Urgent Calls from Distant Places: An Emergency Doctor’s Notes about Life and Death on the Frontiers of East Africa

by Marc-David Munk

A profound exploration of emergency medicine practiced at the most remote and challenging frontiers of East Africa. This inspiring collection of essays finds hope and meaning in the face of extraordinary odds, as a young physician asks: What are the ethical and moral dimensions of saving one life knowing countless others will die?

In 2008, a young doctor set out for Kenya, to volunteer with the famed AMREF East African Flying Doctors Service. An emergency physician looking to make a difference, Marc-David Munk flew dozens of missions as a flight surgeon to eleven East African countries, including war-torn Somalia and the Democratic Republic of Congo.

From his unarmed air ambulance, Munk and his team treated patients suffering from severe trauma, possible Ebola hemorrhagic fever, elephantiasis, malaria, and gunshot wounds. The crew dodged corrupt officials, landed planes on unlit grass strips after first scaring away livestock, were threatened by al-Shabaab jihadis, navigated war zones, and clandestinely treated a U.S military serviceman. They also experienced some of the most beautiful parts of Africa and met the incredible people who live there. The tight-knit crew was passionate about saving lives despite the risks inherent in flights across war zones.

In Urgent Calls from Distant Places, the missions described are real and compelling. Readers will meet sick NGO workers in Somalia, malnourished Ugandan soldiers, suicidal teenagers, violent cow rustlers, American special forces, albino children murdered for their body parts, and even 19th-century explorers David Livingstone and Henry Stanley. Each chapter details the medical challenges of the mission but also explores the greater philosophical questions raised by treating patients in East Africa: African history, the impact of colonialism, communism, religion, terrorism, and war. Munk examines the unique histories and politics of the eleven countries he visits.

Urgent Calls is the story of the doctors, nurses, and pilots who tackled complex and dangerous missions to save lives. The book also bears witness to the author’s moral development as a healer and as a human. Urgent Calls takes readers to the wild beauty of East Africa and embraces the challenges of healing patients with humility, gratitude, and hope... one life at a time.

Genres: Memoir, Africa, Nonfiction, Medical

378 pages, Hardcover

First published January 22, 2024

Reviews

[Glen · Rating 3 out of 5]

I won this book in a goodreads drawing.

A doctor, tired of dealing with the bureaucracy centered medicine, volunteers to go to Africa and work emergency medicine there.

A lot of muddled thinking about colonialism, but the descriptions of the actual incidents is gripping.

[Booknblues · Rating 4 out of 5]

Urgent Calls from Distant Places: An Emergency Doctor’s Notes about Life and Death on the Frontiers of East Africa details the time which Munk served in AMREF (East African Flying Doctors Service), Which is an emergency service which flies doctors to attend to patients in emergency medical situations, retrieve and transport the said patients to Nairobi.

The book is broken down into chapters of individual emergencies and retrievals from various spots in Africa to Nairobi. Some of these are extremely hairy situations for both the patient and doctor.

I found this book fascinating, but recognize that it will not be of interest to everyone.

[Chelsea Ryan · Rating 4 out of 5]

Eye opening and interesting

[Crystal · Rating 4 out of 5]

Urgent Calls from Distant Places

A doctor decides to take the chance (and risk) of a lifetime. True stories of a doctor that was given an opportunity to essentially be a life-flight doctor for all of East Africa. Random cases of illness and injuries from people all over the world. The doctor and his crew have to deal with governmental issues, religious issues, societal issues, language barriers, lack of supplies, greed, the elements, and uncooperative people. Doctors already have it rough in a hospital full of machines and competent colleagues. The author faced many of the same issues but without machines and a bunch of other people; and he had to take care of patients on a plane as it went from one place to another.

I appreciated the glimpse of what life was like for the people living in the various countries at the time. Not just stories of healing the sick and patching the wounded. These behind-the-scenes stories of the issues faced and why they exist made this even more enjoyable for me. I learned some new information and confirmed some other things I had learned but forgot.

#GoodreadsGiveaways

[Katie Hall]

I loved this book -- and am so happy I got an early copy. Part medical adventure, part history of Africa, part personal story -- I lost myself in these pages ... and learned much that I didn't know. With beautiful writing, the author, who is a doctor who worked in Nairobi, takes the reader from country to country in Africa on "emergency runs" to save lives. The situations he finds himself in are almost "too outrageous to be true" -- but they're all true! The book details esoteric diseases like elephantiasis and malaria and bizarre parasites; encounters with U.S. special forces and nomadic Maasai herders; and tales of the NGO officials working at the biggest refugee camp in Africa. He also tells the histories of such African nations as the Democratic Republic of Congo, Kenya, Tanzania, Uganda, Somalia, and many more.

I couldn't put it down. His website has more great quotes: mdmunk.com. Really good.

[Clare O'Brien · Rating 4 out of 5]

Stories that brought tears to my eyes and made me greatly appreciated doctors and aid workers. Some of the interesting topics discussed include broken bureaucracy in Ethiopia stemming from Soviet influence, questioning the model of throwing a bunch of resources to save one person via air doctors versus spending more money on vaccine programs, etc. the latter is powerfully illustrated through a analogy of throwing one starfish into the ocean on a beach of millions– it matters to that starfish.
Some chapters do and rather abruptly without wrapping up the topic/theme as clearly as I would’ve liked or follow up on the story, but that’s also life as the author note – Emergency doctors don’t always know how a patient’s story ends.

[Geoffrey Cornish · Rating 3 out of 5]

A potentially great book diminished by amateurish narration. Lots of good thoughts observations and life changing insights but with too many truncated stories without endings due to the passing over of patients to medical teams and no outcome results. Enjoyable nonetheless, and a brave journey of self discovery by a person you’d love to have a long sit down dinner with.Bravo for telling it like it is and was without thrills and spills but with care and an ethically sound point of view.

[Betty Bennett · Rating 5 out of 5]

A young doctor flees the corporate, profit driven world of hospitalized emergency care in USA and joins an emergency air ambulance service in Africa. Here he is confronted by multiple challenges unknown in this country. He ends his book with call to each reader to focus their vision on becoming their best self despite any challenges before them.

[Marc-David]

KIRKUS REVIEWS: OUR VERDICT: GET IT!

URGENT CALLS FROM DISTANT PLACES
An Emergency Doctor's Notes About Life and Death on the Frontiers of East Africa
Marc-David Munk Creemore Press (378 pp.) $6.99 e-book
January 30, 2024

BOOK REVIEW

An air ambulance doctor revisits his adventures saving lives in Africa in this soulful medical memoir.

Munk, an American emergency medicine physician, recaps his stints from 2008 to 2012 with AMREF Flying Doctors, an NGO that conducts medevac missions out of Nairobi to African locales as far away as Khartoum. His episodic chapters recount trips in difficult, dangerous circumstances—landing at tiny rural airstrips after the pilots ascertained that there were no livestock on the runways; on one occasion, braving potential anti-aircraft fire on a flight into Mogadishu—and his efforts to stabilize patients for the long journey to Nairobi in a flying emergency room. His account pairs engrossing dives into the cases he treated with ruminations on Africa’s travails. Thus, a trip to Congo to collect a priest stricken with heart failure highlights that country’s corruption—airport workers sometimes blocked a plane’s departure until they received bribes—and the success of a bishop in suppressing it. In Ethiopia, the author encountered a Kafkaesque bureaucracy, left over from the country’s time as a Soviet client state, that forbade him to move a patient in diabetic shock 15 feet to the plane until officials approved it. A trip to Kampala to rescue two Australian tourists injured in a motor-bike crash prompts a meditation on Africa’s lack of health and road-safety infrastructures that coddle Westerners. And a trip to a Somali refugee camp to pick up a psychotic aid worker reminded Munk of his privilege in flying back out while thousands immured there couldn’t escape. The author’s gripping, evocative prose conveys the adrenalized pressure of emergency care. (“I could hear the beeping heartrate monitor get slower and slower, a truly ominous sign....Why was the air not entering the boy’s lungs? Only seconds had passed, but they were dire. What was wrong? I felt a familiar sick feeling in my stomach—the one I get when things spin out of control.”) He also captures the plangent ironies of his inability to treat Africa’s manifold dysfunctions. (“I would frequently evacuate patients from one awful hospital in East Africa, provide them American-standard care in the air, and then deposit them at a second awful hospital.”) The result is a true-life medical drama that combines tense heroics with mordant reflections.

An enthralling portrait of high-wire emergency care performed under the most trying circumstances.