Living in Emergency: Stories of Doctors Without Borders

The most recent Friends of MSF film screening was, quite literally, packed out. Audience members perched on windowsills and pressed up against walls to see Mark Hopkins’ 2009 documentary, Living in Emergency: Stories of Doctors Without Borders. The first of its kind, the film records the everyday experiences of individual doctors working for the French NGO Médecins Sans Frontières (MSF) or Doctors without Borders. The challenges these doctors face over the course of their six-month missions shed new light on the grim nature of the crisis situations that regularly attract MSF emergency aid services.

The film focuses on the MSF missions to Liberia and Eastern DRC. The Monrovia medical centre is one of the only hospitals in the Liberian capital, offering medical services to a population of over one million in a city still recovering from a recent civil war. The situation in the DRC is no less fraught. The clinic is located in an area plagued by ongoing rebel violence. Patients suffering from gunshot wounds are a common sight.

Doctors out on their first mission struggle to cope with their new responsibilities. A surgeon flown in from Tennessee describes his arrival in the Monrovia hospital as ‘a shock’, adding, ‘you can’t describe the smells, the smell of puss, […] the smell of your own panic’. Medical cases that might attract the attention of half a dozen specialists in an American hospital are entrusted to a single doctor. The cases themselves are also more daunting. One doctor comments, ‘everything is supersized here in terms of severity’.

Adding to the pressure is a sense of inadequacy. Faced with a woman suffering from a punctured womb, a man with a bullet wound in the side of his head, or a boy with a gangrenous leg, doctors continually have to make do with limited supplies and little assistance. In a vexed tone, one doctor protests, ‘it’s low-grade medicine. We compromise in the way we do medicine’.

Given the stress doctors are subjected to, the 24/7 shifts, it is not surprising that many do not return to MSF for a second mission. Nevertheless, despite the fear, the frustration, and the burn out, doctors are rewarded with the sense that ‘what you do makes more of a difference’. You may be the ‘first doctor someone has seen in 27 years’.

This immediate, on-the-ground assistance is also what distinguishes MSF from other aid organizations. An Australian doctor stationed in the Congo, ensconced in a late night, beer-fuelled discussion, refers to organizations like UNICEF with derision. He contrasts the official aid donor approach of endless meetings, principled discussions and noble rhetoric with the hands-on, patient-by-patient relief provided by MSF in disaster-torn areas. While some aid initiatives get swallowed up in byzantine administrative processes, MSF is forever responding to acute cases of individual, human need.

There are, nonetheless, drawbacks to MSF missions, most notably and, at times, painfully, their limited duration. As an emergency aid organization, MSF acts in moments of crisis. When the crisis-situation subsides, MSF must move on. There is no ensuring, however, that an adequate health system will be there to pick up where MSF leaves off. Part of the NGO’s work, therefore, involves negotiating with local Ministries of Health to develop some kind of long-term healthcare plan. The results from these efforts are often unsatisfactory. In the end, patients receive treatments, but so many more are left waiting.

By Michaela Collord ~ 11 November 2010

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Links

To find out more about the film and to watch the trailer, visit http://www.livinginemergency.com/

The screening was hosted by Cambridge University Friends of MSF – for more information about the society, visit their Facebook group.

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