Dr Annie Gilmour, from Nelson, New Zealand, recently completed her first field assignment with Médecins Sans Frontières (MSF) in Guji, Ethiopia, where our teams are providing emergency medical aid to internally displaced people.
What led you to apply to work with MSF?
I’ve wanted to work with MSF since I was 11 years old. Originally, I wanted to be a mountain climber. I admired Sir Edmund Hillary and came up with the idea to be a volunteer doctor in one of the clinics he’d set up in Nepal, then climb Mt Everest on my days off. It seemed like an easy plan at the time! From there I became more interested in humanitarian medicine and started reading about MSF. The organisation’s work really resonated with me, and I was set on the idea: I downloaded the application form aged 12.
“We had to use Kiwi ingenuity to find solutions, like using wire to hang intravenous fluids from the roof of a Landcruiser or creating continuous positive airway pressure out of nasal prongs (used to deliver oxygen to a patient) and plastic bottles.”
You just completed your first assignment in Guji, Ethiopia. What are our teams doing in Guji?
The project in Guji is an emergency mission, started in response to conflict that has resulted in the displacement of several hundred thousand people. The project has been providing emergency assistance to internally displaced people by means of water, sanitation, shelter, vaccination, and healthcare. We have an amazing team from all over the world who are extremely motivated and working around the clock to improve the situation.
Could you describe your role as paediatrician in the project?
I was in charge of the malnutrition, paediatric and neonatal wards. My role involved working closely with the local healthcare staff, plus managing our team of MSF staff, to deliver quality medical care to children. Our ward round in the morning covered 30 to 40 children, then there were referrals, admissions and critical cases to attend to. I was also responsible for setting up new systems, training staff, working with our logistics team to improve infrastructure, negotiating with other actors, and advocating for improvements to care.
“One of the most rewarding things was seeing a severely malnourished child smile again. Sometimes it would take over two weeks of careful re-feeding and treatment, but when the life and the sparkle finally come back to their eyes and they smile back at you for the first time… that was the most amazing feeling in the world.”
What stood out for you in this assignment?
Trying to deliver quality care in such a low-resource context was extremely challenging. The children we treated were sicker than any I had seen back home, or in my previous work abroad. They needed tertiary level intensive care, but we didn’t even have x-ray or blood tests. Many arrived in a terrible state – severely malnourished, co-infected with tuberculosis or HIV, or in severe respiratory distress. We had to use Kiwi ingenuity to find solutions, like using wire to hang intravenous fluids from the roof of a Landcruiser or creating continuous positive airway pressure (CPAP) out of nasal prongs (used to deliver oxygen to a patient) and plastic bottles. To be fair, credit goes to my Australian nursing colleague for showing me this brilliant technique!
One of the most rewarding things was seeing a severely malnourished child smile again. Sometimes it would take over two weeks of careful re-feeding and treatment, but when the life and the sparkle finally come back to their eyes and they smile back at you for the first time… that was the most amazing feeling in the world.
How have your skills and experience from previous jobs proved useful for your role with MSF?
I studied medicine at Otago University, and took time to train in low-resource settings including Ghana, Sri Lanka, and a previous stint in Ethiopia. I worked in Nelson hospital after graduating where I was able to rotate through different specialties and complete a postgraduate diploma in paediatrics. I also volunteered with the ‘I Have A Dream’ program and the Red Cross Refugee Resettlement program. I studied French at school and did two language exchanges, which proved helpful working with a multinational team. Maybe even more useful has been my experience travelling on a budget: backpacking, tramping, climbing, and being used to pushing the limits of my comfort zone. This meant that life in Guji was comfortable, by comparison, despite sleeping on the floor in a room with five people, with no electricity or running water, and working 24/7!
What advice would you give to other doctors considering working with MSF?
Please apply! It will be one of the most useful things you can do with your skills and the years of training you have. You will have some of the best days of your life and some of the worst days of your life, but ultimately, you can make a huge difference to the lives of others. As doctors we already have this sense of wanting to help people, and working with MSF allows you to do that on a larger scale.