The recollections of a young MSF doctor provide a refreshing take on the humanitarian aid worker experience.
By the time aid workers decide to pen a memoir of their experiences, the initial pull of a humanitarian career has often been replaced by a creeping sense of disillusionment.
Like in Tony Vaux's The Selfish Altruist, and Emergency Sex And Other Desperate Measures: True Stories from a Warzone by Kenneth Cain, Heidi Postlewait and Andrew Thomson, aid workers' recollections tend to embody an increasing scepticism and frustration, often seeking to clarify the deep clash between ideals and the reality of aid work on the ground.
Band-Aid for a Broken Leg by young doctor Damien Brown is a refreshing diversion from this norm. Subtitled 'Being a doctor with no borders (and other ways to stay single)', this searingly honest and funny personal account of Brown's postings abroad with Doctors Without Borders (MSF) in Angola, Mozambique and Sudan charts the emotional highs and lows of helping those in need in isolated and under-equipped conditions.
Brown is a candid author who spends time unpicking the fragile emotions surrounding his work as a doctor, but is equally unafraid to admit that it was difficult going without sex for long periods of time, and that cabin fever could set in so strongly that major fights with colleagues could arise from arguments as mundane as over whether glass is a liquid or a solid.
Humanitarian hardships
In Brown's first posting, he is sent to Mavinga in south-east Angola - a small, dusty outpost that is surrounded by the looming threat of uncleared land-mines left over from the bloody civil war.
For Brown, this is a return to an Africa he'd never expected to see. A native of South Africa, his parents moved to Australia when he was 14 and were anxious when he told them where MSF was first sending him.
Before MSF, his experience abroad had been confined to backpacking and volunteering for a few months in a clinic in Thailand. In Mavinga, he is promoted to the head of the hospital, working alongside three other expats and a large group of local staff - many of them war veterans.
He has to traverse the awkward landscape of not speaking Portuguese when almost none of the staff speak English, and gets a crash course in Portuguese from the cook, Dominga, so he can memorise the key terms and questions he needs to successfully navigate the hospital rounds.
Perhaps ironically, the thing that makes Brown's account so interesting is that he never actually reaches any of MSF's frontline conflict situations. After his placement in Angola, he is sent to Mozambique for a short time, where he gets closer to frontline work while helping to manage a predicted cholera outbreak.
But just as he is about to be sent out to his next full placement in Somalia, the security situation rapidly deteriorates and he is sent instead to a project in what is now South Sudan, though he remains out of the way of major conflict areas such as Abyei.
Instead of patching up soldiers and working in the urgency of a full-scale war therefore, Brown's account revolves around the dynamics of short-term volunteers inserting themselves into tight-knit communities and the unrelenting poverty of the places in which MSF has a long-term presence, often as the only organisation providing medical care for huge swathes of population.
Brown is unafraid to admit that it was difficult to be initiated into the close community at the hospital in Mavinga, especially after several of the health workers walked out on him following an altercation in his very first shift.
Christened Novo Doctor ('new doctor') for his entire time in Angola, he learns quickly that hospital politics and diplomacy are as much a part of the job as treating patients, and does not pretend that his work wasn't challenged or that his presence was always liked.
In one of the most starkly honest parts of the book, he details the final straw that led him to terminate his Sudan contract several months early. During a shift, a critically ill woman is brought in for treatment for a rare molar pregnancy, complications with which are causing her to bleed to death.
Doctors are forced to wait for hours until the husband arrives as no treatment can be administered without his consent. The treatment itself is simple - she needs an operation and blood transfusions - but when the husband arrives, he refuses any treatment for her despite the repeated pleas of hospital staff. This episode pushes Brown over the edge, and he retires from humanitarian work indefinitely.
A bed for the night
While this breakdown and ending to his work with MSF are painful, Brown emerges from his experiences surprisingly optimistic, and there is a positive tone throughout the book.
It feels like he used the writing of the book as a kind of mental filing cabinet - a way for him to retrospectively sort through the barrage of experiences and emotions he felt while working, but didn't have a chance to work through at the time.
He praises MSF as an organisation, though acknowledges that humanitarian work has many critics. By working on a medical frontline, Brown is engaging in what David Rieff describes as "a bed for the night" humanitarianism - immediate interventions that can save lives but don't necessarily guarantee that the people they treat are any less vulnerable than they were before.
MSF is aware of this. The self-reflective, Nobel Peace Prize-winning organisation was formed in 1971 after a group of doctors and journalists broke away from the Red Cross, protesting that the organisation had been too silent on atrocities committed during the Biafran War in Nigeria.
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'Bearing witness' (in French témoignage) became a key tenet of MSF's philosophy that refuses to confuse silence with neutrality, and in Angola there is a poignant chapter about when Brown stumbles upon the heart-wrenching oral testimonies recorded by MSF staff when they first entered Angola after the civil war.
Brown's own book is also about bearing witness to inscrutable poverty, frustratingly preventable diseases and the joy that comes from being able to cure people who would otherwise have had no hope.
Ultimately, the book's positivity and humour perhaps come from the fact that Brown is a doctor, and therefore able to fully appreciate when medicine at its most rudimentary has paid off.
It is difficult to imagine an MSF logistician writing a book as empowered by the small victories of this human outreach, victories which Brown takes the time to celebrate at every chance he gets.
Damien Brown is currently studying for a Masters in International Health at the London School of Hygiene and Tropical Medicine. Upon completion he intends to finish his medical specialty training in Australia and then re-join MSF in sub-Saharan Africa.
Francesca Washtell studies International History at the LSE. She is President of the Development Society, and Editor of the London Globalist, a student international affairs magazine.
