Reasons

I'm a humanitarian aid worker. I have a hard time whenever someone starts telling how great a job I'm doing. My normal responses run the gamut from a humble "thank you" to the usual, "I don't do it for the recognition" to the adamant "I'm not a super hero!"

Well-meaning bystanders applaud me all the time, and I am uncomfortable with it. I have finally fine-tuned my response to a semi-stranger when they eventually ask "so what do you do?"

"I'm do project management for an international medical organization."

"Oh, uh, cool. That sounds... international"

The conversation moves on.

Much better than:

"I work for Doctors Without Borders."

"OMG, tell me everything about you. You are now the coolest person I've ever met. How many people have you seen die?"*

*Disclaimer: This generic reaction is slightly exaggerated and has never actually happened to me in these exact words, but you'd be surprised how close people get. UPDATE: I have been asked how many people have I seen die. The other party hedged and clarified the question was to ask if it was a non-zero number.

I reflect often on why people's admiring or favorable reactions make me so uncomfortable. I can't quite pin it down. But it's true that I don't do my job so that others can be grateful of my work or sacrifice or efforts.

I do what I do because I can't imagine working for my own personal gain.

I have access to the internet, I have a first-rate education, I grew up with roads, running potable water, sewers, traffic lights, police, a fire department. We even had a dog as a pet. My childhood was spent climbing trees and getting dirty.

I have so much more than the vast majority of this world's population, I cannot imagine working to amass personal wealth. Why wouldn't I work to help the less fortunate?

Also, it is the most challenging occupation I could think of doing, and I want to pit myself against the most difficult situations, for the most possible net gain in the wellbeing of the world. It's logical.

A Cappella

Amid layers of cultures, I teared up at the performance of five Slavic men singing a cappella.

I'm standing in an ancient Roman palace that has evolved over the centuries into old town Split in Croatia, and a group of a cappella singers are promoting their CD and showing off their traditional song. They were on a break when our walking tour passed by, but our guide asked them to give us a sampling and they responded with enthusiasm. They smoothed their cumberbunds, put away their smart phones, gathered themselves and launched into a rousing song.

The look on their faces is one of concentration and purity. For some reason, people tend to pinch their eyebrows while singing. It makes them incredibly honest-looking and endearing. Here in this open dome, built thousands of years ago, these men are making art and culture. What they are doing has nothing to do with survival or putting food on the table. It strikes me hard as a reminder of what I fight for. I am on 10 days' vacation between a posting in Chad, trying to contain first an epidemic of meningitis, then, when that died down, an epidemic of measles, and my next posting in Democratic Republic of the Congo to fight the Ebola outbreak in a war zone.

My life has become an experience of dusty roads, no running water, intermittent electricity and patchy, haphazard interpersonal relationships. I give up a lot. But confronted by culture, even a glancing encounter in a ruined vestibule of a former palace, I get a dose of motivation and perspective. Life is not about torturing bitter plants out of sandy soil. It's not about planting four posts to hold up a tarp to give shelter to a family. Human life is about something more, be it dancing at a funeral, telling stories around a campfire, playing games as a group, or making music. Even when the most urgent of human needs take precedence, when survival itself is threatened and the only hope is external humanitarian aid, aid for the basic human condition given freely by strangers, humans are more. Humans need art, creativity, culture. And finding that in unexpected places reminds me how rare it is. How in the life of the beneficiaries of the aid we provide, in the life of my patients, they lack for food and water, medical care and shelter. But they lack for laughter and art too. They need it, they are capable of it. There is so much more work to do. And I mourn that.

Food

Two nights ago, I ate at a Michelin star restaurant in Bordeaux. Tonight, I am sitting under the stars, at a roadside food station on the side of the main road, eating grilled beef tongue and barbecued tilapia, served with heads and skin. I am serenaded by the competing music bleeding from the night clubs on either side of us, as I feel for my food guided by the spill from the harsh fluorescents at the phone repair shop across the street. Motorcycles zip by constantly, carrying passengers about their evenings, and people flow by on the side of the road in front of us. I am anonymous in the darkness at this un-named food stand owned by a woman who argues vehemently that she has never given a receipt in her life and she will never give one, no matter how much I insist. The air cools off and starts to circulate, giving relief from the Tchadian hot season on this first day of April, the hottest month of the year. As I settle in to wait for the food, I stare at the stars, which filter through the dust and minimal light pollution to give a little more illumination to work with. Tomorrow I go back to work negotiating, inventorying, consulting, summarizing, explaining, reporting, cajoling, deciding. But for now, I breathe.

Helicopter

MSF has given me many "firsts", including first time on a helicopter. I feel so cool when I get to casually talk about jumping on the helicopter and visiting our field projects. It's loud, without a lot of space, but it's a helicopter! That makes it fun and exciting no matter what.

Field Visit

I saw a tornado in the desert.
It passed by
Like everything else below.

Recalibration

I work with populations that are stressed and traumatized. It starts to get to me, and I don't often realize it. I become calloused and cynical. Babies die, old people get left for dead, women get raped. War passes through towns, entire lives go up in flames, and the sun still rises. My calculations are about the emergency minimum for people to not get sick. Can a family live on 5 gallons of water per day? For how long? My horizons shrink and violence becomes the norm. I lose sensitivity.

I see mothers in their teens, with babies strapped to their backs, hauling water all day. The only redeeming factor of the baby is that it is lighter than the water on their head. Children becomes burdens in this war-torn land.

Then I get moments that break through my calloused shell, that jolt me out of the apathy and cynicism that have become my normal.

I see our driver bouncing a baby up in the air and cooing. A 50 year old man with grey in his beard, beaming like a kid with chocolate. "Aww, is that your son?" "Nope." He's just happy to see a baby.

I pass by a vaccination site, full of people waiting in the sun, crying children, and loud health promoters. A mother takes the time to kiss her child's boo boo after getting vaccinated. She stops crying. I continue on with a lighter step.

Early Mornings

Dawn is stretching itself across the eastern sky. I used to be excited when I had to wake up before first light to go out on field activities. Now it's just early. I stir myself enough to take a picture of the sunrise, since I have an hour car ride to the mobile clinic site that I'm visiting. I'm out so early to check up on the setup procedure, which I have heard is still problematic, even after 3 weeks of activity. We should be able to set up a functional mobile clinic in a couple tents within an hour and a half, and apparently we are taking 4 hours. When I heard about that, I programmed myself on the next early morning ride.

The next day, I'm on the road again at 6am, before first light, but this time by foot. I'm walking from the living compound to the pharmacy compound to give a cold chain training, and the sun is rising in front of me. I load my training with funny expressions, so the audience of 40 people packed into the cold chain shelter will remember the information I am droning at them. I call the ice packs pregnant, I talk about chickens hatching. I'm not sure if anything I say resonates with these nurses and doctors, but I hope it is memorable. I'm recalling my physics classes in high school, with the high specific heat of water, and the second law of thermodynamics. Somehow, I don't think bringing that up would be helpful. I'm referencing science and asking the trainees to think back to their school days, in science class. I have no idea how the school system is structured in Uganda, whether they were expected to learn any of this or not. We go over the state changes of matter, and the freezing point of water. We get stuck on the fact that ice can be colder than 0 degrees. We go over it again. I think we get past that. I hope I'm not giving offense. We move on to condensation. Hopefully without condescension.

The rest of the day passes in meetings and reports, and the sun sets with me still in the pharmacy compound, finishing a meeting over whiskey. As we walk back to the living compound, we mourn there is no time for our favorite workout video, to say goodbye as a team.

Because tomorrow I leave at 6am for the end of my mission. I will see the sun come up one more time this week, while on the road in Uganda.