Hope in Hell
Inside the World of Doctors Without Borders
by Dan Bortolotti
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Gripping accounts of medical workers who volunteer to serve in some of the world's most dangerous hotspots.
The humanitarian organization, Doctors Without Borders, (also known as Médecins Sans Frontières or MSF) delivers emergency aid to victims of armed conflict, epidemics, natural disasters and those who lack reliable health care. Each year, more than 2,500 volunteer doctors, nurses, and other professionals join locally-hired staff to provide medical aid in more than eighty countries.
At the forefront are the volunteer doctors who risk their lives to perform surgery, establish or rehabilitate hospitals and clinics, run nutrition and sanitation programs, and train local medical personnel. This book follows these volunteer doctors as they risk their health and lives to treat patients in desperate need.
Combining engaging text with dramatic color photographs from around the world, Hope in Hell examines the lives of individual MSF volunteer medical professionals.
Topics include:
- Performing emergency surgery in the war torn regions of Africa and Asia
- Understanding cultural customs and societal differences that affect health care
- Witnessing and reporting genocidal atrocities.
Also, the most recent world events are explored and how MSF is reacting to them. These include the challenges of delivering aid during the Rwandan massacre and the controversial decision to criticize the U.S. for delivering humanitarian aid to Afghan citizens while at war.
The book also covers the raucous founding of Doctors Without Borders in 1971 as the first non-governmental organization to both provide emergency medical assistance and publicly bear witness to the plight of the populations they served. In 1999, the organization was awarded the Nobel Peace Prize.
Hope in Hell is a fascinating and often harrowing account of the men and women who struggle to improve the lives of people in desperate need.
close this panelChapter 9: New Fridge Syndrome
Kenny Gluck knew something was up when he saw a car slide out from the roadside to block the convoy he was traveling in. "We had left the hospital in four vehicles, and we hadn't even gotten out of the town yet when two cars cut us off -- one in the front, one in the back -- and a bunch of people in masks and carrying Kalashnikovs got out." The men opened fire, but no one was hit -- their goal wasn't to kill but to scare. "And they succeeded," Gluck says dryly. "They pulled me out of our car and pushed me into theirs. They whacked me over the head with a rifle butt and then put a coat over my head so I couldn't see."
It was January 9, 2001, and Gluck, 38 at the time, was MSF-Holland's head of mission for the North Caucasus, which includes war-torn Chechnya. On the day he was abducted, Gluck was leaving the town of Stariye Atagi, about 12 miles from the Chechen capital of Grozny. It's an area he knows well, having worked in Chechnya from 1994 to 1996 with another NGO, and since early 2000 with MSF. He's fluent in Russian, too, though it didn't help him that day in the kidnappers' car. "They didn't say anything except, 'Shut up and keep your head down.' We drove for about an hour, switched cars, then they put me in a house where we waited for a while." Gluck was moved three times that first night, before being forced into the root cellar of another house. The floorboards were just a few feet above him, making it difficult to sit up. Onions, cabbages and carrots lay on the rocky dirt floor, along with a mattress that would be Gluck's bed for the next nine nights.
Kidnapping is something of a national pastime in Chechnya, and expats are not exempt from the violence. In 1995, veteran aid worker Fred Cuny visited Chechnya on behalf of billionaire philanthropist George Soros, only to disappear in April. It's assumed he was murdered, along with three colleagues, though their bodies have never been found. The following year, six Red Cross workers -- four Europeans, a Canadian and a New Zealander -- were sleeping in their hospital compound, not far from where Gluck was abducted, when they were executed by masked men carrying guns fitted with silencers. Then Camilla Carr and Jon James, British psychologists working with a small Quaker NGO, were abducted in July 1997 and held for 14 months. By the time Carr and James were released, MSF had pulled out of Chechnya because of the insecurity, but by February 2000 they were back. And so were the kidnappings -- that August three more Red Cross workers were abducted, though they were released after a week. In all, at least 50 humanitarian aid workers have been kidnapped in the North Caucasus since 1996.
Finding those responsible for these attacks is extremely difficult. To begin with, the abductors do not usually make ransom demands; often there is no negotiation at all. The region's power politics are complex -- Gluck estimates there are 50 or 60 active military groups, and their alliances are rarely clear. So, when he was dragged from the car and MSF received no communication from his attackers, the trail quickly turned cold. The organization immediately suspended all its activities in the area and called on the Russian authorities to investigate, but even Gluck himself didn't know why he was being held. "They talked to me quite a bit, but I didn't feel that the people talking to me were the decision makers; they were just guards. They said they were hoping to trade me for captured people, but I don't know if that was true. They were Chechens, I could tell that, but I didn't know whether they were fighting on the Russian side or the anti-Russian side. I didn't get to those questions."
Gluck's case is proof that the best type of security is being known in the community. "All the Chechen doctors there knew me, and I had a lot of friends in this area, and they were getting in touch with everybody -- Russian groups, criminal groups, pro-Chechen groups -- saying this was unacceptable. People who deal in these activities get wounded a lot, so the Chechen surgeons had operated on a lot of people, and they just went to all their contacts and started pushing for my release. To each of the groups they thought could be involved they would say, "Look, your mother or your cousin was treated in an MSF-built surgical facility, with MSF drugs that Kenny himself brought in here. How can you do this? You have to take responsibility for getting him out.' Partly they were saying unethical things, like, "We're going to stop treating your people if this keeps going on.'
"My conditions improved dramatically after that first nine or ten days, and I'm pretty sure that around this time some of these doctors got lucky and talked to the right group. Someone was getting through to the kidnappers and saying, 'Treat him nicely.' After that, I was moved to a room that was about two meters by a meter and a half. They surprised me -- they came and asked what kind of food I wanted, what I needed. I didn't ask for any change in the food -- I thought it was fine before. They were just giving me normal Chechen village food, nothing surprising, and more than enough of it. What I said was, I need news, things to read, and they gave me that."
A few days after he was moved from the cellar, Gluck's captors assured him he had nothing to fear. "According to them it was settled, and it was just a matter of working out how I would be released. I was talking with them a lot about how to do it, and in the end they did exactly as I requested." He suggested that the kidnappers drop him off at the home of a Chechen surgeon who was a personal friend of his as well as being known among both the separatist and the pro-Russian groups. But the days dragged on and he began to wonder if it was false hope. "Things happened that were terrifying -- there were moments when I thought they were taking me outside to shoot me. There were times when the house shook so hard from the shelling that plaster was falling off the walls."
Finally, on the night of February 4, Gluck was told he was going to be freed. They put a mask over his head and bundled him out of the house and into a car. "In the car they were very apologetic. These were different people -- by their voices, I could tell these were older people, clearly with more authority. They were apologizing to MSF, saying, 'This group didn't know who you were, we're very sorry, we re going to punish them,' all of that. While I was blindfolded, they gave me back my passport. I had passes from the Russian military to travel in Chechnya, and they gave me those back, as well as my MSF ID card. I'd had seven hundred dollars in cash in my pocket, because we needed to make some advances on construction material, and they gave me that, which surprised me a lot. I'd had a very cheap watch which I always carried -- you know, seven dollars on Canal Street in New York -- and they said, 'We're really sorry, we can't find your watch.' I was like, 'I'll live.'"
Around midnight, the mystery voices stopped the car and pushed Gluck out. He asked whether he could remove the blindfold, but they refused, telling him simply to walk away from the cat Then they drove off. "I heard someone yelling at me in Chechen, so I said, 'I don't speak Chechen, speak to me in Russian.' And he said in a very crude way, 'Who the hell are you?' I lifted off the mask and I realized it was the Chechen surgeon." Gluck's liberators had driven him right into the doctor's compound. "He yelled at his wife, 'Get up! We have a guest. Put food on the table.'"
Immediately, the Russian secret service, the FSB, took credit for securing Gluck's release, but it soon became clear that claim was nonsense. The Russian authorities had been as ineffective as they usually are when aid workers are abducted. MSF says it doesn't know exactly who was responsible for the kidnapping or the release, but before Gluck was pushed from the car, the libe
Dan Bortolotti is a writer whose work appears in books and magazines throughout North America. He is the author of Exploring Saturn, Tiger Rescue and Panda Rescue.
close this panelTraces the history of the world's largest independent medical humanitarian organization... grimly poignant.
You will meet a few of these extraordinary people and hear their stories. In the midst of some of the worst hells on Earth, they really do bring a glimpse of hope.
Emphasizes that much of the organization's work takes place not in war zones but in remote, impoverished locales.
Describes but never romanticizes... Direct and evocative, this well-written book pushers readers to the edge of a world of grueling realities not know by most Americans. Summing Up: Recommended.
All in all, I found Hope in Hell to be a nicely balanced book about this type of work/volunteerism that I've been curious about for years.
Reveals the human face of MSF. Bortolotti has captured the expats' varied voices and personal stories.
Dan was in some of the world's most dangerous countries, chronicling the stories of volunteer medical workers.
Some physicians still do manifest the noblest virtues of medicine... a worthwhile read for prospective international aid volunteers.
Comprehensive picture of the essence of volunteerism.
A fine read, compelling in its story. Just the pages on its fight against malaria are worth a lot.
A gripping tale as it describes how the group manages to care for patients in the most inhospitable and dangerous corners of the earth... a solid read.
It is in the considerable space that Bortolotti gives to the emotions of the group's staff members that the book really shines... authentic and inclusive... informative and touching.
Well written and filled with excellent color photographs that give the reader a realistic picture of the work these amazing volunteers undertake.
Inspired... Much of what Bortolotti reports is noticeably absent from the daily headlines, so this eye opening account is all the more chilling, and MSF's efforts achingly more compelling.
Looks at the history, politics and motivations of MSF and its volunteers... analyzes the difficulties that MSF faces.
Bortolotti interviewed hundreds of medical personnel who spoke frankly about their experiences... allows the reader a very honest look at MSF.
