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doctors without borders
16
NOV / DEC 2014
I
Healthcare Journal of new orleans
about every medication and procedure.
“When they brought the patients to the
hospital and they got the salt water and they
already had the suspicion about it and then
they died, it seemed very clear to them that
that was the cause. There was a tipping point
where we had a whole ICU room of patients,
and they all died in a span of 24 hours,” says
Dhand. “The next day I went into work in the
morning. There was no one there, and no one
came to the hospital that day. Then it was the
job of our outreach team to go and convince
these families that this person that’s in this
tent is clearly dying and is definitely going
to die unless you bring them in. If you bring
them in, they might still die, but we might be
able to help them.”
The outreach teams go into the commu-
nity to visit people in remote areas – or, in
the case of this refugee camp, try to
work with people in their homes
and convince them of the value
of medical treatment. The facil-
ity had multiple wards – inpa-
tient, outpatient, ICU, psychi-
atric, pediatric, maternity, and
feeding center for malnourished children –
and Dhand credits the outreach workers for
helping re-establish trust.
Another important aspect of cultural sen-
sitivity is respect for the established medical
systems. MSF offers free medical care, but
that can be a problem for local health ser-
vices that rely on fees.
“We try to keep focusing on emergencies,
and routine things we let the local health
clinics take care of, because that’s the way
they can run,” says Reynaud.
In addition to crisis care, MSF has an edu-
cational mission.
“For a lot of the (local) doctors we work
with, it’s often one of the first times they’ve
been able to work with the equipment that
we bring in – also the supplies,” says Ren-
aud. “They’re able to do procedures and treat
patients in ways that they’ve read about but
never really had the facility with which to
do it. That in itself can be a great education.
When we were in Sudan, we were doing a
big vaccination campaign against measles.
(Some) of the people I trained had one or two
days’work with other groups. I went through
a training with them (on) how to become a
vaccination team – what the role of each
person was, how it would work, how to put
things together. At the end of the training,
we had six vaccination teams that we could
Right, a local ambulance.
Far right, Batil hospital.