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Healthcare Journal of new orleans
I
NOV / DEC 2014
15
Reporting to the main office in Paris, he
offered observations about what other non-
governmental organizations (NGOs) were
doing, what kinds of medical attention were
needed, and recommendations for howMSF
might help.
“We set upmobile clinics to cover as much
of the area as we could, and then we did a
big project with water and sanitation because
that was the most pressing need,” says Reyn-
aud. “There were a lot of children who were
getting diarrheal diseases from drinking the
impure water. So we could treat the diarrheal
diseases, but the root of the problem was to
get better water. That was a big part of our
project, to address the problemand the cause
of the problem.”
The only constant is unpredictability, even
with long-term missions, which require a
10-12 month commitment and are usually
tied to an existing hospital or clinic. It can be
in a place where MSF has an established rela-
tionship with the community and might be
providing the only medical care in the area
or in a place such as a refugee camp that
shows no sign of closing. The assignment
might start out as assisting a local doctor on
the border of Darfur and Chad – but then life
happens: That doctor has to leave because
of family problems.
“Being the only doctor in that hospital, it
can be a very overwhelm-
ing experience with all the
responsibility,” says Rey-
naud. “But at the same
time (it’s) a very exhil-
arating experience
because you’re able
to manage running a
hospital by yourself.”
Both Reynaud
and Dhand enjoy
going to unusual
places and meet-
ing people from around the
world. Translators overcome the language
barrier among staff, but the cultural divide
– especially with the native people – was
sometimes exasperating.
In South Sudan an outbreak of Hepati-
tis E caused considerable tension. Locals
there had a superstition about salt, accord-
ing to Dhand, yet supportive care for patients
with Hepatitis E required saline solution.
The stress of living in a refugee camp com-
pounded the frustration of the locals, who
were discouraged from practicing their tra-
ditions and superstitions in the name of
medicine they didn’t understand.
“Do we lie to the patients and tell them it’s
not salt water when it is because we know
this patient’s going to die if they don’t get
fluids?” she says. “We would usually do a
mixture of salt and sugar actually because
their blood sugars would drop so low. They
would taste the fluid that we were giving
the patients; and if they tasted any salt, they
would refuse it.”
A native who spoke English helped a lit-
tle. He would explain the medical treatment,
why it was needed and the possible results.
Sometimes he was able to gain permission
from a patient or family. But with 400 to 500
patients entering the hospital per week, it
wasn’t practical to have such conversations
MSF hospital in
Agok, South Sudan.
©Valérie Batselaere/MSF
Haiti.
©Benoit Finck