Panorama Czech branch of Doctors without Borders: five years of rewarding work
The Czech branch of Doctors without Borders was established in 2006 and has grown rapidly in the five years of its existence. In 2011 it sent volunteers to 48 missions in twenty-one countries, not only doctors, but nurses and logistic staff both from the Czech Republic and Slovakia. I spoke to its director Pavel Gruber about its early beginnings and present challenges.
“The original idea came from the group of doctors and nurses and other professionals who were already working on the mission with Doctors without Borders’ Austrian office. When they were leaving there came a moment when they realised they were quite a large group, so they floated the idea that doctors without borders would open a Prague office. It was quite a long and difficult process. However, in 2006 the office was established in Prague, and since that time it has been slowly growing; from one or two men or women up to ten employees today.”
Last year you sent volunteers to 48 missions in 21 countries round the world. Where are you helping now? Where is the situation most critical? What is your biggest challenge at present?
“Our ongoing biggest challenge, or the biggest current crisis, is definitely the situation in South Sudan. Because South Sudan is a brand new state, which has only just celebrated the first year of its official existence, you can imagine the situation is really difficult there, and the situation is getting much more difficult because the flow of refugees from North Sudan to the northern region of South Sudan continues and continues. The latest figures suggest 170, 000 refugees, and the flow continues, and often the refugee camps are settled in places that are absolutely not suitable to accommodate tens of thousands of people. So yes, if you ask me about one major crisis, I would point to South Sudan.”
And how many doctors have you got there? What are they treating?
“The Prague office is responsible not only for the Czech Republic, but also for Slovakia, and in South Sudan this year we have three or four people from here – two doctors, a pharmacist, and some logisticians, so I’d say South Sudan one of the most common destinations for Czech and Slovak professionals.
As for what they’re treating – in these northern regions, it’s really emergency activities. The patients come in in a really bad state; for children the first treatment is for malnutrition, and for adults, who haven’t had any medical attention for weeks, very often it’s for diarrhea. Now the rainy season is starting we can expect outbreaks of measles, cholera and malaria, so in that region it’s emergency life saving assistance, which is the core of what Doctors Without Borders do. Doctors without Borders is also appealing to other humanitarian aid organizations because aid is still insufficient. There are not enough humanitarian workers, and even though we’re a medical organization we are also having to supply these people with drinkable water and sanitation and I can only repeat our call for all global humanitarian workers to increase their presence in South Sudan.“
What conditions are these doctors working in? Are they working in field hospitals that you have there?
“The conditions vary a lot, depending on whether we’re talking about emergency projects in refugee camps for example, or the projects in war zones, or natural disasters or long-term projects such as HIV AIDS, massive vaccinations programmes and so on. So on the one hand we could have a real field hospital with very rough conditions, and then we also have missions where we have very well established hospitals, for example when we work in former state hospitals, where you can image conditions are a bit easier. “
“The cooperation of the locals is a key part of our work. We could never achieve what we do without them. So local participation plays an important role on all levels, from drivers up to doctors, and just staying with the medical aspect, the local doctors, pharmacists and nurses make up a crucial part of our teams. Our aim is not only to give them our direct assistance, but to give them the capacity to provide training. We always try to keep in mind that we are an emergency operation, so we try to reduce our presence if possible. Obviously there are countries where it’s not possible, but we try to keep our presence to the most crucial months or years, and then hand over to the ministry of health or the local authorities. “
What about the patients themselves?
“Once again here the situation is very variable. One of the biggest challenges is the lack of emotional feedback that our doctors receive. These people are probably struggling so much that when they receive assistance, for us it’s sometimes difficult that they don’t respond with a smile or something like that, but we need to understand that these people have undergone such horrific conditions, so hard for us to imagine, that they cannot respond. That’s one case. Generally the patients appreciate Doctors without Borders’ efforts. In many regions we are the only health facility looking after over a thousand people, as in South Sudan for example. In Africa you can often find other healthcare providers, but Doctors without Borders provides all its assistance free of charge, and this is crucial.”
How do you recruit doctors? Who are the volunteer doctors that come to you asking to be sent out?
“When recruiting, we generally try to get across our mission, why we do it, what are goals are, and then often we are approached by doctors who want to know more. As well as this we organise information evenings that are open to all, because it’s not only doctors, it’s nurses, laboratory workers, pharmacists, and not medical positions such as logisticians that we need. So during these information evenings everyone can learn more about what the mission is.”
Are they young people or well established doctors in the country?
“There is a slight difference between the Prague office and the older Doctors without Borders offices in the rest of Europe. The typical volunteer is 50-60years of age, has had a long career, has grown up children and is looking for something new in his professional life. In the Czech Republic we don’t get many of these types. They tend to be around 30-40 already with some experience, because we can’t take anyone who has only just left medical school – we have certain requirements, but we usually see a younger generation of doctors from the Czech Republic.”
Do they get sent out on one mission to get experience, or do you have people who go from mission to mission and actually find it very rewarding?
“We have many people who do several missions. Of course you always start with the first mission and then it’s up to you – you can chose whether you want to apply for missions again and again. There are people who go on the first mission and then find that it’s not the kind of environment they want to work in, but on the other hand we have dozens of ex-pats who have gone through five of six missions and they are the kind of people who tend to keep repeating it. And these are the most valuable people, because they have so much experience – we know them and they know us, so if we’re talking about the most difficult environments, these people are the most welcome.”
The Czech branch has only been here for just over five years – what can you do to make yourselves more visible in the Czech Republic to get more sponsors?
“We’ve launched a two-year campaign, which has several goals. First of all to promote Doctors without Borders: the fact that it exists, and what we want to do. Secondly to persuade people to join us: to apply for and go out on missions, and third to attract possible donors, because Doctors Without Borders’ philosophy is to rely on private donor rather than institutional donors such as governments or other global institutions, because to keep our impartiality and neutrality it is key for us to maintain what we achieved last year, which was ninety percent of our income from private donors. The campaign of course also promotes any kind of donations, especially regular donating. Lastly the campaign is to raise awareness about what is going on in the world in regions that are not as lucky as Europe is.”