The road (more like dust-track!) thus far… – Alan de Lima Pereira

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Alan de Lima Pereira, a medical doctor, has worked with MSF in the state of Chhattisgarh in India, Abder Rafi in Ethiopia and Leer in South Sudan. He shares his experiences of these places.

When I first heard about Doctors Without Borders / Médecins Sans Frontières (MSF) as a 14 year old, little did I know how it would affect my life and work and provide me with experiences that continue to shape me today. As a happy-go-lucky Goan teenager, I heard a story about a couple of foreign doctors who were then relaxing in Goa after volunteering for MSF during the earthquake in Gujarat in 2001. They spoke about some of the places they had worked previously in corners of the world that I didn’t even know existed, through wars, famines and epidemics.

I’ll admit that every time I replayed that story in my mind, my young imagination might have added new dimensions until it reached its present form: stuff of legend! Little did I know then that life’s road would lead me to graduating as a medical doctor and somewhere further down that same road when faced with the proverbial fork, it was MSF that came-a-calling.

To some extent I have been living that same legend that I played out in my head umpteen times, and yes, it has been an incredible journey thus far….

It seems like a simple truth of life: absolutely everybody deserves the right to health. Yet, so much of the world is still eons away from achieving this and places where MSF work has been an uncomfortable and constant reminder of this gross inequity that we need to do our bit to fight.

I started working for MSF in Bastar region of Chhattisgarh in 2009 where so many of our country’s men, women and children are caught in the power struggle between Maoist (Naxals) and government forces. Due to the dense forests there and the ongoing security situation, access to healthcare is a real problem and we ran mobile health clinics, sometimes walking for 2-3 hours each day with essential drugs and vaccines to designated clinic sites. It helped open my eyes to health issues not too far away from home and at the same time, increased my interest in learning about health crisis situations all over the world.

So in July of 2011, when the opportunity to work in Ethiopia presented itself, I had my backpack packed again and was on the plane to Addis Ababa. I was sent to the north-west of the country to work on a project dealing with visceral leishmaniasis or kala azar (Hindi word for black fever). The patients were young migrant workers who came from the highlands of Ethiopia to work on the farms, got bitten by the sandfly, and contracted kala azar, a disease said to be >90% fatal if left untreated. HIV compounded the problem and made treatment very challenging.

A few months after I got there, the famine in Somalia drove thousands of Somali refugees to seek shelter and food across the border in Ethiopia. UNICEF estimated that there was one child dying every 6 minutes as a consequence of hunger during the peak of the crisis. We worked in what was at the time the newest refugee camp in the world (Hiloweyn) and from where I could see Somalia.

Reaching far-off places

In 2012, it was time to move to the newest country in the world, South Sudan, which gained independence in June 2011. I was working as the HIV-TB doctor in Leer (where MSF has been working for 23 years and counting), a non-descript village in the middle of wetland. There are no roads to Leer for most of the year and the only way to get here is a few days walking or by small NGO aeroplanes. With the rains, even small planes couldn’t land and we were dependent on old Russian chopper. And yet, since it was the only health service in the state, our 300 bed hospital was not enough to cater to the needs of the Nuer tribe that lived in the region.

I have been fortunate to see some of the most breathtaking places through travels with MSF; Chitrakote waterfalls in Chhattisgarh, the deserts of Somali region, the highlands of Ethiopia with its hidden treasures like the historic town of Lalibela, life on the Nile in Sudan, varying cultures and the most beautiful people. Schistosomiasis, brucellosis, leishmaniasis and a multitude of worms and parasites in addition to your regular disease fare will keep the medically inclined on their toes. Getting to these places meant we had to use varied transport options; from walking to bicycles, land cruisers to tractors and small Cessna planes to helicopters. Let’s hope that when I write about my next mission, I will be able to add a nice wooden dinghy in the Amazon to the list above!

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