My six month mission with MSF in Pakistan is rapidly drawing to a close. My replacement, Fahad, another South African, has arrived and I have the time to look back over what I have done here. Certainly I have not managed to get finished all the things I had (with unrestrained idealism) hoped for at the outset, but some small progress has been made. Some further links with the local community. Some treatment success stories. Perhaps even some lasting influence on the way medicine is practiced here in NWFP. And if that is all, then it is enough for me. There is much more that still needs to be done, but it will be done by other hands than mine.
As the last few days wind down, despite my tiredness and my readiness to move on, I am torn. There are things here with the power to make me want to stay: places, opportunities to use and share my knowledge and experience but most of all, people. I have had the chance to meet and work with an incredible group of dedicated and talented people from Pakistan and from all around the world. Thank you to all of you for your commitment and hard work. Though it may not always seem so, it does make a difference.
Moving through town and at work, my brain records snippets of what is going on around me, filing them away. I see a small boy, running alongside the railway track; he is wearing a bright purple woolly hat against the early morning chill. He turns and smiles at me and I wonder: in this place where I have seen the tragic consequences of so much violence, when exactly that innocence will be lost? My bed and desk are covered with slips of paper that I pore over: lists, and list of lists of the things I need to get done before I leave, things I need to hand-over to my replacement, reports and summaries and protocols I need to write – a mountain of words to climb that seems impossible in the time I have left and yet it is essential, to ensure continuity, to ensure that any worthwhile momentum I may have generated in our work will not be lost.
The images of patients stays with me: the wizened, gaunt face of a man on his death bed, dwarfed by the size of his own white beard, his lungs severely scared by TB; the history in the eyes and hands of a woman with joint pain, who I am unable to help in the way I would like, partly because of the languages which divide us.
And other scenes from this other world that I have been part of for a while that refuse to be overlooked: heavily armed soldiers on guard duty outside the fort with the sweeping panorama of the mountain rising above them in the distance; the menagerie of sheep and goats, cows and chickens, donkeys and buffalo, walking and grazing and toiling in the narrow streets; the sun setting to the sound of the evening prayer as I walk on the roof, learning some basic Spanish with the help of a new colleague.
All these things will stay with me. For though I will soon leave Pakistan, it will never leave me as I find myself profoundly changed by having been here. Wherever I go in the world after this, whatever I do, I will carry these images, these snapshots of how life is in this other place. I will be forever grateful for the perspective I have gained, for the things I have learned, and I know that they will help me to be more appreciative of just how fortunate I am in life. Holding onto this, perhaps I can go on to take full advantage of the many opportunities I have with renewed vigour, in the sound knowledge that there are many who cannot even imagine such chances. A worthwhile goal I think, and a responsibility I now accept with profound gratitude.