Tuba City resident Dr. Edward Chu recently returned from a six-month stint with Doctors Without Borders/Médecins Sans Frontières (MSF) in Bangui, the capital of Central African Republic. Here is his report on his trip:
Thanks to my colleagues at Tuba City Regional Health Care Corporation, I was able to take a temporary leave from my position in the ER and as the medical director of the Tuba City and Inscription House EMS service units to undertake my first assignment with MSF in CAR — a country that has been entangled in a brutal civil war since 2013.
As the medical activities manager in the Bangui General Hospital, my main responsibility was to supervise and train my Central African colleagues, although I occasionally took care of very sick patients in the ER during mass-casualties — treating victims of motor vehicle accidents, stabbings and gunshot wounds. In 2016 the team undertook 3,700 surgical interventions.
We are an adult surgical hospital, serving patients over the age of 15, the vast majority being patients with fractures needing urgent surgery. The other surgical cases we saw were either penetrating trauma or infections like appendicitis or hernias. Many patients came very late to the hospital either because of ongoing fighting or long distances, so we saw a lot of infections.
I remember a young boy who fell out of a tree, his knee cut open exposing 6 inches of bone. He spent a month lying in bed at home before family were finally able to bring him to an MSF project in the countryside, in Bria (where much of the fighting is occurring), who then flew him to our hospital. Unfortunately, we had to amputate his leg. Had he arrived sooner we might have been able to save his leg or amputated less.
During my time in Bangui the country was experiencing a period of relative calm, but shortly after I returned home at the beginning of May, CAR slid back into a full-scale humanitarian emergency. Renewed and intense fighting in several locations across the country has provoked even more displacement.
At the beginning of the year, more than 20 percent of the population were already displaced (that’s more than 800,000 people, half of whom have fled the country); since I left Bangui, an additional 88,000 people have been displaced, 20,000 of whom have crossed the border into Democratic Republic of Congo.
Bangui General Hospital is the referral trauma surgical hospital for all MSF projects in the country; we receive patients from other hospitals in the capital, but also from surrounding areas including Bria, where much of the fighting is happening.
We also have a clinic that provides care for victims of sexual violence — women, men, and children — and I along with the other international doctor and local midwives conducted their examinations. It’s one thing to hear about horrible stories of mass killings and gang rapes in the news, but to meet women who often have been forced to witness family members killed before being kidnapped and gang raped for weeks is chilling when you’re sitting in an examination room in the capital.
It’s a vivid reminder that you’re living in a country that is still very much at war; where the worst types of violence are being perpetrated on the innocent. The experience made it clear to me why it is so important that MSF provides this type of specialized emergency medical and psychosocial care wherever we can.
I see my involvement with MSF as an extension of my work here in Arizona and elsewhere: using my medical skills to treat those with limited access to health care. I’ve been working on the Navajo reservation since 2013; our patients have to travel long distances for medical care and many are victims of violence and sexual assault. I also volunteer with an FEMA/OFDA search and rescue taskforce, and have previously volunteered in Uganda, Lebanon, and — when I was living in Flagstaff — with the Coconino County Search and Rescue team.
I’ve always planned on doing international work, and MSF has a well-deserved reputation for being one of the best organizations in humanitarian emergencies. Its history of bringing health care to those most in need is what motivated me to work with MSF and I hope to go to the field again one day.