© MSF

Planning to work in an unaccustomed and entirely new context with security concerns is definitely not the first thought for any doctor soon after completing three strenuous years in post graduation. I was interested, but at the same time was a bit hesitant, because of the varied challenges it posed. After a wait of seven months following my initial interviews, I was excited about the nature of this job. Having heard that most of the patients there are children, I comforted myself that, as a paediatrician, I would be able to do a reasonably good job. However, as often happens in medicine, I was made to feel humble when, within the first week of my stay there, there were the deaths of five children, all siblings, due to some sudden mysterious sickness. In spite of our best efforts to establish the cause, which included a field visit to look for possible toxin exposure, I was clueless about what was going on. There are very few circumstances which put down the morale of a doctor like that.
New people, new ways

Medical challenges

Being the only doctor for such a huge project, for most of my mission it was a difficult job indeed. But when the results are visible with the cure of most patients, you get the one thing that would keep you going in any hard conditions job satisfaction. Little did I imagine that there would be an outpatient department in a village, attended by about 250 patients with malaria every day during the peak season. The survival of scores of tuberculosis patients would be under question if it were not for this humble primary health centre. Witnessing the malnourished children recover after a prolonged battle was extremely gratifying. It was again a huge challenge to manage violence-related injuries in a resource- limited setting like that, especially the gunshot wounds. Worth mentioning is the case of a fiveyear-old child shot in her chest, resulting in distress due to accumulation of air in her chest. I had to insert a chest tube to drain that air. She recovered and walked home happily. Similar was the case of a seven-year-old boy whose brain tissue was visible due to a fracture of his skull as a result of a gunshot. After first aid in my hospital, he was flown to the MSF surgical centre nearby and he recovered. The treatment of numerous fractures, especially with the nonavailability of X- ray facilities, was another monumental task, but again the services offered in this regard were commendable. The antenatal and perinatal care offered to the community was tremendous.

Life on mission

© MSF

Life on mission was significantly different from life at home. Hearing gunshots every alternate day from my place of stay is not something I was used to. Luckily that was not surprising, thanks to the elaborate briefing and frequent security updates offered to international staff. Having nowhere to go for a change did not make things better, but soon we learnt to live with that, thanks to the support that international staff offered to each other.

On the whole it was a great experience for me, medically and otherwise. The magnitude of medical assistance provided by MSF in that hospital is incredible and phenomenal. I am very glad to have been part of the team and played a small role in that task. Very few other places, I feel, would provide me with a setting where I feel my hard work is so meaningful. I am very thankful to everyone who gave me this privilege.

– Aravind Swaminathan