Free eBook An Imperfect Offering: Humanitarian Action in the Twenty-first Century – Carcier.co

As Albert Camus wrote, the doctor s role is as a witness to witness authentically the reality of humanity, and to speak out against the horrors of political inaction The only crime equaling inhumanity is the crime of indifference, silence, and forgetting James OrbinskiIn , James Orbinski, then a medical student in his twenties, embarked on a year long research trip to Rwanda, a trip that would change who he would be as a doctor and as a man Investigating the conditions of pediatric AIDS in Rwanda, James confronted widespread pain and suffering, much of it preventable, much of it occasioned by political and economic corruption Fuelled by the injustice of what he had seen in Rwanda, Orbinski helped establish the Canadian chapter of M decins Sans Fronti res Doctors Without Borders MSF As a member of MSF he travelled to Peru during a cholera epidemic, to Somalia during the famine and civil war, and to Jalalabad, AfghanistanIn April , James answered a call from the MSF Amsterdam office Rwandan government soldiers and armed militias of extremist Hutus had begun systematically to murder Tutsis While other foreigners were evacuated from Rwanda, Orbinski agreed to serve as Chef de Mission for MSF in Kigali As Rwanda descended into a hell of civil war and genocide, he and his team worked tirelessly, tending to thousands upon thousands of casualties In fourteen weeks , men, women and children were exterminated Half a million people were injured, and millions were displaced The Rwandan genocide was Orbinski s undoing Confronted by indescribable cruelty, he struggled to regain his footing as a doctor, a humanitarian and a man In the end he chose not to retreat from the world, but resumed his work with MSF, and was the organization s president when it was awarded the Nobel Peace Prize inAn Imperfect Offering is a deeply personal, deeply political book With unstinting candor, Orbinski explores the nature of humanitarian action in the twenty first century, and asserts the fundamental imperative of seeing as human those whose political systems have most brutally failed He insists that in responding to the suffering of others, we must never lose sight of the dignity of those being helped or deny them the right to act as agents in their own lives He takes readers on a journey to some of the darkest places of our history but finds there unimaginable acts of courage and empathy Here he is doctor as witness, recording voices that must be heard around the world calling on others to meet their responsibility Ummera, ummera sha is a Rwandan saying that loosely translated means Courage, courage, my friend find your courage and let it live It was said to me by a patient at our hospital in Kigali She was slightly older than middle aged and had been attacked with machetes, her entire body rationally and systematically mutilated Her face had been so carefully disfigured that a pattern was obvious in the slashes I could do little for her at that moment than stop the bleeding with a few sutures We were completely overwhelmed She knew and I knew that there were so many others She said to me in the clearest voice I have ever heard, Allez, allez Ummera, ummera sha Go, go Courage, courage, my friend find your courage and let it live From An Imperfect Offering


10 thoughts on “An Imperfect Offering: Humanitarian Action in the Twenty-first Century

  1. Nastassja Nastassja says:

    She was slightly older than middle aged She had been raped Semen mixed with blood clung to her thighs She had been attacked with machetes, her entire body systematically mutilated Her ears had been cut off Her face had been so carefully disfigured that a pattern was obvious in the slashes Both Achilles tendons had been cut Both breasts had been sliced off Her attackers didn t want to kill her they wanted her to bleed to death They knew just how much to cut to make her bleed slowly She She was slightly older than middle aged She had been raped Semen mixed with blood clung to her thighs She had been attacked with machetes, her entire body systematically mutilated Her ears had been cut off Her face had been so carefully disfigured that a pattern was obvious in the slashes Both Achilles tendons had been cut Both breasts had been sliced off Her attackers didn t want to kill her they wanted her to bleed to death They knew just how much to cut to make her bleed slowly She lay on the road, a 1 taped to her forehead, and now we were just looking at each other Je m excuse, je m excuse, I said, apologizing for the pain my pinching forceps gave her She blinked once, slowly to let a wave of pain pass She held my forearm I felt a wave of nausea as I looked again at the pattern someone had cut in her face I turned from her and vomited for the first and only time during the genocide.She waited as I spit out what was left of the bile in my mouth Then she touched my forearm again I looked into her brown eyes Ummera I wasn t sure if she was saying it to herself, but then she continued Ummera sha Sha, I thought, it means my friend She was speaking to me Ummera, ummera sha she repeated I tied off the bleeding arteries where her breasts had been The nurses were calling again, Docteur, le pro chain, le pro chain Vite, Docteur The woman was one among many, among hundreds She knew there were so manyAgain she reached to touch my forearm She didn t hold it this time She nodded, looking at me Allez allez Ummera, ummera sha, she said in a slow whisper Go, go Courage, courage, my friend It was the clearest voice I had ever heard.I finished this book feeling repulsed yet oddly comforted The sheer weight of human suffering is palpable, and the corresponding list of depravity goes on to include everything from genocide, to pharmaceutical greed, to the exploitation of famine relief In stark contrast stands James Orbinski, a man I have subsequently developed a great deal of respect for In some of humanity s darkest moments he remains vigilant, dedicated, and compassionate in his work He doesn t differentiate between the large and the small fights, and from opposing big pharma to putting his own life in danger to save a single person Orbinski is a guiding light in a world of darkness While many parts of this book were deeply disturbing, reading it all from the perspective of such an exceptional human being lent a silver lining of hope.Where I live, we simply do not grasp what occurs in other parts of the world We read about it, we may watch it on television we may even meet someone who has experienced it, but that is never a substitute for being there Many of Orbinski s words describe scenes of unimaginable horror The largest portion of the book is devoted to his role in the midst of the Rwandan genocide, an event that affected him profoundly Yet rarely does he address the personal impact of his experiences There are many scenes that I found difficult to finish, including one that forced me to put the book down for the rest of the day the one I have quoted above How Orbinski managed not only to survive but to be a positive force in the midst of such suffering and chaos I will never know.As advocate and for a time president of Medicins sans Frontieres, Orbinski s work has taken him all over the world Other chapters are devoted to Afghanistan, Somalia, Zaire and Kosovo among others He developed MSF s Access to Essential Medicines campaign, and established Dignitas International in Malawi to combat its rampant HIV AIDS epidemic The latter topic deeply resonated with me, having travelled to Malawi three years ago As a tiny, landlocked country with one of the highest HIV AIDS infection rates in the world, it rarely receives much press The exceptionally high death rate means countless orphaned children and broken families, an out of control intellectual workforce drain, and little to no healthcare support It s not uncommon to meet someone there who has lost their entire family.The most compelling part of this book stems not from its darkest passages, but from the voice of its author If one man can face such daunting challenges with so much care and perseverance, perhaps there is hope for us after all


  2. pri pri says:

    a while ago, I saw the film Triage and there leaned a bit about Dr James Orbinski and his work it was incredibly moving and i was absolutely fascinated with his work and with what a great story teller he is The film covered his return to Somalia and Rwanda where he had worked for MSF Doctors without Borders and his then current endeavor of writing a book about his experiences and viewpoint i do highly recommend the film the book itself is athorough look at his life, motivation a while ago, I saw the film Triage and there leaned a bit about Dr James Orbinski and his work it was incredibly moving and i was absolutely fascinated with his work and with what a great story teller he is The film covered his return to Somalia and Rwanda where he had worked for MSF Doctors without Borders and his then current endeavor of writing a book about his experiences and viewpoint i do highly recommend the film the book itself is athorough look at his life, motivation, and time spent working for MSF and beyond it s difficult to say this is a good book in a conventional sense as the subject matter is at times frustrating, horrific, and emotional yet it is the best book i ve read in some time but again, I find Orbinski is an incredible story teller focusing in on such small but important moments in the midst of detailing the political situations it is amazing to me that someone can see the worst of humanity and still have hope, still fight and that, to me, was the question i had reading this book.Quote Stories, we all have stories Nature does not tell stories, we do We find ourselves in them, make ourselves in them, choose ourselves in them If we are the stories we tell ourselves, we had better choose them well I ask again and again, How am I to be, how are we to be in relation to the suffering of others It is about a way of seeing that requires humility, so that one can recognize the sameness of self in the other It is about the mutuality that can exist between us, if we choose


  3. Banu Altunbas Banu Altunbas says:

    Being an MSFer myself, I can relate to many of the stories James Orbinski talks about in his book This book is about the passion that we all have for the work we do on the field, and the genuine interest in humanity And there is one picture in the book where James took it in Masisi DRCongo, that has Jean PP as a young driver next to James Jean PP is still working today with MSF in North Kivu He hardly recognized himself in the picture though


  4. Ocrema Ocrema says:

    The book is really cool.


  5. Amanda Amanda says:

    An open, honest, beautifully disturbing account of humanitarian work James Orbinski is an inspiration He does what most of us would be afraid to even attempt If you have an interest in human rights and want to hear the truth, read this book.I read the introduction as a preview onNext thing I knew I had to own this book His thoughts were compelling and insightful from the first line, making you think about the politics our world is caught up in and how humantarianism fits in to the g An open, honest, beautifully disturbing account of humanitarian work James Orbinski is an inspiration He does what most of us would be afraid to even attempt If you have an interest in human rights and want to hear the truth, read this book.I read the introduction as a preview onNext thing I knew I had to own this book His thoughts were compelling and insightful from the first line, making you think about the politics our world is caught up in and how humantarianism fits in to the global discussion He does not accept the easy answers but searches for the raw uneasy stories that lie beneath And let me tell you, some of his stories will turn your stomach Some of the images I was left with will never leave meI can t imagine seeing it first hand The chapter on the Rwandan genocide was the hardest to get through Yet, I never wanted to stop I rather know the truth than hide from it This is our world and no matter how hard you try that is one truth you should not hide from Orbinski decided, once coming back from Rwanda, that he rather know the truth about the world then be blinded by propaganda and pretty pictures Ifof us would make this choice our world would have the chance to be a better place.I also really appreciated the chapters on Somalia, the DRC, Afghanistan, and the Afghan Iraq invasion I was educated on issues I was not aware of For brief moments, as I read its pages, this book opened my eyes Some people live this everydaythey live it I was captivated by the destruction and violence, the idea that this brutality resulted from human hands But I was also captivated by the perseverance, hope, and kindness that human beings possess In these chapters, I caught a glimpse of what these countries have, and are facing, daily It made me want to knowThis book gave me the desire to seek out answers.One thing I truly loved about Orbinski s writing was that he did not let his successes get in the way of his story telling Often, when reading political pieces I get frustrated by the egos that are involved I never felt this with Orbinski He has reason to be proud of himself, yet he reamins level headed with his humility intact I found that he placed facts and stories in front of me without forcing me to choose his ideals and beliefs I really appreciated and respected that Finally, I want to say that I am grateful to Mr.Orbinski for striving to make our world a place he wants to raise his children, for being open to sharing his experiences, for remaining hopeful in the face of so much hate, and for educating me on the issues that matter


  6. Emily Emily says:

    This book was heartbreaking and intense, but important nonetheless It s the memoir of a physician who worked in the field with MSF for many years and then went on to become the international president of the organization Dr James worked all over the globeSomalia, Congo, Kosovo, North Korea, Russia, Central and South America, Zaire, and Rwanda during the Rwandan genocide in 1994 His stories and the details of these global conflicts, from the perspective of a humanitarian aid worker and p This book was heartbreaking and intense, but important nonetheless It s the memoir of a physician who worked in the field with MSF for many years and then went on to become the international president of the organization Dr James worked all over the globeSomalia, Congo, Kosovo, North Korea, Russia, Central and South America, Zaire, and Rwanda during the Rwandan genocide in 1994 His stories and the details of these global conflicts, from the perspective of a humanitarian aid worker and physician, are shocking and gut wrenching In his accounts he not only addresses the horrors of human suffering worldwide, but also the politics during these events and how detrimental they sometimes were to the humanitarian effort I was shocked to learn how little it would have taken for the UN or the United States to intervene in Rwanda and spare the lives of over 800,000 men, women and children not to mention the manywho died in refugee camps of starvation or infectious disease It wasn t until weeks, and hundreds of thousands of brutal killings later, that the UN finally acknowledged the situation as a genocide so that appropriate international intervention could even take place.After working in the field, Dr Orbinski went on to advocate for AIDS HIV patients in Africa, going up against the pharmeceutical industry who feared that releasing their patent on antiretroviral drugs in order to allow for a generic, would disturb their profits With the international clout of MSF he was successful in forcing the pharmaceutical company to release the patent, making possible the production of a generic, thereby lowering the annual cost of the ARV treatment from 15,000 per year to 200 per year per patient.Reading this book, I feel grateful for the existence of people like Dr Orbinski who sacrifice and risk so much to work in some of the most difficult situations a person can imagine, who have a profound compassion and concern for the health, well being and survival of far less fortunate people, who are willing to stand up and speak out on their behalf, and who are able to do all of this while maintaining a certain humility and somehow, unbelievably, sanity


  7. Dianne Everson Dianne Everson says:

    I gave this worthy of 5 stars book a 4 star review because to me it was too harrowing at times, although that should not be changed by the author, but the subtitle humanitarian action in the 21st century didn t reveal the fact that it dealt so thoroughly with the Rwanda genocide and msf doctors without borders.Orbinski is a good writer, and as a humanitarian must be almost legendary.This book deserves to be read, and should be read.Canada has not only its D Allaire who saw Rwanda from our m I gave this worthy of 5 stars book a 4 star review because to me it was too harrowing at times, although that should not be changed by the author, but the subtitle humanitarian action in the 21st century didn t reveal the fact that it dealt so thoroughly with the Rwanda genocide and msf doctors without borders.Orbinski is a good writer, and as a humanitarian must be almost legendary.This book deserves to be read, and should be read.Canada has not only its D Allaire who saw Rwanda from our military perspective, but also our Obinski, a doctor who accomplished so , mixing healing with an Amnesty International perspective, and that of a research scientist who fought for inexpensive new drugs for Africa Imagine fighting big Pharma, inaction of the United Nations, for neutrality of NGOs in Kosovo, and for dignity to all.You don t have to Orbinski did it all, thus redeeming humanity and hope in the midst of mans inhumanity to man


  8. Laurie Laurie says:

    This book is written by a former president of Doctors without Borders Each chapter chronicles his experiences and the Borders organization in various countries including Afghanistan, North Korea, Rwanda, Sudan, etc Sometimes I got lost in all the names and politics of it all but I learned a lot The theme that stood out to me is the relationship between humanitarianism and politics and how so many try to keep the two separate but this is near impossible I especially enjoyed one of the last ch This book is written by a former president of Doctors without Borders Each chapter chronicles his experiences and the Borders organization in various countries including Afghanistan, North Korea, Rwanda, Sudan, etc Sometimes I got lost in all the names and politics of it all but I learned a lot The theme that stood out to me is the relationship between humanitarianism and politics and how so many try to keep the two separate but this is near impossible I especially enjoyed one of the last chapters on his work in trying to promote access for life saving drugs to developing countries Except for a few exceptions, the author writes from a very objective standpoint which is helpful so that the reader can make up their own mind especially when it comes to the politics but I think I would have liked to know a littleabout his own reactions and feelings on things


  9. Mark Mark says:

    Orbinski s book is an easy read and is a great starting point for people who know little about the Rwandan genocide I enjoyed his vivid, raw and at times lurid detail of the events that unfolded I have a profound degree of respect for his selflessness and his relentless pursuit to help others and lobby for their plight I especially enjoyed the last chapter on his advocacy work to allow cheap access to drugs in developing countries, his fight against the PHRAM lobby and his explanation of the Orbinski s book is an easy read and is a great starting point for people who know little about the Rwandan genocide I enjoyed his vivid, raw and at times lurid detail of the events that unfolded I have a profound degree of respect for his selflessness and his relentless pursuit to help others and lobby for their plight I especially enjoyed the last chapter on his advocacy work to allow cheap access to drugs in developing countries, his fight against the PHRAM lobby and his explanation of the politics behind ARVs and its relation to the pharmaceutical companies and western governments It was succinct and concise, and his arguments for the ending of pharmaceutical monopolies on patented ARVs was clearly presented


  10. Stephanie Allen Stephanie Allen says:

    This is one of the most powerful books I have ever read It seemed that the entire book was a manifesto for preserving the power of humanitarianism pure humanitarianism, free from political tangles or ulterior agendas It was refreshing and poignant timely and timeless The book was very well researched, which is one of the reasons it took me two months to read The level of detail about political exchanges and turmoil was impressive and I learned a great deal Reading this reminded me of huma This is one of the most powerful books I have ever read It seemed that the entire book was a manifesto for preserving the power of humanitarianism pure humanitarianism, free from political tangles or ulterior agendas It was refreshing and poignant timely and timeless The book was very well researched, which is one of the reasons it took me two months to read The level of detail about political exchanges and turmoil was impressive and I learned a great deal Reading this reminded me of humanitarian ideals that must be upheld and how easy it is to be ensnared by nationalism Would recommend this book to anyone interested in global health or international relations, especially those feeling burnt out or compassion fatigued