Interview with Philippe Tanguy, MSF

Philippe Tanguy is the Head of Communications at Médecins Sans Frontières Australia. MSF is the leading independent humanitarian organisation providing emergency medical aid to victims of war, famine, disease and natural or man-made disasters all over the world. Philippe recently visited Democratic Republic of Congo (DRC) and shared with me his insights about the situation in DRC, the challenges of providing medical aid in the field and what keeps him motivated.

What I find inspiring about people like Philippe is that they are able to stay positive, actively making a difference despite setbacks, challenges and disheartening situations.

You visited Bon Marché Hospital in Bunia, DRC in April-May this year. Can you tell me a bit about your experience there?

Bon Marché Hospital in Bunia, DRC is an emergency hospital, built three years ago at the height of the major crisis in the region. The region is prone to extraordinary outbreaks of violence which are quite unpredictable and involve numerous militia fighting each other. There are also other rebel groups coming from outside the borders.

Security is at a premium. For humanitarian aid workers, there is a curfew—sometimes it’s 8 o’clock at night, sometimes it’s 9, which every volunteer has to observe. Everybody is in touch with each other through a 2 way radio and walkie talkies. Unlike normal NGO and UN vehicles, MSF vehicles are painted with a pink stripe around them. This means that they won’t be shot at by the rebels and militias, because MSF provides medical aid for their people as well as the opposing people.

Can you describe the setting of the hospital?

The hospital itself is on the ground. There’s no concrete floor except the two small operating theatres. It’s set up in the middle of a refugee camp. It is made up of wooden poles to hold up plastic sheetings so it’s a tent hospital. It’s been like this for the last years. Now MSF is embarking on building a semi-permanent structure. This makeshift hospital has more than 300 beds. And it has something like over 2500 consultations a month.

What are the main diseases/medical issues that are treated in Bon Marché Hospital?

The majority pathologies are malaria, measles, which particularly affect children, dehydration and diarrhoea. There is also cholera, typhoid and even pneumonic plague in DRC. The emergency hospital takes the form of an intensive care unit which is always completely packed. A fairly large percentage—about 25–35% is made up of civilians who have been wounded as a result of the fighting.

Who staffs the Bon Marché Hospital?

We have at Bon Marché at any one time 17–20 international volunteers and they’re supported by more than 300 national staff. So that gives you an idea of the size of the hospital. It’s small in size but it’s extraordinarily big in what it does and the way in which it does it. Everything goes on from 6 o’clock in the morning till something like 10 o’clock at night, at the most frantic pace because you’re actually seeing people who are almost fatally ill every hour coming in you know in that emergency structure.

What are some of the challenges of providing medical care in the DRC?

Unfortunately the mortality rate is high. One of the reasons for this is that by the time the patients come to us, it becomes so late that there’s very little that can be done. Sometimes children come in when you cannot even find a vein in their skin to feed them intravenously and to give them the drip because they’ve been suffering from such bad diarrhoea and malnutrition and they’re so thin when they come after days and days of travelling.

Because of the conflict around the hospital, they have to negotiate and circumnavigate the hostile villages, they have to seek shelter in one family but not another, and they have to dodge bullets and gangs on the rampage. This also means it takes a long time to reach the hospital.

In these settings, it is not uncommon for a child to very quickly get into a very weak state and not be able to fight
diseases which are completely treatable and curable. Nobody should be dying of measles and nobody should be dying of malaria. I mean it’s just a pill a day to fix you. But of course people do get affected in the most fatal way by these diseases because the conflict has compounded the situation and on top of that the total lack of public health infrastructure.

In families with several children, there is the agonising situation where the mother must leave behind her other children and organise for them to be taken care of. If it’s her husband then he can’t go into the field to actually plough the field and feed them.

There is no ambulance. There are no roads for ambulances to get through.

So you see you’re completely dealing with a different set of parameters, a completely different environment, and it takes a lot of resistance, resilience, on everybody from the national staff to the international volunteers, for them to be there in those conditions. They work so hard and so relentlessly to get things going and to have that kind of reputation that we have now—MSF has been declared the top NGO in Ituri for 3–4 years running now.

How do you stay focused and motivated given all the obstacles you come across in your work?

The patients keep you going. In spite of the high mortality rate, there is also phenomenal success … When the patients have a smile and are thankful for MSF—that keeps you going … because you can see that you are making a bit of a difference. One must be realistic but at the same time you are completely motivated to keep on. There’s no question of giving up in that kind of situation.

Oh you get discouraged and on occasion you get disheartened—particularly with individual cases. Sometimes the sheer hugeness of the task and the fact that it goes on and on and doesn’t seem to have an end in sight can get you down. Our volunteers are very equipped to deal with that situation—they’re trained and get the psychological support that they need. But generally speaking the work being done is so worth while that you don’t even begin to think otherwise.

What sorts of things are you doing to raise awareness in Australia about the urgent situation in DRC?

Well at the moment we have this Congo exhibition, which has been travelling around the world and is touring Australia at the moment. The exhibition sprang from the idea of the photographers themselves, who are world renowned photographers. They came for one month, took their photos and donated the 10 best photos each for this exhibition. Through it we hope to document and depict the suffering but also the kind of hopefulness that the civilian population of DRC demonstrate in the face of extraordinary adversity. Some of those photos are quite uplifting and quite muted in their statements. MSF hopes that by showing the essential humanity, our work will be documented in terms of what we do, which is really about the doctor-patient relationship and trying to heal those people who have suffered and bring them some medical aid when there is no structure to do that in their country.