Posts tagged field

Photo: Patients at the community hospital in Bangui, where MSF treated people wounded in conflict. CAR 2013 © Francois Beda/MSF
In Central African Republic, the Violence Has Ended But the Emergency Continues
“At the height of the crisis, confrontations, shootings, and abuses occurred daily. Today, tension and violence have subsided and we are now in a particularly delicate phase—a sort of false calm that is both fragile and potentially explosive. Seleka’s two main groups will have to begin negotiations to establish an imminent power-sharing arrangement. There could be friction and clashes within this young coalition,” says MSF head of mission in CAR, Serge St-Louis.
As a medical organization, we are very concerned about the unmet needs among a population that was already very vulnerable prior to the Seleka offensive. There are thousands of displaced persons who now live in extremely precarious conditions, without medical care, shelter, food, or water. The health situation is critical in several regions. There are serious shortages of drugs and supplies and there are no health care personnel in the medical facilities. Based on our latest admission figures, the seasonal epidemic of malaria, which is endemic in the CAR, appears to have begun and will surge in the rainy season.

Photo: Patients at the community hospital in Bangui, where MSF treated people wounded in conflict. CAR 2013 © Francois Beda/MSF

In Central African Republic, the Violence Has Ended But the Emergency Continues

“At the height of the crisis, confrontations, shootings, and abuses occurred daily. Today, tension and violence have subsided and we are now in a particularly delicate phase—a sort of false calm that is both fragile and potentially explosive. Seleka’s two main groups will have to begin negotiations to establish an imminent power-sharing arrangement. There could be friction and clashes within this young coalition,” says MSF head of mission in CAR, Serge St-Louis.

As a medical organization, we are very concerned about the unmet needs among a population that was already very vulnerable prior to the Seleka offensive. There are thousands of displaced persons who now live in extremely precarious conditions, without medical care, shelter, food, or water. The health situation is critical in several regions. There are serious shortages of drugs and supplies and there are no health care personnel in the medical facilities. Based on our latest admission figures, the seasonal epidemic of malaria, which is endemic in the CAR, appears to have begun and will surge in the rainy season.

How Does it Feel to Lose a Patient?
Dr. Lucy Doyle has worked with MSF in DRC and the Dadaab refugee camps in Kenya.
Most patients’ deaths are anticipated by their physician. The doctor may observe a constellation of findings leading to a particular lethal diagnosis, and the physician prepares the patient as well as him or herself for this impending loss. This is similar in the field and at home, though in the field it hurts more to watch someone die of something that might have been treated easily here in the US.

How Does it Feel to Lose a Patient?

Dr. Lucy Doyle has worked with MSF in DRC and the Dadaab refugee camps in Kenya.

Most patients’ deaths are anticipated by their physician. The doctor may observe a constellation of findings leading to a particular lethal diagnosis, and the physician prepares the patient as well as him or herself for this impending loss. This is similar in the field and at home, though in the field it hurts more to watch someone die of something that might have been treated easily here in the US.

Accepting this would, for me at least, be paramount to giving up hope – laying down and accepting that these tiny little humans are not entitled to a life. MSF reject this. Where there is no hope, they create it. Sometimes it is not cheap to do, and just occasionally the main result is the creation of hope rather than its fulfilment. What value you give to hope itself… well, I suppose that is subjective. I don’t know what our hypothetical shopkeeper would charge for it, even in festival season. The more I see, the more I believe it is priceless.
Luke Chapman, MSF doctor treating malnutrition in Bihar, India, on the value of hope. Please leave your comments and questions for Luke below his blog post.
Photo:Women gather at a water tap in T3, the temporary transit site for new arrivals near Jamam. South Sudan 2012 © Shannon Jensen
When the Tap Runs Dry
On Thursday, the pumps at the Bamtiko borehole—the main source of water for Jamam refugee camp—had failed. Imran, MSF’s water and sanitation specialist, led his team in a quick emergency response to replenish and treat the water supply. 
“By the time evening came around that first wet day, I was covered in mud, exhausted, hungry, my clothes bleached by spilled chlorine — a day well-lived. I’m looking forward to doing it again,” says Imran. Read more from his blog on ensuring water treatment in South Sudan.

Photo:Women gather at a water tap in T3, the temporary transit site for new arrivals near Jamam. South Sudan 2012 © Shannon Jensen

When the Tap Runs Dry

On Thursday, the pumps at the Bamtiko borehole—the main source of water for Jamam refugee camp—had failed. Imran, MSF’s water and sanitation specialist, led his team in a quick emergency response to replenish and treat the water supply. 

By the time evening came around that first wet day, I was covered in mud, exhausted, hungry, my clothes bleached by spilled chlorine — a day well-lived. I’m looking forward to doing it again,” says Imran. Read more from his blog on ensuring water treatment in South Sudan.

AID WORKER PROFILES
Name: Gerry Bashein
Role: Anesthesiologist
From: Seattle, Washington
Age: 68Describe the different roles and responsibilities in your assignments? Did you work outside of your specialty? 

Anesthesia for general surgery was a part of each assignment, but some missions included a significant proportion of obstetrics—in Liberia, Sudan, and Sri Lanka—or trauma—in Nigeria, and Indonesia. In Indonesia, I was also in charge of the intensive care unit for both medical and surgical patients. In Sri Lanka, I provided relief coverage for the emergency room doctor.What did you find most challenging about your work? 

I had to deal with illnesses that I don’t normally handle as an anesthesiologist in the U.S. The lack of lab facilities, x-ray, and specialists to discuss medical issues with presented different challenges. Without a lab to do bacterial cultures and other tests and measurements, we gave antibiotics, fluids, electrolytes, etc. empirically. Blood was always in short supply. There was limited or no banked blood. I lost a patient who had a pelvic fracture because we couldn’t get blood in time.Read the rest of Dr. Gerry Bashein’s interview.photo: 2012 © MSF

AID WORKER PROFILES Name: Gerry Bashein
Role: Anesthesiologist
From: Seattle, Washington
Age: 68


Describe the different roles and responsibilities in your assignments? Did you work outside of your specialty?

Anesthesia for general surgery was a part of each assignment, but some missions included a significant proportion of obstetrics—in Liberia, Sudan, and Sri Lanka—or trauma—in Nigeria, and Indonesia. In Indonesia, I was also in charge of the intensive care unit for both medical and surgical patients. In Sri Lanka, I provided relief coverage for the emergency room doctor.

What did you find most challenging about your work?

I had to deal with illnesses that I don’t normally handle as an anesthesiologist in the U.S. The lack of lab facilities, x-ray, and specialists to discuss medical issues with presented different challenges. Without a lab to do bacterial cultures and other tests and measurements, we gave antibiotics, fluids, electrolytes, etc. empirically. Blood was always in short supply. There was limited or no banked blood. I lost a patient who had a pelvic fracture because we couldn’t get blood in time.

Read the rest of Dr. Gerry Bashein’s interview.

photo: 2012 © MSF