A peace agreement in Angola opens up
formerly isolated areas of the country, revealing a population
deprived of external aid for three years...
Full Name: Els Adams
Profession: Public Health
Episode: "The Choice"
ANGOLA | BOLIVIA
In this episode, nurse Els Adams finds too many malnourished people
to transport back to the MSF feeding center. Why does Els only have
Els was on a preliminary assessment visit to the quartering
area – at this stage in the crisis, there were large populations
appearing out of the bush spontaneously and unannounced, so it was
difficult to know when and where more trucks would be needed. Even
if Els had had another truck on this day, the people she brought
back to MSF’s therapeutic feeding center (TFC) would have
exceeded its capacity, leaving no room for patients from the surrounding
areas who were even more in need of help. In successive days and
weeks, MSF greatly increased its presence and its effectiveness
in the country by sending more volunteers and building more feeding
In this episode, there is no suggestion that
the Angolan government or the United Nations are responding to the
nutritional crisis in Angola…where are they?
The response of the Angolan government and the United
Nations to the Angolan nutritional crisis was much later than MSF
would have liked. Initially, there was an inexplicable hesitance
to acknowledge the severity of the crisis by both parties. When
this episode was filmed, the UN and the Angolan government had started
to address the situation, but remained bogged down in bureaucratic
negotiations concerning how best to respond. Eventually, both did,
but only after thousands of lives were lost unnecessarily.
In this episode, a young boy named Dino dies
at a district hospital in Angola while under the care of MSF medical
aid workers. What is the cause of Dino’s death, and why was
MSF unable to prevent it?
Dino was anemic – his malnutrition had resulted
in a lack of hemoglobin. There is a possibility that a blood transfusion
would have saved his life temporarily, but severe malnutrition compromises
the immune system, and there is no guarantee that he would have
continued to live. Dino didn’t get the transfusion he needed
because the Angolan government health workers who staffed the provincial
hospital in Malanje had gone home for the night and locked up the
blood bank and the laboratory equipment necessary to type Dino’s
At this early stage of the crisis, as the scale of
the needs were just starting to become evident, MSF was relying
on the Angolan Ministry of Health (MOH) for intensive care medical
procedures such as blood transfusions. In response to cases like
Dino’s, MSF met with the director of the MOH regarding the
best way to coordinate a combined response to the emergency and
quickly assigned personnel to assist the hospital’s staff.
Later in the episode we see MSF doctor Jacqui Mukoyogo working alongside
Angolan government health workers to coordinate emergency transfusions.
What happened to Inez, the girl who Els carries
on her lap to the Therapeutic Feeding Center?
According to Els, Inez recovered very well; “After
a few weeks, she was unrecognizable – she became a very pretty
girl, with full cheeks and shining skin. The staff in our feeding
center took very good care of her, and some of the cooking ladies
bought some clothes and shoes for her. One day an aunt of her appeared,
and took her with her to live in Luanda.”