This humanitarian aid worker tells Catriona Richardson about his life working for the aid agencies Médecins Sans Frontières and Merlin
When the children of the Dinka and Nuer tribes of southern Sudan make clay models they make planes--they can't make cars because they have never seen one.
I worked with the Dinka and Nuer tribes for a year as the only medical doctor on an isolated project in western Upper Nile. It was one of the most fascinating experiences of my life. After finishing my general practitioner training, I wanted to work in a developing country and applied to Médecins Sans Frontières, which sent me to Sudan for a year.
The programme included managing kala-azar, tuberculosis, brucellosis, and primary healthcare conditions. This was mainly hands-on clinical work, including diagnosing and treating tropical diseases that I had previously only read about. We lived in mud huts and were completely cut off from the outside world apart from planes arriving every two weeks with supplies. It was a totally different way of life with no vehicles and no currency, as everything was bartered for, including wives, with bars of soap and cows.
A year later I went to Herat in western Afghanistan, where I was project coordinator providing health care to a camp of between 15 000 and 20 000 internally displaced people. It was a Taliban controlled area, which posed a whole range of problems, the main one being how to get access to the female population. It was almost impossible to employ women in any capacity, and male doctors were not allowed anywhere near female patients. Fortunately, we had a female general practitioner who was able to see women. I was also involved in exploratory trips to assess different health issues in other areas, including one to the Iranian border. I loved working in Afghanistan; the people were so friendly and proud.
The final project I worked on for Médecins Sans Frontières was in Burma. I was a project coordinator for malaria control, HIV and AIDS education, and primary healthcare programmes. I was also involved in research into the use of mosquito nets. The work was interesting, and it gave me the opportunity to travel in Burma.
Between going overseas, I worked as a locum general practitioner and went on epidemiology and management courses organised by Médecins Sans Frontières. Management skills are vital if you want to work overseas, as you often oversee large teams of expatriate and local staff as well as liaising with groups such as the Taliban or the Burmese Junta. Most of the agencies offer training, and it is a wonderful opportunity to learn new skills that can also be used in Britain.
After returning from Afghanistan, I was torn between general practice and humanitarian work. It was a tough decision, but I decided to take the humanitarian route. When I returned from Burma I studied for a masters degree in health policy, planning, and financing at the London School of Tropical Medicine and the London School of Economics. I already had a diploma in tropical medicine before my general practitioner training, but I felt that I needed to study humanitarian work topics in more depth.
After this, I started working for Merlin as health adviser on variety of different projects. Merlin is a non-governmental organisation based in the United Kingdom that provides health care for people in crisis and disaster situations. It tries to work in partnership with existing developmental systems for at least three to five years, which particularly appealed to me.
One of the advantages is that I am based in London so I can have a life here but also travel all over the world to advise on Merlin projects. I am usually away for three weeks every month, and I have been to some wonderful places, including East Timor, Tajikistan, and India. I have also been back to Afghanistan to put together proposals for projects.
Humanitarian work offers a flexible career structure with the opportunity to do things you would not otherwise do. For example, one highlight was setting up a teaching programme for nurses. The most obvious perk of humanitarian work is the travel. You go to exotic places that tourists never see and meet interesting people. The work is stimulating and rewarding, and it is humbling to work with people who are often so courageous.
But it is a stressful job. You are often working under a lot of pressure in a small team in a difficult environment, coping with poverty and corruption. It can be hard to match your expectations with the realities and limitations of the job. You go out thinking that it will be hands-on clinical work and that you will be making a big difference, but often you don't.
You also need to consider the financial aspect of this sort of work. Initially, you earn about £500-£600 ($780-$930; a790-a950) a month, although all your living expenses are paid for. Also, when you are overseas a lot it can be hard to maintain links with people, and in most cases it is difficult to take a partner with you, so it is much easier for single people.
Although I would highly recommend humanitarian work, it is not a decision to be taken lightly and you should not do it for a bit of adventure. It is a Pandora's box--many people who think they will do it for just a year before returning to mainstream medicine find that they are addicted. But it is a wonderful way to use your medical skills and definitely worth considering. Becoming involved in humanitarian work was one of the best decisions I have ever made.
Some advice if you are considering humanitarian work
* You need to have at least two years' postqualification experience for humanitarian work, and a diploma in tropical medicine and hygiene is helpful
* Being able to speak a foreign language is an advantage
* You need to have a flexible attitude, and you must be able to get on with people from completely different backgrounds and have an empathy with the local people
* An interest in international politics is essential
* Be aware that you could do more harm than good
Useful addresses
Merlin, 5-13 Trinity Street, London SE1 1DB. (tel 020 7378 4888);
email hrenquiry@merlin.org.uk or
www.merlin.org.uk
Médecins Sans Frontières, 124-132 Clerkenwell Road, London EC1R 4DJ, (tel 020 7713 5600);
email www.msf.org or
office@london.msf.org
