© Ramón Pereiro/MSF
As I step out of the door of the aeroplane and onto the stairs I feel the tropical heat hit me like a wall. It’s not all that different to walking into the steam baths at home in Gothenburg. I ask myself again what I’m doing here. The answer is that I have been driven by a combination of humanitarianism, a sense of adventure, and a thirst for professional challenge, and am now beginning my first mission for MSF in Guinea-Bissau.
Guinea-Bissau is not the most typical country for an MSF response. MSF is primarily focused on responding to emergencies like natural disasters or conflict. In Guinea-Bissau, a West African nation with a population of 1.8 million, there has been no conflict since the year-long civil war in 1998. But this does not mean it is politically stable: although it is a democracy, there have been four successful military coups since it gained independence from Portugal in 1974, and not a single president has completed a full, five-year term in office since 1994, according to World Bank data. All of this has contributed to a very slow pace of development, with poor infrastructure and almost nonexistent education, healthcare, and judicial systems. According to the United Nations Human Development Index, Guinea-Bissau is one of the least developed countries in the world.
MSF has been here periodically during cholera outbreaks, which occur because of limited access to clean water. There is also a lack of nutritious food, limited opportunities for education, and a lack of access to healthcare. All of this affects children the most: a large number, since 40% of the entire population is under the age of 15.
The statistics speak for themselves. Of every 1,000 children born in Guinea-Bissau, about 90 die before they are five years old. In Bafatá, a region around 130 km to the east of the capital, the figures are estimated to be even higher. These numbers are among the worst in the world. Against this backdrop, MSF decided to launch a project focusing on child medicine in 2014, starting in Bafatá and expanding to the capital, Bissau.
The project in Bafatá supports the local hospital and a number of health centres in the region, which has a population of roughly 100,000 people. We also work in the villages providing information about healthcare, offering counselling services, and diagnosing and treating diseases like malaria.
I am employed as a paediatrician in the hospital, where I will be managing and training four Bissau-Guinean doctors employed by MSF. Of course, they have much more experience of local illnesses than me, which means that at the beginning the roles are reversed, and I will learn from them.
After one day in the capital I continue to Bafatá. The land is flat and dry, but I am surprised by how green it is even in the middle of the dry season. The whole thing still feels overwhelming, but I am taking things one day at a time and trust that things will soon feel more familiar.