film on the list, Living in Emergency.  This film is a heart wrenching documentary about three MSF doctors in Africa.  Two are in Liberia in 2003 after a 15 year long civil war working at Mamba Point Hospital, a MSF hospital, which, at the time, was the only free emergency hospital for a city of one million people.  The third doctor is in the Democratic Republic of Congo.

The film focuses on the impact that these missions place upon the doctors who volunteer.  The doctors describe the missions as being not what they expected, unimaginable, indescribable, rewarding, and draining.  "Thousands apply to MSF each year, but given the challenges of the work, MSF accepts very few volunteers.  From these few who are chosen, only a small number advances beyond their first mission" (Living in Emergency).  Being a doctor in the field is difficult for many reasons: the doctors come in at the very last minute to try and fix what should have been fixed years ago, they become responsible for far more than what they were responsible for in their home countries, there is no limit between what is personal and what is professional, they must know their personal limits as doctors, and they have to quickly decide when and when not to operate.  

Of all the previously stated difficulties, one trumps them all: being able to recognize when to leave.  When MSF decides to pull a mission out of a country, the doctors have to notify the natives.  The natives often feel they are being abandoned and beg the doctors not to leave.  MSF wants to help those in need, but is unequipped to fix the underlying social and political problems that cause and maintain crisis.  When the emergency and immediacy dies down, that is the indication that MSF's work is finished and it is time for them to move on.  Although, the end of crisis does not mean the end of suffering.  

Many doctors go abroad to fix people, but also to try to heal themselves.  MSF missions, and humanitarian work in general, change you and your priorities in one way or another.  It is what you do after your MSF mission that ultimately defines you.

"Doctors Without Borders and the Value of Life"

 

Last Thursday I attended a presentation at Fordham University given by Peter Redfield about his book, Life in Crisis: The Ethical Journey of Doctors Without Borders.  The presentation was open to the public but mainly consisted of Fordham students and MSF reps.  Redfield centered the talk around defining the 'value of life' and what it means to MSF.  He then displayed the following quote on the screen by Hannah Arendt: "For what matters today is not immortality of life, but that life is the highest good."  MSF believes that 'life is the highest good' and therefore will do whatever is humanly possible to save them.  

MSF was founded in 1971 as a French alternative to Red Cross.  It began as an emergency oriented relief organization and has more or less stayed true to its initial statutes, with the exception of the hospital that is being built in Haiti.  MSF works to save lives that are in crisis and therefore does not pick and choose which life to save based on age, social standing, genders, or defining characteristics.   In the field the doctors are constantly in a state of triage where patients are treated based on their bodily state.  

Redfield described MSF to be anti-utilitarian, to possess egalitarian ethos, and to have realist problems of limits.  "Life is a categorical value and cannot be sacrificed for anything," said Redfield, articulating MSF's moral philosophy on saving lives. 

MSF has often been criticized for being palliative.  It is geared towards short term relief instead of long term development.  This has to do with limited resources, both manpower and medical supplies, a focused mission centered around crisis relief, and the fact that there are other organizations whose main goal is to train the locals or build hospitals in developing countries.  

This presentation was great! It taught me some basics about the company but focused on why MSF does the work that it does, which was really what I wanted to know.  I hope to attend more presentations like this during the rest of my project!

Indian Supreme Court rejects Novartis Patent Case

Monday April 1, 2013 was my first day of work at MSF.  It was also a landmark day in the International Health Care World as the Indian Supreme Court rejected the Novartis Patent Case.  When I first entered the office I could tell something was going on.  Men and women were running in and out of colleagues' offices notifying them of the triumphant news.  

Novartis created a new version of the cancer medicine, Glivec, and tried to patent it.  Novartis was denied this attempt because it violated Section 3(d) of India's patent law.  Section 3(d) states that patents will not be granted for modifications of preexisting drugs, only for truly "genuine inventions" according to an article in the Huffington Post.  In a MSF press release Dr. Unni Karunakara, MSF's international president said, “This is a huge relief for the millions of patients and doctors in developing countries who depend on affordable medicines from India, and for treatment providers like MSF.  The Supreme Court's decision now makes patents on the medicines that we desperately need less likely. This marks the strongest possible signal to Novartis and other multinational pharmaceutical companies that they should stop seeking to attack the Indian patent law.” 

The Novartis case brought the publicity that MSF needed to educate ordinary citizens of the wrongs they are trying to right.  

Why did I choose the project I did?

I decided to work at a non profit humanitarian organization for my senior project because of my grandfather.  My grandfather spent his professional life working as a cardiovascular surgeon at the St. Thomas hospital in Nashville, Tennessee and a small hospital in Bosobe, Democratic Republic of the Congo.  He and his wife would travel to Bosobe two or three times a year, over the duration of thirty-five years, for about a month long to check on the hospital and to deliver boxes, weighing up to seventy-five pounds each, of medical supplies.  He strove to be "a doctor where there was no doctor."  My grandparents first travelled to Bosobe in 1969 to work at a Swedish hospital.  When they arrived they realized that the 'hospital' that they were supposed to work at was nothing more than a building with two Swedish nurses.  It seemed as if the people they were to come and take over for, and who had supposedly been there for two years, had never shown up.  They quickly realized that things in the Congo were much worse than they had allowed their expectations to believe, and if they were going to make a difference they would have to take matters into their own hands.

Hearing stories about my grandparents' adventures in Bosobe as a child, and still today, made me want to do something to help those less fortunate than I.  Doctors Without Borders (MSF) is an amazing relief organization that does just that.  MSF goes into disaster zones to give aide to those who would not otherwise receive it.  MSF does more than just give aide; they also speak out about the wrongs they see.  While in the field the doctors and volunteers see first hand the hatred and mistreatment of the poor.  These wrongs are then exploited when the doctors and volunteers return to MSF's main offices in the States, Paris, Belgium, and a number of other countries.  "Speaking out is not only part of MSF's identity, it is part and parcel of MSF's credibility."  (A Way Forward (2010)).

I look forward to learning more about MSF throughout my project!