A Story from Somalia

The following is an excerpt from James Orbinski’s An Imperfect Offering.  I’ve just begun the book, and I’m intrigued to read more of what he has to say: both of the extremely despairing and beautiful, his work as a humanitarian doctor, and his views on politics.

Here, Orbinski describes his first act as a humanitarian doctor.  In October 1992, after arriving in Baidoa, Somalia (known at the time as the City of Death), assigned as MSF’s (Médecins Sans Frontières/Doctors Without Borders) medical coordinator, he noticed some movement within one of the morgue tents.  After first turning away and not wanting to know what this could mean, he looked and saw that the wind was strong enough to move a tent flap.  But then the man’s eyes fluttered.  He was laying among the dead.

He weighed less than 70 pounds, and I thought him light as I tried to catch his arm from falling.  I did this without thinking.  I acted not as I thought I should but as I had no choice but to do.

All the beds inside the medical tent were taken, so I laid him on the ground.  A helper put a blanket over him.  She was irritated and told me impatiently that he had been moved to the morgue because there was not enough time or people to look after all of the patients, and in any case, he was going to die anyway.  At that moment, I felt rage at the efficiency of placing the living among the dead.  And I felt despair – for him, for myself.  I could be him, dependent on the actions of a stranger for the hope of at least dignity in death.

His eyes opened and closed.  He shivered under the blanket, and soon he was dead.  This was the last violated remnant of a fuller life.  I didn’t even know his name, but I knew he had been someone’s son, someone’s friend and possibly someone’s husband, someone’s father.  What choices led to civil war and famine, leaving hundreds of thousands of people like this man to suffer in this way, at this time, in the last decade of the twentieth century.

These kinds of stories are atrocious.  But they also must be told.  For our world is filled with choices, Orbinski sees humanitarianism “as a challenge to political choices that too often kill or allow others to be killed”.  If we do not know the effects of such choices – the real life stories of people and their communities – we have little motivation to change political choices, to raise our voice, to speak out against injustice, violence, dehumanization, or genocide.

Dr. James Orbinski, and the documentary “Triage”

Click the link for the full film: http://www.nfb.ca/film/triage-trailer/ *

It was an honour today to hear Dr. James Orbinski in my lecture today.  After hearing him, I felt compelled to do some research on him and came across the film Triage, linked above.

(for a brief bio, scroll to the bottom of the post)

Watching the film was not always easy, but I would say it’s a must-watch.  It ought to be noted that it must be approached with reverence — his journey is eye-opening, traumatizing, beautiful, and very real.  It’s fascinating to see him revisit the places he served, to see some people/patients who remembered him, and his old friends.  It’s troubling to see some of the damage that was done, along with the ignorance of a new hospital executive who had no idea of what occurred in Kigali and the state of the hospital during the genocide.

I don’t have regrets about the decisions [I had to make], I have complete outrage at the circumstances in which these decisions had to be made.  I still have, and I always will I think, a nearly uncontainable rage about what happened in Rwanda, in Somalia and in many other parts of the world and about what’s happening now in many parts of the world. To see mothers and fathers and children dying of indifference, dying of neglect, of abuse, of somebody’s political calculation, that that doesn’t matter. It fills me first of all with just profound sorrow that they have to live that and die it. And then it fills me with rage, frankly. And the question then is what do you do? What do you do with that?

He ends the film with these remarks:

On a personal level, I’m definitely writing for my children. I want them to know who their father is.  How I have really struggled to live in a way I think is right and that I feel is right, and I want them to understand there’s no perfect answer.  But there’s the right question, and theres a right way to live your question, and a right way therefore  to live your life.

There are so many crucial issues that have to be addressed: global warming, the war on terror, the use of torture, just a litany of issues. None of these issues will be addressed unless we take our responsibility as human beings and from a place that respects the dignity of others – including our enemies.  And I think this becomes more and more clear to me with each passing day.  This is the lens, this is the way with which to see the world.

He has witnessed the worst of what mankind can do: famine, epidemics of preventable diseases, war and its crimes, and genocide; political failure and the struggle to be fully human when it does; an endless catalogue of terrors, and in these things seeing himself, knowing that he might be merely a spectator to them, that he might suffer them, collaborate with or inflict them on others.

Watch the film, let me know what you think.

Other information on Dr. Orbinski:

His work with Médecins Sans Frontières (MSF, or Doctors Without Borders) began in 1992, where he worked in Baidoa, Somalia during the civil war and famine,  in Goma, Zaire (Congo) with Rwandan refugees in 1996; and in Kigali, Rwanda, during the genocide as Head of Mission for MSF.

He then became the president of MSF in 1998 until 2001 and accepted the Nobel Peace Prize in 1999 on behalf of the organization.

From 2001-2004 he co-chaired the working group which created and launched the Drugs for Neglected Diseases Initiative (DNDi): a global not-for-profit drug development organization that develops medicines and other health technologies for diseases largely neglected by profit driven research and development companies.

Dr. Orbinski is a founding board member of the Global Alliance for TB Drug Development, and the Stephen Lewis Foundation and Canadian Doctors for Medicare He is a founding member of the editorial boards of Open Medicine and Conflict and Health, two new independent, peer-reviewed open access on-line medical journals that are committed to the best science and that see health in its larger political and human context. He also sits on the editorial board of Ars Medica, a new journal that explores the interface between the arts and medicine, and examines what makes medicine an art. (info from National Speakers Bureau)

He is now an associate professor of medicine and political science at the University of Toronto.  He is also a Senior Fellow at the U of T’s Massey College, and at the Munk Centre for International Studies where he is focusing on Global Health and international affairs.

* National Film Board of Canada = awesome.