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ADOCTORIN KIGALIDr. James Orbinski served as head of mission forDoctors Without Borders during the Rwandan Genocide.What he saw there transformed him BY STACEY GIBSONJuly 3, 1994, one of the final days of theRwandan Genocide. In the bullet-scarred KingITwasFaycal Hospital in Kigali, Rwanda, Dr. JamesOrbinski was amputating the leg of a 14-year-old land minevictim. The boy’s foot was hanging precariously from his calf,held together by threads of flesh laced with bone and a pieceof shoe. Orbinski, the 33-year-old co-founder of DoctorsWithout Borders Canada, had performed many amputationsduring his six weeks in Rwanda – treating hundreds of victimsinflicted with machete wounds, or injured by grenades andland mines – but this was his first time unaccompanied byanother physician. Orbinski was afraid he might cut an artery,and kill the child. Medical instruments were scarce, and all thehospital’s surgical blades were broken. The only tool at his disposalwas a hacksaw. In half-an-hour, Orbinski sawed off theboy’s leg above the knee; he then shaped and stitched the tissue.The nurse placed the severed limb in a bucket on thefloor. The boy’s mother rushed through the operating doorsand toward her son, screaming, “Mama-we! Mama-we y’ nola.”(“Mommy is here.”) She held him around the head. He whispered,“Mama-we, Mama-we.” The boy’s leg was gone, but hewas alive. It was, says Orbinski, “an imperfect offering.”Orbinski’s new book, An Imperfect Offering: HumanitarianAction in the Twenty-First Century, to be published April22 by Doubleday Canada, traces the journey of a humanitariandoctor who has served in some of the world’s most dangerousconflict zones. Orbinski, 47, was international presidentof Médecins Sans Frontières (Doctors WithoutBorders/MSF) from 1998 to 2001, and he accepted theNobel Peace Prize on the organization’s behalf in 1999. Overthe past quarter-century, he has worked in places such asSomalia during the famine and civil war; in the refugee campsin Jalalabad, Afghanistan; and at the Kosovo-Macedonia borderduring the NATO bombings in 1999. His book exploresevery facet of his work, from the deeply personal to thebroadly political: How does a man persevere – and, furthermore,create meaning and invoke change – after witnessingthe most violent, sadistic acts human beings can inflict onone another? What is the role of the humanitarian in thepost–Cold War era, in which traditional rules of war havebeen swapped for anything-goes ethical nihilism? How couldMSF confront politics and public apathy during crises so ithad the space and resources to heal patients? The notion ofimperfection permeates many of Orbinski’s answers. “Thebook’s title is inspired by the poem and song Anthem, byLeonard Cohen, and there’s a beautiful line where he says,‘Forget your perfect offering. There is a crack in everything,’”says Orbinski, who earned a master’s degree in internationalrelations from U of T in 1998. “When I read that poem, itstruck me that that’s the essence of my experience over thelast 20 years as a physician, as a putative humanitarian, as aperson who has tried in various ways to influence the politicalprocesses that determine who gets what, when. It’s verymuch an imperfect process with equally imperfect outcomes,but it doesn’t obviate the absolute necessity of trying. Youachieve something, and sometimes just enough to go on.”“The story in the book of the young boy whose leg Iamputated is a very good example of that. The boy survived.His mother obviously loves him and he is alive, and had I notamputated his leg he probably would have died within 24PHOTOGRAPHY: CHRISTOPHER WAHLWWW.MAGAZINE.UTORONTO.CA 19