James Orbinski, former President of MSF, is a veteran of many of the world's most complex and disturbing humanitarian crises. In 1998, he received the Governor General's Meritorious Service Cross for his work as the MSF Head of Mission in Rwanda during the 1994 civil war. The following year, he was also the recipient of the 1999 Nobel Peace Prize on behalf of MSF. In his book, An Imperfect Offering, he describes his experiences on the medical front line.
An Imperfect Offering:
Humanitarian Action in the Twenty-first Century
By James Orbinski
Publisher: Doubleday Canada
ISBN: 978-0-385-66069-3 (0-385-66069-3)
Available from amazon.co.uk and rbooks.co.uk
Excerpt from the book:
It was my first act as a humanitarian doctor. And there wasn’t anything medical about it. It was October 1992. I had been assigned as MSF’s medical coordinator to Baidoa, Somalia, a city that had become known around the world as the “City of Death.” There, and throughout the country, MSF had set up feeding centres, clinics and hospitals to give assistance to people suffering from starvation and a civil war that was becoming more brutal by the day. By the time the United Nations and various non-governmental organizations flooded in, hundreds of thousands were already dead. I landed in an American military C-130 Hercules on the airstrip just outside of town. An hour later, I was stunned into silence at a feeding centre, looking out over some three thousand people, an island of human hunger in the desert.
They sat in rows on the hard soil, emaciated and waiting. They were mostly silent, mostly beyond exhaustion. The wind was hot against my face. I couldn’t help breathing in the fine dust it carried. I watched one woman with her infant in her lap. With a small stick, she was drawing something in the dust. She dropped the stick and poked her child. He didn’t cry, and he didn’t wake. Maybe he was asleep, or maybe he was comatose — I couldn’t tell. She picked up the stick and continued drawing. As I watched her, my knees weakened. I sat on a crate of medical supplies.
In a corner of the feeding centre was a single white tent that had been designated the medical tent. Beside it were three others designated as the morgue. They were full — bodies piled as small imperfect pyramids, each at least three feet high. From the corner of my eye, I saw a movement on top of one of the piles. I turned away. I didn’t want to know what it could mean. I looked to see if the wind was strong enough to cause a tent flap to move, or a piece of cardboard to fly though the air. It was. Then I saw his eyes flutter. The wind caught his long shirt and ballooned it over his body. He lay among the dead, skin stretched taut over his exposed ribs and pelvic bones. One of his hands grasped at something, anything, whatever the wind might hold. I carried him to the medical tent. He weighed less than 70 pounds, and I thought him light as I tried to catch his arm from falling. I did this without thinking. I acted not as I thought I should but as I had no choice but to do.
All the beds inside the medical tent were taken, so I laid him on the ground. A helper put a blanket over him. She was irritated and told me impatiently that he had been moved to the morgue because there was not enough time or people to look after all of the patients, and in any case, he was going to die anyway. At that moment, I felt rage at the efficiency of placing the living among the dead. And I felt despair — for him, for myself. I could be him, dependent on the actions of a stranger for the hope of at least dignity in death.
His eyes opened and closed. He shivered under the blanket, and soon he was dead. This was the last violated remnant of a fuller life. I didn’t even know his name, but I knew he had been someone’s son, someone’s friend and possibly someone’s husband, someone’s father. What choices led to civil war and famine, leaving hundreds of thousands of people like this man to suffer in this way, at this time, in the last decade of the twentieth century?
Excerpted from An Imperfect Offering by James Orbinski
Copyright © 2008 by James Orbinski. Excerpted by permission of Doubleday Canada, a division of Random House of Canada Limited. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.