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MSF Doctor

Testimony of a medical practitioner who acts as a hospital director, human resource manager, surgeon and senior doctor in an MSF-supported hospital near Damascus.

“August was the worst we’ve seen [here] medically. Hundreds of injured are coming in. Sometimes we have to go two or three days without sleeping. This month is incomparable to before. It is the worst I’ve seen. We are trying our best. We are trying to save lives and that’s what is keeping us going. We cannot do anything about the siege, it is what it is, and we are just struggling to survive. Of course, I have to hang on to hope. There is always hope.

There is much fear and depression in our community. You see it everywhere. Whenever there is a shelling or the sound of a plane, everyone desperately rushes home or to a shelter. The sound of a plane in the sky is terrifying. It is hard to explain how the situation is on the ground. You have to see it with your own eyes to understand, and even then it is unbelievable. We have seen huge numbers of injured over the past month; in these circumstances anyone who isn’t injured or dead can count themselves lucky.

Medically, we’ve had to become used to the situation, so we do things like rationing of medicine. Rationing has become an important part of our work. We have no choice, so we try to make do with what we have. There are too many patients, too many stories. But one patient shows the madness of this crisis – a child – who I will never forget until I die: he had injuries all over his face, his arms, his legs, and yet he was laughing! Just laughing and laughing. Children usually are afraid of our injections and needles, but he was not. He just laughed, laughed at everything.”

Syria
Ramadhani Lubunga

Ramadhani Lubunga

26, Burundian refugee

“I’ve been living in Nyarugusu for six months but have actually spent most of my life as a refugee: I grew up in another camp in Tanzania after my parents and I were forced to flee our country. I still find the conditions here difficult, though – it’s a struggle to get enough food and water and living in a tent wears you down. I’ve just been diagnosed with malaria and I can’t stop shivering and shaking. I have a headache and nausea and feel very cold. I’m also worried about my wife. She is four months pregnant but has been having stomach pains and is now in the camp hospital. I’m scared about what might happen to our unborn baby. Refugees never have a good life, but it’s better than living in fear at home. I can’t and won’t go back home. I will stay in this camp until I die.”

Tanzania
Taisiya Gregorivna,

Taisiya Gregorivna,

82, has lived in Pavlopil, a village just a few kilometres from the contact line in eastern Ukraine, for the last 46 years. Since 2014, Taisiya’s house has been shelled twice, forcing her to move to a safer place for a while. After receiving the support of her family to rebuild her house, she is now back home. Over the past months, Taisiya has received medical care from MSF for a heart condition she suffers from, as well as mental health support to cope with what she has been through.

“I can’t recall exactly when my house was first damaged by shelling, but I remember being very scared. Two shells hit the road, just in front of the main entrance, with shrapnel damaging the walls and some windows. The second time was during winter. I was alone in the house, and it was a very dark night outside. The roof was shelled twice. It was destroyed together with some of the rooms.  All the windows also broke apart. I called my daughter who lives in Mariupol and left for the city the day after. I am so grateful for my family: my four children, six grandchildren and eight great-grandchildren. They are a great support. They take such good care of me; they are the ones who helped me to get my home back. Look around – others didn’t get so lucky.”

Ukraine

Amrita Ronnachit

Doctor

"Treating TB has some parallels with treating cancer. The treatment can be long and arduous, with toxic medications, which have terrible side effects. Pretty much the same as chemotherapy. And sometimes, it fails and the TB comes back. When it happens, it’s hard not to wonder if there was more that we could have done.

Today I visited a patient whose treatment has failed, and his results show that the TB is coming back. He is a young 19-year-old boy who has studied to become a mechanic. He was almost at the end of his treatment, just one month to go, when he started to have some symptoms again. At first he told himself that it was just the flu – he often gets it. But last week I saw his test results – it’s not the flu. And further testing has showed that his TB, which was the multi-drug resistant form, is becoming more resistant, what we colloquially refer to as ‘pre-XDR’. XDR, or extensively drug-resistant TB, is one of the most resistant forms of TB, and is very, very hard to treat successfully.

I tell him that the regimen we have been giving him is not working, and we will need to switch to another combination of drugs. It also means we will have to start his treatment all over again, a full 20–24 month course. The months of treatment that he has had so far won’t count, and he will have to restart his daily injections again.

“Twenty months of treatment? Fifteen to 16 tablets a day, right? No, I would rather die.”

Through the surgical mask I can hear his strangled breathing. He is trying not to cry but eventually he can’t hold back the tears."

Uzbekistan

Cecilia

58, lives in the Libertador municipality of Caracas. She witnessed her son’s murder at the hands of a criminal gang. She has been undergoing psychological treatment for four months.

”I feel better thanks to you, you are the only one who listens to me, understands me and does not judge me, makes me see the light when I see everything dark. When I'm on the street I remember what we talked about here [in the sessions] and then I feel better.”

Venezuela