Dr. James Orbinski, past president of Médecins Sans Frontières

by Sofia

Dr. James Orbinski: “Global Health and Humanitarianism”

Abitibi-Consolidated Lecture
Thursday, September 25, 2008 at 7pm
Alumni Auditorium, Henry F. Hall Building (H-110) 1455 De Maisonneuve Blvd West

  • Montrealer!
  • 1988: spent a year in Rwanda studying HIV/AIDS, saw so much preventable pain
  • Book: An Imperfect Offering
  • Hannah Arendt, “we are not born equal, equity is a choice”
  • Ursula Franklin
  • Equity = people in similar situations should be treated similarly. Solidarity central to human health. Health equity is a politically determined choice.
  • Inequities = 3.8 billion live on less than 2 U$D

Borders are ideas that shape our vantage points that are global in scope but definitely have local consequences. Solidarity ≠ compassion, although it might stem from it; from compassion only offers pity/charity. Solidarity means: equal in worth/diginity; restored autonomy; seek injustice, seek change; seek political responsibility.

Kigali, Rwanda (systematic, government-run genocide): Parents paid to have children shot rather than have them slaughtered. Belgium, France, USA stopped UN from acting.

25-yr-old youth in South Africa, dying of AIDS: “Why do you come here with only kindness when I need only medicine? Why no medicines for me in South Africa, like in your country?” To respond “not my domain” = moral obsequience that is obscene. MSF illegally brought in antiretroviral medicines. Global committee working informally brought down prices from $15,000 to $200.

MSF: Treatment is possible for HIV/AIDS in the developing world. “Refuse to accept the unacceptable.” Consensus that “charity is enough for the poor” is very wrong.

WHO: Health must trump trade.

So many people die from curable diseases because poor people’s health does not represent a returnable profit. Failure of market and public policy.

Alternatives exist! If we choose to see it and choose to do it, alternatives for political choices for human dignity exist.

Problems in health in developing world not just about lack of access to medicine. Malawi: 5 consecutive drought years due to climate change. People in Canada are dying from increased smog due to climate change. So these things are affecting everybody, and will be increasingly so.

Sudan: Black African rebels take Arab government, claim they were favoring Arab Africans.

Canada: 30 new/resurgent diseases since Industrial Revolution (yellow fever, malaria, West Nile virus, Lyme Disease)

Malawi: 36 year age expectancy; 19 people are doctors in Malawi… in entire country; brain drain: more Malawi doctors in Manchester, England than in all of Malawi

Need for a comprehensive & integrated solution

Universal healthcare in Canada in peril: Alberta already “3rd way” to privatized

UNICEF in South Africa: boy was stitched up, had no payment, so doctor took the stitches back out.

Health care cannot be commoditized. Canadian healthcare, Tommy Douglas: not the best, but certainly one of the best, if not the best of the Western world in terms of equity.

Equity of one, equity of all

Simone de Beauvoir, “when tormented by the world, I wanted to change the world, not my place in it…”

Humanitarian action needed because political world sometimes fails, but needs political realm to exist. Without our voices as humans and citizens, world will not change. We must refuse to remain silent, do not be paralyzed by fear; call those responsible to become accountable.

Advice for people who want to become doctors and do work like MSF:

  • Acquire practical, concrete skills
  • Be able to physically do things with your hands
  • Clinical management
  • Managing and prescribing medicines
  • Epidemiology of country specficially
  • Health care system of country
  • Learn language! Goes a long way
  • Students: recognize, no absence of labor in developing world, no need to build a school or lay a brick. Skills, knowledge, resources is what is needed. Cultivate skills, knowledge that will be a better contribution.

UN did not fail in Rwanda, Burundi, or in Darfur; it was the only legitimate, organized way.

  • Permanent 5 nations that fail when they come down to money, soldiers
  • Paralysis is not of the UN but of the politics between the permanent 5
  • P5 are the largest producers and sellers of arms in the world
  • UN formal institutional structure: first of its kind in 8,000 years of recorded history, and only 60 years old
  • In order for UN to work, citizens must hold their governments accountable.

Canada is 9th most powerful country in the world

  • As citizens we allow our government to do what it wishes
  • We are at war in Afghanistan!
  • We are allowing Americans to perform tortures in Afghanistan, in Guantanamo Bay
  • Collateral damage
  • Deviation from Geneva Convention
  • We can change our governments and then the UN will function better (Robert Cox, political theorist)

Important to study social movements: environmental movement, slavery abolition, women’s rights. Paul Sebaty: policy change processes have observable patterns

  • Organizational structure
  • Core knowledge base
  • Argumentation
  • Political opportunism

WTO: Donar declaration

Anthrax scare: “good for goose, good for gander”


Organizations supported by James Orbinski: