I’ve been swimming for a while now. Not quite 'lost in a longing to understand', but certainly a little off the black line in the pursuit of an accountable life.
I loosely answer to the label of remote area emergency medicine and tropical medicine specialist working in disaster and humanitarian health. I am interested in the optimal delivery of health care to complex populations in great need and in the ethics of the delivery of this care, with a particular focus on conflict regions, and on the underlying structural violence visited upon vulnerable populations.
Camus said, "There is no happiness if the things we believe in are different than the things we do". I believe in the human right to health. I believe that the man I watched die of Ebola across an orange plastic fence in Sierra Leone, 2015, has the same worth as my stepfather. When I hold a child’s airway in my hands in remotest, most seemingly forgotten South Sudan, I hold that of my niece.
Happiness is not elusive, but it must mean a great deal more than a slogan on a yoga bag, rooted as it can only be in deep accountability to the humanity of both ourselves and others. I quote Paul Farmer ad nauseam in saying, "If access to health care is considered a human right, who is considered human enough to have that right?” I am prone to finding happiness - of sorts - lying on the floor of remote clinics, tucked beneath a mosquito net, in difficult to access places. Access is the challenge and the key.
I’ve been privileged to stumble across brilliant people and immense souls. From the expansive love of family and friends forever dear, to small remarks never forgotten, I’ve swum through complex places with a shark net - not impermeable, but ever-allowing. It is to these people I respond as I start to compile this work.
An early career mentor said in a recent email: you know the winds and shoals now. He’s a knack for words, this one, for it is somehow the ocean that unites this work and my station within. When the need is to act, the clinical space is redemptive. When you cannot stop the war, you can treat the child in front of you. It is not enough, but it is not nothing. It is not a full and robust response to an unjust world, but it can surely be counted as an human attempt. When the need is to pause, I turn to the ocean. I paddle an ocean ski or play among the waves, body surfing to shore.
“As long as I kept moving, my grief streamed out behind me like a swimmer’s long hair in water. I knew the weight was there but it didn’t touch me. Only when I stopped did the slick, dark stuff come floating around my face, catching my arms and throat till I began to drown. So I just didn’t stop”. Barbara Kingsolver - one of the greatest contemporary observers of the human condition.
I type from an uneasy moment of pending peace in a conflict zone held dear. The generator rumbles loudly, chatting, I suspect, to the concertinaed barbed wire that is its constant companion. The year is 2019. The ocean is warming, rising and acidifying. The moral sway of the West has declined as right-wing popularism seems to continue its uncommon upstroke. Migrants die needlessly in the Mediterranean as humans of self-promoted worth sit in judgement over lives of which they do not know and for which they cannot care.
I draw arrows in a notebook between the ocean, migration, climate change and often-protracted conflicts. Great swathes of poverty and food insecurity drive and are driven by matters debated academically as my own nation clings to its resource-wealth rather than embracing a world that eagerly awaits. One Health. One World. It is Planetary Health. It is Revolutionary Medicine. Let’s go.
Nothing is stronger than an idea whose time has come.
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