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Hope in Hell: Inside the World of Doctors Without Borders

Hope in Hell: Inside the World of Doctors Without Borders
By Dan Bortolotti

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Gripping accounts of medical workers who volunteer to serve in some of the world's most dangerous hotspots.

The humanitarian organization, Doctors Without Borders, (also known as Médecins Sans Frontières or MSF) delivers emergency aid to victims of armed conflict, epidemics, natural disasters and those who lack reliable health care. Each year, more than 2,500 volunteer doctors, nurses, and other professionals join locally-hired staff to provide medical aid in more than eighty countries.

At the forefront are the volunteer doctors who risk their lives to perform surgery, establish or rehabilitate hospitals and clinics, run nutrition and sanitation programs, and train local medical personnel. This book follows these volunteer doctors as they risk their health and lives to treat patients in desperate need.

Combining engaging text with dramatic color photographs from around the world, Hope in Hell examines the lives of individual MSF volunteer medical professionals.

Topics include: - Performing emergency surgery in the war torn regions of Africa and Asia - Treating the homeless in the streets of Europe - Understanding cultural customs and societal differences that affect health care - Witnessing and reporting genocidal atrocities.

Also, the most recent world events are explored and how MSF is reacting to them. These include the challenges of delivering aid during the Rwandan massacre and the controversial decision to criticize the U.S. for delivering humanitarian aid to Afghan citizens while at war.

The book also covers the raucous founding of Doctors Without Borders in 1971 as the first non-governmental organization to both provide emergency medical assistance and publicly bear witness to the plight of the populations they served. In 1999, the organization was awarded the Nobel Peace Prize.

Hope in Hell is a fascinating and often harrowing account of the men and women who struggle to improve the lives of people in desperate need.


Product Details

  • Amazon Sales Rank: #122207 in Books
  • Published on: 2004-10-02
  • Original language: English
  • Number of items: 1
  • Binding: Hardcover
  • 304 pages

Editorial Reviews

From Publishers Weekly
This mostly admiring portrait of Doctors Without Borders/Médecins Sans Frontières (aka MSF), the nonprofit that won the Nobel Peace Prize in 1999, emphasizes the inner workings of the organization and is animated by interviews with mid-level staffers and by site visits to MSF projects in Angola, Afghanistan and Pakistan. In between, journalist Bortolotti traces the history of the world's largest independent medical humanitarian organization, whose genesis was the Biafran horrors of the late '60s. Histrionic founder Bernard Kouchner (whom Bortolotti didn't interview) left the group in 1979 after disputes about tactics; not until the early 1990s did MSF spread to North America. Only about a quarter of field volunteers are, in fact, doctors, and most staff are local hires rather than foreigners. MSF volunteers resist being described as heroic ("It's not noble; it's an attempt," one says) but acknowledge that the crucible of crisis does test character. Some stories (illustrated by stock-looking photos, including two color inserts) are grimly poignant: a middle-aged surgeon tells of relying on his lower-tech training to perform surgery in Sri Lanka and Liberia; a logistician describes how to negotiate with drugged-up child soldiers at a Sierra Leonian checkpoint. While Bortolotti could have been clearer, for example, on the mechanics of MSF's fund-raising apparatus, he notes that even critics of humanitarian aid admire MSF for attempting to intervene under seemingly impossible circumstances.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

From The New England Journal of Medicine
In 1971, I was 10 years old and growing up in Brooklyn, New York. I was never a good eater, and the summer of that year was no different. Every dinner at the small dinette was an interminable ordeal punctuated by my mother's insistent plaint, "Eat, Jerry. Don't you know there are children starving in Biafra?" Indeed, I did not know. Where was Biafra? Now, as I sit reading at my own dinette 33 years later, the Biafran crisis again rears its ugly head. It was partly in the flames of that conflagration that the humanitarian organization Doctors without Borders was born, a group that is the subject of Hope in Hell. The book describes the early history of Doctors without Borders, also known as Medecins sans Frontieres, and goes on to track the group's sometimes tumultuous internal political history as it developed into an organization that received the Nobel Prize in 1999 and became renowned for its accomplishments in numerous human disasters. Some attention is also paid to the mechanics of the association, from its organizational structure to its innovations in the field of disaster relief. These advances have allowed Doctors without Borders to respond faster and with more efficiency than do most other relief organizations. (Figure) The group's method of fund-raising -- primarily through private donations -- is contrasted with the methods of other organizations, which rely on large gifts from the United Nations or national governments. The different sources of funding in part explain the brash outspokenness and, some would say, self-righteousness of Doctors without Borders when the group decides that a certain situation is contrary to the accepted mores as it perceives them. Doctors without Borders uses the French word temoignage, or testimony, to describe such witnessing, and this advocacy has brought it into conflict with the various groups within the organization as well as with other relief organizations and sovereign nations. The criticisms that have been leveled at Doctors without Borders, partially as a result of temoignage, are discussed in Hope in Hell, although not in great detail. Nevertheless, Bortolotti's critique is consistent with his factual and objective portrayal of the group. There is very little hyperbole, which allows the reader to see the manifold ethical controversies inherent in war and charity. Most of the drama in the book appears in interviews with the group's field workers at various levels, including doctors, nurses, project coordinators, and can-do logisticians. These interviews describe life in the field well and bring out the complexities involved in human devastation and the response by Doctors without Borders. It is in the considerable space that Bortolotti gives to the emotions of the group's staff members that the book really shines. Having been on a mission to Afghanistan, I found Bortolotti's account, through his interviews, of the sentiments of volunteers while they were in the field and, even more importantly, after they returned to be authentic and inclusive. It was validating in a way that only confirmation of shared experience can be. The poignancy of the stories of volunteers, coupled with a revealing account of the inner workings of Doctors without Borders, makes this book informative and touching. Jerry R. Dwek, M.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

From Booklist
*Starred Review* It may be difficult to read this book, not because it is poorly written--it is in fact the inspired opposite--but because it makes the meager number of volunteers comprising Medicins Sans Frontieres (MSF) look like the last hope for millions who suffer subhuman living conditions and death, visited upon them by tyrants and thugs more often than by natural disaster. Born in France nearly 30 years ago, MSF, known in the U.S. as Doctors without Borders, struggles to remain true to its philosophy of delivering humanitarian aid divorced from all political affiliation. Still, the notion that humanitarianism can be totally agenda free presents constant challenges for the international group as it struggles to dispense essential medical services to places where no other such providers dare to go. Bortolotti says the Congo is one of the "greatest humanitarian disasters of our time" and the South Sudan is "another planet"-- places where, but for MSF, there would be no hope for thousands. Much of what Bortolotti reports is noticeably absent from the daily headlines, so this eye-opening account is all the more chilling, and MSF's efforts achingly more compelling. Donna Chavez
Copyright © American Library Association. All rights reserved


Customer Reviews

The Real MSF5
Almost everyone has an opinion on MSF(Médecins Sans Frontiéres). The author Dan Bortolotti in "HOPE IN HELL" provides what is surely a complete and trustworthy account of this organization. The book will once and for all confirm that MSF is still the only fully independent relief organization which seeks to alleviate human suffering, regardless of how that suffering was caused: by dictators, war barons, corrupt governments, or even relief teams which have fled the field.

"Hell" in the title is perhaps missguiding. The majority of doctors, administrators and logisticians, regardless of having suffered from diseases and trauma brought on by witnessing ghastly cruelty, still go back for more.

Before commenting to anyone on MSF again, read "HOPE IN HELL". It will not only alter your opinion but probably persuade you to support a relief organisation which really makes a difference. You might even become one of the doctors, etc, who helped to make the difference.Hope in Hell: Inside the World of Doctors Without Borders

Informative and entertaining5
This is a quick read which provides excellent insight into the history and development of MSF as well as its current organization and on-the-ground operations. The historical component is well integrated into the many personal stories of physicians, logisticians, and other critical team members of MSF in the field. This book does a nice job balancing the positive and negative aspects of MSF's mission and how it is implemented. Even with the fair number of criticisms of the organization, I am still eager to be involved with such a remarkable group of people.

I couldn't put this book down5
This is an AMAZING book. It takes alot for a book to really captivate me, and Hope in Hell did so about a page into it. I recomend this book to everyone, whether your an avid reader into good stories, or wether your like myself and considering a career with the MSF.

The book makes sure to cover all jobs that you could fill with the organization, with the execption of working for one of their western offices. It covers job descroptions for water sanitation workers, Logistians (excuse my spelling), Nurses, Doctors, and Surgeons. I feel it is great for people considering work with the MSF because it gives you the full story through acounts from actual volunteers, not only does it tell you the nature of the feild work, but also the effect it has on people pschologically when they return home, and how they react once back in their "homes" (and how they realize their only home is with the MSF).

The book also spends time discussing the structural aspect of the organization as well as politics and Drug research.

I bought the book and couldn't put it down, a great read.