Vector Issue 2 - 2006

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Lending a Hand: the Aid Issue page 2 Article photo courtesy of Tonya Littlejohn nomadic herding practices coexist with an increasingly youthful population. The outcome of these major structural changes is that services do not always reach the most vulnerable groups. In my brief time there, I was involved in work aimed at adolescent development and well-being. Up to 55% of Mongolia’s Dr Moore is a Plastics and Craniofacial Surgeon in Adelaide, South Australia. His medical school days were spent at the University of Otago, New Zealand, following which he came to Adelaide to undertake his fellowship, having earlier completed his training in Plastic and Reconstructive Surgery. He has a longstanding involvement in developing world healthcare through his involvement with the Overseas Specialist Surgical Association of Australia (OS- SAA) Dr Moore, how did you first get Q: involved in developing world medicine? A: A few years ago I met a doctor from the NT, Dr John Hargreaves, who had set up the organization that was to become OSSAA, which coordinated surgical trips to locations in East Timor and Indonesia that were extremely disadvantaged. He convinced me to go along on one of these visits for a fortnight to East Timor in 2000 immediately post-independence. After going on that first trip I haven’t looked back. How often do you go overseas and Q: what do you do? We travel four to six times a year. A: Herders in Mongolia Next week I am going to East Timor which will be the nineteenth time I have made that trip. What is done on these trips varies according to the skill set of the surgeons on that particular expedition. My area is Plastics and Craniofacial surgery so the main conditions that I deal with are cleft lips and palates, and burns. I also come across a variety of other conditions such as other congenital abnormalities of the head and neck as well as tumours involving these regions. Looking at the OSSAA mission Q: statement it says that one of your aims is to provide local training in services. Lessons from a frozen Capital 3continued from page 1 population are under the age of 24, many of which live remotely or outside traditional care structures such as family or community. It was in the midst of this complex and dynamic situation that I discovered that despite my desire to contribute to broader social and political change, ultimately it was the small scale, targeted programs that proved most effective at addressing the immediate needs of Mongolian people. For instance, delivering life skills training to abandoned teenage girls and outreach services to women in isolation fostered independence and had a sustained and tangible impact. Sustainable assistance also involves giving a voice to the disempowered. In many communities, the most vulnerable populations often do not have a say in the decisions that affect them the most. It is vital to create avenues for collaboration and Interview with: Dr Mark Moore Moving towards local sustainability A: and independence is one of the ultimate goals of our organization. When I first moved to Adelaide the hospital I worked at had an arrangement with the Malaysian government whereby we trained many of their Plastics trainees. At that time Malaysia had no home grown surgeons in that area, so we helped them develop that capacity. They are now at the point where many of these surgeons are conducting their own outreach services to places in Malaysia that are less advantaged like Sarawak. I consider that a real success story. Similarly whenever we operate in any of these sites we try to get some of the local staff, both doctor and nursing, involved so that their skills are built up. We still have a long way to go but are slowly getting there. The signs though are so promising that AusAid is starting to look at our operation as a potential model to replicate elsewhere in the region. Do you think that doctors in the Q: developed world have an obligation to assist those in the developing world? A: I think every doctor, and indeed every person, if they choose to can contribute to the health of those in the developing world. This contribution can be made in countless ways, many of which don’t involve actually travelling to these sites to practice medicine because that is not always going to work for an individual person. It could be through fundraising, assistance with running organizations like OSSAA or by covering the clinical responsibilities of your colleagues who do go overseas. Something that I am against however is a phenomenon that I call “medico-eco tourism” where doctors, often the more junior ones, head to third world countries on one-off visits and undertake operations without adequate follow-up and in some cases the necessary Article photos courtesy of Dr Mark Moore build meaningful partnerships between marginalised populations and the Government. In this spirit, the creation of a national level young people’s forum gave the country’s silent majority the opportunity to articulate their own concerns to policymakers and institutions. It has since become a powerful medium for representation, giving users the confidence to speak out and decision-makers the choice to listen. From such experiences in Mongolia and elsewhere, I have observed the benefits that aid and technical assistance can accrue to the most vulnerable populations. Certainly, the delivery of aid is a complex and difficult undertaking. Nevertheless, in places where the Government cannot, appropriately targeted aid continues to provide services and programs to those who face the greatest burden of poverty and ill health. by Tonya Littlejohn expertise. One of OSSAA’s principles is to try and send the same surgeons back to the same sites so that some degree of continuity of care exists, along with the opportunity to build an ongoing relationship with the site which provides a whole range of attendant benefits in terms of training and ease of providing services. I also think the medical schools should play their part in this area as well, such as through bilateral exchanges with medical schools in developing countries. Organisations such as your IHN are a good way of starting and increasing this involvement. A: Is there a patient or experience that Q: stands out for you? If I had to choose one it is probably the case of a young married woman who was severely burned to the face and chest while in her late teens. The burns were such that she couldn’t close her eyes and had difficulty putting food continued on page 34
Interview with: Dr Mark Moore 3continued from page 2 in her severely scarred mouth. We have done a number of staged operations for her which have made an enormous change to her quality of life. Her ability to deal with these circumstances and get on with life has amazed and inspired me – since we first met she has gone on to have two young children with her husband who has also been extremely supportive. You give up the opportunity to earn Q: a large amount of money when you go on these trips and stay in some fairly primitive conditions. Why do you do it? I don’t think anyone does this sort A: of work for purely altruistic reasons. It is not in human nature to do that. There are rewards for everyone which varies according to the person. For me it is the opportunity to share experiences like the one I mentioned before of the burns patient. The other gratifying aspect is the true appreciation your patients give you for your time and skills. I have patients here in Australia who will grumble if they have to wait 30 minutes in my waiting room, whereas in East Timor some of my patients with significant deformities will have been waiting 6 weeks for a scheduled operation which we will have to cancel at the last minute and post-pone to our next trip which will be months away. And yet they still thank you for even considering them. Any advice for young starry eyed Q: junior medicos who want to go Crescent and Oxfam Australia shared their success stories of emergency relief, empowerment of local communities, microfinance initiatives and many other excellent projects. Between sessions, delegates mingled with NGOs at their respective booths, browsed through posters detailing what international health groups had achieved or simply lounged over the delicious lunches to discuss the equally plentiful food for thought. Day three was geared at answering the perennial question, “How I can do something NOW?” We learned about student volunteering opportunities, electives advice, an internship at the UN, strategic planning for international health groups and how to get involved with indigenous and refugee communities locally. This was all topped off with a panel discussion with a junior doctor, a nurse and a retired colonel who answered questions and provided advice on career planning. This conference was a landmark event for AMSA’s International Health Network, a collaboration of all the university international health groups. The IHN chair presented their achievements including a comprehensive website: www.ihealthnet. net, Vector magazine, and much more. The smooth running and quality of the conference is a credit to its organisers, students from UWA who did a great job with the academic programme as well as cultured entertainment and lavish food throughout. Amongst all I heard and learnt at DWC, it was the sweet, sad, and often hilarious anecdotes from people on the field that I cherish. I am so grateful to have experienced the camaraderie of all present with out and heal the world? [Laughs] Go A: in with your eyes wide open – for some doctors, travelling to these places isn’t going to work out. For those of you who do get involved, the rewards are enormous – it makes you a better doctor and a better person. AMSA Developing World Conference 2006 Delegates gather in the main lecture theatre War. Injustice. Poverty. Natural disasters. In an age where turning on the evening news can lead to instant despair, it’s hard to find the inspiration to believe that things can change for the better. For me, AMSA’s second Developing World Conference did exactly that and more. Over three days almost three hundred students, medicos and gurus of international public health and development gathered on the lush grounds of UWA, Perth, for “Talking Truths: Global Perspectives on Health”. The conference was much more than a dry information session on statistics of death, disease and devastation. Keynote speaker Prof Dev Bhasa urged us to think about the concept of “truth” – is it state sponsored knowledge we subscribe to or do we truly understand the needs of the people we are trying to help? Then there was the fantastic, cerebral debate on Neoliberal economics and its impact on health. Prof Komesaroff ’s discussion on how aid can disempower rather than foster existing capacity within developing communities made me realise how ignorant and naïve I still was. Other speakers discussed the crucial topics of fair trade laws, the powerhouses’ abysmal foreign aid commitment, war and its toll on health, doctor poaching and more. But it was not all doom and gloom. Representatives from NGOs such as Opportunity International, Red Cross/Red “Not only is another world possible, she is on her way. On a quiet day, I can hear her breathing.” - Arundhati Roy by Andrew Perry Yasinta Black their infectious enthusiasm and dedication. I am certainly looking forward to more learning and a reunion of these ideals at Developing World Conference 2007, to be held in Adelaide. Until then, I’ll put my best foot forward and have faith that that better world is one step closer. Students gather on the grassy common of UWA Formation of the new IHN committee Varga, Ruth, Fred Alok and Sneha by Gail Cross page 3 Article photos courtesy of Sneha Parghi Article photos courtesy of Dr Mark Moore Lending a Hand: the Aid Issue
Page 1: Aid: or does it? She stood outside
Page 5: © Antonin Kratochvil / VII Médeci

Vector Issue 2 - 2006

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