{"id":1879,"date":"2010-05-01T20:04:25","date_gmt":"2010-05-01T19:04:25","guid":{"rendered":"https:\/\/stg-blogs.bmj.com\/bmj\/?p=1879"},"modified":"2010-05-04T15:54:57","modified_gmt":"2010-05-04T14:54:57","slug":"kiran-james-jobanputra-a-world-without-msf","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmj\/2010\/05\/01\/kiran-james-jobanputra-a-world-without-msf\/","title":{"rendered":"Kiran James Jobanputra: A world without MSF"},"content":{"rendered":"

\"Kiran\"It’s hard to contemplate Bunia without MSF. Bon March\u00e9 (the MSF hospital) is truly an institution \u2013 everyone I meet has either worked there or been a patient there \u2013 usually both.\u00a0 The community was initially devastated to learn that Bon March\u00e9 would be closing, and the fact that we will be here for some years supporting the General Hospital has softened that blow to some extent, even though no one in the community quite understands what that support will entail. And I have to acknowledge that we\u2019re not all that sure either, because here we are being pulled out of our comfort zone \u2013 from responding to humanitarian crises \u2013 into the unfamiliar world of development aid.<\/p>\n

Our disengagement strategy has evolved through a series of stages, governed (as these things are) by political, financial and cultural factors, as much as by experience as to what works in practice. The complexity of \u2018integrating\u2019 what are essentially a series of specific and focused MSF programmes (Paediatrics, HIV, Women\u2019s health) into a very general health system is baffling, involving everything from assuring the availability of ink for printing surveillance charts, to advocacy at national and international level for provision of anti-retroviral drugs. To make matters more confusing, each of the numerous partner organisations has its own way of working, its own timetable, and its own agenda \u2013 and sensitivity to this is a prerequisite for effective collaboration.<\/p>\n

The fact that I am reflecting on all this does not mean (unfortunately) that I understand it. I am only just beginning to get a feel for the landscape, and to identify the points where we may be able to have an influence.\u00a0 As a doctor I feel like a fish out of water, knowing that there must be many people who could do a better job of this than me. But I remember my father saying that there\u2019s always someone out there who\u2019ll do a worse job of it, and this gives me some reassurance.<\/p>\n

So, to return to the original question, can we conceive of life here without MSF? For Bon March\u00e9 is not just a structure, an employer and a community service; it implies a way of working, an ideology, even a particular relationship with the community \u2013which won\u2019t be possible to replicate as we move from one hospital to the other. This does not have to mean giving up on such ideals \u2013 but it means weaving those ideals into reality, such that the difference between the two ceases, eventually, to exist.<\/p>\n

Kiran James Jobanputra<\/strong> has been working as a doctor with MSF in Somalia, Kenya, and Niger since 2007. He is currently project coordinator of the MSF Hospital (Bon March\u00e9) at Bunia, DRC. This blog also appears on the MSF website<\/a>. <\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

It’s hard to contemplate Bunia without MSF. Bon March\u00e9 (the MSF hospital) is truly an institution \u2013 everyone I meet has either worked there or been a patient there \u2013 usually both.\u00a0 […]<\/p>\n

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