Hope in Hell: Inside the World of Doctors Without Borders

by Dan Bortolotti

More fascinating and harrowing accounts of the volunteer professionals who risk their lives to help those in desperate need. Praise for the second "Direct and evocative, this well-written book pushes readers to the edge of a world of grueling realities not known by most Americans."
-- Choice Doctors Without Borders (aka Medecins Sans Frontieres, or MSF) was founded in 1971 by rebellious French doctors. It is arguably the most respected humanitarian organization in the world, delivering emergency aid to victims of armed conflict, epidemics and natural disasters as well as to many others who lack reliable health care. Dan Bortolotti follows the volunteers at the forefront of this organization and its work, who daily risk their lives to perform surgery, establish or rehabilitate hospitals and clinics, run nutrition and
sanitation programs, and train local medical personnel. These volunteer

Genres: Nonfiction, Medicine, Medical, Africa, Health, History, Politics

320 pages, Kindle Edition

First published October 1, 2004

Reviews

[Ocrema · Rating 5 out of 5]

That book is totally outstanding.

[Taariq Hassim · Rating 3 out of 5]

A fairly interesting if dry look into MSF history and ethos

[Gahermi class 5-12 · Rating 5 out of 5]

This book is totally outstanding.

[Liralen · Rating 4 out of 5]

That's not to say that the truth is more mundane, only that it's more complex—and thankfully so. A nuanced portrait is always more interesting than a caricature. (16)

That's my kind of approach!

Interesting look at MSF—its history and then what it has been involved in more recently. I'd love to see an updated version of this, since so much has changed, globally, in the last ten years. Bortolotti has the benefit of being unconnected with the organisation, which means he doesn't pull punches when it comes to discussing less pleasant parts of MSF's history (infighting, bad calls...). That said, he falls pretty firmly on the side of MSF.

I don't actually think it's a great book if you already know more than the basics about MSF or other international humanitarian aid, but it has depth and would make a great resource/introduction for teenagers. (Something for international relations classes?)

A few interesting things to note:

• Maggy Barankitse makes a cameo appearance! Listed here only as 'Maggie' (153), but how many other people named Maggie/Maggy were known for running orphanages in Ruyigi?

• Learned a new Spanish vocabulary word when the author snarked out about other possible uses of 'MSF'...Many Single Females; Meses Sin Follar; etc. (86)

• MSF operated in North Korea for about three years before pulling out because it couldn't work with the government / felt its operations were ultimately helping to prop up the government that was causing the problems in the first place.

• There's a photograph (132) of Sudanese hustling to collect fallen bits of maize following a food drop. It's striking, in some ways more so than (for example) photos of children in a refeeding ward—here you can see the tension in every person's limbs.

[Heather(Gibby) · Rating 3 out of 5]

A look at the World of Doctors without Boarders from its inception until the time the book was written. It lightly touches on a large variety of topics, and would be a good introduction to the world of humanitarianism. The MSF has managed to stay independent and neutral despite some of its internal conflicts over the years.

Two sections I found particularly interesting.
-the reliance on donations and private funding can lead to some interesting scenarios. such as when people are donating funds earmarked for a specific conflict or disaster, but MSP is not involved in that particular cause, or if significantly more funds are received for a particular cause, and are much more needed somewhere else.

-another piece I found really interesting surprising was the information regarding malaria treatment, cures and prevention are available, but the difference of a few cents per person, people are receiving ineffective treatments. There is a lot of interesting information about the funding for pharmaceuticals. I think this is a side topic, I will explore in a little more detail.

[Ezra Adams · Rating 5 out of 5]

One of the most sobering, compelling, and meaningful books I have ever read. I finished this the same day I completed my med school application.

[Bethany Shiell]

A broad, brutal and honest look at the reality of the challenges faced by MSF staff and patients. A good read for anyone considering humanitarian work, or wanting a further understanding of its complexities.

[Sarah · Rating 4 out of 5]

"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."

"We are not sure that words can always save lives, but we know that silence can certainly kill."

- Excerpts from Dr James Orbinski's Nobel Peace Prize acceptance speech

[Evalina Street · Rating 4 out of 5]

After reading this book you will get an understanding of what many humanitarian workers go through on a regular basis in the field. You also catch a glimpse of how their lives change as a result of the turmoil and hardships they encounter. How do you really come back to a civilized nation and expect regular citizens and friends to understand what you've been through, seen and dealt with first hand? I recommend this book, not only for the brief glimpses into cultures and problems countries face, but also to be able to identify with and try to understand what these humanitarian workers have gone through. My heart goes out to them and all that they've seen and I still can't comprehend how incredibly blessed we are to live in such a rich, bountiful and strong nation.

[Marikit · Rating 2 out of 5]

I picked this book after looking in the library's medical book section. I've thought about joining Doctors without borders in the future, so I decided to try reading it. It's like reading a long newspaper or magazine article. I found it informative and shedding light on different aspects of the organization, the good, the bad and the ugly, and its aims and principles. It shares stories of the lives as a volunteer, both medical and non medical, and insight on various communities where medical help is desperately needed. it doesn't make out the volunteers to be heroic cowboys, but just people who want to help others. Good book to read to learn the ins and outs of this organization.

[Nadir · Rating 4 out of 5]

Worth reading to understand what this organization does, how it's done it in the past, and the people who do it. Developed great respect for MSF after reading this book (both for their commitment and bravery and for the way they get things done with next to nothing).

[Alexander Anthony · Rating 5 out of 5]

The heroes of our age are not to be found in the pages of a comic or on the Big Screen - it is the people who we notice only when they're gone. In my mind, those Doctors resemble Astronauts - venturing where none would dare go voluntarily.

[Joshua Nomen-Mutatio]

Doctors Without Borders is a fine organization. People should look into it and support it if possible.

[Megan · Rating 3 out of 5]

ok . read it for nha. learned more abt msf not bad like that it covers the nuance behind volunteer work and various experiences positive negative

[Lisa Wei · Rating 5 out of 5]

This book is an example of outstanding journalism covering a compelling story, in this case about Médecins sans Frontiers (MSF), its origins, its ethos & principles, its operations and its people. I wish I had read this book earlier in my career, as it would've helped me understand why MSF is the way they are, and what drives their outspokenness and boldness in an otherwise very diplomatic sector. I loved Chapters 3-4 (We Don't Need Another Hero, Doc in a Hard Place) that brings us into the field with the doctors/nurses who are serving in dangerous conflict or disaster zones. Chapter 8 on Supporting Actors (a.ka. the non-medical staff who set up field operations and enable the medical staff to do what they do) was also eye-opening to see other kinds of contributions beyond medical that one can make in the humanitarian sector. Bortolotti's immersive writing is accessible and engaging, making you feel like you are right there in the action. You can't help finishing this book and feeling immense respect for MSF and all humanitarian field workers for the difficult work they do. Highly recommend!

Notable quotes:
"Nigeria is about corruption elevated to a national pastime, sizzling late-night dance clubs, fierce national pride, unimaginably vast oceans of poverty, crime and suffering dotted with islands of obscene luxury and wealth for the fortunate few, mile after mile of windblown trash caught in branches and barbed wire. God, I hated Nigeria. God, I'd love to go back."

"The bad days are when I feel that the things people around me see as significant are quite a lot different from what I've done with my life. People construct their identities around what they consume. And everyone's getting married, and buying a house and a car, and I'm not. You start to wonder, 'Am I supposed to be doing that? Am I supposed to be getting mutual funds?' You just start to panic, like 'Oh my God, I'm doing this wrong. I'm falling behind.' You freak out because you're one step away from homelessness. But that was only a day."

"We would like to see a more just world. But we have to focus on what we can do. And what we can do is something simple, small, and profound."

[Abi · Rating 5 out of 5]

I enjoyed this. Whilst it's hard to say a book is unbiased without knowing its subject from within, this book at least convincingly appears to offer a broad and honest and unbiased insight into MSF, as an anti-political, humanitarian, maverick-charactered employer and international medical aid organisation.

This book was on my reading list when studying Tropical Disease Biology with the Liverpool School of Tropical Medicine. Being as busy as I was at University, this book was never even read before my final exams, but I had ordered it off Amazon and guarded its place on my shelf.

If you're interested in working for MSF, this seems to highlight the group's strengths (maintaining its original, strictly medical aims; actively avoiding becoming too financially dependent on governments and their departments in order to uphold their right to take any stance and free themselves of most political labels and stereotyping when providing foreign aid) and weaknesses (without engaging in long-term development programmes for the struggling populations of the world, how can there be hope in these situations beyond the immediate medical relief? Also MSF's reallocation of its workers too soon after the last project).

[Vicky Garcia Crescia · Rating 4 out of 5]

Hope in Hell dives into the intrinsically complex questions msf and humanitarian endeavors around the world have had to face over the years. From the founding ideals that created msf, to compelling stories and fascinating insights, this book covers a wide breadth of topics - (yet it would be good to update the ones on malaria and AIDS). I especially liked all the snippets of interviews from logisticians, doctors and nurses...


a few of my highlights:

“some people look on aid work as heroic, as though he had selflessly sacrificed his career and put his life on the line to help the poor and suffering. The reality is hardly that simple. MSFers are commonly asked why they do aid work, and the query annoys most of them, not only because of its tiresome frequency but because motivations are difficult to distill into a concise answer.”

“it is not for humanitarians to ask who is right in a war, but only who needs help. Peace is not their business, even if it is their desire.”

“From my point of view, there isn’t such a distinction between speaking and acting. I think we permanently speak out, in a way.”

“We would like to see a more just world, but we have to focus on what we can do. And what we can do is something simple, small and profound.”

[Kristin · Rating 3 out of 5]

This was an enlightening look at Doctors Without Borders, although one of the first points made in the book is that even among English-speaking volunteers, the organization is almost exclusively referred to by its original French name, Médecins Sans Frontières (MSF). I would have liked it to highlight more of the missions, specifically those of a primarily medical focus, instead of getting into a lot of the politics of MSF, both internal and external, but I suppose a comprehensive look at the organization has to include those things too. I hadn't realized how misleading the name is, that very few of the ex-pats who work with MSF are actually doctors or nurses, until reading this book, but providing for the basic health needs of impoverished communities takes many hands, especially from the local population who will be tasked with continuing what the MSF volunteers started long after they've departed for their next job. Overall, a decent book and I enjoyed the photos, but not one I would read again, nor did it necessarily inspire a feeling of 'I really want to give up my current life to work with MSF instead'.

[Alex Ortiz · Rating 5 out of 5]

History of MSF with variety of stories that opened up my eyes to the gritty nature of work. Had a more down-to-earth effect on my perspective of medicine that House of God and refused to sugarcoat the thoughts and daily lives of these workers.

- Sparked interest in healthcare administration/leadership.
- Importance of grit in medicine.
- "The purpose of humanitarian action is to save lives, alleviate suffering, and restore human dignity.
As a physician I understood how to save lives and physically alleviate suffering. It was less clear
what restoring human dignity meant and yet, in the end, it may well be that this is the most
powerful of services that we can offer in humanitarian assistance."
- Reassured my decision to become a physician.

[Chalsey Alina · Rating 5 out of 5]

Super great book, informative, engaging, and moving. I will say though the editing could've used a little work, the chapter titles don't have anything to do with the content till 15 pages in and the transitions between topics are almost non-existent. It's really hard to follow sometimes it's like the book gets easily distracted. Still enjoyed it though.

[Colby · Rating 4 out of 5]

While not an entirely uplifting book, I feel it gave an accurate portrayal of the lives of humanitarian aid workers, and gave insight into not only the work, but the morals/ethics behind the work that MSF does on the daily.

[Jay Moran · Rating 4 out of 5]

Very glad I read this book, and I highly recommend it to any aspiring public health or aid workers. The words about being passionately non-political really resonated with me. They are there to be doctors: thats it. To whomever needs it, wherever they may be.

[Huyen Nguyen · Rating 5 out of 5]

This book is one of the reasons I became a long term donor to MSF. It provides readers with ample opportunities to reflect on what it means to be human, and to wonder what more we can do/could have done to relieve the suffering of others.

[Susan · Rating 1 out of 5]

Started off interesting then I found it jumped around and seemed repetitive at times and confusing at other times. Stopped reading at page 58.

[Gabby kampman · Rating 5 out of 5]

Learned things about msf I didn't know before. Can't wait to work with them!!

[Nina Struc · Rating 4 out of 5]

Very good book to give inside into world of Doctors Without Borders. As an employee it gave me valuable advice how to survive transition period between missions.

[Owen Little · Rating 4 out of 5]

Great book providing the history, reputation, and current climate of MSF. Great look into the lives and psyche of volunteers. I now want to eventually work as a logistician for MSF.

[Heather Smith]

Very informative book about the beginning of the organization, aspects of the organization and stories.

[Glenda · Rating 4 out of 5]

An interesting read about the inside workings of MSF.

[Hai Lin · Rating 5 out of 5]

This book is very enlighting and is worth reading many times.