From Bunia

Once again I find myself wondering what drives us to undertake this sort of work. I remember my friend Daniel saying that there are 4 motivations for working with MSF – escape, adventure, money and idealism. In talking of escape, he was referring to the fact that many undertake this sort of work when they are trying to put their past behind them and move on, or even literally escape an uncomfortable situation back home. Undoubtedly the promise of adventure and challenge is attractive to many, and for some even the modest salary is a draw.  Finally on Daniel’s list is idealism…tacked onto the end as an afterthought…. as if to suggest that such motivations are rare amongst people working in the humanitarian sector.

I love the honesty of Daniel’s analysis. And I agree with the theme…that we carry an emotional baggage that influences our motivations and behaviour. I think most of the international staff working with MSF show an escapist tendency, and a search for adventure goes hand in hand with this. But is this it? Is idealism just the gloss that we apply to our heap of emotional baggage? Can we say with confidence whether we are motivated by idealism? And does it matter, if the results are the same either way?

Of course it doesn’t matter… is the immediate response I am tempted to make. The humanitarian industry runs on funds not idealism, and this is a good thing, because the sector needs level-headed economists, not uncritical idealists. The well-known line from Yeats’ poem comes to mind : “The best lack all conviction….the worst are full of passionate intensity.”

It’s easy to be convinced by Yeats’ statement because we have all experienced this, and because the words sound valid. Yet if we make an effort we can all recall people who have bridged this gap, who have bought their ideals, their humanity to bear, without sacrificing their pragmatism. James Orbinski, in his writings on his experience with MSF, shows a untiring humanitarian spirit, an appreciation of humanity, which is nonetheless set within a pragmatic public health perspective. I think we all remember individuals who have influenced us (and reassured us) in this way.

So does it matter whether or not we are idealistic? It depends on the outcome we are looking for – simply achieving the objectives of the current project…. or going further, hoping to influence those around us, to express our personal vision, or perhaps to empower others to express theirs. We all influence others – we all make a statement -  whether we like it or not; and thus perhaps idealism can be redefined as taking responsibility for this, and consciously choosing the manner in which we influence others, to advance our ideals.  

So to return to the first question: it is not so hard to say whether we are idealistic. I do feel that I have a vision… not a very original vision, perhaps a vision that almost all of us share… and I allow that vision to influence the way I interact with others. Perhaps this vision is not always very salient, perhaps my motivation flags at times; but it is always there, peeping through amongst the emotional baggage, at the origin of my desire to do this work (I believe), and not just a gloss I have applied as an afterthought.

At first I felt that one of the risks in this job was that you can spend too much time talking.  At present I feel as if there’s not enough time to talk.

It’s currently time to reflect, to identify how far we have got in achieving our objectives for the year, to identify which objectives are still to be met, and then making modifications to our activities to achieve those objectives. To do this, it goes without saying that we need to attain a shared vision that each member of the field team ascribes to – which involves a lot of talking – and we then need to bring this vision before the coordination team, to establish a vision that they too share. Yet in parallel this vision needs to be compatible with that of our partners – the local health authorities, the NGOs and development organisations that are also involved. Unless we manage to elaborate a vision that everyone shares, implementation will be extremely difficult. The challenge is to make enough time to talk with everybody.

So yes, as it turns out my role is that of a full time talker! My medical activities are peripheral, and security research can be done in the evenings. Most of my time is spent chatting, reflecting and philosophising. As a student this would have sounded like the ideal life. But now that I am aware of the stakes, of the responsibility this entails, I have to acknowledge that talking is easy as long as you’re not worried about the content or outcomes. Being a professional talker is tricky, because it requires you to rethink and relearn an activity that is essentially automatic and unconscious.

So, I’m sure I made piles of mistakes at first, perhaps negotiated some things inelegantly such that I had to redo the whole process over a beer in order to reassure my collaborator. But this is happening less and less. Finally the partners are starting to have confidence in me. I think it takes about 6 months to reach this point….which is the average length of a mission with MSF!