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Doctors without borders: When solidarity saves lives

Biafra, Nigeria, at the end of the 1960s, while rescuing victims in the midst of a brutal civil war, thereby young doctors and journalist perceived the limitations of international humanitarian aid. Access to the location was difficult. Besides that, whoever would be willing to help them would have to face bureaucratic and political barriers. The situation made these young doctors in France create the organization named Médecins Sans Frontières (MSF) (Doctors Without Borders) in 1971, for the proposal of not only supplying humanitarian aid associated to medical help, but also to make the public aware of the suffering of their patients, making their realities become visible that no longer could remain neglected, according to the organization’s point of view.

Thus, the Doctors Without Borders have sought to supply essential health care where these services were most necessary and, due to this, they have faced delicate contexts, such as armed conflicts, epidemics, and natural disasters. Currently, this movement is active in over 70 countries — 30 on the African continent, the organization maintains projects in Africa focused on caring for patients who suffer from HIV, tuberculosis, multi-drug-resistant tuberculosis, hepatitis, epidemics such as cholera and Ebola, meningitis, malaria, reproductive health, victims of sexual violence, victims of armed conflicts, homeless, refuges, undernourished, and vaccination.

The team recruited for Doctors Without Borders in Brazil and who are willing to serve in projects overseas is currently made up by 140 professionals. Among these, there are about 30 Brazilians who are in Africa. “But this number is constantly changing “, states Vanessa Monteiro Cardoso, a psychologist, who is a recruiter and administrator of careers in Doctors Without Borders in Brazil. According to her, from January to May 2015, the Brazilian office of MSF has already received around four hundred résumés from diverse specialties.

There are several professional profiles of Brazilians who seek to work for Doctors Without Borders. “They are from all over the country. There is, for example, no region that displays more interest than others”, she says. Now regarding the most noteworthy characteristic of the Brazilian professional, the administrator says the identification with the humanitarian value is what the Institution foremost preaches. “It is the most humane side this professional brings and generates the greatest identification to the program and the locations where they are present”.

The selection process for working in the program is quite thorough. It is necessary to speak English or French very well, fit into one of the professional profiles required by the organization, have at least two years of professional experience in the respective field, humanitarian motivation, and be available for at least twelve months. Except for surgeons, anesthesiologists, and gynecologists, who can stay for a period of at least six weeks, all the other professionals stay on the field from six to twelve months. They earn a salary for the time worked, sign a contract for a definite time period and are given an expense account in the local currency for personal expenses. The MSF even pays for the cost of two-way airline tickets for the projects, visas, vaccinations, and offers health and life insurance. Besides that, the organization also supplies psychological support for the professional and his/her family.

How the MSF arrives in each country

The organization is not related to governmental bodies from any country. But, the NGO carries out an exploratory mission to become familiar with the region and its inhabitants. This mission tries to identify the real needs and perceive the level of demands from that specific population. In order to become established in each region, the MSF gets in contact with the responsible health entity for that location, requesting authorization for its activities. During the period when it is established in that region, the MSF also works jointly with local professionals, training them, so they are capable of continuing treatments and enlarging the perspective of these professionals.

In case of a natural catastrophe, the care given by MSF is considered as emergency. In this case, there is no need for bureaucratic procedures, as it simply takes place by transferring the teams to the needy regions. “In moments like this, the search for professional tends to increase”, states Vanessa Monteiro Cardoso.

In spite of being recognized as one of the main international humanitarian aid organizations in the world, the Doctors Without Borders also faces some challenges. According to Vanessa, its administrator, the organization has sought to expand its specialized professional staff, such as in the case of orthopedic surgeons, obstetricians, and pediatricians.

”I have even delivered a baby in the middle of a road”

Denilson Borges, a male nurse, joined Doctors Without Borders in 2013. He is from Minas Gerais State, born in Ipatinga and he left the city of Belo Horizonte, where he lived to look for the office for the organization in Rio de Janeiro to participate in the recruiting process. In September of the same year, he was sent to a refugee camp in Upper Nile State, which is two hours and a half by plane from Juba, the capital city of South Sudan. “I worked as a supervisor of three basic health care centers, each one of them was staffed with ten professionals who attended from 110 to 130 patients every day. The working schedule was from eight a.m. to 5 p.m. and on Saturdays from 8 a.m. to 1p.m. Besides that, I would work shifts on duty to care for emergency cases”, he tells.

He as a professional, nowadays he is 34 years old, and he remembers how he worked in a region with one of the worst health care systems in the world. “We arrived in a period of heavy rainfall and Malaria is a common disease in that period. Two months later, I had to lead a team who was caring for patients during an outbreak of pneumonia. We increased the sizes of teams, expanded the installations, and extended our working hours. Besides that, we cared for patients who had been infected with hepatitis E, a disease directly linked to faulty sanitation systems”.

For him, the sincerity of the institution was essential so that he could carry out the complex and challenging work he faced. “I have even delivered a baby in the middle of a road. I cared for the recuperation of a two-year-old girl who could not gain weight due to various complications caused b serious tuberculosis”, he tells. “All these things make great changes in you, not only professionally but also as a human being. This is so fulfilling. I was going to stay for only six months, but I ended up extending my period for another three months”. After that experience in South Sudan, Denilson Borges has already participated in working for Doctors Without Borders in India and now in he is Brazil waiting for his next mission.

”The treatment is much more complete”

Alexandre Fonseca Santos, 45, from São Paulo has been a doctor without borders since 2010 and he has already been on missions in South Africa, Zimbabwe, Afghanistan, and Syria. In spite of having worked for the Brazilian Unified Health System (SUS) for thirteen years, as a professional he had nourished the desire since he was in college to join a humanitarian aid organization. His expertise as a doctor and a public health administrator has been essential so that he could act in Cape Town, jointly with the local government, in the creation of strategies for treating and preventing AIDS.

After that, he went to the border between South Africa and Zimbabwe to treat patients who were infected with the HIV virus. Care was given in mobile clinic setup on farms in that region. “The South African government had already defined a public policy. So, we worked, overall, based on the experience for decentralized healthcare”, he explains. A similar health care project was done in the rural areas of Zimbabwe. “The healthcare services were good. The government already had many clinics. The problem arose because of the decentralization of the healthcare caused a considerable increase in demand”, he tells.

The first years I spent in Africa stamped the passport, so that Dr. Alexandre would share his experiences in other countries. The result, according to him, could not be more gratifying. “We are in contact with professionals from several countries. This exchange experience is so good. Besides that, this contact with the patient you cannot easily get from your years in med school”, he says. The doctor also attributes his success to MSF, for the multidisciplinary treatment given to patients. “The treatment is much more complete, since the patient is treated by all types of health professionals”. At the moment, Alexandre Fonseca is working in Brazil as a public medical administrator and also offers his office to Doctors Without Borders.

Countries with MSF activities in Africa

South Africa, Burkina Faso, Burundi, Cameroon, Chad, Ivory Coast, Egypt, Ethiopia, Guinea, Guinea-Bissau, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mozambique, Niger, Nigeria, Kenya, Central African Republic, Democratic Republic of Congo, Sierra Leone , Sudan, South Sudan, Swaziland, Tanzania, Uganda, and Zimbabwe

History in Brazil

Currently, Doctors Without Borders does not have any projects in Brazil, but they maintain an office for recruiting professionals, raising funds and publicity initiatives, as well as a medical unit for giving support to neglected diseases.

1991 MSF arrived in the country to combat a cholera epidemic in the Amazons. After controlling the outbreak, the organization remained in the region until 2002, promoting preventive medical work among the indigenous tribes. The project in the Amazons was concluded after non-governmental organizations and the Indigenous Sanitary Special Districts took over that work

1993 The first urban intervention of MSF took place in Rio de Janeiro, as they implemented a project for providing care to homeless children.

1995 MSF began to provide general clinical care, gynecology, obstetrics, and pediatrics, dental care, psychological, welfare, appointments, and nursing procedures in the community of Vigário Geral. The project was then transferred three years afterwards to an organization led by residents who were trained by MSF.

1996 The organization also began in Rio de Janeiro, a preventive program for sexually transmitted diseases and aids, distributing condoms and preparing thematic workshops in the communities in the northern zone of the city.

2003 MSF maintained until 2005, a Complete Healthcare Center in the community of Marcílio Dias, providing general clinical care, gynecology, pediatrics, mental health, and welfare services in the Maré Complex in Rio de Janeiro. The unit was also transferred to be managed by a local organization.

2006 The organization opened an office in Rio de Janeiro.

2007 The German Complex created an Emergency Unit, also in Rio, where until the end of 2009, it proved emergency care, mental health care, ambulance transfers to hospitals in the region and guidance to the city’s public healthcare network.

2010 Heavy flooding hit the states of Pernambuco and Alagoas and thousands of houses were completely destroyed. Teams from MSF provided psychological support, distributed kits, worked in improving the water supply and sewage conditions, monitoring, and training.

2011 In the beginning of that year, cities in the mountainous region of Rio de Janeiro were hit by heavy rains and psychologists from MSF trained mental health professionals to work in the region hit by rains. In October, MSF responded to a humanitarian crisis involving Haitian immigrants in the city of Tabatinga, in the Amazons, distributing basic necessities and providing activities promoting healthcare.

2013 Specialized mental health professionals provided their support services to teams in the national healthcare network in caring for survivors from the Kiss Nightclub fire, in Santa Maria (RS) and their families.

2014 At the time when the Madeira River flooded, teams were sent to evaluate the medical-humanitarian situation of the local communities and rule out the possibility of an outbreak of cholera. It was concluded by the local authorities that they were prepared to care for the needs of the affected population. Even so, the organization gave medical training to share their experience in the treatment of cholera and organized a document with preventive measures that could be adopted locally in order to prevent a possible outbreak.

How is the recruiting process performed to select a professional who wishes to join the NGO Doctors Without Borders

Resumé Analysis

Resume Analysis is only considered if in English or French or if there is a motivational letter in Portuguese.

Pre-interview

A pre-interview is carried by telephone with the people who are selected from the first phase. Part of the interview is done in one of the required languages

On-site activity

The candidates participate in an on-site recruiting activity. This last step, takes an entire day, it includes an informative meeting on the organization, individual interview, a practical experience test, and a foreign language test.

Waiting period

The approved candidates in the selection enter a variable waiting period, until the most adequate position is found for each one’s profile. The standard period for participation is approximately nine months. The professional does not choose the country where he/she will work.

Professional who can participate are surgeons, anesthesiologists, gynecologists, general practitioners, pediatrics, epidemiologists, infectious disease specialists, physiotherapists, nurses, obstetrics, pharmacists, laboratory supervisors, psychologists, psychiatrists, administrators, financial managers, logistics, specialists in water works and sanitation.

How to help MSF

It is possible to help MSF by giving monthly donations or as a Virtual Volunteer, speaking about the work of the organization through the internet. For further details see the following link on two available initiatives at: www.msf.org.br/como-ajudar.

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