Working for MSF in Bentiu, Sudan
I worked on a project in an area of internally displaced people in the southern part of Sudan in a town called Bentiu (population 70,000). This was a remote location and involved flying in and out, about 1000kms from the capital Khartoum
The clinic had a capacity for about 150 inpatients and would see 100 outpatients a day. Facilities were very basic; wards were a combination of mud huts, tents and tin roofed sheds. There was no running water and only intermittent electricity. The lab performed FBC, sputums, malaria films and stools. There were no X-ray facilities.
Sudan is a country of 40 million and is the biggest country in Africa. There has been ongoing civil war for 20 years in which over two million have died. Issues are complex, but in a nut shell, power and wealth is controlled by a small group of non democratically elected people who happen to be Arabic Moslems and many other groups in the country feel (quite correctly) that they have been hard done by and suppressed and have fought for a better deal. This has led to huge numbers of people displaced within the area of Bentiu. MSF had been running this clinic for three years.
An amazing clinical experience as well as life/cultural experience. There were programs for the treatment of TB, Kala Azar and Leprosy. Most of the patients were also malnourished (BMI as low as 7) so their treatment included therapeutic feeding, nutrition and vaccination.
A large number of the patients seen were children with only a small number of deliveries seen (most deliver at home). The program was largely medical as there were no surgical facilities. People needing surgery had either poor outcomes or could sometimes be sent to a military hospital
You do make a difference. People get better and though they go out of the clinic into a dreadful situation and may well return this is very satisfying.
- Ward rounds
- Attending clinics
- Education and training
Six expatriates; including two doctors, a nurse, coordinator, lab tech and logistician. Also about 100 national staff, including one doctor and four nurses. The rest of the national staff had no formal training just MSF on the job training.
The major language between staff was Arabic but most of the patients spoke local language. All the staff spoke some English. I had a designated translator when I was in clinic /OPD and the nurses translated on the wards.
The other side:
Its an all encompassing experience; you live and work very hard with a group of people in an environment that is hard, hot, dusty and isolated. We had no email and often could not leave the living and working compound for weeks at a time due to security concerns. The food was bad and diarrhea was common.
With regards to security, there were a number of active Militia and most men over 14 carried machine guns. MSF does all it can to keep you safe but you can be in the wrong place at the wrong time
This is not a tourist country as travel is restricted by a complex system of permits which means you can't move around the country without permission
MSF (Medecins Sans Frontieres or Doctors without Borders)
Independent NGO initially started by a group of French Doctors in 1973 who were working for the Red Cross but became frustrated with inability to speak up about the situation. MSF has a goal to both provide medical care to those most in need and to advocate for the people and bear witness to the situations in which they work. There is an office in Sydney that is primarily for recruiting and marketing. The projects are run by one of five European sections (French, Dutch, Belgian, Spanish, Swiss) and you will be placed via one of these, most often the French. You don't need to speak any language but any you do will make things easier
Minimum 6 months - MSF covers all your costs while you are working on the project and you are paid about $1000 a month into your Australian account
How to organize it:
- Fill in application form and send with your resume and covering letter to MSF in Sydney (www.msf.org.au) Do this early as the process takes a while.
- An interview is then arranged, either next time they have somebody in Melb or if you are in Sydney. They have info nights a few times a year so keep an eye out
- They will offer you a position and you will then accept or not
At interview you will be asked where you would like to work and where you would not be prepared to work. The more flexibility you have the more likely you are to get a position at the time you would like to go, however do not feel you have to say you would work in a conflict zone if you would not be happy with that.
Minimum 2 years doctor experience. Previous work in rural areas, smaller hospitals, paediatrics, O and G, and public health is an advantage.
You need to be at a position that you feel comfortable making independent medical decisions as it is not unusual to be the only doctor on a project. Don't feel that you are not experienced enough, in a lot of ways extra years in the Western medical system will never really prepare you for a refugee camp or mud hut hospital. The first 6 weeks overseas will be a huge learning curve whatever stage in your career you are at.
The most important attributes are flexibility and skills in working and living in close quarters with a group of people from very different backgrounds and cultures.