- © 2008 Canadian Medical Association
An Imperfect Offering: Humanitarian Action in the 21st Century Dr. James Orbinski, Doubleday Canada; 2008 448 p $35.00 ISBN 978038566093
The rich beauty of Dr. James Orbinski's writing contrasts with the stark poverty and suffering of the people he has served in many chaotic regions of the world with Médecins Sans Frontières. This haunting memoir balances evil and hope as Orbinski weaves his own story and reflects on the evolution of Médecins Sans Frontières through stark encounters with brutal challenges and the suffering of millions of human beings in the last 2 decades: genocide in Rwanda and Darfur; epidemics of HIV in sub-Saharan Africa, cholera in Peru, tuberculosis in Siberia; civil war in Somalia, Afghanistan and the Balkans; famine in North Korea. He presents a well-researched historical and political context for all these horrors — including the roles of wealthy Western nations that exploit these same situations in search of natural resources, such as oil, or for political leverage.
This is an important book. We Canadian physicians need to examine our own professional lives and learn from this example of profound engagement. As we meet health workers in this context who struggle with fear, who drink and smoke too much, swear and weep, we begin to understand humanitarian action. The people these heath workers serve are not objectified but are portrayed with dignity and as finely observed individual characters.
This book exposes truths most of us would rather not know. Do not put it down. Just as Orbinski went back into conflict situations when illness or insecurity gave him the option of returning home, you too should stay with this book. See what you become after reading it.
A life so deeply engaged with the relief of suffering allows few moments for reflection, yet this fine book, this imperfect offering, carefully details those moments for us. If you are a medical student, read this book as you decide how you will lay out your professional life and which set of rewards you will pursue.
Read this book. When you reach the paragraph about Belgian soldiers swinging and roasting a Somali child over a fire, keep on reading or you will never understand how United Nations peacekeeping troops — Canadian, American, European, African and Asian — became so brutalized.
This book bears witness; it is a grim testimony. It never flinches and never descends into cynicism. Read it slowly and hug your children.
Take comfort with Orbinski as his cook makes him cinnamon rolls so he will feel at home in the killing fields. Take comfort knowing that Kigali prostitutes organized to feed and care for orphans. Take comfort as the Rwandan woman, who had been raped and brutally attacked with machetes, tells Orbinski: “Allez allez, ummera, ummera-sha.” (Go. Go. Courage, courage, my friend.) as he leaves her to go to the next patient. Take comfort when Orbinski's Canadian friend Father Benedict sends him a poem by Gerard Manley Hopkins in the midst of the Rwandan genocide to remind him that in the midst of death, life is continually renewing “and for all this, nature is never spent; there lives the dearest freshness Deep down things…”. Another Hopkins line comes to my own mind “This seeing the sick endears them to us, us too it endears.” Oh, yes.
Keep reading this book. Read it and rejoice that in a world with such evil, the humanitarian efforts of Médecins Sans Frontières were honoured with the Nobel Peace Prize (1999), and that it was a Canadian physician who accepted the award as its president.
Footnotes
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For 20 years, Gretchen Roedde has worked to develop maternal and child health, and HIV programs, in 25 countries.