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Working with extraordinary people

As the Chairman of Medicins Sans Frontieres/Doctors without Borders, I am privileged to work alongside a whole range of committed volunteers who support so many people all over the world. At the last count, we have over 35,000 people in our organisation and around 90 per cent of those are nationals living and working in their home countries. We have an amazing group of young people from the UK who take time off at the early stages of their careers in medicine and nursing to develop their skills and respond to a crisis. Around 35 per cent of people in the field working for MSF are on their first mission and the remainder are those who have chosen to come back for more. Some people will do dozens of missions for us in their careers.

A growing number of so-called ‘dinosaurs’ who are medical doctors, surgeons and nurses reaching the end of their careers, are also joining MSF to contribute their skills and experience. These older professionals are well placed to deal with challenging missions which require maturity. They often cope when things aren’t going so well and can act as mentors.

I should know because I joined MSF in 2005 when I had already retired from the NHS in my sixties and I was at the end of my career in clinical practice. It seemed wrong not to try and relieve some of the misery in the world.

As a ‘dinosaur’, I found myself dealing with emergency situations in difficult areas. In certain patriarchal cultures where advancing age is held in high esteem, my task included growing out my grey beard to show respect to local elders. This can open doors to government ministers and local warlords when other avenues are firmly closed.

I started off working in surgery, maternal health and infectious disease prevention in countries including Burundi, Congo and Somalia before becoming one of MSF’s senior surgical advisers in 2008. In this role, I helped implement emergency surgical projects on the ground in Haiti within a week of the earthquake there in 2010. That taught me a lot about the realities of working in crisis zones. At the beginning of the mission, we didn’t have enough basic drugs and I had to surgically amputate a young girl’s leg with only local anaesthetic. It wasn’t technically difficult but to do that on a conscious child was a challenge.

War zones have the added complication that hospitals and medics can come under attack. We go to great lengths to protect our teams and our partners and clearly, if the situation is too dangerous, we can’t work in certain areas. What is new, unfortunately, is that we, along with organisations like the Red Cross, are becoming very vulnerable to aerial bombings from 35,000 feet up. The US airforce bombed our treatment centre in Afghanistan in October 2015 and our clinics in the Yemen have been targeted repeatedly. We have launched a campaign to get the UN Security Council to recognise the safety of patients in hospitals but many competing factions now see hospitals as legitimate targets. We are constantly reassessing the situation for our people in locations like Syria, Iraq and Somalia.

The risks are there but the rewards can be incredible, both in terms of working with amazing teams and seeing what a dramatic difference you can make. For many people, a mission with MSF is a life-changing experience. We would like to see more applications from nurses, particularly those who have a background in infectious diseases, HIV and maternity. It is always great if someone has a smattering of  Spanish or French. We need family doctors, orthopaedic trainees, obstetricians in their 2nd or 3rd year as well as mature surgeon and trauma doctors. However, if you are someone who doesn’t want to get your feet wet on a camping weekend in Wales, this probably isn’t an option for you. Conditions can be basic and electricity may not always be available. We eat what the locals eat, whether that is boiled rice or bean stew. In many places, we have to fly fuel in.

The Department of Health is keen to make it easier for more people to take time out of their regular jobs and work for voluntary organisations like MSF.  It’s not easy and we do hear about people who simply can’t get permission to do a three-month stint with us. I’m optimistic that we are moving forwards and everyone realises that doctors who hone their skills with MSF can bring these benefits back to the NHS.


Dr Paul McMaster
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