Q&A with South Africans working at Doctors Without Borders

Spanning the globe, the international organisation Médecins Sans Frontières (MSF) – Doctors Without Borders in English – helps those affected by natural disasters or caught in conflict zones. We profile South Africans working in this organisation, elevating the country’s reputation through the work they do.

MSF
Claire Waterhouse has been an MSF fieldworker since 2012. She works during the Ebola outbreak in Western Africa in 2015. (Image: Supplied)

Compiled by Priya Pitamber

In 1971, 13 doctors and journalists in France joined forces to form Médecins Sans Frontières (MSF), known in English as Doctors Without Borders.

Its aim, reads the MSF website, was to “establish an independent organisation that focuses on delivering emergency medical aid quickly, effectively and impartially while also speaking out about what they witnessed”.

On its founding, it comprised 300 volunteers ranging from nurses to doctors and other staff to help people in distress, both natural and man-made and those caught in the middle of armed conflict.

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“MSF remains fiercely independent of both governments and institutions,” reads the website. “MSF also reserves the right to speak out to bring attention to neglected crises, challenge inadequacies or abuse of the aid system, and to advocate for improved medical treatments and protocols.”

Today, the MSF has offices in 28 countries, including South Africa. And South Africans in the organisation help raise the country’s profile through the work they do. We talk to four such MSF staff.

Claire Waterhouse joined the MSF as a field worker in 2012.

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Stefan Kruger, a doctor with the MSF, is proud to contribute as a South African to the international community during times of need. (Image: Supplied)

Stefan Kruger, 33, is a Cape Town doctor. He has sporadically worked for the MSF since 2012.

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Anna Cilliers is a professional nurse with the MSF. She travels to South Sudan in June 2013 for a vaccination campaign to reduce the spread of seasonal meningitis. (Image: Supplied)

Anna Cilliers, 47, is a nurse and has been with the MSF since 2012. She is responsible for co-ordinating medical activities at project/field level.

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Midwife Jeanne Rene (Zani) Prinsloo has been with Doctors Without Borders since 2012. She’s travelled to Pakistan, the Philippines, Afghanistan, South Sudan and other countries putting her skills use. (Image: Supplied)

Jeanne Rene (Zani) Prinsloo, originally from the Eastern Cape but now living in Johannesburg, is a social worker and a midwife. She has been with the MSF since 2012.

Brand South Africa: How did you get into this role?

Claire Waterhouse: I had moved back to South Africa from Hong Kong and was looking for a job. MSF caught my eye and luckily, I caught theirs too. They offered me a mission in the Central African Republic for six months and the rest is history.

Stefan Kruger: I always had the idea of spending at least a part of my career doing humanitarian work. When the timing was right I followed the normal recruitment process of MSF South Africa.

Anna Cilliers: As a young and inexperienced nurse, I was introduced to the work of MSF during the 1980s when I read The Dressing Station by Jonathan Kaplan, where he also writes about his work experiences with MSF in conflict zones. I knew then that I would like to join MSF in the future.

I qualified and worked as an intensive care nurse and in 2003 joined international medical humanitarian organisations to work in Iraq and Liberia.

In 2007, I returned to South Africa and worked for a few years in Johannesburg with community-based organisations. In 2012, I applied at MSF. My work and life experiences prior to that definitely prepared me for my work with MSF. My first project in June 2013 was as a nurse in South Sudan where we did a vaccination campaign to reduce the spread of seasonal meningitis.

Jeanne Rene (Zani) Prinsloo: Two quotes inspired me a great deal:

“The best way to find yourself is to lose yourself in the service of others.” – Mahatma Gandhi

and

“Service to others is the rent you pay for your room here on Earth.” – Muhammed Ali

My skills, strong sense of humanity and willingness to positively contribute to improving other people’s lives were the motivating factors for me to join MSF.

Here I am four years later, still at MSF and I am happy to have made this decision. I also love travelling, so by joining MSF, I am also [able] do that.

BSA: How does your work help elevate South Africa’s national profile?

CW: There are not that many South Africans in the field, so I hope that when we are seen in the field, it helps to elevate the country’s profile by showing that there are South Africans out there working hard all over the world to make a difference and provide emergency medical care to those who need it most.

SK: MSF is a truly multinational organisation and it is part of an international community that cares about some of the greatest tragedies of our time. I love the fact that I get to be a part of it, as a South African.

AC: MSF makes it possible for nondescript South Africans like me to help elevate South Africa’s profile. MSF provides opportunities for South Africans to work and live in places where access to medical care is severely limited.

In the different countries where MSF is present, we predominantly work in partnership with the national ministries of health. In Pakistan where I worked for the past 20 months as the project medical co-ordinator at a hospital in the north western region, I might not be remembered by name, but as the South African nurse/co-ordinator who worked with MSF.

My responsibility for representation is to both MSF and South Africa. I’ve observed in the different countries where I have worked, national health authorities – once they know I’m from South Africa – will refer to South Africans who previously worked in the country.

Mostly these South Africans with MSF have been remembered for their good technical skills, their humanitarianism and as being good people.

It is MSF that raises South Africa’s humanitarian profile internationally by employing skilled and experienced persons to work in its projects.

JP: I am proud to be from South Africa, and from the African continent. It is always interesting to discuss our vast history, and people find it fascinating.

In essence, working with MSF internationally gives me an opportunity to represent my country, and introduce other nationalities to this unique, special and beautiful part of Africa.

I am proud that South Africa has a lot of qualified healthcare professionals who can serve the country and beyond. I am always proud to serve others beyond my borders.

BSA: What has been the highlight of your career?

CW: There have been many, many highlights, but I think near the top is probably being involved in the Ebola crisis last year. This was especially towards the end of the epidemic, in Guinea, where we finally started to feel like we had overcome it and that there might be light at the end of the tunnel.

SK: I became quite involved with the response to the Ebola outbreak in West Africa. The highlight was not the start, when it took centre stage in international media, but going back to West Africa for a third time and seeing that there was an end in sight.

AC: The “thank yous” from patients whose lives were saved or from those who benefited from our services.

It is also enriching when we are able to provide supportive care, such as pain control, and to be there in times of need. I have had the honour of being part of this kind of care in conflict zones and in Ebola projects.

Other highlights are when communities and health authorities gratefully acknowledge our services in their towns and villages, which often are rural settings with no or limited infrastructure.

The acknowledgements ultimately go to the donors who contribute to the work of MSF and to the office teams in our home countries who make it possible for us to provide the humanitarian services worldwide where needed.

JP: Over the years, I have had the privilege of working in various countries and places; all of them are different in many ways. Use your imagination to travel with me:

In the Philippines, the devastating Typhoon Haiyan left many people homeless and without access to medical care. However, the positive attitude of the Filipinos taught me some valuable life lessons and gratitude. Despite losing everything, they remained resilient and adapted to the new situation.

In Pakistan, I experienced quite a culture shock and I had to adapt to strict cultural norms and values. Although Pakistan is similar to Afghanistan in many ways, the hospitality and warmth of the Pashtu culture surprised me. The Pakistani MSF colleagues are among the best people with whom I have ever worked.

When I worked in a refugee camp in South Sudan I realised that it was possible for us to make people feel like “we found love in a hopeless place”. The simplicity of everyday life, and MSF camping style meant living conditions were challenging. Our vibrant team, both local and international, taught me to go back to basics and together we survived.

The highlights of a career in this field are definitely contributing to decreasing maternal and neonatal mortality, ensuring access to healthcare for people who are otherwise excluded.

In addition, working with amazing international teams teaches you a lot, just as much as they learn from you. This is a great privilege to be exposed to diversity – to learn it and to live it.

BSA: What has been the most challenging part of your job and how did you overcome it?

CW: Honestly, it’s probably feeling homesick, missing the familiar and your family and friends. You overcome this just by going on. The field is tough but rewarding and you meet amazing people and make lasting friendships to get you through each mission.

Equally, the Ebola crisis was extremely emotionally draining and challenging on all levels. It was really difficult to face the enormity of the situation every day, especially in Liberia.

I’m not sure if we ever really overcame the challenge, just learnt to focus on the good instead: our brilliant national staff on the ground who gave up everything so bravely to work for their countries, every patient we managed to heal, the feeling of working in a team so united to beat this thing.

SK: Doctors tend to always want to do things hands on, right there and then. With MSF, there are often bigger rewards when planning and putting longer term systems in place, at times a tough balance to strike.

I remember hearing a distant explosion while in Afghanistan and instead of rushing to the emergency room with my colleagues, [I] stayed back to finish the inventory for our mass casualty kits.

AC: The most challenging part of my job is to accept the things we cannot do. The tough choices. When working in a conflict zone or in a remote resource-limited area, MSF has to prioritise care.

This means, for example, we cannot provide the specialised treatment to individual patients diagnosed with cancer or children who need heart surgeries as this requires highly specialised care facilities and personnel.

We will provide supportive care and often refer them to other organisations or the local ministry of health who might be able to help.

JP: The lack of sleep! Once you’re on an assignment adrenaline takes over, and you just want to keep working. The desire to do more in a very short period of time is the driving factor.

However, working with a good team always helps because you can delegate some duties to fellow team members. This helps to ensure sustainability of a project and it equips team members with different skills.

I have also seen that we cannot save everyone because women and babies access our services too late just because of the particular circumstances in remote areas or conflict zones. However, we never give up, and our focus remains on saving as many lives as we can.

Yes these realities are hard but I am not desensitised. In all of this, three simple words always help me in making decisions: “Know your limits”.

Working in war and conflict zones poses its own challenges, and keeping our teams and patients safe in our facilities remains a priority. Living conditions, especially in emergency settings, can also be challenging. I always practise yoga to keep me focused and balanced, and it’s an activity widely practised by MSF team members in different projects.

BSA: What advice can you offer anyone interested in getting into a line of work such as yours?

CW: If this is what you want, don’t give up! It’s not always easy to get into this line of work, but it is so worth it, even though there are difficult at times. The work MSF does makes me proud to work here every single day.

SK: Some people may not go back to the field for a second mission, but no one regrets the first.

AC: MSF requires professional, skilled and experienced doctors, nurses, para-medical staff, health management, logistics experts, human resources, administration and finance personnel to deliver a high standard of care in our projects.

I would advise anyone who would like to join MSF to be intentional in career choices and to get at least two to three years of experience in your particular field of work before applying.

I am glad I had 12 years of nursing experience in different contexts and other humanitarian settings before I joined MSF.

The living and working conditions with MSF often are challenging due to the unpredictable security contexts of the location and therefore a mature approach and prior life and specific work experience are invaluable advantages to help ease challenges in the field.

JP: It is a privilege to do this work. And while it is not easy, it is very rewarding because your skills can be used where they are needed most:

  • Working with MSF will enrich your experience but you also need to be flexible, adaptable and creative to keep thinking outside of the box.
  • If you like extreme travelling and adventure, this it is for you.
  • Be humble and always willing to learn. Team work is key in realising our end goal.
  • You might miss the comforts and familiarity of home, but you always get the best out of every assignment you go on.
  • You will learn so much about yourself on a personal and professional level, pushing yourself to the limits, ultimately becoming a better human being.

BSA: Is there anything else you’d like to add specifically related to your field?

SK: There is actually a fair amount of diversity in the projects that MSF takes on. It therefore requires a wide range of different professionals, with different interests and / or specialities.

AC: Working with MSF is more than a job for me; it’s my passion and vocation. How MSF started and why it exists resonates with my core outlook on life.

I am passionately South African as well because what we’ve experienced in our country has prepared me to work in cross-cultural settings in politically unstable and conflict countries. Our history, as South Africans, has also taught me tolerance and to listen and learn from people who are different from me or my tribe. Thank you fellow South Africans for providing me with this priceless gift.

If you’d like to work with MSF, click here, or if you’d like to donate, click here.

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