On the frontlines of global crises

By Georgia Kartas
A wounded man is treated at the Médecins Sans Frontières clinic in Northern Syria.

Nine Million Lives
Médecins Sans Frontières

Referencing the nine million people per year treated by Médecins Sans Frontières (MSF), or Doctors Without Borders, Nine Million Lives presents real-life stories taking place in more than a dozen countries, in some of the most challenging circumstances imaginable. These are stories of hardship, injury and illness, but also of commitment, hope, small miracles and determination.

MSF is an independent global organisation for medical humanitarian aid. For over 40 years, its workers have been treating victims of natural disasters, conflicts, epidemics and other medical emergencies. This e-book collection gives us a glimpse into MSF’s activities at the frontlines of crises around the world.

A common sentiment pervades each account: the importance of helping people who face traumatic, life-changing catastrophes to find hope and rebuild. As Adam Sharp, treating wounded victims from the frontline in Syria writes: “The provision of healthcare genuinely helps people maintain control and dignity in their lives.”

And some of the success stories littered throughout reveal the truth of Sharp’s statement. In Sierra Leone, obstetrics/gynaecology specialist Dr Stephen Torres successfully delivers a breech birth where the baby was so near death it started turning blue. In Jordan, Dr Ali Al-Ani recounts treating a seven-year-old boy who lost his right leg and had his left severely damaged – they were able to reconstruct his damaged leg sufficiently enough for it to bear weight, and the boy was able to walk again. In Eastern Chad, Nurse Flora Escourrou tells of how MSF recruited local staff and managed to vaccinate 100,000 children against a measles epidemic within two weeks.

The ability to solve seemingly impossible logistical challenges is a requirement of MSF workers. In an anecdote from the Democratic Republic of Congo, a refrigerator is carried along muddy rainforest tracks by motorbike and swollen rivers by dugout canoes. It is needed for complex sleeping sickness tests which require certain components to be kept cool – a logistical nightmare in remote areas.

In another account, Dr Natalie Roberts, working in Aleppo, Syria, witnesses the difference that the provision of basic things like a medicine kit can make. MSF had set up a blood bank in a secret location in Aleppo; before this blood bank, people were being treated with unsafe blood.

“You can’t solve it all,” Dr Roberts writes. “But as MSF we do what we can, and it’s vital that we continue to help.”

Imparting knowledge is also a key aspect of the medical assistance provided by MSF. When treating children with HIV in Zimbabwe, Dr Ann Sellberg explains HIV to an HIV-positive 9-year-old boy through pictures.

“This child had a better chance of caring for himself and his condition when he knew what he was suffering from,” she says. “If we are managing to get most kids to know about their status, then we will have made a huge difference to this population. And even if MSF isn’t around in the future, the impact will still be here.”

Nine Million Lives also emphasises the importance of mental healthcare when providing medical assistance. In the wake of Typhoon Haiyan’s devastation in the Philippines, diarrhoea and respiratory infections are rampant, there is little shelter for survivors, and mosquitoes – bringing with them malaria and dengue fever – are a looming threat. MSF focuses on supporting local medical facilities with staff, drugs, medical equipment – setting up four 100 square metre inflatable medical tents – but also mental healthcare, because in forensic psychiatrist Steve Cohen’s words, “primary healthcare includes mental healthcare”.

Honest, confronting and inspiring, MSF’s collection of short stories provides an emotional insight into the vital, resilient work that MSF does on a daily basis to assist people in crises across the globe.

In another account from the Philippines, a mental healthcare program for elementary school children helps them identify and process fear and stress, in turn aiding recovery and healing processes. MSF also provided psychological support in Sierra Leone for local non-medical staff such as the hygienists and cleaners who were helping combat the Ebola epidemic in 2014. Family and friends were often afraid to approach these staff, but many now know the basic rules to follow in order to prevent contracting the virus. Additionally, MSF provided support to these non-medical staff when they were stigmatised in their community. Traditionally in Sierra Leone, for instance, bodies are taken care of by the tribal elders and young local hygienists are perceived to be disrespecting their culture for dealing with the dead.

This e-book also underscores the need for medical providers to maintain neutrality in warzones. In South Sudan, Nurse Abdul Wassay – an Afghan refugee who survived war and chose to return to a conflict zone with MSF – recounts the importance of honouring the organisation’s commitment to impartiality and neutrality as it ensures the security of MSF teams and patients. MSF kept patients from different sides of the conflict separated in different wards, and searched every person entering the inpatient care area for weapons.

“We not only faced the challenge of treating serious injuries, we also needed to make sure the battlefield didn’t make its way into the hospital,” Nurse Wassay writes.

Nine Million Lives depicts individuals displaying hope, determination and resilience in the face of harsh realities. Honest, confronting and inspiring, MSF’s collection of short stories provides an emotional insight into the vital, resilient work that MSF does on a daily basis to assist people in crises across the globe.

When an anaesthetist in the Southern Highlands of Papua New Guinea describes some of the horrific violence that occurs there on a devastatingly regular basis, he emphasises that, while “there are no quick solutions…for a society where violence has become such an accepted part of daily life,” MSF workers remain hopeful “that by being there, by providing much needed medical care, we are helping to make a real difference”.