Book: An Imperfect Offering. Dispatches from the Medical Frontline

Author: James Orbinski

Publisher: Rider Books (Ebury Publishing), 2008

Reviewer: Martyn Drakard

James Orbinski, humanitarian, doctor and one time international president of Medecins sans Frontieres (MSF) - Doctors without Borders - knows the greatness and meanness we humans are capable of. In "An Imperfect Offering, Dispatches from the Medical Frontline" unassumingly yet forcefully he tells his experiences in some of the conflict areas of the past twenty years.

Spat upon by Albanian youths in Kosovo; feeling hopeless as he comforts the dying in Rwanda; getting to the root of what happened afterwards in eastern Zaire as hundreds of thousands were hounded westwards to die of starvation and disease; fighting to get generic ARVs to stem the Aids deaths in southern Africa; being stopped in the forest by Mai-Mai rebels; watching the marines arrive on the Somali beach and, shortly afterwards, Black Hawk down in Mogadishu.

Prisoners in Siberia dying from TB, cholera in Peru, children being torn to pieces by landmines in Afghanistan, famine and repression in North Korea are all here; and the deliberate hindrances of the Khartoum government to allow humanitarian aid reach the south. Even New York, where he'd just arrived for a meeting when the Twin Towers were attacked.

And the politics and the double-dealings. The callous indifference of the superpowers towards the Rwandan genocide has been well documented elsewhere, but their hypocrisy regarding the humanitarian disaster in Zaire from 1996 until the present day, where it's a fight for mineral resources over the dead bodies of millions of innocents, has not; and his account of this alone makes the book worth reading.

Besides battling to take medical aid to where it was desperately needed, he had another war to fight: enabling MSF to operate independently without manipulation or interference from external politics, a fight that took him once to a meeting in the White House.

Perhaps what comes out best are his descriptions of intensely tragic human situations: the old French priest in Kigali who had sheltered a large group of children in his church for the three months of the war; the woman who had had all her limbs amputated by genocidaires to slowly bleed to death. Who, he asks himself in amazement, can take hold of a child (or an old woman) and hack her systematically to pieces as the victim screams with terror, and the murderer doesn't feel something?

If Orbinski is anything he is a fighter. One evening he was chatting with some people in an Afghan camp. Along came an old man who had fought with the Mujahideen and lost a thumb and finger. "American bullets in a Chinese rifle!" the old man laughed, and went on: "No scars, no story, no life." It could be the sub-title of this book.