July 21, 2005

Doctors without Borders - Journey into the World of Humanitarian Aid

Just yesterday I completed an interview with Doctors Without Borders/ Médécins Sans Frontières (MSF) and while researching their website, I found that some of the volunteers at MSF had written really interesting stories about their experiences in foreign countries. MSF gave me the permission to republish some of these stories, I think you'll find them very interesting since they shed light on the situation of the local population and the experiences of the volunteers in some of these far away places.

Journey into the World of Humanitarian Aid
By Brian K. Smith

As I flew over Cuba, a goal I had set eight months earlier was realized — I wanted to see this vibrant country that has a rich cultural and musical presence in Canadian society. The view of Cuba was short (only three minutes), and at 32 000 feet it was a little high to absorb any of the sounds or smells of this island country. On we raced across the Caribbean Ocean to Nicaragua above the beautiful turquoise blue.

Brian Smith

This trip had its beginning fourteen months earlier when a kind Quebec doctor from Médecins Sans Frontières had given me and a video cameraman permission to get on a Red Cross medical evacuation flight out of Afghanistan to Pakistan. We had been left behind earlier in the day by the United Nations because we had too much equipment for their overcrowded twin prop plane. I was very grateful to MSF because after eight days in Afghanistan, my health had started to rapidly deteriorate.

MSF has an office in Vancouver, and in April this year they had an information night at Vancouver General Hospital. I decided to attend, hoping there was something I could offer to this international organization. A few weeks later, I couriered a portfolio of my work to the head office in Toronto. This included medical and corporate photography from St. Paul's Hospital, and a selection of my travel photos from third world countries I had visited. I included a profile of my professional memberships and associations in the photographic world. I also have Spanish as a second language. My proposal to MSF was to help them through my experiences. The realization many years ago that my life's passion was photography has made me want to share this gift with organizations like MSF, and also to help young aspiring photographers realize their dreams.

In my carry-on luggage, I had a variety of Canon camera gear, and a large bag of film from Kodak Canada donated to this project. I also carried my itinerary for the thirteen days I would spend in Nicaragua. I wanted to make sure I didn't arrive to a group of very busy people who would look at me in a confused way, saying they had no idea why I was there. The flight was a perfect low-level approach to Managua — just skimming under the bottom of threatening thunderheads. I noticed as I got off the plane there was the classic CIA agent sitting three rows behind me. He watched everyone while he sucked on his lollipop. I never did see him come through customs and immigration. I breathed deeply as I step onto the Nicaragua soil. The smell of Central America filled my nose — the hot humid air was heavy in my lungs. Every place has its own particular smell. I waddled through the congestion of taxi drivers, with my heavy bags to my MSF driver. He was the only one in the crowd that knew my name. Once we got inside the unmarked truck, I double-checked that it was my name he had said! Ronald only spoke Spanish, so I had to become quickly functional after a five-year hiatus from speaking this foreign language. We understood each other well enough. Twenty minutes later, we arrived at the MSF head office. I was greeted by the receptionist Casta, who introduced me to Liz Steele, financial administrator for MSF Nicaragua. Liz introduced me to the Director of the mission, Chus Alonso. As Director, she coordinates the different projects throughout Nicaragua that are sponsored by MSF Belgium and Switzerland. These are the countries that sent me to Nicaragua through the head office in Toronto. I was taken to my accommodations on the outskirts of Managua.

On Tuesday, September 7th, 1999, I started my tours of the camps created by the devastation of hurricane Mitch (October 1998). The first settlement I went to was Nueva Vida (new life). The displaced people in this small village had lived on the shores of Lake Managua for many generations before the hurricane struck. The storm raised the level of the lake five meters — ten months later it was still many meters above normal. We traveled to Mateare, just outside of Managua, to look at sanitation and water projects. The MSF staff explained to me in great detail about the projects they were working on. This included the complications created by local and national governments, and the dedication and sometimes burnout of MSF staff dealing with these logistics. The hurricane devastated about one half of Nicaragua. A steady torrent of rain fell unceasingly for an entire week.

On Wednesday, we headed off to Chinandega, two and a half-hours northwest of Managua. Between Leon and Chinandega, we stopped at the side of the highway to view an earth filled home. A six-member family parished inside when Casita Volcano's lake spilled over the top of the mountain and set off a huge landslide/mudflow that obliterated three villages. It resulted in the loss of two thousand lives. Shortly after we arrived in Chinandega, Andre, head of administration, took me to Limonal Chinandega refugee camp. What is seen at first looks okay, a fertile river delta where the displaced people live, but after three hours of touring what was not so apparent was shocking. Surrounding these poor people is a river contaminated by the garbage dump. The garbage dump and cemetery directly drain through the soil of the camp — this is not to be outdone by the holding lake for the city sewer and nearby slaughterhouse. During heavy rains, this lake overflows directly into the camp. I will never forget the nauseating smell in the garbage dump.

The next morning I toured the center of Managua with two MSF doctors who work on the Street Children Project. These abandoned or runaway children make their lives by whatever means they can, from stealing to prostitution. All of them are glue inhalers — it deadens their pain of this seemingly hopeless situation. We met about twenty kids in three different locations. A lot of tension exists between the merchants and the children; however, I could immediately see the trust bond that exists between the MSF staff and these kids.

In the afternoon, I went on a one-hour flight to the Caribbean Coast. My destination was the Great Corn Island. This tropical paradise is feeling the effects of the drug trade from South America. There I documented the HIV/AIDS seminar that was hosted by MSF at the island's hospital. The participants included hospital staff, nurses, and the doctor.

I went to Bluefields on the Mosquito Coast the following day. This was a magical place for me. It is a mix of Spanish, Creole, and Afro Indian people. Most speak a funky, Jamaican style of English in addition to Spanish. The MSF staff gave up their five-day holiday to tour me around in their panga (small boat). Our trip to Pearl Lagoon was incredible. We travelled along a canal bordered by a lush growth of mangrove trees and palms. This fresh body of water is huge, and at its end, is the village of Orinoco. It has a population of fifteen hundred people. Two teenagers guided us from house to house through the village. I didn't hesitate to ask everyone I met if I could photograph him or her. We went to one other village before turning around - Tasbapouni. After one hour of photographing many of the inhabitants, a village representative questioned me about my motives. My guide told him that I was with a human rights organization. This definitely didn't go over well. I quickly corrected him, and clarified that I was with a humanitarian group. I was permitted to continue. Whether it was this situation or the afternoon heat, it left me totally drenched in sweat. My MSF companions in comparison seemed fine — this must be an effect of my thick Canadian blood. To compensate, we drank fresh coconut milk in the sweltering afternoon sun. The return journey back to Bluefields that day was surreal. We glided down the waterway with a fiery sunset to the west behind huge thunderheads. Mangroves and palms framed the scene perfectly.

I stayed an extra day in Bluefields and was rewarded by an exciting afternoon of photography in the Town Square. Everyone was dressed in uniforms for the independence celebration. That evening we drove to a mountain view-point, to the west of Bluefields to witness the sunset over the jungle. A spectacular and fitting end to my Caribbean sojourn.

The following morning, I had an early flight back to Managua. After checking into the MSF house, I caught a bus to Granada. Unfortunately, it was totally closed for the holiday. For many centuries, it had been the grandest city in the Americas. In 1857, an American, who had corruptly proclaimed himself president of Nicaragua, was forced to flee Granada. Upon his departure, he set the city on fire, loosing this treasure of the Americas forever. The present city has a stately appearance, but lacks a feeling of its five centuries of history.

On September 16th, my driver, Gustavo, and I departed on a six-hour journey to Nueva Segovia - the most northern province. The purpose of our trip was to visit Casa Materna in the mountainous village of Quilali. On our way we past fields of rice and tobacco. The winding road became rough and narrow as we climbed through the mountains towards the Honduran border. More than once we were surprised to find a herd of cattle greeting us around a sharp canyon corner. Devastation from hurricane Mitch was still very evident along the scared Rio Coco, the largest river in the province. The riverbank's raw edges were clear of vegetation fifteen meters above its present level. Most settlements along rivers in this northern frontier province were swept away. During my first day in Quilali, I visited the San Bartolo camp with the MSF staff. MSF constructed wells that the local people can easily maintain and service themselves. They were also showing the inhabitants how to make cement construction bricks. These are used for the building of solid, rain resistant homes, and for the lining of wells and outhouse toilets.

My last assignment was to visit Casa Materna, a complex containing diagnostic quarters with a prenatal classroom, and a delivery room. Up to twelve women can stay there at one time. This is mainly for high-risk pregnancies in the third trimester. Many of the patients are young teenagers. The atmosphere within is calm and soothing. Before leaving for Managua, I took a walk along the back streets of Quilali. Families invited me into their yards to photograph them. At noon, Gustavo and I departed in the Land Rover jeep for our trip back to Managua. I felt sad that this incredible journey was coming to a conclusion. MSF had provided an unforgettable personal experience — the most memorable of all my travels.

As my flight took me northeast over Nicaragua towards Miami, I reflected on the past thirteen days. The MSF staff had immediately made me feel like part of the team. Thorough briefings on the history and current situations that they shared with me made this trip an educational experience. The Nicaraguan people demonstrated an incredible resilience to situations that are very difficult to tolerate. Through the dedication and hard work of the MSF staff the quality of life is gradually improving for these people.

I am very grateful to have the opportunity to show the world through my photography how MSF is making a big difference to those who are in need of humanitarian aid.

By Brian K. Smith
www.msf.ca

Related Articles:
Read my interview with Doctors without Borders
Doctors without Borders: Visiting an Afghan Refugee Camp
Doctors without Borders: El Salvador, after the Earthquake
Doctors without Borders: Water for Ixtahuacan
Doctors without Borders: Visiting MSF in Sierra Leone
Doctors without Borders: Lost between River and Sky
Doctors without Borders: Journey into the World of Humanitarian Aid