Captains Without Borders
Laotian children, waiting for food at the refugee camp from his 2005 Thailand mission.
Captain Phil Sacks was the first SEA captain to volunteer for a mission with Doctors Without Borders. This excerpt below is from an email received just after Phil arrived for his second mission, this time in the Sudan.
I can’t begin to describe the situation here. I arrived in Juba, South Sudan not quite two weeks ago, and then flew to Aweil two days later. I think that means I have been here for ten days. We have been working 12-14 hour days. The original goal of the mission, to support a maternity ward in a hospital has been dwarfed by our new emergency mission, which is to supply food and non-food items to several thousand displaced people in the area surrounding Aweil. Many of the children are malnourished, or severely malnourished, so we are also setting up therapeutic feeding programs. In these cases, children may stay at our centers, which are tents, for a week or so, to be fed special foods. Most would probably die otherwise.
12 February 2008 – Phil Sacks from the Sudan
Phil Sacks (right) and staff celebrate Hmong New Year.
Doctors Without Borders / Médecins Sans Frontières (MSF) is an independent international medical humanitarian organization that delivers emergency aid to people affected by armed conflict, epidemics, natural or man-made disasters, or exclusion from health care in nearly 70 countries. MSF sends doctors, nurses, logisticians, water and sanitation experts and administrators on aid assignments to work in the field alongside locally hired staff providing medical care. According to their website, “MSF’s decision to intervene in any country or crisis is based solely on an independent assessment of people’s needs – not on political, economic, or religious interests. MSF does not intervene according to the demands of governments or warring parties.”
A 28-year career SEA Master, Phil applied for his first deployment with Doctors Without Borders late during 2005, looking to spend an upcoming sabbatical in humanitarian service. To his surprise, he was immediately invited for an interview in New York City where he also took the qualifying examination. Once he had qualified for a mission, he returned to New York for an orientation program and awaited an assignment. MSF pays travel expenses, provides a stipend and offers health and dental benefits for field staff. Personnel live together in the field and are usually provided with a local cook and housekeeper. Field staff have the option to decline an assignment after they receive an offer, and are normally given at least two months notice before deployment.
In April of 2006 Phil accepted his first mission and left for Thailand in July of that year. Since 2005, MSF has been providing healthcare and water supply to what has grown to be over 8,300 Laotian Hmong people taking refuge in a camp of 30-40 acres size in the Phetchabun Province. The Hmong people are an ethnic minority who supported the Americans during the Vietnam War and cite persecution as a reason for fleeing their country even today.
Our main distributions to the refugees are food and charcoal, each bi-weekly, on alternate Fridays. We are attempting to re-institute a distribution of a few additional critical non-food items, such as plastic sheeting for roofs, a cooking stove, pots, and blankets. However, it is becoming apparent that the demand is greater than our supplies. It is quite a problem to decide who should be first in line to receive what we have to give away. How do we determine the neediest? Quite a challenge. And, it seems, the more we give away, the more people ask for. If we begin giving away extra rice to the elderly not served by the large distribution for families with children, everyone gets in line for their share.
23 September 2006 – Phil Sacks from Thailand
An outdoor market in Nigeria.
Phil served as the logistician / administrator for the MSF team that included an American nurse, a French doctor, one Thai staff member and totaled 72, including local workers. In the period of a year, the number of refugees at the camp had grown from 6,500 to almost 8,500.
Bernard Kouchner, now the foreign minister of France, established Medicins Sans Frontieres in France 37 years ago. In 1968, he had responded to a call from the Red Cross for doctors to go to Biafra at the time of their fight for independence. What he saw sparked the organization, formed by him and his fellow doctors, that would take emergency care to locations impacted by violence or natural disasters.
The work here is very interesting. I’m sure all relief missions are unique, but this one has a few differences from most other MSF missions. In most refugee and displaced person camps, there are several non-governmental organizations (NGOs) present, and MSF is generally responsible for medical services only, or perhaps also water supply. Here we are the only major relief agency (except for a few very tiny NGOs that give out a little rice now and then, or bibles). So, we are responsible for essentially all services here. We take care of water, latrines, garbage, vector control (rats and mosquitoes), food and non-food distributions (stoves, charcoal, blankets, and tarps), in addition to MSF’s more customary medical services. We operate an outpatient dispensary (OPD) that sees about 80 patients a day. For problems more serious than can be handled on-site, we refer and transport patients to one of several nearby hospitals. MSF pays all the bills for refugee referrals. The OPD has a staff of about 20 people, all refugees from the camp with various levels of medical training. Some were trained as medics in one of the other refugee camps they have lived, going back 30 years for some, since the end of the French and American wars in SE Asia.
I am responsible for all of the services other than the Outpatient Dispensary (OPD). The logistics team is about 50 people. Half are refugees from the camp, and the other, local Thai citizens, some ethnic Thai and other Thai-Hmong.
27 August 2006 – Phil Sacks from Thailand
Captains Steve Tarrant (center, left) and Al Hickey (center, right) with the Nigerian staff.
Captain Steve Tarrant started as a mate in 1997, and worked with SEA in various teaching positions until becoming a full time faculty member captain in 2003. He began community service work much earlier as a kid. Steve says the event that drew him to MSF service was the 2005 Haitian rescue on the Corwith Cramer. Steve was captain of that vessel when 51 Haitian refugees were sighted floating in Caribbean waters and were safely transported to Jamaica aboard the Cramer. (See Following SEA, Summer/Fall 2005.) After that powerful experience, he was moved to go to Haiti to try to understand the story of the Haitian people. Just months before going to sea with Class 197, Steve had been working as a volunteer at the AmeriCares Free Clinic in his hometown of Stamford, CT. Later AmeriCares was able to connect Steve to the Haitian Health Foundation (HHF) who provide improved health and hope to over 200,000 people in rural southern Haiti. Donations to SEA in honor of the crew and students of C-197 and in support of the refugees were directed to HHF, and ultimately provided badly needed fetal heart monitors for Haitian babies. Steve went to Haiti in January 2006 and when he returned, he wanted to do more.
I’m here in Port Harcourt, Nigeria, population of about 5 million-although census records are supposedly poor. I co-manage 208 Nigerian hospital staff in a 70 bed trauma hospital in one of the worst parts of town, Diobu. We admit lots of gunshot and knife wound victims, road traffic accidents and sexual violence cases. The cops, cults, gangs, militants and military shoot each other then come to our hospital. We don’t deny anyone admission. Care is free. The expatriate staff of physicians and nurses comes from the US, Japan, France, the Congo and Ireland. They are a great team. I relieved a friend and colleague here so my introduction to the place and situation was very thorough. He left me in good shape.
25 November 2007- Alan Hickey from Nigeria
The orthopedic ward at Teme Hospital.
It is happenstance that Alan Hickey followed Steve as a logistician at the Teme Hospital in Port Harcourt, Nigeria. After talking with Phil when he returned from Thailand, Steve applied for a mission with MSF. His tour of duty in Nigeria began on May 23, 2007 and ended on November 23, 2007, just as Al relieved him at the hospital. Doctors Without Borders has been managing this 70-bed trauma center since October 2005. The team in Port Harcourt includes 10 expatriates, each stationed for 6 months to a year, and 4 medical specialists with shorter assignments, serving between two and four months. This area, in the southeast corner of Nigeria, was once called Biafra when it succeeded in the late 1960’s. Civil war raged for three years; thousands of humanitarian aid workers witnessed atrocities. When the war was over, Biafra reverted back to Nigeria. Now it is a densely populated, oil rich area where there is a struggle to gain power and control natural resources that has sparked outbreaks of violence among fragmented networks of armed groups. The Teme Hospital serves victims of this and other violence.