Episode: "The Choice"
Full name: Els Adams
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
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
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