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Cross-border medicine
When Richard Heinzl was a medical student at McMaster University in the mid-1980s, he opted to take an elective in Uganda. That decision would change his life and the lives of many more Canadian physicians.
While in Uganda, Heinzl met doctors from Belgium who were working on behalf of a little-known international charity called Médecins sans Frontières (MSF). "They were young doctors," he recalls. "They were adventurers. They were working extremely hard but also having fun, and it impressed me."
They made such an impression that in 1988 Heinzl began organizing the Canadian Chapter of Doctors Without Borders/Médecins sans Frontières. It took him 3 years, but he persevered and became the founder of MSF Canada. "In the beginning I did this by speaking to anybody who'd listen, and then it snowballed," says Heinzl. Doctors, nurses, administrators and clerks all came forward to lend a hand.
"People believed in this idea," he says. "The niche that we have is that we are a medical relief organization and, more importantly, a humanitarian organization that does whatever it can to get to people in crisis."
In 1990 Heinzl became MSF Canada's first field volunteer during a mission to Cambodia. He was soon followed by about 15 others. Ten years later, MSF Canada has sent more than 650 medical and nonmedical volunteers overseas, including nearly 200 physicians. The organization now has volunteer-staffed offices in Toronto, Montreal, Vancouver, Halifax and Ottawa. The Canadian branch president, Dr. James Orbinski, became the international president in 1998. Last year MSF, which now has chapters in 18 countries, won the Nobel Peace Prize.
As a member of MSF, Heinzl has treated patients in the mountains of Turkey, isolated towns of Cambodia and communities ringing the Iraqi desert; the trips have taken him away from Canada for up to a year. Regardless of where he is, however, there is one constant: people in crisis. In many cases the crisis is the result of war, but MSF volunteers also respond to floods, famine and fires.
In Iraq, Heinzl treated 300 patients a day for a few days. "Then," he says, "I collapsed." In Cambodia, he examined, treated and talked with people who had never seen a foreigner; if they had seen them, the foreigners were probably wearing military gear. In each country Heinzl visited, he lived like the locals. In Cambodia, this meant living without running water or electricity, and cooking meals over a fire.
"We go in and listen very carefully to what is happening locally," says Heinzl, who grew up in Hamilton and now lives in Oakville, Ont. "For the most part you have to have basic health care — clean water, sanitation, vaccinations. These are not the concerns of typical Canadian doctors.
"These are very difficult places to work in. You see people die needlessly, and people deal with that in different ways. Most take comfort from the fact that they are helping some people."
Still, Heinzl says the real heroes following disasters are the local residents who suffer through hunger, pain and disruption. "The focus should be on the local people who don't get to come home to Canada," he says. "They're just caught up in somebody else's war."
Although it's been a few years since Heinzl set up shop on the other side of the world, he's still crossing borders. Today, however, the borders are in cyberspace. "I'm fascinated by the Internet," says Heinzl. "E-health has not exploded yet, but there will be a critical mass and then you'll have an explosion."
Heinzl says Internet-based medicine will never replace doctors and nurses, but he is convinced that it will become a central part of providing good health care. He bases that belief on first-hand experience.
"In Cambodia, there were times when we did not know what was wrong with certain patients, and so people died," he says. In cases like this, he argues, something as simple as email could save lives by providing access to experts. In the end, he says, the Internet is going to lead to the "globalization of medicine."
And Canada must play a central role in globalization. "The future is that the world will be shrunk," he says, "and borders will be meaningless."
Physicians interested in the work being done by MSF can visit the organization's Web site. — Donalee Moulton, Halifax
Copyright 2001 Canadian Medical Association or its licensors |
