From A Busy General Practice in Southern New South Wales to Uzbekistan with MSF

The morning air was as cold and refreshing as a glass of champagne as I sat on the back veranda laboriously writing out Russian sentences. The house behind me was silent – my co-worker, Margriet, had gone for her morning run. It was Sunday. The office was closed, and later, after breakfast, Margriet and I would walk to the bazaar. An hour’s walk along the sandy banks of the canal, before the day warmed up too much, would be exercise enough for me. Doing our bazaar shopping I’d have a chance to practice the Russian I was struggling to learn. The women at the stalls, in their flowered Uzbek dresses, would laugh, and show their golden teeth, and call me ‘Sister’, and I would feel triumphant when I made myself understood.

It suddenly seemed strange and improbable that I should be here, a 62 year old general practitioner, sitting on a veranda in a country the name of which puzzled even the very knowledgable clerk in an East Grinstead post office when I filled in a change of address slip – ‘Uzbekistan – let me think – never done a change of address for there before – its coming to me - used to be Soviet, am I right?’ This was before Uzbekistan entered world news and consciousness. Why was I sitting here, trying to force Russian verbs into my reluctant brain, rather than putting my feet up at home with the Sunday newspapers?

At the same time I was vividly aware of how fortunate I was, to be looking out at the high blue sky of Central Asia above a crumbling stone wall where a cat was picking her way at the back of the garden, to sharing an Uzbek house with Margriet, who, though thirty years younger than me had become friend as well as colleage, to wake in the night to hear the sound the farmyard sounds of a donkey braying, a cock crowing, on the outskirts of Urganch, a city which one guidebook described as ‘a typical Soviet city of no interest to the tourist,’ but which I was coming to love.

I was in Urgench because of Medecins Sans Frontieres. I was there on my first mission as a volunteer. And Medecins Sans Frontieres was there because of tuberculosis.

Tuberculosis – in my years as a general practitioner I hardly needed to give it a thought. I came across only a handful of cases in twenty years. But here, in Uzbekistan, big tuberculosis hospitals were filled, patients often had to be turned away because there were no beds, and doctors had to keep the disease very much in the front, not the back of their minds. That baby who failed to thrive, that young soldier who thought his hip pain was from an injury – after all, he played football, that forty-year-old woman with the bad back - the symptoms could all mean TB. The swollen neck gland or the swollen knee, the vague weakness, the night-sweats – and of course, the cough that lingered long after the flu or cold – all these too could mean TB. And TB meant lengthy treatment, first in hospital, then, even more challenging, at home, where the patient, now feeling well, must go on taking medication for months.

I was project coordinator of our regional TB project, where the MSF team worked with Ministry of Health staff to implement an effective TB treatment programme, to try to stem the epidemic which was ravaging so many former Soviet countries.

The idea of working as a volunteer, and in particular for MSF, had come to me more than twenty years before. Our family was in northern Thailand, where my husband was working as an agricultural consultant, and where I was lucky enough to get a job as a physician in a local hospital. One day, idling in the doctors’ dining room after lunch, I noticed an article in a journal about some young French doctors who were working in Africa, trying to bring help to people who needed it most. They called themselves Medecins Sans Frontieres, and their name excited me, and their philosophy of giving help where there was most need, beyond any artificial boundaries, inspired me. When I went home that evening I showed my husband the article and said ‘Those are the kind of people I’d like to work with, that’s the kind of work I’d like to do, some day.’ ‘Why not?’ he asked. ‘When the children are older.

If Medecins Sans Frontieres are still around.’ This was long before the MSF logo was a well-known icon, long before the Nobel Prize, long before the organization had grown to like a great vine, working in some 80 different countries. My husband, who had seen many NGOs in the course of his work, was used to small organizations flowering suddenly and withering and dying within years. He was also used to my sudden enthusiasms, and tolerant of them. Not only tolerant - anything I wanted to do, he made seem possible, if not immediately, then some time I put thoughts of Medecins Sans Frontieres to the back of my mind, and then, years later, when my children were grown and I had the unwanted freedom of widowhood, I brought the thought of it forward again.

My life was settled and comfortable, in a busy general practice in a country area in southern New South Wales, in a pretty, rural area, which seemed to me a little bit like England, with its rolling green hills and sharply-defined seasons. I was able to go back to England often, I had family and friends, good colleagues and a pleasant a bunch of patients as one could wish for. But I wanted something more, something different.

I was reading Chekhov’s description of his journey to Salkhalin Island – a tsarist prison in the remote east of the Russian Empire. Chekhov, by the time he made this journey, was a well-known writer as well as a doctor.

He decided to report on conditions of prisoners in Sakhalin, saying that he wanted, as he put it, to repay something of his debt to medicine. That phrase impressed me and I realized that this was, in some sense, what I wanted to do. Every doctor has, perhaps, in some sense, a debt, to medicine. We are among the world’s fortunate ones, to have had the opportunity and ability to study, to have work which is useful, to be, by world standards, rich. I, too, had the good fortune of being, in my sixties, still in good health. I should, for a year, do something to repay my debt. It seemed time to try to go back to my old dream, to work for MSF. If they would have me.

When I went for the first interview I was not at all confident of this – after all, I was a GP, not a surgeon or trauma specialist. And I was not young – some of the missions I read about sounded as if they would be more suitable for SAS candidates than for elderly grandmothers. But, to my surprise and delight, I was accepted.

It was six months before I was ready for a job. I had to wind up my practice and sell my house in Australia, spend some time with my far-flung family, leave suitcases under people’s beds and in their attics, rent out my flat in London, and then, I was ready for a job.