Imperfect Offering: Humanitarian Action for the Twenty-first Century

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From one of the world’s greatest humanitarian activists comes a searing personal memoir that is also an urgent call to confront suffering in all its many forms.

Having seen things we hope never to see, confronted suffering and dispassion and evil we hope never to encounter, and faced deep personal torment, James Orbinski still believes in “the good we can be if we so choose.” His chosen medium for revealing this is stories from his own experience—a doctor’s indelible testimony from the front lines in Peru, Somalia, Afghanistan, Rwanda, Zaire—embodied in which are warnings, hope, and lessons in how we can inject humanitarian activity into our lives. Being political, he has discovered, is not only reserved for politicians; admitting imperfection is essential to compassion. With an eye for detail like that of the finest journalist and the empathy of the most committed doctor, Orbinski’s powerful voice is matched by the urgency of his message. At a time of great political and moral uncertainty, An Imperfect Offering is invaluable reading for anyone who wants to make a difference.


“This book is a series of stories in which I ask, again and again, ‘how to be in relation to the suffering of others.’ It is a personal narrative about the political journey I have taken over the last twenty years as a humanitarian doctor, as a citizen, and as a man. It is about the mutuality that can exist between us, if we so choose. I have come to see humanitarianism not as separate from politics, but in relation to it, and as a challenge to political choices that too often kill or allow others to be killed. At its best, politics is an imperfect human project. It is at its worst when we delude ourselves into thinking it can be perfect. Speaking is the first political act. It is the first act of liberty, and it always implicitly involves another. In speaking, one inherently recognizes that “I am and I am not alone.” In this space lies our humanity.” (a composite from chapter 1)

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Editorial Reviews

From Barnes & Noble
The author explains this "imperfect offering" best. "This book," he writes, "is a series of stories in which I ask, again and again, 'how to be in relation to the suffering of others.' It is a personal narrative about the political journey I have taken over the last twenty years as a humanitarian doctor, as a citizen, and as a man. It is about the mutuality that can exist between us, if we so choose. I have come to see humanitarianism as a challenge to political choice that too often kill or allow others to be killed." Dr. James Orbinski's narrative takes us to famine-ravaged Somalia, Afghanistan in the strife of civil war, and Rwanda in the midst of genocide. An urgent call for individual action.
Publishers Weekly

In this captivating look at humanitarian intervention in the 20th century, Orbinski, former head of the NGO Médecins Sans Frontières (Doctors Without Borders), uses stories from his decades of service with the group to examine "how to be in relation with the suffering of others." The author describes his time on the front lines of suffering in Russia, Somalia and Afghanistan. When Orbinski recounts his second term in Rwanda during the 1994 genocide, the book reaches an emotional peak: it was his "undoing," and struggling with the horror he has seen, he drifts into a "netherworld of confusion," fighting to regain his "footing as a man, as a doctor and as a putative humanitarian." His ensuing reflections on humanitarianism are as riveting as his personal thoughts, which include diary entries, recollections and correspondence with friends in the humanitarian and diplomatic corps. The book manages to be both personal enough to construe the human toll of political and social disasters without falling into the trap of maudlin, patronizing depictions of human suffering. Orbinski, who accepted the Nobel Peace Prize for Médecins Sans Frontières in 1999 does credit to his organization and his humanitarian credo. (Oct.)

Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
Library Journal

As both a frontline caregiver and past president of Doctors Without Borders, Orbinski has led humanitarian efforts to aid and treat victims of some of the most harrowing events of the last few decades. Here he recounts his time as a doctor in famine-stricken Somalia and the seemingly futile medical aid attempts during the Rwandan genocide. Rounding out these accounts of humanitarianism in the face of insurmountable suffering are stories of his work in Peru, Afghanistan, and Russia and of his efforts to bring humanitarian concerns to the global political scene. On its surface, Orbinski's personal narrative is a chronicle of humanitarian efforts at the turn of the 21st century. Yet in retelling his life's work, Orbinski asks two much larger questions: "How am I to be?" and "How are we to be in relation to the suffering of others?" It is an underlying but persistent call to action that makes this work more than just a memoir. Orbinski seamlessly blends the personal with the political, offering his own experiences within the context of the more powerful global forces at work. In this revealing personal narrative, he has taken humanitarianism from its apolitical, reactive sphere to one in which it is an active enterprise where individuals and organizations shape the world we live in. Recommended for public and academic libraries and essential reading for anyone who considers him- or herself a global citizen.
—Veronica Arellano

Kirkus Reviews
A doctor who has witnessed the worst forms of inhumanity in hot spots around the globe takes an unflinching look at the political and economic forces that provoke human suffering and offers a moving meditation on the nature of humanitarianism. Orbinski was president of Doctors Without Borders when it received the Nobel Peace Prize in 1999, and this book echoes and expands on his acceptance speech. He argues that humanitarian action must be free of political influence, must not become a tool of war and must not be silent in the face of human-rights violations. Its goal is the relief of human suffering, and though imperfect, it is essential. In 1994, the author was chief of mission for DWB in Kigali, Rwanda, when a million men, women and children, 85 percent of all the Tutsis, were exterminated. By withdrawing its forces from Rwanda, the United Nations "became little more than a cowering paper lion," Orbinski charges, "offering earnest resolutions and fine humanitarian rhetoric while the superpowers pursued their national interests." The genocide in Rwanda provides some of the most horrific scenes of human brutality and suffering, but the author also takes the reader to the sites of a cholera epidemic in Peru, a minefield-surrounded refugee camp in Afghanistan, civil wars and famine in Somalia and Sudan and to Kosovo, where humanitarian action became a justification for military and political intervention. He tells powerful stories of individual courage and suffering, but equally important, he offers lucid accounts of the complicated political alignments and realignments shaping events. After completing his term as president of DWB, the author took up a new battle, spelled out in hispenultimate chapter: the fight for access in the developing world to essential medicines against infectious diseases and the setting up of community-based care centers in developing countries for people with HIV/AIDS. Readers spurred to action by Orbinski's example will find organizations worthy of support in an appendix. An important, consciousness-raising work.
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Product Details

  • ISBN-13: 9780802717092
  • Publisher: Walker & Company
  • Publication date: 9/30/2008
  • Pages: 448
  • Product dimensions: 6.50 (w) x 9.30 (h) x 1.40 (d)

Meet the Author

James Orbinski is past international president of Medecins Sans Frontieres/Doctors Without Borders, and accepted the Nobel Peace Prize for MSF in 1999. Prior to joining MSF, he was a medical researcher in Rwanda in the late 1980s, and a family doctor in small town Canada. With MSF, he worked in Peru, in Somalia during its famine and civil war, in Afghanistan during its civil war, in Rwanda through the genocide and in Zaire during the slaughter that followed. In 1999, he helped launch MSF’s Access to Essential Medicines Campaign, and he has spoken on behalf of MSF before the United Nations Security Council, the leaders of the World Health Organization, the United Nations High Commission for Relief, the World Bank, and at the White House and before government ministers and heads of state the world over. When his term as president of MSF ended in 2001, he worked as chair of MSF’s Neglected Diseases Working Group. In 2004, he left MSF to found Dignitas International, an organization committed to community-based care for people living with HIV/AIDS in the developing world. He lives in Canada.

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