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The LancetComprehensive picture of the essence of volunteerism.
— Amanda Walters
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More fascinating and harrowing accounts of the volunteer professionals who risk their lives to help those in desperate need.
Praise for the second edition:
"Direct and evocative, this well-written book pushes readers to the edge of a world of grueling realities not known by most Americans."
Doctors Without Borders (aka Medecins Sans Frontieres, or MSF) was founded in 1971 by rebellious French doctors. It is arguably the most respected humanitarian organization in the world, delivering emergency aid to victims of armed conflict, epidemics and natural disasters as well as to many others who lack reliable health care.
Dan Bortolotti follows the volunteers at the forefront of this organization and its work, who daily risk their lives to perform surgery, establish or rehabilitate hospitals and clinics, run nutrition and sanitation programs, and train local medical personnel. These volunteer professionals:
This new and revised third edition includes updates and new inside stories from recent relief operations, and it covers changes within the organization, such as its new emphasis on nutrition. There are also many new and revealing color photographs and insights gained from the author's 2009 trip to Haiti, where he found three different arms of MSF operating in dire conditions.
Hope in Hell is a widely acclaimed portrait of a renowned Nobel-winning humanitarian organization, revealing how Doctors Without Borders provides immediate and outstanding medical care.
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.'"
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
Introduction: Fixing Up the Humans 7
Chapter 1 Stand and Deliver 13
Chapter 2 Biafra and the Bumblebee 48
Chapter 3 We Don't Need Another Hero 75
Chapter 4 Doc in a Hard Place 102
Chapter 5 In the Yellow Desert 125
Chapter 6 Ugly Realities 147
Chapter 7 How the Other Half Dies 169
Chapter 8 Best Performance in a Supporting Role 202
Chapter 9 New Fridge Syndrome 222
Chapter 10 You Can't Stop a Genocide with Doctors 260
"Ours Is Not a Contented Action" 290
Author's Note 298
Notes on Sources 300