on 16 January 2013
The title of the book pretty much sums up beautifully the nature of the work that Dr.Damien Brown does in Africa as a volunteer doctor with MSF - Doctors without Borders. It is a book that evokes multiple emotions in you as you read it - at times breaking your heart, at times making you laugh, at times feeling despondent about Africa and volunteer work, at times feeling inspired, at times completely upbeat and optimistic about the future. The thing that strikes me most about the author is his honesty and openness in evaluating his time as a doctor with MSF in Africa and never losing his perspective even under trying and testing conditions. The book also brings out the essential goodness of the 'ordinary man' in the street, or 'hospital' so to speak.
Dr.Damien Brown, as a young 29-year old from Australia, offers himself as a volunteer doctor to serve in Angloa with MSF. He is sent as the only 'resident doctor' to Mavinga, an outpost in SE Angola consisting of only mud huts in an area surrounded by scores of landmines - remnants of a long civil war. He has for company three other expatriate medical practitioners and a few Angolan health workers, who are actually veterans of the long civil war. Dr.Brown goes in there speaking little Portuguese, the local language. His six-month stint, to say the least, was eventful. He attends to a man mauled by a leopard, wrestles with cultural conflict with his Angolan health workers,
treats severely malnourished children, assists a surgery by 'cleaning' the instruments by holding them up to the fire, argues with relatives of patients who insist on their patient being 'operated upon' because that is what is seen as the 'Rolls Royce' of medical care, is shocked by his own Angolan colleague who, after having cut open the stomach of a patient, challenges Dr.Brown to decide as to which organ to remove......
However, it is not all gloom and disease and death either. The lighter side of life in Mavinga is brought out in the context of the four expatriate volunteer workers - three of them men and one , a blonde young German woman named Andrea. Unfortunately for DR.Brown and Pascal and Tim, she happens to be a born-again Christian and so any casual fling was out of the question. The narrative also spells out in the end that many aid workers eventually end up being partners or spouses of other aid workers. Dr.Brown humorously refers to it as 'double the baggage in one relationship'!
In the author's own words, his Angolan experience is summed up as follows:
" ...the reality of medicine in developing countries is that people die of preventable conditions that are easy to treat or even prevent. Of the millions of children who won't survive the year, most will succumb to one of six things : poor nutrition, pneumonia, diarrhoea, malaria, measles or lack of basic neonatal or maternal health care, all of which are easily managed or prevented. ".
As for his own time in Mavinga, it is " a confusing, intoxicating, frustrating, heartbreaking, inspiring, disillusioning and life-affirming blend of all the best and worst things. Of Angolans, he says, "...no one mopes, or says Poor us. They just get on with it".
After six months in Angola, he returns home to Melbourne, Australia, but feels alienated by the trivialities of the 'problems' in the Australian context of total security and affluence. His mother talks about an anxiety disorder that the family dog is undergoing and the need for anxiety pills for the dog; at the supermarket, he watches an overweight kid throwing a tantrum because his mom bought him 'that' chocolate bar instead of the twenty other varieties he wanted....It is all too much to handle for Dr.Brown and he takes off again to Africa with MSF to regain his balance.
He serves a short stint in Mozambique and then six more months in Nasir, South Sudan - a place as far off from civilization as one would want. In Nasir, in addition to the expected malnutrition, diarrhoea and malaria, he deals with clans of people with gunshot wounds in the fight for 'cattle' which is often valued more than human lives in Nasir. As if this is not enough, he finds himself in a heartbreaking situation where a dying pregnant woman needs to be operated upon urgently but her husband forbids it by refusing permission - result of a strong patriarchal culture where even the woman's life is in the hands of her husband. This was the last straw on Dr.Brown's back and he decides to return home to Australia.
In the final chapter, the author asks the question," ...So, is there really any point to this line of work? Is there any lasting benefit to the people that MSF tries to help? Or does the aid industry just bumble on blindly, patting itself on the back for 'at least trying' , all the while perpetuating its own existence?' Dr.Brown resolves this dilemma in the following words:
My head says it is futile. My heart knows differently. I hope to be in the field again sometime soon.
The book is simply brilliant.