I first met Dr. James Orbinski in 2004, at a special screening of Hotel Rwanda, sponsored by Massey College. All I knew is that he had been president of Medecins sans Frontières (Doctors without borders) and had been in Rwanda when the genocide happened. When stood in front of the movie theatre after the screening, I remember being shocked at how young he looked for someone who had done so much and then deeply moved by his honesty, candour, and outrage of the crimes he witnessed. And he has witnessed many.
Born in England to Irish parents, Orbinski immigrated to Canada with his family in 1967 and grew up in Montreal. In his quest to do something practical to relieve the suffering of others, he went to medical school and after graduating, got a one-year research grant to work on HIV/AIDS research in Africa, more specifically, Rwanda. His year in Africa led him to join MSF and witness many of the horrors of the late 20th century. In 1992-93 he was in Somalia during the civil war and famine, in Rwanda in 1994 during the genocide, in Zaire in 1996 dealing with the refugee crisis caused by the genocide, and the list goes on. In 1999, during his tenure as president, MSF won the Nobel Peace Prize. He eloquently described the work of MSF during his acceptance speech at Oslo:
Our action is to help people in situations of crisis. And ours is not a contented action. Bringing medical aid to people in distress is an attempt to defend them against what is aggressive to them as human beings. Humanitarian action is more than simple generosity, simple charity. It aims to build spaces of normalcy in the midst of what is abnormal. More than offering material assistance, we aim to enable individuals to regain their rights and dignity as human beings. As an independent volunteer association, we are committed to bringing direct medical aid to people in need. But we act not in a vacuum, and we speak not into the wind, but with a clear intent to assist, to provoke change, or to reveal injustice. Our action and our voice is an act of indignation, a refusal to accept an active or passive assault on the other.
His words, on that day nearly 9 years ago, strike a cord even today while we watch the drama of Myamar unfold:
Humanitarianism occurs where the political has failed or is in crisis. We act not to assume political responsibility, but firstly to relieve the inhuman suffering of failure. The act must be free of political influence, and the political must recognize its responsibility to ensure that the humanitarian can exist. Humanitarian action requires a framework in which to act.
In conflict, this framework is international humanitarian law. It establishes rights for victims and humanitarian organisations and fixes the responsibility of states to ensure respect of these rights and to sanction their violation as war crimes. Today this framework is clearly dysfuntional. Access to victims of conflict is often refused. Humanitarian assistance is even used as a tool of war by belligerents. And more seriously, we are seeing the militarisation of humanitarian action by the international community.
I strongly recommend the rest of his speech, which has much to say about his view of humanitarianism, the role of the state and of the international community.
In 2004, Orbinski went to Malawi accompanied by James Fraser, who also worked for MSF. Devastated by AIDS, Malawi was simply unable to care for the 14% of its population which was HIV-positive. During that trip, he visited a hospital in Zomba crammed with sick patients, 90% of whom were HIV-positive. The hospital was so full, some patients were lying outside, under the trees. There was one nurse, and no doctor. In his recent book, An Imperfect Offering: Humanitarian action in the twenty-first century, describes the episode and its consequences in detail:
I spoke with Alice [the nurse], and she wept when I asked simple questions about how she had seen the disease spread. In a feeble effort to console her, I said, “There is always hope.” She wiped away her tears and said, “Yes, Dr. James, there is hope, but it’s a long way from here.”
James Fraser and I decided at that moment to leave MSF and start a new organization, one that would actively help communities face the crisis on their own terms. We called it Dignitas International, and it is committed to community-based care for people living with HIV in the developing world. Working with village health workers, doctors, nurses and officials from Malawi’s Ministry of Health, and in alliance with a team of international researchers, we have developed a prevention and treatment program at the hospital and in the villages of Zomba. We have ten thousand HIV-positive patients under our care and bring to them the best tools and treatment that medical science has to offer. And with Malawi’s Ministry of Health working with us, there will be more who get treatment. Thousands want it, and they will get it. In creating a world of practical possibility, there is hope.
Orbinski’s work has been showcased in a couple of documentaries:
Evil revisited follows his return to Rwanda 10 years after the genocide and the recent Triage: Dr. James Orbinski’s Humanitarian Dilemma follows him to not only Rwanda, but also to Somalia and Congo searching for the true meaning of humanitarianism.
As an undergraduate student, I was very involved with genocide studies. Concordia is home to the Montreal Institute of Genocide Studies and I use to attend most of their workshops. I also took a seminar on humanitarian intervention in the 20th century, in which I had to opportunity to read many books from the fields of history, political science and international relations on the crises of the past century. Although I have moved on to a different field of history, as a human being, I continue to be interested on the topic and follow the work of people like James Orbinski, Stephen Lewis, and Roméo Dallaire. Part of the reason why I’m behind in revising my conference paper is that I haven’t been able to put down Orbinski’s book in the past few days. He has brought me to tears many times and has left me with my biggest struggle: how can I make myself useful to the world around me? How can I live right?
As a young man, Orbinski constantly struggled with right living. He once asked Benedict, a very wise monk at Oka Monastery, in Montreal, how he knew the way to right living. The monk answered, “Well, like everyone else, James, I get out of bed and put one shoe on at a time. I walk around this log and I break these small branches as I step. I am acting and being acted upon. Meaning is in the living, not simply in the thinking or feeling. And it seems to me that living well is mostly about loving well.” After a pause, he continued, “Correct answers can rarely be given. We can though, be conscious of the questions so that we can live ourselves into the answers, into what in retrospect can be right living.”