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

Sat, Jun 21, 2014, 01:00

On the hospital steps, two staff stand smoking. Maybe it’s the price of cigarettes – a pack costs just over a euro – or maybe it’s the stress, but most MSF staff chain-smoke on mission. These smokers are reminiscing about a man in his 40s they cared for recently. As he recovered from a blast injury, he joked about marrying three staff members. One of them stops suddenly. “Oh but his story ends sadly,” she says. “When he was discharged he returned to his village and was shot dead. I don’t know why.”

They fall silent and finish their cigarettes.

As they do, a little boy is carried past in the arms of a nurse. Both are laughing. The boy’s mother is a few steps further back, carrying a plastic bag of clothes and teddies. She isn’t laughing. Her face is creased with worry. She is bringing her child to their new refugee camp “home”.

The boy has a metal brace attached to one of his legs. It looks crude but is anything but. It is an external fixator and is needed when a bone has been broken into too many pieces for the doctors to set it using conventional methods. Put simply, bone fragments are bolted to the external structure and, given enough time, they should fuse. Half the people in the MSF ward have external fixators attached to one or more limbs. Those who don’t are missing limbs.

Dr Kul Deep is an Indian orthopaedic surgeon working with MSF for a month, as he does every year. It seems like a strange choice for a holiday? He laughs. “It’s different to my regular work. I swap the stresses of my day-to-day job for these stresses once a year and go home with my battery fully charged.” Like many of the medics, he enjoys the challenge of the work and the complexity of the cases.

Luis Eguiluz is chief logistician with the Dutch mission in Amman and oversees staff accommodation, transportation and the medical supply chain. When terrible things happen anywhere in the world, people like Eguiluz are the first on the ground establishing the supply lines needed for medics to do their job. He has been working with MSF for more than 10 years. “The biggest challenge here isn’t supplies but the complexity of the injuries,” he explains.

“It’s not what we’re used to. We’re talking about very advanced weaponry so the level of human destruction is very high.”

Why has he given his life to this? Eguiluz pauses before answering. “I don’t know. As humanitarians we’re dreamers maybe?”

He talks of dreamers, but his world can be a place of nightmares. “It’s frightening sometimes, for sure, but that fear is something you learn to deal with,” he says.

Eguiluz’s wife also works in the humanitarian field and they travel together with their children. He was in the Central African Republic during last year’s coup and managed to get his family out hours before the MSF compound was stormed by militia. He and 15 staff were trapped inside.

“They ransacked the place and I had Kalashnikovs pointed at my head. But it wasn’t the first time for me,” he says without bravado.

“I knew what to do. They wanted our cars so I just told them to take them. This is what you need to do in such situations. My job was to protect my staff. You don’t know the level of anger these guys have and, in many cases, the cost of a human life is nothing. You just have to get them out of the place. So you give them whatever they want. The only thing I asked was that they take the MSF stickers off the cars. I didn’t want them killing people in cars carrying our name.”

They said no.

Ahmed, one of the NGO’s drivers, bounces into the courtyard where Eguiluz sits smoking. “I hope you don’t write about drugs,” he says by way of introduction. “Then you will get killed.”

I look alarmed. He smiles. “You know, like that woman journalist who was shot in your country by the men on the motorbike? She was writing about their drugs. It was a great film.” Veronica Guerin is his only connection with Ireland.

Sharon Mealy has a few more. She is 39 and from Kilkenny, although it has been years since she called it home. She is a supply consultant on her fourth mission. “I like how MSF works and how it stays where it is needed most for as long as it is needed,” she says as she sips black Barry’s tea and cradles rashers that have just been hand-delivered by an Irish colleague. “They’re not illegal here but it’s hard to get good ones,” she laughs.

Then the laughing stops. “This work can get you down sometimes but you have to realise that, if you weren’t here, the lives of some people would be so much worse. We are affecting change on a small level but we are still affecting change. We’re not trying to fix all the problems in the world. We can’t do that. But we can help some people.”

Some of those MSF is helping are on hospital beds in the desert an hour’s drive from Amman. In less than three years the Zaatari refugee camp has grown from nothing into a massive city of barbed wire, tents and tension. There are more than 100,000 people living behind a perimeter patrolled by heavily armed Jordanian soldiers. The MSF car is waved through the gates as new arrivals trudge miserably along the dusty paths leading to the United Nations reception centre. Military jets fly low overhead and the burr of helicopters is constant.

It is midday and the camp is quiet. The dusty streets are filled with children walking home from school with sky-blue Unicef rucksacks on their backs. It is not always this calm. Last month a refugee was killed and dozens more injured in clashes with Jordanian forces. The influence of criminal gangs is growing and aid workers are often confronted by hostile refugees driven to the edge of reason by displacement.

MSF’s hospital is protected by razor wire but, despite the hostile backdrop, calmness reigns. “One of our core principles is to try and restore a person’s dignity, and that can be done through simple things like privacy in the dressing station or a clean ward or something as simple as a basketball hoop,” Mays says as we walk through the unit.

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