The Doctor is Out

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The essence of MSF work is emergency, and 'hospitals' are makeshift affairs at best. 'Once a situation is stabilized, we hand it on to other organizations,' says a nurse. At Little Wall Camp on the Zairean border, an abandoned warehouse has been converted into a temporary hospital; its unpaved 'floor' consists of lumps of dusty volcanic rock awash in muddy puddles. Outside is the now-empty refugee camp; 16 corpses are pulled from its tents.

An assistant methodically walks up and down each aisle, spraying a cloud of disinfectant from a converted European garden-herbicide sprayer. A 10-year-old girl, abandoned by her parents, will not eat. An MSF press officer says the child 'wishes to die,' but he coaxes her until she reluctantly takes a mouthful. He estimates the organization is giving 1,000 oral rehydrations and 200 intravenous drips each day on this short stretch of road.

People regard MSFers with awe --or bewilderment. They see women and men who abandon comfortable sinecures in Canada and Europe to heal the sick, often under savage conditions: tormented by extremes of heat or cold, bitten by poisonous snakes and insects. They calmly go about their business in the midst of Third World genocides, plagues, famines, and floods, dispatching colleagues to new posts with the traditional adieu: 'Have fun!' They might have dry toast and coffee for breakfast and a hurried meal in the evening, then sleep for a few hours before returning to work the following morning fueled only by more coffee and toast. All this for an airline ticket, room and board, and a few hundred dollars each month.

The workers are sometimes stricken with malaria or diarrhea, and they run the risk of contracting typhoid and cholera. From Chechnya to Yugoslavia, Rwanda to Cambodia, they increasingly are targets for local death squads, as political factions begin to see them as useful pawns in the political process and as dangerous witnesses to their activities.

It is only natural for us to see people who voluntarily embrace such hazards as heroes or saints pursuing private, perhaps mystical, visions. But MSFers themselves are ambivalent about their image. Frank, a Canadian M.D. who often walked alone and unarmed into the Zairean jungle with his medical kit on his back, remembers being held captive for three hours while drunken militiamen fought over the soap he carried in his backpack. 'What am I doing here?' he asked himself. 'I'm catching the next plane home.' But as the adrenaline and the shaking fear left his body, so did the desire to abandon his mission. Jean, another Canadian physician, recalled the time she and some other women medical workers in a Kurdish refugee camp in Turkey overheard Turkish army soldiers planning to break down their doors and rape them. The women shouted and made tough, angry noises, she recalled, then added, 'Well, they were just going to rape us, not kill us.'

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