Episode: "The Choice"

Full name: Els Adams
Nationality: Dutch
Profession: Public Health Nurse
Birthplace: Soest, Netherlands
Hobbies: Hiking, reading
Years with MSF: 12
MSF missions completed: Nicaragua, Angola, Peru, Cuba, South Sudan

What brought you to MSF?

As a child I was fascinated by the tales about people like Albert Schweitzer. I come from a Christian family, where principles like solidarity and compassion were highly valued. As an adolescent, I started travelling in various developing countries, and enjoyed living temporarily in different cultures. I felt that contact with people from other cultures broadened my mind, and enriched my life. By joining MSF I was able to combine the elements of doing useful work with (often marginalized) people in great need, and enjoying the pleasures that working with people in a different cultural environment offers. Besides, the work is never boring or routine, and it is very inspiring to work for an organization that is able to respond to people's needs in critical moments.

What was your most memorable moment with MSF?

There are too many to count… the powerlessness I felt in the nutritional emergency in South Sudan, where so many people were starving; the thrill of working in the streets and on the beaches in Havana, discussing HIV/AIDS prevention with Cuban sex workers; the satisfaction you feel if a very malnourished child in a feeding center is really getting better and becomes healthy and happy again; the fear I felt when the war in Angola got too near and we were evacuated in a plane that was under fire; the fascination I felt when I was visiting a very remote Indian village in the Peruvian Andes on foot, and found a whole community praying together for some sick lamas, but not interested at all in what MSF could do for them. Really, each mission has its moments that you never forget.

Overall, what was your impression of your mission in Angola?

My overall impression was satisfaction that we were able to respond to the emergency. We (MSF) were the first ones to react, and were criticized by the UN for it. However, I was very convinced we did the only right thing. The periods of the emergency were very intense, and exhausting, but I look back at it as a very good mission. I think we have been able to achieve something, and certainly have made a difference for many of the people that we were working for.

What did this mission mean to you personally?

The Angola mission as a whole was an unforgettable experience. I felt deeply involved with what was happening, and very happy that we were in the position to do something. I still have clear memories of the emergency period, getting people out of the bush or the UNITA camps, opening feeding centers and working like crazy to do as much as possible with the resources that were available. At the same time, sometimes I see the images of children that we were not able to save. But in general I feel privileged that I was there, at that time, with that team, and despite all constraints, that we were able to deal with the problems we faced.

What are your hopes for the populations you served in Angola?

As I have spent four years of my life in Angola, I have become very attached to its people. I think I have seen quite a lot of the suffering caused by the war, and really hope that the war is definitively over, and that people can start to build their lives again, and suddenly may feel that they have a future. I hope that the government will take up its commitment to provide more chances to the population, but I am not too optimistic about this…

In this episode, when MSF arrives at the quartering area, you’re forced to make extremely tough decisions about who to bring back to the TFC. What was the sequence of events that led up to this – and what happened to the people left behind?

First of all, it is important to realize that at this point, MSF was the only group responding to these needs. The UN was not nearly as active. Mark's and my trip was the first assessment trip to this quartering area, and we really did not know what to expect in terms of severity and numbers. Secondly, even if we had had four trucks, we would not have had the capacity to feed all of those children that day. Our TFC was full to overflowing and we were preparing another to handle all of the patients. Our trucks also went to Damba, the other quartering area, and believe it or not, the situation there was even more critical. Regarding the people we couldn’t take – there were trucks sent the next day and the day after to pick up more.

What do you think were the lessons learned from the 2002 famine?

For MSF: I think that the importance of remaining independent was confirmed again; if we had followed the UN line, we would not have responded to the needs of the people, and children like Inez, and many others, certainly would have been sacrificed for political reasons. By following our own mandate, we were able to make our own choices, even if they were against the UN political line. I think we should remember this lesson for the future as well.

For the Angolan government: Care for your people, respond to their needs. They are all Angolans, who deserve to live in dignity after so many years of war and suffering.

For the UN: There are moments when 'political games' should be abandoned. There are moments when you should not think twice about responding to people’s suffering.

In this episode, we see a young boy named Dino die because the staff at Provincial Hospital (an Angolan Ministry of Health facility) has closed its doors and left for the night, locking up the equipment necessary to give him the blood transfusion he needs. How do you deal with a situation like this in the midst of a huge humanitarian emergency?

MSF was depending on the MOH (Ministry of Health) facility. It was a constant frustration, and it did happen with frequency that MOH staff would not be available. We always had extra supplies (blood bags etc) for our patients, but still needed the MOH for their laboratory facilities and staff. It also happened that we transferred patients for surgery to Provincial Hospital who then later died because the MOH surgeon did not show up, or did not have adequate supplies. We discussed the behavior of the MOH staff with the national director of MOH, and later the situation improved slightly.

If the MOH staff makes mistakes, it does not mean that MSF therefore can or should start running a government hospital which is the responsibility of the Angolan government. We’re an independent aid agency – we can do our personal best for our patients and advocate for improvements in government health care, but we can’t overstep our bounds. It is the reality we have to live with, but which is pretty difficult at times, I have to admit...

Do you know what happened to Inez, the girl you helped in episode one of the National Geographic series?

She recovered very well. After a few weeks, she was unrecognisable – 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. That is all I know.

Ton Koene photo of Els with Inez