I began working with Doctors Without Borders in 2008. My first mission was in a remote project in northwestern Ethiopia treating malnourished children, people with HIV infections and those suffering from a neglected parasitic infection known as kala-azar.
My journey to the field took a full week, culminating in a 10-hour, sweltering, cramped tractor ride through mud at a maximum speed of five kilometres an hour. A novel retention strategy, I thought: By the end of the ride, I cared little where I was dropped off so long as I got to get out, and I had little desire to leave via the same route any time in the near future.
I spent six months in the project, officially there to treat the illnesses mentioned above. In reality, we also provided care for a host of other ailments as we were next door to a sadly under-resourced and under-staffed Ministry of Health facility.
The staff, what few of them there were, knew they weren’t equipped to treat some of the more serious illnesses that presented, so these patients were sent to us: children with respiratory distress from pneumonia, women with complications of childbirth (though we were not a surgical facility, nor did we have the capacity to refer to one), the occasional knife wound from a dispute that turned violent.
At the time, I did not consider myself to be a “humanitarian.” I did, however, begin to reflect on my reasons for being there in the first place. I didn’t come up with much. “It’s really interesting. I get to work with such a wide range of people” seemed hollow and incomplete.
I returned to the field after the January, 2010, earthquake in Haiti. Following that, I adopted a rotating schedule in Canada and in the field, spending about half of each year abroad – Congo-Brazzaville (cut short by a scary medical evacuation for personal illness); northwest Pakistan for a high-security emergency mission in the heart of the “War on Terror”; the Central African Republic, with its grinding, almost unfathomable poverty; Haiti, again, to assist in co-ordinating the response to cholera, now sadly endemic in the country.
While other Canadians dream of holidays on a white sand beach, my thoughts drift toward war zones and droughts. Now, watching the news has a more personal side, as reports of violence in far-flung regions make me worry about friends and former colleagues.
What motivated me to embark on such a path? I am certainly asked that question often enough.
“Do you think you’re making a difference?” I am asked. “Do you think it does any good?” And the more cynical “Why do you bother?” And, of course: “Why don’t you spend your time helping people who need it here?”
It (mildly) distressed me that I couldn’t come up with a good reason, a succinct response. I certainly had no illusions that I was “saving the world.” Nor did I feel that I was responding to some spiritual or karmic desire to “do good for humanity.”
What was the drive? (Most certainly not the paycheque!) As well, those who have been on the receiving end of my field-based electronic rants know all too well that the challenges and difficulties of working in such contexts often threaten to overwhelm me.
Yet I return, time and again. The fatigue wears off, the frustration abates, and within several months of returning from the field, I am again drawn by the descriptions of conflict and disaster.
After a lot of thought, the explanation I have come to is this: Each of us has the capacity to contribute a small amount, or not, to the world while we are living in it.
In Africa, in Asia or in Canada, good that is put into the world is good that is put into the world. Period.
My work in the field brings perspective to my work in Canada, and vice versa, and makes me a better physician in both locations.
Sharing my experiences with medical colleagues and patients, on both sides of my career divide, broadens the awareness of each for the existence of the other.
If my work in a small community in northern Canada inspires someone to assist in bridging the gaps in health status between groups of Canadians, that is a success. If the same individual decides to focus her efforts internationally, that is also a success.
Does saving one child from pneumonia or one mother from dying in childbirth make a grand difference? It does to them.
And is doing nothing because one can only do a little a valid excuse to actually do nothing? It is not.
We have little understanding of the impacts of our actions, even those felt to be inconsequential. A child who doesn’t die of pneumonia or malaria will perhaps be afforded the chance to attend school, become a teacher and contribute to his community. A driver working in rural Pakistan who witnesses a female surgeon saving the life of his neighbour may rethink his attitude toward education for his daughters.
Optimistic? Yes, possibly overly so. Yet this is the response I give now when asked the inevitable “why?”
It’s a version of the quote of Edward Everett Hale: “I am only one, but I am one. I cannot do everything, but I can do something. And I will not let what I cannot do interfere with what I can do.”
And that’s why I’m a humanitarian.
AnneMarie Pegg lives, intermittently, in Yellowknife.
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