An Imperfect Offering: Humanitarian Action in the Twenty-first Century


James Orbinski - 2008
    . . . The only crime equaling inhumanity is the crime of indifference, silence, and forgetting.—James OrbinskiIn 1988, James Orbinski, then a medical student in his twenties, embarked on a year-long research trip to Rwanda, a trip that would change who he would be as a doctor and as a man. Investigating the conditions of pediatric AIDS in Rwanda, James confronted widespread pain and suffering, much of it preventable, much of it occasioned by political and economic corruption. Fuelled by the injustice of what he had seen in Rwanda, Orbinski helped establish the Canadian chapter of Médecins Sans Frontières (Doctors Without Borders/MSF). As a member of MSF he travelled to Peru during a cholera epidemic, to Somalia during the famine and civil war, and to Jalalabad, Afghanistan.In April 1994, James answered a call from the MSF Amsterdam office. Rwandan government soldiers and armed militias of extremist Hutus had begun systematically to murder Tutsis. While other foreigners were evacuated from Rwanda, Orbinski agreed to serve as Chef de Mission for MSF in Kigali. As Rwanda descended into a hell of civil war and genocide, he and his team worked tirelessly, tending to thousands upon thousands of casualties. In fourteen weeks 800,000 men, women and children were exterminated. Half a million people were injured, and millions were displaced. The Rwandan genocide was Orbinski’s undoing. Confronted by indescribable cruelty, he struggled to regain his footing as a doctor, a humanitarian and a man. In the end he chose not to retreat from the world, but resumed his work with MSF, and was the organization’s president when it was awarded the Nobel Peace Prize in 1999.An Imperfect Offering is a deeply personal, deeply political book. With unstinting candor, Orbinski explores the nature of humanitarian action in the twenty-first century, and asserts the fundamental imperative of seeing as human those whose political systems have most brutally failed. He insists that in responding to the suffering of others, we must never lose sight of the dignity of those being helped or deny them the right to act as agents in their own lives. He takes readers on a journey to some of the darkest places of our history but finds there unimaginable acts of courage and empathy. Here he is doctor as witness, recording voices that must be heard around the world; calling on others to meet their responsibility.Ummera, ummera–sha is a Rwandan saying that loosely translated means ‘Courage, courage, my friend–find your courage and let it live.’ It was said to me by a patient at our hospital in Kigali. She was slightly older than middle aged and had been attacked with machetes, her entire body rationally and systematically mutilated. Her face had been so carefully disfigured that a pattern was obvious in the slashes. I could do little more for her at that moment than stop the bleeding with a few sutures. We were completely overwhelmed. She knew and I knew that there were so many others. She said to me in the clearest voice I have ever heard, “Allez, allez. Ummera, ummera-sha”–‘Go, go. Courage, courage, my friend–find your courage and let it live.’—From An Imperfect Offering

Band-Aid for a Broken Leg


Damien Brown - 2012
    But the town he's sent to is an isolated outpost of mud huts, surrounded by landmines; the hospital, for which he's to be the only doctor, is filled with malnourished children and conditions he's never seen; and the health workers—Angolan war veterans twice his age who speak no English—walk out on him following an altercation on his first shift. In the months that follow, Damien confronts these challenges all the while dealing with the social absurdities of living with only three other volunteers for company. The medical calamities pile up—including a leopard attack, a landmine explosion, and having to perform surgery using tools cleaned on the fire—but it's through Damien's evolving friendships with the local people that his passion for the work grows. This heartbreaking and honest account of life on the medical front line in Angola, Mozambique, and South Sudan is a moving testimony of the work done by medical humanitarian groups and the extraordinary and sometimes eccentric people who work for them.

Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World


Tracy Kidder - 2003
    Doctor, Harvard professor, renowned infectious-disease specialist, anthropologist, the recipient of a MacArthur "genius" grant, world-class Robin Hood, Farmer was brought up in a bus and on a boat, and in medical school found his life’s calling: to diagnose and cure infectious diseases and to bring the lifesaving tools of modern medicine to those who need them most.Mountains Beyond Mountains takes us from Harvard to Haiti, Peru, Cuba, and Russia as Farmer changes minds and practices through his dedication to the philosophy that "the only real nation is humanity"—a philosophy that is embodied in the small public charity he founded, Partners in Health. He enlists the help of the Gates Foundation, George Soros, the U.N.’s World Health Organization, and others in his quest to cure the world. At the heart of this book is the example of a life based on hope, and on an understanding of the truth of the Haitian proverb "Beyond mountains there are mountains": as you solve one problem, another problem presents itself, and so you go on and try to solve that one too.

Emergency Sex (And Other Desperate Measures): True Stories from a War Zone


Kenneth Cain - 2004
    Andrew strives for a better world through his life-saving work as a doctor. Heidi, a social worker, is in need of a challenge and a paycheck, and Ken is fresh from Harvard and brimful of idealism. As their stories interweave through the years, from Rwanda, Bosnia and Somalia to Haiti, the trio reveal a world of witnessed atrocities, primal fear, desperate loneliness and base desires. They fend off terror and futility with revelry, humour and sex; ask hard questions about the world order America has created, the true power of the UN, and whether there is any possibility for change.This is a startling celebration of the power of humour and friendship, of the limits of human compassion, and the need for a warm body and a cold beer during a Condition Echo lockdown. A book that shows the human cost of global politics and the tragic truth that wars are much more avoidable than our governments would ever admit. A brilliant, provocatively funny and fast moving book.

Six Months in Sudan: A Young Doctor in a War-torn Village


James Maskalyk - 2009
    I went to Sudan, and am writing about it again, because I believe that which separates action from inaction is the same thing that separates my friends from Sudan. It is not indifference. It is distance. May it fall away.”In 2007 James Maskalyk set out for the contested border town of Abyei, Sudan, as a doctor newly recruited by Médecins Sans Frontières (Doctors Without Borders). Equipped with his experience as an emergency physician in a downtown hospital and drawn to the hardest parts of the world, Maskalyk spent his days treating malnourished children, coping with a measles epidemic and watching for war. Worn thin by the struggle to meet overwhelming needs with few resources, he returned home six months later more affected by the experience, the people and the place than he had anticipated.Six Months in Sudan began as a blog that Maskalyk wrote from his hut in Sudan in an attempt to bring his family and friends closer to his hot, hot days. It is the story of the doctors, nurses and countless volunteers who leave their homes behind to ease the suffering of others, and it is the story of the people of Abyei who suffer its hardship because it is the only home they have. With great hope and insight, Maskalyk illuminates a distant place and chronicles the toll of war on one community, one man, and the cost of it to all of us.

Chasing Chaos: My Decade In and Out of Humanitarian Aid


Jessica Alexander - 2013
    But the world that she encountered in the field was dramatically different than anything she could have imagined. In this honest and irreverent memoir, she introduces readers to the reality of the life of an aid worker. We watch as she helps to resettle refugees in Rwanda, manages a 24,000-person camp in Darfur, and helps a former child soldier in Sierra Leone get rid of a tattoo that was carved into his skin by a rebel group. But we also see the alcoholic parties and fleeting romances, the burnouts and cyncism, the plans and priorities that constantly shift and change. Tracing her personal journey from idealistic and naïve newcomer to hardened cynic to hopeful but critical realist, Alexander transports readers to some of the most troubled locations and shows us not only the impossible challenges, but also the moments of hope and recovery.

28: Stories of AIDS in Africa


Stephanie Nolen - 2007
    It is essential reading for our times.In 28, Stephanie Nolen, the Globe and Mail’s Africa Bureau Chief, puts a human face to the crisis created by HIV-AIDS in Africa. She has achieved, in this amazing book, something extraordinary: she writes with a power, understanding and simplicity that makes us listen, makes us understand and care. Through riveting anecdotal stories – one for each of the million people living with HIV-AIDS in Africa – Nolen explores the effects of an epidemic that well exceeds the Black Plague in magnitude. It is a calamity that is unfolding just a 747-flight away, and one that will take the lives of these 28 million without the help of massive, immediate intervention on an unprecedented scale. 28 is a timely, transformative, thoroughly accessible book that shows us definitively why we continue to ignore the growth of HIV-AIDS in Africa only at our peril and at an intolerable moral cost.28’s stories are much more than a record of the suffering and loss in 28 emblematic lives. Here we meet women and men fighting vigorously on the frontlines of disease: Tigist Haile Michael, a smart, shy 14-year-old Ethiopian orphan fending for herself and her baby brother on the slum streets of Addis Ababa; Alice Kadzanja, an HIV-positive nurse in Malawi, where one in six adults has the virus, and where the average adult’s life expectancy is 36; and Zackie Achmat, the hero of South Africa’s politically fragmented battle against HIV-AIDS. 28 also tells us how the virus works, spreads and, ultimately, kills. It explains the connection of HIV-AIDS to conflict, famine and the collapse of states; shows us how easily treatment works for those lucky enough to get it and details the struggles of those who fight to stay alive with little support. It makes vivid the strong, desperate people doing all they can, and maintaining courage, dignity and hope against insurmountable odds. It is – in its humanity, beauty and sorrow – a call to action for all who read it.

My Own Country: A Doctor's Story


Abraham Verghese - 1994
    Nestled in the Smoky Mountains of eastern Tennessee, the town of Johnson City had always seemed exempt from the anxieties of modern American life. But when the local hospital treated its first AIDS patient, a crisis that had once seemed an urban problem had arrived in the town to stay. Working in Johnson City was Abraham Verghese, a young Indian doctor specializing in infectious diseases. Dr. Verghese became by necessity the local AIDS expert, soon besieged by a shocking number of male and female patients whose stories came to occupy his mind, and even take over his life. Verghese brought a singular perspective to Johnson City: as a doctor unique in his abilities; as an outsider who could talk to people suspicious of local practitioners; above all, as a writer of grace and compassion who saw that what was happening in this conservative community was both a medical and a spiritual emergency."

War Doctor: Surgery on the Front Line


David Nott - 2019
    From Sarajevo under siege in 1993 to clandestine hospitals in rebel-held eastern Aleppo, he has carried out lifesaving operations in the most challenging conditions, and with none of the resources of a major metropolitan hospital. He is now widely acknowledged as the most experienced trauma surgeon in the world.War Doctor is his extraordinary story, encompassing his surgeries in nearly every major conflict zone since the end of the Cold War, as well as his struggles to return to a “normal” life and routine after each trip. Culminating in his recent trips to war-torn Syria—and the untold story of his efforts to help secure a humanitarian corridor out of besieged Aleppo to evacuate some 50,000 people—War Doctor is a blend of medical memoir, personal journey, and nonfiction thriller that provides unforgettable, at times raw, insight into the human toll of war.

The Wisdom of Whores: Bureaucrats, Brothels, and the Business of AIDS


Elizabeth Pisani - 2008
    With swashbuckling wit and fierce honesty, she dishes on herself and her colleagues as they try to prod reluctant governments to fund HIV prevention for the people who need it most—drug injectors, gay men, sex workers, and johns.Pisani chats with flamboyant Indonesian transsexuals about their boob jobs and watches Chinese streetwalkers turn away clients because their SUVs aren't nice enough. With verve and clarity, she shows the general reader how her profession really works; how easy it is to draw wrong conclusions from "objective" data; and, shockingly, how much money is spent so very badly. "Exhibit A": the 45 billion taxpayer dollars the Bush administration is committing to international AIDS programs.

Pathologies of Power: Health, Human Rights and the New War on the Poor


Paul Farmer - 2003
    Paul Farmer, a physician and anthropologist with twenty years of experience working in Haiti, Peru, and Russia, argues that promoting the social and economic rights of the world’s poor is the most important human rights struggle of our times. With passionate eyewitness accounts from the prisons of Russia and the beleaguered villages of Haiti and Chiapas, this book links the lived experiences of individual victims to a broader analysis of structural violence. Farmer challenges conventional thinking within human rights circles and exposes the relationships between political and economic injustice, on one hand, and the suffering and illness of the powerless, on the other.Farmer shows that the same social forces that give rise to epidemic diseases such as HIV and tuberculosis also sculpt risk for human rights violations. He illustrates the ways that racism and gender inequality in the United States are embodied as disease and death. Yet this book is far from a hopeless inventory of abuse. Farmer’s disturbing examples are linked to a guarded optimism that new medical and social technologies will develop in tandem with a more informed sense of social justice. Otherwise, he concludes, we will be guilty of managing social inequality rather than addressing structural violence. Farmer’s urgent plea to think about human rights in the context of global public health and to consider critical issues of quality and access for the world’s poor should be of fundamental concern to a world characterized by the bizarre proximity of surfeit and suffering.

Better: A Surgeon's Notes on Performance


Atul Gawande - 2007
    But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable. Gawande's gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable. At once unflinching and compassionate, Better is an exhilarating journey narrated by arguably the best nonfiction doctor-writer around (Salon). Gawande's investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.

The Big Truck that Went By: How the World Came to Save Haiti and Left Behind a Disaster


Jonathan M. Katz - 2013
    Jonathan M. Katz, the only full-time American news correspondent in Haiti, was inside his house when it buckled along with hundreds of thousands of others. In this visceral, authoritative first-hand account, Katz chronicles the terror of that day, the devastation visited on ordinary Haitians, and how the world reacted to a nation in need.More than half of American adults gave money for Haiti, part of a monumental response totaling $16.3 billion in pledges. But three years later the relief effort has foundered. It’s most basic promises—to build safer housing for the homeless, alleviate severe poverty, and strengthen Haiti to face future disasters—remain unfulfilled. The Big Truck That Went By presents a sharp critique of international aid that defies today’s conventional wisdom; that the way wealthy countries give aid makes poor countries seem irredeemably hopeless, while trapping millions in cycles of privation and catastrophe. Katz follows the money to uncover startling truths about how good intentions go wrong, and what can be done to make aid “smarter.”With coverage of Bill Clinton, who came to help lead the reconstruction; movie-star aid worker Sean Penn; Wyclef Jean; Haiti’s leaders and people alike, Katz weaves a complex, darkly funny, and unexpected portrait of one of the world’s most fascinating countries. The Big Truck That Went By is not only a definitive account of Haiti’s earthquake, but of the world we live in today.

The Blue Sweater: Bridging the Gap Between Rich and Poor in an Interconnected World


Jacqueline Novogratz - 2009
    It all started back home in Virginia, with the blue sweater, a gift that quickly became her prized possession—until the day she outgrew it and gave it away to Goodwill. Eleven years later in Africa, she spotted a young boy wearing that very sweater, with her name still on the tag inside. That the sweater had made its trek all the way to Rwanda was ample evidence, she thought, of how we are all connected, how our actions—and inaction—touch people every day across the globe, people we may never know or meet.From her first stumbling efforts as a young idealist venturing forth in Africa to the creation of the trailblazing organization she runs today, Novogratz tells gripping stories with unforgettable characters—women dancing in a Nairobi slum, unwed mothers starting a bakery, courageous survivors of the Rwandan genocide, entrepreneurs building services for the poor against impossible odds. She shows, in ways both hilarious and heartbreaking, how traditional charity often fails, but how a new form of philanthropic investing called "patient capital" can help make people self-sufficient and can change millions of lives. More than just an autobiography or a how-to guide to addressing poverty, The Blue Sweater is a call to action that challenges us to grant dignity to the poor and to rethink our engagement with the world.

There Is No Me Without You: One Woman's Odyssey to Rescue Africa's Children


Melissa Fay Greene - 2006
    When Haregwoin Teferra’s husband and daughter died within a few years of each other, her life is shattered and she becomes a recluse. But then a priest delivers an orphan to her door. The another, and another... and together they thrive.The distinguished author of Praying for Sheetrock and two-time National Book award finalist puts a human face on the AIDS crisis in Africa. When Haregwoin Teferra’s husband and 23-year-old daughter died within a few years of each other, her middle-class life in Addis Ababa, Ethiopia, was shattered. Bereft and with little to live for, Haregwoin became a recluse. Her self-imposed exile to a hut near her daughter’s grave was interrupted when a priest delivered first one, then another, orphaned teenager into her care. To everyone’s surprise, the children thrived, and so did Haregwoin. As word spread, children of all ages began to appear at her modest home: an infant brought by a dying mother, an orphaned brother and sister whose grandfather was too poor to feed them, a baby left on her doorstep. Haregwoin’s small compound became known as the rare place where ailing parents and impoverished families could safely leave their children. Soon Haregwoin was caring for sixty children, running an unofficial orphanage and day school, and learning first-hand about her country’s and her continent’s greatest challenge: the AIDS pandemic that is leaving millions of children without parents to care for them. With the flair and grace of a novelist and the reportorial instincts of a seasoned journalist, Melissa Fay Greene gets to the heart of the AIDS crisis, in a story that is nevertheless one of hope. There Is No Me Without You is the story of Haregwoin and her children: a story of struggle and despair, but also of the triumph of saved lives, and the renewed happiness of children welcomed by adoptive parents in Ethiopia, America, and around the world. Haregewoin’s remarkable story convinces us that the crisis in Africa touches every one of us in some fundamental way. At heart, this book is about children and the parents they need to care for them.