Breaking borders mending lives
From field hospitals to sprawling refugee camps, humanitarian aid organisation Médecins Sans Frontières operates in some of the world’s most dangerous places
I can’t stop staring at the blood seeping into a tube stretching from the bandaged wound on the little girl’s head as she hands me her drawing. Dressed all in pink, she watches with saucer-like black eyes as I run my fingers over the crudely coloured flag. She points at the blocks of red, white and black and explains, in rapid Arabic, that it’s the flag of Yemen, the war-cursed place where she suffered catastrophic injuries in an explosion last year.
Using the international language of smiles and silly hand gestures, I tell her how brilliant the picture is while a team of plastic surgeons from Médecins Sans Frontières (MSF) whisper nearby about the next phase of treatment needed to rebuild her badly scarred face.
Her younger brother, who almost never leaves her side, is also bound for the operating table and needs a prosthetic ear to replace the one he lost in the same blast.
A grizzled Iraqi man shuffles up and pushes another picture into my hand. It’s black, red and white too, but he didn’t draw it. It’s a photograph of his mangled arm, taken minutes after he was caught up in a bomb attack last year. The image is all black scorch marks, white bone fragments and blood. But that was then. Now he holds up the arm with a smile. The bomb’s impact remains painfully evident but, as he tells me, at least he still has most of the limb. If it weren’t for MSF, it would have been lost.
The French section of the Nobel Peace Prize-winning NGO occupies one floor of this Red Cross hospital in the Jordanian capital Amman, where it performs reconstructive and orthopaedic surgery on victims of conflicts across the Middle East.
Such is the enduring nature of the violence that MSF is building its own hospital in the city later this year.
When MSF opened its Jordanian mission a decade ago it was primarily to help the war-wounded from Iraq, Yemen and Afghanistan. But as the broken-body count from these countries started falling slightly in 2011, an equally bloody conflict erupted 100km away in Syria.
Since the uprising against Bashar al-Assad’s regime began, more than 150,000 people have been killed and countless more maimed. About 2.5 million civilians have fled to neighbouring countries, while almost 10 million have been internally displaced. Almost 200,000 people have simply disappeared.
MSF is bound by its charter to be apolitical to give it better access to all victims, but it still has licence to highlight the horrors it witnesses. It alerted the world to the use of chemical weapons in the Syrian conflict last year and was quick to identify the particularly savage nature of the war. Explosive-stuffed barrels indiscriminately dropping from helicopters, and mortar and shells levelling towns and forcing survivors into desert landscapes pock-marked by landmines, have led to blast injuries on a scale that has shocked many MSF veterans.
And MSF veterans are hard to shock. By any measure it’s a hardcore NGO and one always seen racing towards catastrophes as others flee them. In recent weeks the Ebola virus has spread through western Africa, killing hundreds. But instead of pulling out or restricting its missions there, MSF expanded them.
It is the same story in the Central African Republic, where it continues to run field hospitals as a bloody civil war intensifies. And it was the same in Rwanda, the Democratic Republic of Congo, Haiti, Sudan, Iraq, Afghanistan and hundreds of other black spots where MSF’s people have put themselves since 1971 when a group of French doctors and journalists came together to do something in response to the Biafra crisis in Nigeria.
The first MSF mission I visit in Jordan is in the once-sleepy town of Ramtha, two kilometres from the Syrian border. The town is not so sleepy now. Hours before we arrive, three stray shells intended for the conflict zone landed on its outskirts, and the dull but deadly drone of war is a constant soundtrack. “We can be sitting on the balcony in the expat house having a drink after work when we hear the bombs going off. It’s a real buzz-kill,” one MSF veteran tells me. It sounds glib – even callous – but it’s not. It’s just a fact.
MSF’s project co-ordinator here is American nurse Michelle Mays. She is also in charge of the MSF hospital in the sprawling Zaatari refugee camp nearby and has responsibility for more than 100 medics and logistics experts. It’s a lot to heap on the shoulders of someone in her early 30s, but Mays wears the burden lightly. “You’ve arrived at a very stressful time,” she tells me breezily as we are introduced.
For the next three hours she’s run ragged putting out metaphorical fires, but she stays breezy throughout.
“My family tell me MSF has made me more relaxed,” she laughs. “I think you have to be. You can’t be stressing the little things. This posting is less dangerous than others, maybe because we’re not in the middle of the conflict. But that brings stresses of its own. It’s hard to be outside the conflict. We’re used to going into the field to find the wounded but we can’t do that. We have to wait for them to be brought to us. That can be frustrating.”
Mays is on her fourth mission, having served previously in sub-Saharan Africa and Haiti. What compels her to keep returning to the field? “I studied nursing but didn’t want to play a traditional role. And I had an interest in international conflict resolution so this seemed like an obvious choice,” she says.
“It can be hard to carry on sometimes but also hard to stop. When you go home you love the peace and the quiet and the fact that there are no bombs going off, no calls in the middle of the night, but then you start to miss it. Sometimes I wish I could find an excuse to stay at home.”
The mechanics of medical practice here are simple enough. Syrian field hospitals, staffed largely by MSF’s local teams, treat patients as best they can, with some of the most seriously wounded winding up in Ramtha. They are first brought to an ER run by the Jordanian health department and if they meet MSF criteria they are transferred across a car park on rattling trolleys to its self-contained wing. Broadly speaking, MSF criteria means war wounds from the chest down. Amputations and shattered bones have become a speciality.