Doctors Without Borders: Reminding Us of a Stark Reality

Dr. Unni Karunakara

Martha Dale, director of China programs, Yale GHLI

As Dr. Unni Karunakara, international president of Médecins Sans Frontières (Doctors Without Borders), spoke recently as part of the Global Health Leadership Institute’s Spotlight Series at Yale about the 40-year history of MSF, I was transported back to the comfort of my living room where such humanitarian relief efforts were terrifying images thousands of miles away projected on TV screens or displayed in the paper.

When at first exposed to the stories of children starving in Biafra (reason enough to clean my plate in the early 1970s); Pol Pot’s slaughter of Cambodians and the resulting refugees crisis (genocide in real time); or the famine in Ethiopia of the 1980s the imagery soon becomes a lasting memory. As we become witness to more of these tragic events, it seems that our conscience inured and our capacity to react dulled. I checked-off from my mental record the list of countries and humanitarian disasters that rolled by during Dr. Karunakara’s slide presentation – each a stunning photographic portrait of victims of famine, genocide, natural disasters, armed conflict - in Somalia, Sudan, Liberia, Chechnya, Afghanistan, Rwanda, Haiti, Central America, Japan and more. Yet, this same timeline of disasters has been matched by unparalleled heroic efforts by MSF volunteers who embrace these events as opportunities for “action in the presence of failure,” providing assistance to people in their greatest time of need.

I realized then, as citizens of the world we have grown far too accustomed to assuming that violence, neglect or catastrophes will forever be present. The world is better for having MSF with its dual goals of providing humanitarian medical assistance as well as bearing witness - by speaking out to bring attention to these crises. Organizations such as Yale GHLI work in succession with MSF and other agencies providing humanitarian relief work and to help rebuild over the longer term infrastructure and systems for sustained health care delivery. And to our best ability we must all be both witnesses of and responders to human suffering.

Leaving Ghana

Rebecca Distler,
GHLI Student Fellow

September 2011

When I went in for my last day of work in Ghana on August 12th, it didn’t feel like my last day. I was still trying to finish the in-service training manual I had been working on all summer and was still setting up meetings -- even though I wouldn’t be there for them. I was thinking about the progress I had made on the national service policy. But I definitely wasn’t thinking about saying goodbye. So I was horribly shocked to find that when I arrived on Friday, most of the people in my office were all away for a conference. That’s when it started to sink in – that I might never see these people again.

If there is one thing I learned in Ghana, it is the importance of showing up. On Monday morning, a mere 10 hours before I was to fly out of the country, I had a friend drive me to a hotel about an hour outside of the city, where I waited outside the conference meeting room to track down my office mates on their lunch break. When I saw Dr. Nyonator, one of the delegates, he proudly and jokingly introduced me as his “daughter”. I got to give necklaces to the secretaries, shake the men’s hands and exchange e-mail addresses. But most importantly, I got to say goodbye.

I loved my work in Ghana, but what truly made the experience was the people. I could not have asked for a better summer, could not ask for better friends or colleagues. And what I’ve learned is that it is not enough to love what you do – that’s important, yes. But it is also important to be inspired by and challenged by the people you work with. And it is important to always show up, to demonstrate not only your respect but also your true friendship. It is the Ghanaian way, and I think it will also become my way too.

Leaving South Africa

Ryan Park,

GHLI Student Fellow
September 2011

Coming home to be met by Hurricane Irene and the frantic pace of senior year only solidified my feelings of missing South Africa. Though I left South Africa at a time when my work was just starting picking up speed, I’m very proud of what I was able to help the delegation accomplish. We’re working with two private organizations, BroadReach Health Care and Foundation for Professional Development, to provide training, mentorship, and resources to facility-level health care managers and leaders. Programs will start in the next month in two districts in KwaZulu-Natal and several areas of Gauteng. Since these programs address an area of critical need for South Africa, everyone involved is extremely hopeful that they will have a large impact on maternal and child deaths and on the strength and efficiency of the health system overall.

I’m incredibly grateful to the countless South Africans who made my time in their country the most productive and intellectually stimulating experience of my life. At every meeting, whether it was at district, provincial, or national health offices, with private health care organizations, or at the University of Pretoria, people were welcoming and friendly, yet extremely professional and dedicated. Many people with whom I worked (including the six delegates) had enormous work-loads and severe staff shortages – particularly by U.S. standards – yet they jumped at an opportunity to contribute to the GHLI delegation’s project, seeing in it a way to improve their country’s health system. It was such a privilege for me to work with so many dedicated people throughout the health sector, and I feel very fortunate that GHLI made the opportunity available to me. Even before the plane took off from Johannesburg, I was already brainstorming ways to go back.

Final Weeks in Rwanda

Eleanor Hayes-Larson,

GHLI Student Fellow
September 2011

My experience in Rwanda was incredibly rich on a variety of levels, both at play and and work. One of my goals for the summer was to leave feeling like I really knew the country. I traveled almost every weekend and saw nearly every corner of the small country. I met and spoke with many people who varied in age, profession and background and feel like I now possess a good understanding of the country. I was very welcomed by my colleagues in the Ministry of Health and leave with new friends. (The picture above was taken with my colleagues as they took me out to dinner on my last night in Rwanda.)

I left Rwanda having completed several rounds of revisions and editing on documents that had not officially been approved for adoption by the time I left but were getting close. When validated, these documents will represent the introduction of the first national policy on health research for Rwanda – very exciting!

The other exciting thing about my work in Rwanda this summer is the way it has laid the groundwork for further improvements to the country’s health research. The policy creates a space for the development of strategic plans, other operational documents and research agendas that will truly guide the way forward for research in Rwanda.

As I sit in my room in New Haven, I am very glad to have had the opportunity to work with the Rwandan delegation and to work on the research policy and guidelines. I will continue to work on the documents until they are approved, and I particularly look forward to seeing the ripple effects of more documents and plans being created, which will ultimately result in more and improved research for health in Rwanda.