Dr. Richard Heinzl

A powerful mix of wanderlust and medical training inspired Dr. Richard Heinzl to create the Canadian chapter of Médecins Sans Frontières (MSF). Also known as Doctors Without Borders, the Canadian chapter has taken part in over 1,800 medical relief assignments in more than 80 countries since its inception in 1991.

Heinzl himself has travelled and worked in 75 countries, and although he is no longer directly working in MSF projects, he is still involved in international health consulting. Over the last year, however, he has devoted his time to writing a memoir about his first MSF mission in Sisophon, Cambodia, Cambodia Calling: A Memoir from the Frontlines of Humanitarian Aid (Wiley, 272 pp.).

“An MSF mission is the most important work you will ever do — helping populations caught up in war and poverty. [It’s] the most important crisis facing humanity,” Heinzl tells Fast Forward. “But it’s also the most fun you’ll ever have, because you will experience a kind of freedom over there that doesn’t exist back home.”

This freedom comes at a cost. Calgary emergency doctor Maya Harari has gone on many MSF missions in war-torn countries. Her first mission in 2000 was in northern Sudan where she, on occasion, feared for her life. “A fight between two Janjaweed soldiers broke out one day, and before we knew it, everybody in the market pulled out their Kalashnikovs — tension was very high, so you couldn’t walk anywhere,” recalls Harari. “That night we slept low on the ground, on the mud floor inside our mud hut.”

So what keeps Harari — who has 17 years experience in the emergency room at Calgary’s Rockyview General Hospital — involved in MSF missions? “I keep going back, because few people are doing it, and there is a huge need for humanitarian aid,” says Harari. “Now that I’ve worked with MSF, I realize what a huge difference I can make.”

Harari can get a call at any time from MSF officials requesting that she jump on a plane within the next 48 hours for emergency medical relief. “When I get that call, I have to find other doctors to cover my shifts in about one day, but that’s never been a problem,” she says. Then she’s off to Paris to meet with MSF France officials, where she is briefed and then sent to her crisis destination. Her missions, so far, have taken her to Sudan, Thailand, Burundi, Angola and Liberia.

“With war and conflict everything falls apart — the roads don’t work, there’s no electricity to keep vaccines cold, you don’t have easy access to clean water — the health infrastructure just fails,” says Heinzl. “War is bad for people’s health.”

In his memoir, Heinzl writes about the chaotic times during his first MSF mission in Cambodia, including the inability to fully communicate with the locals, combined with the lack of food and resources and, at one point, getting quite ill and losing a lot of weight. Unfortunately, the memoir mostly feels disconnected from his work as a doctor, and from the geo-political events and community that surround him — except for a group of children with whom he creates a special bond. The scenes with the children are probably the most powerful ones in the book, as they seem to open that window and opportunity to witness Heinzl’s soulful and caring side.

“I realize that readers may expect a political piece about MSF and humanitarian action and that stuff is incredibly important, as is the work done by MSF volunteers,” says Heinzl. “But I chose to write about the most important part of this whole experience for me. I wrote honestly about what it was like, how imperfect I was and everyone else was — and yet — how beautiful and remarkable it was over there.”

For Harari, part of this beauty comes from experiencing a new perspective on medicine. “When working in refugee camps or in isolated villages, you are forced to look at the broader picture of public health,” says Harari. “You get to make decisions and gain skills that you wouldn’t normally acquire here in Canada.” Harari also goes on to explain how diagnosing and treating patients without X-rays or lab tests is challenging, “but it’s also amazing what you can accomplish without that technology.”

Heinzl also recalls the challenge of saving lives without access to medical technologies. “We often had patients in front of us, and we didn’t know exactly what was wrong or the best way to help,” he says. “There was no telephone system — no phone calls for that entire year in Cambodia.” However, with today’s emergence of tele-health technologies that allow medical specialists to provide information and diagnostics over the Internet based on photographs and descriptions of symptoms, MSF doctors could gain access to specialists worldwide in the future.

In fact, Heinzl has just returned from a family holiday in Dominica, where he also did a bit of work, talking with professors and students at Ross University School of Medicine. “I do hope to involve that kind of [telehealth] activity in Dominica, but it will be up to them,” says Heinzl. “Out of the need for better communication [when working in the field], we saw all kinds of possibilities for the web and how it could shrink the globe by moving health information and knowledge to where it’s needed with great ease.”