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Band-Aid for a Broken Leg

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A powerful, surprisingly funny, and ultimately uplifting account of life on the medical front line, and a moving testimony of the work done by Medecins Sans Frontieres

Damien Brown, a young doctor, thinks he's ready when he arrives for his first posting with Medecins Sans Frontieres in Africa. But the town he's sent to is an isolated outpost of mud huts, surrounded by landmines; the hospital, for which he's to be the only doctor, is filled with malnourished children and conditions he's never seen; and the health workers—Angolan war veterans twice his age who speak no English—walk out on him following an altercation on his first shift. In the months that follow, Damien confronts these challenges all the while dealing with the social absurdities of living with only three other volunteers for company. The medical calamities pile up—including a leopard attack, a landmine explosion, and having to perform surgery using tools cleaned on the fire—but it's through Damien's evolving friendships with the local people that his passion for the work grows. This heartbreaking and honest account of life on the medical front line in Angola, Mozambique, and South Sudan is a moving testimony of the work done by medical humanitarian groups and the extraordinary and sometimes eccentric people who work for them.

360 pages, Paperback

First published July 1, 2012

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About the author

Damien Brown

4 books31 followers
Damien Brown is an Australian doctor based in Melbourne. He began writing seriously after his last humanitarian posting with Medecins Sans Frontieres, encouraged by readers of a blog he kept while working in Africa. This is Damien's first book.

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Displaying 1 - 30 of 136 reviews
Profile Image for Diane in Australia.
668 reviews790 followers
March 23, 2019
Damien is an Australian doctor, born in South Africa, who joins Médecins Sans Frontières (Doctors Without Borders) and is sent to work in Angola, Mozambique, and South Sudan.

He works under very primitive conditions, in an unsafe environment, and faces illnesses he has never seen before. Add in the fact that he is the only doctor, and the health workers that assist him are Angolan war veterans who do not speak English, and you begin to see the challenges.

Damien writes in an engaging manner, relating events from all areas of his experience ... medical, personal, cultural, emotional.

If you like reading about a dedicated doctor ... but a very human one ... who is devoted to his patients, you'll enjoy this book.

4 Stars = Outstanding. It definitely held my interest.
Profile Image for Charbel.
149 reviews33 followers
April 9, 2015
Band-Aid for a Broken Leg tells the moving story of MSF volunteer Damien Brown as he works in Angola, Mozambique, and South Sudan, all the while learning what it truly means to be an aid worker.

Though Brown is not an extraordinary author (though more than competent), the book still managed to move its way up to my favourites shelf. The brilliance of this book lies in the touching tales told. In many ways, this is not Brown's story; it's the story of all the patients he's helped (and lost).

Though the conditions in these countries are well known, Brown recounts events that would nonetheless surprise the reader. From working in an area where conflict can erupt at any second, to losing a severely malnourished child, Brown's metal and adaptability were tested quite vigorously. In many cases his patience was tested as well, having to remind himself (often) that he comes from a very different culture and that his middle-class-Australian view does not form an adequate scope for understanding the mentality of the locals.

The different African lifestyles are beautifully described, as are the people who Brown came across (whether they'r expats or locals). The day to day routines, along with many emergencies, are aptly presented without boring the reader. One particular aspect that I enjoyed were the awkward moments in surgeries (performed only in urgent times) which very often left Damien dumbstruck. Entire chapters in this book can be boiled down to stories of love, beauty, and resilience.

Of course as might be expected, the book also contains a lot of tragedy. As the reader, I risked getting attached to some of Damian's patients; their individual quirks (Brown received two marriage proposals!) rendered them quite dear to me as I looked forward to finding how they fared. Unfortunately, many of them died after having known nothing but poverty and war. This was emotionally difficult for me because I was keenly aware that this is not fiction; those are real people in real situations. If nothing else, this book has managed to put my problems into perspective and has enhanced my gratitude for what I have.

My advice is this: read this book. You won't regret it.
Profile Image for Angela Oliver.
Author 23 books45 followers
July 28, 2012
A heart-breaking memoir, that also manages to be heart-warming and rather sobering. I admire Damien - for going places I would not dare to tread and daring to make a difference - no matter how slim. He tells his experiences with a certain amount of wry humour and does not dwell on the grief, although of that there is plenty. The political situation in many of the African countries is a worrying one. I devoured this book, and at times I laughed, other times I just wanted to cry, but one thing I took away from it is how lucky I am - to be born in a "western" country where "luxuries" such as nutritious food and safe water can be taken for granted and where I am unlikely to step on a landmine or get caught in the gunfire of inter-tribal warfare.

But it is the story of the people that I love the most - the little boy with the beads, the children who make a model village from clay, the various native nurses and doctors with their little quirks and ideas. Brown does not view them as victims, and they do not see themselves that way, and one cannot help but feel humbled that we "first worlders" feel we need so much, when these people are happy with so little and the importance of family, friends and fun exceeds the need for big shiny "toys".
Profile Image for K..
3,804 reviews1,023 followers
August 28, 2018
Trigger warnings: graphic medical procedures, war, death, death of a child, stillbirth, blood, gore, lots and lots of poop.

This book was fascinating. It's a memoir by a South African-born, Australian doctor who's unsatisfied by medicine in Australia and who promptly joins Médecins Sans Frontières. Sent to Angola, then South Sudan and Mozambique, Brown doesn't pull any punches in describing just how confronting his experiences were, how challenging it was to practice medicine with limited resources and support, how strong his culture shock was, how much he struggled with the language.

It's as much a story about Brown's struggles being an aid worker as it is about the people he encountered and the funny experiences he had. It's a story that's often completely horrifying and confronting and sad. It's clear just how much of an impact his patients had on Brown, and I very much appreciated the ending of the book, with Brown discussing his work at a hospital in the Northern Territory, working mostly with Aboriginal patients. On the whole, this was a compelling, funny, and heartbreaking book and I'm very glad I picked it up.
Profile Image for Raghu.
394 reviews77 followers
October 23, 2012
The title of the book pretty much sums up beautifully the nature of the work that Dr.Damien Brown does in Africa as a volunteer doctor with MSF - Doctors without Borders. It is a book that evokes multiple emotions in you as you read it - at times breaking your heart, at times making you laugh, at times feeling despondent about Africa and volunteer work, at times feeling inspired, at times completely upbeat and optimistic about the future. The thing that strikes me most about the author is his honesty and openness in evaluating his time as a doctor with MSF in Africa and never losing his perspective even under trying and testing conditions. The book also brings out the essential goodness of the 'ordinary man' in the street, or 'hospital' so to speak.

Dr.Damien Brown, as a young 29-year old from Australia, offers himself as a volunteer doctor to serve in Angloa with MSF. He is sent as the only 'resident doctor' to Mavinga, an outpost in SE Angola consisting of only mud huts in an area surrounded by scores of landmines - remnants of a long civil war. He has for company three other expatriate medical practitioners and a few Angolan health workers, who are actually veterans of the long civil war. Dr.Brown goes in there speaking little Portuguese, the local language. His six-month stint, to say the least, was eventful. He attends to a man mauled by a leopard, wrestles with cultural conflict with his Angolan health workers,
treats severely malnourished children, assists a surgery by 'cleaning' the instruments by holding them up to the fire, argues with relatives of patients who insist on their patient being 'operated upon' because that is what is seen as the 'Rolls Royce' of medical care, is shocked by his own Angolan colleague who, after having cut open the stomach of a patient, challenges Dr.Brown to decide as to which organ to remove......
However, it is not all gloom and disease and death either. The lighter side of life in Mavinga is brought out in the context of the four expatriate volunteer workers - three of them men and one , a blonde young German woman named Andrea. Unfortunately for DR.Brown and Pascal and Tim, she happens to be a born-again Christian and so any casual fling was out of the question. The narrative also spells out in the end that many aid workers eventually end up being partners or spouses of other aid workers. Dr.Brown humorously refers to it as 'double the baggage in one relationship'!

In the author's own words, his Angolan experience is summed up as follows:
" ...the reality of medicine in developing countries is that people die of preventable conditions that are easy to treat or even prevent. Of the millions of children who won't survive the year, most will succumb to one of six things : poor nutrition, pneumonia, diarrhoea, malaria, measles or lack of basic neonatal or maternal health care, all of which are easily managed or prevented. ".
As for his own time in Mavinga, it is " a confusing, intoxicating, frustrating, heartbreaking, inspiring, disillusioning and life-affirming blend of all the best and worst things. Of Angolans, he says, "...no one mopes, or says Poor us. They just get on with it".

After six months in Angola, he returns home to Melbourne, Australia, but feels alienated by the trivialities of the 'problems' in the Australian context of total security and affluence. His mother talks about an anxiety disorder that the family dog is undergoing and the need for anxiety pills for the dog; at the supermarket, he watches an overweight kid throwing a tantrum because his mom bought him 'that' chocolate bar instead of the twenty other varieties he wanted....It is all too much to handle for Dr.Brown and he takes off again to Africa with MSF to regain his balance.

He serves a short stint in Mozambique and then six more months in Nasir, South Sudan - a place as far off from civilization as one would want. In Nasir, in addition to the expected malnutrition, diarrhoea and malaria, he deals with clans of people with gunshot wounds in the fight for 'cattle' which is often valued more than human lives in Nasir. As if this is not enough, he finds himself in a heartbreaking situation where a dying pregnant woman needs to be operated upon urgently but her husband forbids it by refusing permission - result of a strong patriarchal culture where even the woman's life is in the hands of her husband. This was the last straw on Dr.Brown's back and he decides to return home to Australia.

In the final chapter, the author asks the question," ...So, is there really any point to this line of work? Is there any lasting benefit to the people that MSF tries to help? Or does the aid industry just bumble on blindly, patting itself on the back for 'at least trying' , all the while perpetuating its own existence?' Dr.Brown resolves this dilemma in the following words:
My head says it is futile. My heart knows differently. I hope to be in the field again sometime soon.

The book is simply brilliant.
Profile Image for Lauren K.
490 reviews53 followers
July 31, 2012
Band-Aid for a Broken Leg is an inspiring account of Damien Brown, an Australian doctor who is posted in Africa working for Doctors Without Borders (Medecins Sans Frontieres).

Born and raised in South Africa, Damien Brown relocated to Melbourne as a child with his family. Seeking an alternate medical education experience, Damien practiced tropical medicine in Thailand before accepting a six month post in Angola, Africa. He arrives to a mud-hut village, with a make-shift hospital full to the brim of patients presenting with a range of injuries, illness and diseases. Apart from communicating with his ex-pat colleagues at the Hospital- Tim, Andrea and Pascall- Damien must quickly learn Portuguese if he wants to earn the respect as head doctor in this tight-knit community. He soon realises that his western training in logic and complex medical machines and processes is of little use in Angola and he must get back to basics, connect with the locals and understand a foreign culture.

When his post comes to an end, Damien struggles to assimilate back into a Western hospital in Australia and is soon in a debriefing for another post in Sudan where he spends another six months. With some experience under his belt, Damien has more confidence in this country yet is presented with much more confronting issues pertaining to war and corruption.

Written in first person and present tense, Damien immediately grounded me in his experience as it unfolded. He is an engaging narrator and his honesty provides an insight to him as a real person with flaws and vulnerabilities as he discovers that very little of what happens in these foreign lands is within his control. I think it is the hurdle of ‘the unknown’ and lack of control that Damien learns to accept as an indicator of the growth we see in him as a person and a professional during this role.

Damien was exposed to so many sad, unthinkable cases; extremely malnourished children, gunshot victims and ultimately many deaths- yet must work long hours day after day and not become overwhelmed by this day to day emotional experience overload.

Despite the difficulties of Damien’s work, his experience is truly inspiring. Before I even finished the book I was on the website looking up volunteer opportunities abroad for my line of work (mental health) and found there are- very tempting!

Band-Aid for a Broken Leg is a very humbling story and is a testament to the hard work and dedication of the volunteers of Doctors Without Borders and various other humanitarian organisations who assist underprivileged communities across the world.

Profile Image for Shelleyrae at Book'd Out.
2,493 reviews515 followers
July 20, 2012
In Australia, Medicare subsidises doctor visits, medicines and hospital care and access to quality health care is something many of us take for granted. Band-Aid for a Broken Leg is fascinating true account from Dr Damien Brown of his time as a volunteer with the Medecins Sans Frontieres (Doctors Without Borders)organisation. In Angola, Mozambique and South Sudan, he is faced with the reality of medical care in isolated regions beseiged by war, in fighting and political indifference.

Born in South Africa, Damien Brown emigrated with his family to Australia as a child. After completing his medical training in Australia, he studied in Peru for a diploma in tropical medicine and then volunteered at a clinic in Thailand. He applied to the MSF and was offered a position in Angola an area of Africa still recovering from a 27 year long civil war.
Mavinga, a small township near the border of Namibia, and outlying areas, rely on the MSF for all aspects of health care. Damien describes the primitive conditions of the hospital surrounded by leftover landmines, staffed by a handful of expat's and semi-trained locals. The hospital treats hundreds of patients each day for conditions ranging from severe malnutrition and malaria to grenade wounds. While the conditions sound miserable, there is no modern plumbing and the generator is temperamental, Damien accepts the circumstances with remarkably good grace. He writes of the challenges of treating patients with limited resources, many of whom present when it is almost too late. There are cultural differences to work through, he knows little of the language and the hours are long and punishing, yet he takes solace in even the smallest victories and finds humour where he can.
After six months Damien returns home to Melbourne but finds it difficult to settle back into life and finds himself reapplying to the MSF. He is diverted from his first choice of posting after an outbreak of fighting in Somalia and winds up in Mozambique assisting with a vaccination program before being sent to Sudan.
Damien's experience in Sudan is not dissimilar to that of Mavinga, the hospital is busy and crowded and patient care challenging. But here gun battles erupt nearby, death seems to be more frequent and the stress of the circumstances gets to him. After six months he heads back to Australia wondering how much good he did. Damien's reflections on his experiences are thoughtful and make it clear answers are not easy to come by.
Damien Brown's style of writing is confident and accessible and I am glad he shared some photos of his time in Mavinga and Nasir within the book. I can't express how much I admire his willingness to share his skills with those who need them and his choice to confront the challenges of being a doctor with the MSF. I have no idea how the man is still single!

Band-Aid for a Broken Leg is a heartbreaking, yet uplifting, glimpse of Africa and the challenges of one doctor to provide medical care for it's poorest communities in difficult circumstances. Fascinating and thought provoking I happily recommend it to travelers, those interested in volunteering overseas and anyone who needs some perspective on their latest first world crisis.
Profile Image for Kathryn.
846 reviews
January 3, 2013
Having worked in Africa myself for a short period, so much of this sounds familiar - from language difficulties where a cough is described as chest pain to bizarre infections that are rarely seen in Western medicine, marriage proposals (although the author didn't receive as many as I would have expected!) and improvising with available equipment as required. What I can't relate to are the clan wars in the Sudan and the land mines in Angola with only certain roads being declared land mine free and safe to use. And as much as the culture shock entering those situations can be immense, I can relate to the author's problems with re-entry into Western life.

Loss of life was not something I saw a lot of in Africa, and the author's recounting of children brought into the hospital on the brink of starving to death, only to continue the journey, despite the nasogastric tubes and IV fluids is heart-breaking. As are his accounts of family members refusing an amputation for a gangrenous leg thus ensuring certain death and a HIV positive mum refusing her antiviral medications as she gives up on life and wasting away.

This was a great read with humour off-setting the sometimes tragedy of life in these developing nations. It has been well-written, unlike some autobiographies I've read where the authors' story-telling ricochets from one incident to the next without any apparent rhyme or reason. My only complaint would be the author's language - rather a shame that he had to include swear words throughout - although in moments of great stress I'm sure this would have been true to life! But other than that, I really enjoyed it.
160 reviews
July 14, 2020
I'll admit to buying this - and I'm someone who doesn't buy books. It was second hand.

A great hook of a title, and it's about a Melbourne doctor who decides to work for Medecins Sans Frontiers (and, until he doesn't, but before you get all 'help people in your OWN country, wait til the end).

He was a great author. I want to meet him. He also mentions how the life made him very and who can resist a single doctor. Well I wouldn't resist one, but I wouldn't handle Angola or South Sudan or latrines like he did. I felt it was very honest - there was no bravado. He cried. It got too much for him. There was no cause or campaign he pleadingly asked people to donate to. Seriously, I'd like to meet him...

And Dad saw the title and wanted to read it, and another friend sponsors MSF, so I'll pass it along to him
4 reviews1 follower
December 29, 2012
I wish I'd read this book before working with refugees from Sudan. It gave me much more of an insight into their lives than the word "refugee" possibly could. I now understand what the meant when they said they worked in a hospital as a nurse and that this was something to be justifiably proud of. The challenge in adapting to life in Australia is immense and must be bewildering.
The writing flows beautifully as the reader is drawn into the frenetic pace of providing medical care to patients with diverse needs from malaria, births gone wrong and the unending gunshot wounds. The brutality of some of the local men who appear to relish their uncontested power contrasted with the dedication and compassion of the health workers.
Profile Image for Stoic Reader.
141 reviews15 followers
June 23, 2021
Damien Brown, an Australian doctor, suceeds in depicting the day-to-day experience of a doctor working for the MSF (Doctors without borders) in places where poverty, conflict, tragedy are prevalent and a fact of life. He worked in Mavinga in Angola, dubbed as the "edge of the world" and in South Sudan where tribal or clan wars were the norms. He navigated cultural differences both in health care and personal upbringing. He also was caught in local conflict during his stay in South Sudan that experiencing it first hand, his life at stake, was both surreal and frightening. A beautiful, touching but also disturbing and heartbreaking story, Band-Aid for a Broken Leg is not to be missed.
Profile Image for Liralen.
2,850 reviews185 followers
December 4, 2015
Brown knew when he became a doctor that he wanted to work with MSF (or in similar environments)—and in some ways that's what sets his book apart from other doctors-off-in-developing-countries memoirs. He had an idea of what he was getting into, so although there is genuine dismay at some of the conditions (both working conditions and medical conditions) he experiences, there's a lot more time spent getting on with it and getting down to business.

Along those lines, I appreciated that the focus stayed primarily on the work. There are plenty of excellent work memoirs that marry work stories with personal-life-and-background stories (though...often it helps if the author is an experienced writer...but I suppose that's always true); that being said, often some of the personal stuff feels more important to the author than to the book. Here there are so many interesting (and unusual, to the western reader) things going on at the sites that more of the personal really isn't warranted. (I am, I admit, intrigued by the 'details withheld' designations on the rough map of the Sudanese compound...but that too is a nonpersonal thing!) If Brown had expanded this and broken it into two books—say one about Angola and one about the later field stints—well, they probably would have been thinner on content, but I pretty happily would have read on.

Finally, some nice bits of insight:

On Angolan staff's reaction to MSF news from other parts of the world: Do they not know that others are reading about Angolans and their difficulties, shaking their heads? That when I send my group emails home, watered down as they are, they prompt a flood of pity and disbelief aimed their way? Or that MSF have serious concerns regarding their pulling out of here?
I'm not so sure that they do. And I may be mistaken, but what I suspect is this: they don't perceive themselves as victims. Before, there was a war. Now the war is over. To whom or else can they compare themselves?

The reality is that work here is boring at times, although it's taken me a while to work out why: most of what we do is easy, and most of the health workers do it well. While I'm distracted by the minority of cases with serious conditions...the clinicos quietly manage the majority of inpatients, and almost all of the two to three thousand outpatients, each month. (156)

How strange that we live in a world where a product range needs to be designed, created and sold for the sole purpose of treating the starving. The packet even has its own logo. (239)
Profile Image for Nicole.
1,005 reviews7 followers
September 14, 2017
Surprisingly quick read about one physician's experiences working several assignments with "Doctors Without Borders" (MSF). I'm not entirely sure this book would appeal to anyone outside the medical field but the authors presents an honest and personal account of the challenges he faces both as a doctor and a human being in austere circumstances. There is some medically-graphic depictions as a warning to those who find such things difficult to read. I found the depictions fascinating and could easily imagine the frustration and stifling sense of being overwhelmed with some of the clinical scenarios the author faced in Angola, Mozambique, and South Sudan. I'm not sure yet if MSF was portrayed in a less than positive or merely just a neutral attitude but one does question their thought process in placing the author in Angola where he clearly did not know Portuguese, something I'd have thought would have been quite important for a doctor to be able to communicate with his patients without need for a translator when such assistance is difficult. Regardless, if one want to learn more about what's it's like to practice medicine in difficult conditions with nearly no supplies and amidst conflict but steadfast dedication by practionners, this is the book for you.
Profile Image for Emma Murray.
28 reviews2 followers
June 5, 2020
3.5 More or less what you’d expect when it comes to the memoir of an aid worker: life in the field is rough, there aren’t enough resources, but still, he’s enamoured by his work and circumstance. And thus gets fully sucked into the system only to eventually leave, disillusioned and burnt out, yet still hopeful, filled with a vague desire to, one day, go back to the field.

While this was an interesting memoir, if you were to read just one, this wouldn’t be what I’d recommend (Chasing Chaos by Jessica Alexander would be my current recommendation). That said, I did like it and found it interesting to read about the realities of MSFs work. I think I found it less compelling because he doesn’t really dive into the system as a whole, except for a bit of introspection at the end. Most of the book looks at his personal experience. Though this isn’t surprising given that he’s a medical doctor and not a ‘traditional’ aid worker, I did feel like that level of analysis was missing, and it took away from my engagement with the book.
Profile Image for Charming Language.
73 reviews6 followers
August 23, 2012
This book about a young volunteer doctor working with Médecins Sans Frontières (Doctors Without Borders) made me thankful for just about every facet of my life: thankful I live in an affluent, peaceful country; thankful my children and I only have colds and not malaria, or TB, or HIV; and thankful that if one of us did, heaven forbid, get really sick we wouldn’t have to walk for two days to get to the nearest medical centre. It’s an excellent tonic if you’re having one of those ‘first world problems’ kind of weeks. Fortunately it is also a rollicking good read, never dry or melodramatic, about parts of the world that most of us will only ever see on the evening news.

An extended review can be found at http://thischarmingmum.com
Profile Image for Lynne.
361 reviews1 follower
November 2, 2012
Damien Brown is a young, single, middle class white Australian doctor volunteering with MSF. Chronicling his experiences of working in Angola and the Sudan, his account deals with the difficulties of working in unsafe environments under primitive conditions, not to mention cultural misunderstandings ranging from the whimsical to the tragic. Most heartbreaking of all was the high incidence of malnutrition among the children. I laughed and cried while reading this book and would strongly recommend it to anyone wanting to know more about the work of this organisation.
Profile Image for Rachael.
311 reviews
April 12, 2017
Wow...what an incredible journey I just went on. I feel impossibly privileged to have read this thought provoking book about working as a volunteer doctor on the medical frontline in Africa. More than likely, I would never have chosen such a story if I hadn't had to pick a book for book club this month. However it happened I'm glad I did. I went into this assuming that I would be thoroughly depressed by the end. Not in the least..... Best book I've read in a long time and I'll never stop recommending it!
Profile Image for Rennie.
920 reviews1 follower
January 9, 2016
Balanced view of how 50 years of aid is playing out. What I took from the book was that the model seems broken in spite of the best efforts of good people like the author and the many donors who continue to fund the work. Girl children still start having the first of as many as 8 children of their own at 15 who may not survive and if they do they will likely be under-nourished and unable to get an education that might change things.
Profile Image for Marilyn.
871 reviews
August 17, 2012
This is a biography of Doctors without borders doctor. He works in Angola and Mozambique and is from Australia. It is really gripping reading.
Profile Image for Leanne.
662 reviews6 followers
November 17, 2012
Fascinating memoir by Aussie doctor working in remote outposts in Angola, Somalia, Mozambique & Sudan with Medecins Sans Frontieres.
Profile Image for Keith McArdle.
Author 14 books116 followers
April 5, 2020
Fantastic book. Definitely worth a read to give you a different perspective on the challenges of modern medicine in the third world.
Profile Image for Laura Smith.
20 reviews1 follower
September 17, 2020
Excellent book. A very thought provoking and at times terrifying account of volunteering with MSF.
Profile Image for Linda.
62 reviews
June 12, 2023
Two-thirds of this memoir was devoted to Angola, with a little bit about Mozambique and the rest about Sudan (now South Sudan). I found the last section by far the most interesting. Perhaps it's because I spent a bit of time South Sudan as an aid and development journalist. It terrified the life out of me, so Damien's experiences brought back some shades of PTSD for me. Gosh, it's a frightening place. The lawlessness of the place; there is no safe haven- and one in four people has a gun. Angry young men brandishing AK47s at every turn, glaring at you with evil eyes. And then, the guilt as I flew out of that God-forsaken country when the security situation worsened, while the national aid workers stayed on, because they had to. No chance to escape that wretched place for them. I came away with the highest respect for aid workers, both nationals and expats. They are the world's true heros. Thanks Damien, for being one of them.

This was a good solid read. I read all of it - no skimming due to boredom. The writing is good but not exceptional; hence the middle-of-the-road 3 stars. (My favourite aid memoirs include a bit more of the historical background of the place.) Certainly recommended for anyone wanting to learn more about aid and development work, and for anyone wanting a dose of real life. In the First World we really have no idea what luxuries we live with every day - not the least of which is the extreme unlikelihood you'll be gunned down or kidnapped at any moment. I truly don't know how people live with that reality every single day and night without turning into quivering wrecks.

A couple of quotes/stories I liked:

From Mavinga, Angola (p114) - The local MSF medical team were intensely concerned to learn about the dire situations in other countries, eg Haiti, Lebanon. Damien thought that was odd, particularly given their own desperate poverty in Angola - until he realised that, for the locals, any time when they are not in a war is a good time to be alive. Without contact with the wider world, they have no comparison to make - so this is as good as life can get.

From Mozambique (p210) - a very simple story, a similar theme to that from Angola. 'And like in Mavinga I'm moved by the dignity of it all. No moping, just people playing their shitty hand, getting on with the full-time career that is survival. The Mozambicans here have the most wonderful expression I've ever heard, arguably the best example of a glass-half-full outlook on life. 'Nao ha Guerra.' It translates literally as 'we don't have a war' and it's used as the colloquial equivalent of 'no worries'. Because what problem could anything else be in comparison? There is no longer a war!'

From Sudan (p302) - on the insanity that is Sudan. 'Another group of armed men passes. Three this time, scowling, no uniforms but with AK47s strapped across a shoulder, and as they look over I both cringe with unease and seethe with anger. They're like belligerent teenagers with something to prove, these guys, answering to no one and acting up - albeit with guns. And right beside the kids! Have they no had enough? After thirty-nine years of war, wouldn't they just have flung their guns into the river at the first opportunity! Yelled, 'Ha! We're done! We survived! Take these shitty things back!'

(p312) - when a husband refuses to give permission for a simple procedure that will stop his wife bleeding to death. 'Christ This makes no sense! My hands begin shaking and I lose any self-restraint and step closer, and I find myself shouting with pointed finger that he's about to murder his own wife, and I wonder if maybe she's brought shame on him or frightened him for having borne this unsightly complication instead of a healthy child, because bearing children is a woman's most important role out here - no marriage is complete until the woman has had at least two children for her husband - but I couldn't give a damn about cultural considerations at this moment because hers is one life we can actually save ..... The ward is silent. I'm trembling. This man glares and I'm hot-wet with nerves ... I hate this man and what he represents; what these women, these children and so many other people have to put up with because of people like him, the strongman', the self-righteous minority of men who impose their wills on the rest. The Administrator in Mavinga, the gunslingers in our market, the bombers in Somalia, the post-election gangs in Kenya - the mentality is just the same.....
And the husband just waits, looking as unfazed as when he'd first walked in, still in his business shoes and patterned silk pyjamas. A ridiculous-looking prick.'

That was my favourite part of the book. Righteous rage. Good for you, Damien. For all your professional non-judgement, don't ever lose the rage whenever cruelty poses as culture.
16 reviews
February 26, 2023
This was a fantastic read. Heartbreaking in a lot of places, and some laughs in a few

What I really liked about this was that the author had no sense of self importance whatsoever, and came across as a caring human rather than someone with a God complex.

It really was a good read- probably the most thought provoking and interesting book I've read in a long time
45 reviews
February 5, 2023
An important glimpse inside the relationship between the humanitarian aid industry and the incredible people who benefit from the help they provide. It is not an easy read; there is violence and hopelessness. Despite this, it is both inspirational and self-critical.
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