WEBVTT - MSF's Joanne Liu Still Believes War Has Rules 0:00:02.840 --> 0:00:06.000 This is Alec Baldwin and you're listening to Here's the thing, 0:00:06.760 --> 0:00:10.960 My chance to talk with artists, policymakers and performers, to 0:00:11.039 --> 0:00:14.920 hear their stories. What inspires their creations, what decisions change 0:00:14.960 --> 0:00:22.040 their careers, what relationships influenced their work. Med San Saint Frontier, 0:00:22.600 --> 0:00:25.840 or Doctors Without Borders, as it's known here in the US, 0:00:26.400 --> 0:00:30.159 is a humanitarian aid organization that provides medical help to 0:00:30.240 --> 0:00:35.519 war torn areas and developing countries facing epidemics. It's been 0:00:35.560 --> 0:00:38.080 in the news lately because of a US led air 0:00:38.120 --> 0:00:42.000 strike last fall that destroyed an MSF run hospital in 0:00:42.120 --> 0:00:47.479 Condu's Afghanistan, killing over forty people. My guest today is 0:00:47.600 --> 0:00:51.520 jo Ant Leu, the international president of m SF since 0:00:51.560 --> 0:00:56.680 two thousand thirteen. Founded by doctors and journalists in nineteen 0:00:56.800 --> 0:01:00.920 seventy one, m SF differs from the Red US and 0:01:00.960 --> 0:01:04.080 that they speak frankly about the injustices they witnessed in 0:01:04.080 --> 0:01:07.320 the area as they serve. That's what it has brought, 0:01:08.400 --> 0:01:11.800 is this medical act with the fact that we speak 0:01:11.840 --> 0:01:16.640 out on what we witness. How would you describe the 0:01:16.680 --> 0:01:20.200 mechanism of how the organization works? For example, where you 0:01:20.319 --> 0:01:23.360 go where you don't go. I'm assuming there's places you 0:01:23.400 --> 0:01:25.920 don't go because you don't feel safe there. You can't 0:01:25.959 --> 0:01:29.360 be guaranteed safety. Obviously in recent months you in places 0:01:29.360 --> 0:01:32.360 where you thought you were saving you weren't. So how 0:01:32.560 --> 0:01:38.040 what's the decision making process about where you going? Why? Well, 0:01:38.120 --> 0:01:42.280 in terms of our basic mandate, it's to bring medical 0:01:42.360 --> 0:01:46.720 humanitary an aid two population in distress either stilling to 0:01:46.720 --> 0:01:50.000 read to mandate disaster, which could be conflict arm conflict 0:01:50.080 --> 0:01:53.840 most of the time, or natural disaster. And so we 0:01:53.920 --> 0:01:57.960 end up working from war zones like South Sudan, the 0:01:58.040 --> 0:02:01.520 Central African Republic, or in the Middle East right now 0:02:01.560 --> 0:02:06.000 in Syria and Yemen. Two places where there's an earthquake 0:02:06.480 --> 0:02:10.320 like we've seen in Haiti, or in response to an 0:02:10.320 --> 0:02:15.040 epidemic like we are seeing with measles in the Democratic 0:02:15.040 --> 0:02:18.360 Republic of Congo. So this is the range of where 0:02:18.600 --> 0:02:24.560 we act. And you mobilize predominantly local forces in terms 0:02:24.560 --> 0:02:26.960 of the medical community in a certain area, or you 0:02:27.080 --> 0:02:31.160 bring in outside medical assistance. Are both, so we do 0:02:31.240 --> 0:02:34.720 both and today met San San Francaire doctors without borders 0:02:34.760 --> 0:02:37.880 to present a workforce are about thirty to thirty five 0:02:37.960 --> 0:02:43.320 thousand people overall national and international, and the ratio is 0:02:43.440 --> 0:02:48.639 for each international we have about ten national worker. We're 0:02:48.639 --> 0:02:52.080 working about seventy countries and we have an income budget 0:02:52.120 --> 0:02:56.320 of one pointry billion. So in a country nine that 0:02:56.480 --> 0:02:59.840 of ten people are local, are are indigenous if you will, 0:03:00.080 --> 0:03:03.160 now when you mentioned that you have thirty to thirty 0:03:03.200 --> 0:03:06.960 five thousand medical professionals worldwide at any given time. They 0:03:06.960 --> 0:03:09.160 are people who work in the medical community who come 0:03:09.160 --> 0:03:12.280 and volunteer. If you they have other jobs. Correct, they're 0:03:12.320 --> 0:03:15.680 not full time staff of the national staff are often 0:03:15.840 --> 0:03:19.000 full time staff. Sometimes you you you do that for 0:03:19.040 --> 0:03:21.760 a few years as a full time and then after 0:03:21.880 --> 0:03:24.440 you just go back to your professional life. You grew 0:03:24.480 --> 0:03:28.840 up in Canada, yes, in Quebec, yes, And when you 0:03:29.200 --> 0:03:32.440 were going to medical school, was this something you considered 0:03:32.480 --> 0:03:36.480 an option? Did you think about this kind of relief work? Well, actually, 0:03:36.600 --> 0:03:40.520 I'm one of those very non original people who when 0:03:40.560 --> 0:03:42.560 I was a teenager, I wanted to be a doctor's 0:03:42.600 --> 0:03:47.200 without borders. So this is something that that has started 0:03:47.200 --> 0:03:51.440 when I was a teenager around about thirteen fourteen years old, 0:03:52.160 --> 0:03:55.880 and and in my quest for meaning in life, I've 0:03:55.880 --> 0:03:59.160 read several books. I think like any other teenager we 0:03:59.200 --> 0:04:03.920 all read then in the Auto Motorcycle and then started Yeah, 0:04:04.000 --> 0:04:07.400 and I read one book that was called lepen Almond 0:04:07.560 --> 0:04:09.760 and the Peace in the World, and it was basically 0:04:11.080 --> 0:04:14.440 a testimony of a physician and work overseas with MSF 0:04:14.920 --> 0:04:17.040 and I remember reading it and I just said, Wow, 0:04:17.200 --> 0:04:20.120 this is so cool, and I said, this is what 0:04:20.160 --> 0:04:22.599 I would like to do. But sometimes you know, you're 0:04:22.600 --> 0:04:26.040 a teenager and you make those kind of of statement 0:04:26.120 --> 0:04:30.120 for yourself, but it takes a while to materialize. But 0:04:30.200 --> 0:04:33.320 I'm someone who always deeply believe in in community life 0:04:33.520 --> 0:04:37.479 and and working for the common public good. So I 0:04:37.560 --> 0:04:42.360 end up working and doing international corporation relief work when 0:04:42.360 --> 0:04:45.200 I was eighteen years old in Africa, and when I 0:04:45.240 --> 0:04:46.720 came back and said, this is it. I'm going to 0:04:46.800 --> 0:04:48.640 go into medicine. I'm going to go and work in 0:04:48.680 --> 0:04:52.320 developing world and that's what I'm gonna do. And I'm 0:04:52.360 --> 0:04:54.760 going to do that with Alcos Without Borders. It went 0:04:54.800 --> 0:04:58.240 to McGill in Canada and then came down to New 0:04:58.320 --> 0:05:00.800 York and you were trained at Yeah, I went on 0:05:00.920 --> 0:05:04.760 in my pz R at the n y U. And 0:05:05.400 --> 0:05:09.839 at that time were you only going to school or 0:05:09.839 --> 0:05:12.159 were you taking off sort of speaking, doing some of 0:05:12.200 --> 0:05:16.240 this relief work while you were in school. So during 0:05:16.279 --> 0:05:19.160 my training, I end up doing what we call elective 0:05:19.240 --> 0:05:22.839 medical elective overseas, so I end up going in different places. 0:05:23.960 --> 0:05:27.960 For example, I went to Haiti, I went to Kenya, 0:05:28.520 --> 0:05:31.560 I went to Chad and I end up as well 0:05:31.600 --> 0:05:34.320 working up north because I always told myself that if 0:05:34.360 --> 0:05:37.440 I was willing to go in the middle of nowhere 0:05:37.520 --> 0:05:40.599 in the war, I should be able to go in 0:05:40.680 --> 0:05:43.320 places where they don't have enough doctor in my country. 0:05:43.360 --> 0:05:47.239 So I always until recently, I always did some work 0:05:48.040 --> 0:05:52.400 up north in Canada. What was the first spot he 0:05:52.480 --> 0:05:55.400 went to where you did either disaster related or war 0:05:55.480 --> 0:05:59.040 related medical relief work. Right after my first year of premed, 0:06:00.400 --> 0:06:03.240 I really wanted to get exposure, so I went around 0:06:03.320 --> 0:06:06.280 and begged to go somewhere. And I've told people I'm 0:06:06.279 --> 0:06:09.520 going to do whatever, you know, clean the floor. I 0:06:09.720 --> 0:06:12.320 just want to go. But why do you think that is? 0:06:12.360 --> 0:06:16.040 What was it in you? Do you understand yourself why 0:06:16.080 --> 0:06:19.640 you wanted to go do that? Hi? I think that 0:06:19.800 --> 0:06:27.240 um being the daughter of a migrant as something to 0:06:27.279 --> 0:06:31.880 play about it. I'm awfully grateful for everything I've gotten 0:06:31.880 --> 0:06:35.520 in life and the fact that I got access to education, 0:06:36.240 --> 0:06:38.359 and somehow, I guess I always wanted to give back 0:06:38.400 --> 0:06:40.880 and I wanted to do something meaningful. I'm someone of action. 0:06:41.000 --> 0:06:43.640 I'm a bit some people say I'm a bit hyperactive. 0:06:44.200 --> 0:06:47.880 So that was a fit for me. Your parents emigrated 0:06:47.920 --> 0:06:51.360 from China, Yes, and they were in the restaurant business. Yes. 0:06:51.680 --> 0:06:55.000 Do you have siblings as well? Yeah? They all professional 0:06:55.000 --> 0:06:57.679 people as well the profession, but not in the medical field. 0:06:57.720 --> 0:07:01.120 And you're the one doctor in the family. And so 0:07:01.200 --> 0:07:02.760 what it was? What was the first place you went 0:07:03.400 --> 0:07:06.200 after Premiate? I went for for three months in Chad 0:07:06.320 --> 0:07:09.720 during the war. It was wartime between Libya and Chad, 0:07:10.120 --> 0:07:14.800 and I work in what we call a dispensary and 0:07:14.800 --> 0:07:18.080 and did primary healthcare. But we were doing deliveries and 0:07:18.120 --> 0:07:20.120 I remember doing those three months. I end up doing 0:07:20.160 --> 0:07:23.640 fifty deliveries. The reality is, when I look back at it, 0:07:23.720 --> 0:07:25.560 I'm like, oh my god, I didn't know what I 0:07:25.600 --> 0:07:28.120 was doing really when I once I finished my training, 0:07:28.560 --> 0:07:30.800 But that's what I wanted to do. And you were 0:07:30.840 --> 0:07:34.720 there for three months. And when you left, were you 0:07:35.400 --> 0:07:38.840 spent or you upset or were you energized? And you 0:07:38.880 --> 0:07:44.040 wanted more, see more energized. I've I just said, this 0:07:44.080 --> 0:07:45.800 is exactly what I want to do, but I want 0:07:45.840 --> 0:07:47.600 to do it with I want to be skilled to 0:07:47.600 --> 0:07:49.760 do that. You want to go back and finish your training? Yeah, 0:07:50.200 --> 0:07:52.640 was there ever a time you did this when you 0:07:52.680 --> 0:07:54.680 said to yourself, it's too much for me. I don't 0:07:54.680 --> 0:07:57.880 think I can handle this. So they've been tough moment 0:07:58.480 --> 0:08:02.120 And it's not all rosy. I think it's when you 0:08:02.240 --> 0:08:05.400 try to work and you feel yourself so much in danger, 0:08:06.840 --> 0:08:09.040 and then you are as well thinking that you are 0:08:09.160 --> 0:08:12.920 putting other people in danger. And that's what happened to 0:08:13.040 --> 0:08:15.800 me when I was in Chichenia. We were on the 0:08:15.880 --> 0:08:18.400 attack on a regular basis, that's one thing, but the 0:08:18.440 --> 0:08:22.400 threat of being abducted was so huge back then, and 0:08:22.520 --> 0:08:25.200 we knew that if something were ever to happen to 0:08:25.400 --> 0:08:28.880 the staff, the MSF staff, then we will pull out. 0:08:29.600 --> 0:08:34.600 So we were praying for not having anything bad happening 0:08:34.640 --> 0:08:39.760 to us because we knew they were delivering really needed aid. 0:08:41.240 --> 0:08:44.120 On the other end, it was so nerve wracking out 0:08:44.120 --> 0:08:47.160 of fear. Yeah, it's and and and and I hate 0:08:47.200 --> 0:08:48.800 that because I think I was This is so self 0:08:48.800 --> 0:08:51.320 centered and compared to what all those people are going through. 0:08:51.480 --> 0:08:54.840 Come on, get a grip on yourself, go through that. 0:08:55.000 --> 0:08:56.640 So when you were there, but kind of work did 0:08:56.640 --> 0:09:01.000 you primarily do? MSF was running something Nick, It was 0:09:01.040 --> 0:09:05.880 a very difficult time because we were supporting hospital that 0:09:05.960 --> 0:09:09.800 we're basically undercover because it was such a difficult environment 0:09:09.840 --> 0:09:12.600 to work. But you thought that that was at one 0:09:12.640 --> 0:09:17.600 point more than you could bear. It was tough. It 0:09:17.720 --> 0:09:19.839 was my soldiers and war. I mean, you're exposed to 0:09:19.880 --> 0:09:22.800 some pretty tough thing and and and in some other places. 0:09:23.040 --> 0:09:26.520 Is it's just and I don't particularly like to talk 0:09:26.520 --> 0:09:29.840 about it, but because I really do think it's what 0:09:29.880 --> 0:09:32.960 we go through is difficult. But the reality I just 0:09:33.040 --> 0:09:34.680 go through for a couple of weeks of a couple 0:09:34.720 --> 0:09:38.160 of months in my life. I never chanced to leave, 0:09:38.280 --> 0:09:40.440 and I leave and I just go back to my life. 0:09:41.160 --> 0:09:47.320 But I know that Chechen or Congolese people are back 0:09:47.320 --> 0:09:51.360 then or today, Syrian or Yemen people are going through 0:09:51.360 --> 0:09:55.160 that and they cannot go anywhere else. Yeah, So you 0:09:55.200 --> 0:09:58.199 went back to Montreal, and where do you plug it 0:09:58.240 --> 0:09:59.840 and go back to work? What do you do? You're 0:09:59.840 --> 0:10:02.960 in in office for for MSF? No, No, no, when 0:10:03.000 --> 0:10:05.400 when when I was doing this this this is really 0:10:05.440 --> 0:10:07.840 a lot of film work, not as an international president. 0:10:08.240 --> 0:10:10.240 I was going back to my work doing e er. 0:10:11.160 --> 0:10:14.160 I remember when I came back from Therefore into that 0:10:14.600 --> 0:10:17.840 in two thousand and three and two tho four, Every 0:10:17.840 --> 0:10:21.040 single child I saw, I kept telling the parents, this 0:10:21.120 --> 0:10:24.920 is a really well filled child. I had more difficulty 0:10:25.000 --> 0:10:27.520 to adjust back home than to go to the field. 0:10:27.960 --> 0:10:33.360 Your focus is pediatrics, correct, You're a pediatrician. Every time 0:10:33.360 --> 0:10:36.520 I see a representation of what is horror to me abroad, 0:10:36.920 --> 0:10:39.320 I see children suffering, I see children starving, I see 0:10:39.360 --> 0:10:43.079 children dying, I see children injured, and I was wondering 0:10:43.160 --> 0:10:45.840 if that became a particularly I don't want to make 0:10:45.840 --> 0:10:49.640 the whole conversation about suffering and misery, but you seem tough, 0:10:50.480 --> 0:10:53.440 and were you always tough? Did you have to become 0:10:53.559 --> 0:11:00.160 tough to do this job. You have to be the 0:11:00.160 --> 0:11:03.520 tough side, for sure, and you need to focus on 0:11:03.559 --> 0:11:07.480 what you can save in terms of life and not 0:11:07.640 --> 0:11:12.319 focus on your loss. I'm saying that because I think 0:11:12.320 --> 0:11:15.760 it was two thousand and twelve and there was a 0:11:15.760 --> 0:11:19.320 big famine in some of and people were crossing over 0:11:19.360 --> 0:11:22.080 the country to come to Kenya that that camp and 0:11:22.120 --> 0:11:25.800 it will walk for weeks. And I remember that in 0:11:26.320 --> 0:11:31.560 one day I lost six children. And I work in 0:11:31.559 --> 0:11:34.839 the tertiary healthcare center in Montreal. We see eighty thou 0:11:35.080 --> 0:11:37.959 people on a yearly basis and we see six deaths 0:11:38.000 --> 0:11:42.199 over the year, and so in in only a few hours, 0:11:42.280 --> 0:11:45.640 I had seen that. And and I think that this 0:11:45.640 --> 0:11:48.920 this is the huge difficulty. It's the confrontation with death. 0:11:49.400 --> 0:11:52.520 And it was the same thing about Ebola and why 0:11:52.559 --> 0:11:57.720 a Bola was so difficult at the human level, it's 0:11:58.400 --> 0:12:03.600 the confrontation on a daily basis with death. We are 0:12:03.679 --> 0:12:06.959 trained to save lives and what we did with the 0:12:07.120 --> 0:12:11.559 Bola is of our patient. We lost them. And I 0:12:11.559 --> 0:12:16.240 always told myself, whatever I can do to make sure 0:12:16.280 --> 0:12:21.439 that we cannot repeat history, in my very modest capacity, 0:12:21.600 --> 0:12:23.600 is that we try to do it. I think it's 0:12:23.600 --> 0:12:28.240 completely abnormal that we have somehow found out about the 0:12:28.320 --> 0:12:32.880 virus in nineteen six but despite that, more than four 0:12:33.000 --> 0:12:37.960 years afterwards we had no treatment, no vaccine, and no 0:12:38.360 --> 0:12:44.080 rapid dynastic tools. And that's unacceptable that we had to 0:12:44.160 --> 0:12:47.960 face that. And I think today this is the challenge 0:12:48.120 --> 0:12:52.520 about everything the century has to offer to us. We 0:12:52.600 --> 0:12:55.840 need to put our act together because we have other 0:12:55.920 --> 0:12:59.760 threats today that I think we can somehow troubles should 0:12:59.760 --> 0:13:03.199 a head of time. And this is something about well, 0:13:03.280 --> 0:13:06.880 I think that antibiotic resistance is a big one. It's 0:13:06.920 --> 0:13:09.760 you know, we keep you know, fantasizing about what it 0:13:09.760 --> 0:13:12.680 would be the next bio threat, the next pandemic. It's 0:13:12.720 --> 0:13:18.640 actually already here. So we're gonna basically save our grandparents 0:13:19.520 --> 0:13:22.559 from their triple bypass and they're gonna die for the 0:13:22.640 --> 0:13:26.200 pneumonia because we would not get the right antibiotic to 0:13:26.280 --> 0:13:30.640 save them. When you say the antibiotic resistance, we have 0:13:30.720 --> 0:13:35.000 built up people's tolerance to antibiotics and now we have 0:13:35.200 --> 0:13:37.439 we have nothing left or we're running out of bullets 0:13:37.480 --> 0:13:40.800 to kill these organizing And this is what I Bola 0:13:40.960 --> 0:13:45.200 start us is like something may happen in somewhere in 0:13:45.280 --> 0:13:47.600 the distant world that we don't even know where to 0:13:47.640 --> 0:13:50.480 put on the map, but it will have replaying effect 0:13:50.880 --> 0:13:55.120 and your comfortable New York City life and you you 0:13:55.200 --> 0:13:59.480 went through that with Bola. When you are going back 0:13:59.520 --> 0:14:02.240 and forth to these hot spots, if you will, or 0:14:02.400 --> 0:14:04.240 whatever term you want to use, your going back and 0:14:04.280 --> 0:14:06.160 doing all this good work and you're coming back to 0:14:06.200 --> 0:14:11.080 Canada finish your training. What year and what goes into 0:14:11.080 --> 0:14:13.880 the decision for you to get into the administrative level 0:14:14.080 --> 0:14:18.080 of MSF. I made the conscious decision that's that's what 0:14:18.200 --> 0:14:21.520 I wanted because I believe that today we need more 0:14:21.640 --> 0:14:25.280 leadership in terms of health issues. But back then I 0:14:25.280 --> 0:14:27.400 didn't have a precise idea that I would do that. 0:14:27.520 --> 0:14:31.000 And then the position open up and I ran for 0:14:31.040 --> 0:14:33.880 it and I got elected. So what year was that? 0:14:34.480 --> 0:14:38.880 It's June. So actually my mandate is coming up for 0:14:39.080 --> 0:14:41.840 term now, and you are eligible to do it again 0:14:41.920 --> 0:14:44.320 or you don't get a second term, you need to run. 0:14:44.560 --> 0:14:47.320 You're gonna run? Are you going to run? Most likely? 0:14:48.880 --> 0:14:51.080 I thought we were going to get your campaign announcement 0:14:51.080 --> 0:14:56.480 on our show How Exciting Um? What is around the world? 0:14:56.800 --> 0:15:01.040 What would you say or the primary causes of the 0:15:01.080 --> 0:15:04.960 problems that you see? Are they purely political? Is it diet? 0:15:05.040 --> 0:15:08.600 Is it food? Is it a hygiene? Is a cleanliness? 0:15:09.480 --> 0:15:12.600 What are the things you think can happen that will 0:15:12.840 --> 0:15:16.760 change the situation you've come across in the world. Well, 0:15:16.800 --> 0:15:19.360 I'm not sure I'm that competent to answer this very 0:15:19.760 --> 0:15:24.000 complex question. I remember once I was asked, if you 0:15:24.040 --> 0:15:26.200 had one wish, what would you wish for the world, 0:15:26.560 --> 0:15:30.840 and I would said enough water. That's a problem. It's 0:15:30.880 --> 0:15:34.000 a huge issue because if you don't have enough water, 0:15:34.200 --> 0:15:37.720 then you don't you can do agriculture, you can feed yourself, 0:15:37.760 --> 0:15:40.200 but as well after that you can clean yourself and 0:15:40.280 --> 0:15:43.680 you cannot prevent infection. And so I really to think 0:15:43.680 --> 0:15:46.920 that if you want a thriving society, you need to 0:15:46.960 --> 0:15:49.160 be fed. In the work that you did in certain 0:15:49.200 --> 0:15:53.560 areas of the world, particularly in Africa where there was drought, 0:15:53.600 --> 0:15:56.600 where there was persistent drought, were you led to believe 0:15:56.640 --> 0:15:58.720 by people you work with that climate change was a 0:15:58.720 --> 0:16:02.560 big part of that. I think it plays a role, 0:16:02.640 --> 0:16:05.200 and I can see to which extent, but we know 0:16:05.360 --> 0:16:11.720 that it's it's a game changer before disaster strikes. MSF 0:16:11.840 --> 0:16:15.400 places doctors as well as water and sanitation experts in 0:16:15.560 --> 0:16:19.240 high risk areas. Their website reports that they've treated their 0:16:19.280 --> 0:16:26.160 first patient from Hades two earthquake within three minutes. Listen 0:16:26.240 --> 0:16:29.600 to the Here's the Thing archive where Dr Robert Lusting 0:16:29.760 --> 0:16:32.560 talks about what he would do to solve the world's 0:16:32.600 --> 0:16:39.160 obesity problem. I would think very strongly about limiting access 0:16:39.200 --> 0:16:45.000 of sugar beverages to infants and children like zero. Take 0:16:45.000 --> 0:17:02.360 a listen at Here's the Thing dot org. This is 0:17:02.360 --> 0:17:06.080 Alec Baldwin and you're listening to Here's the Thing. My 0:17:06.160 --> 0:17:10.920 guest today is Joanne Leeu, the international president of Medicine 0:17:10.960 --> 0:17:15.719 San Frontier or Doctors Without Borders, the international aid organization 0:17:15.760 --> 0:17:19.520 that provides medical relief to countries in need. In two 0:17:19.560 --> 0:17:23.480 thousand eleven, unable to secure permission to provide care for 0:17:23.680 --> 0:17:28.240 undocumented migrants, MSF pulled out of Thailand. They had been 0:17:28.280 --> 0:17:31.600 there for thirty five years. We don't like to think 0:17:31.640 --> 0:17:35.840 of ourselves as being a permanent presence because it's need basis. 0:17:36.359 --> 0:17:40.760 But the reality there are some conflicts that have been 0:17:40.800 --> 0:17:45.120 ongoing for decades. But if we look at our portfolio 0:17:45.200 --> 0:17:48.760 of countries where we are, it's basically a third of 0:17:49.320 --> 0:17:52.760 where we work it's in conflict area, about the third 0:17:52.800 --> 0:17:55.840 of it it is in post conflict area, and and 0:17:55.880 --> 0:17:59.080 about the third it's it's it's it's roughly in what 0:17:59.200 --> 0:18:04.000 I call table environment, where we work more in terms 0:18:04.119 --> 0:18:09.439 of either access to healthcare or for epidemics or for 0:18:09.520 --> 0:18:14.240 pandemic like HIV and So the reality is it's context 0:18:14.320 --> 0:18:17.480 like democratic complique of Congo. We've been there for decades 0:18:18.160 --> 0:18:21.280 south so that I was visiting it this far. We've 0:18:21.359 --> 0:18:24.399 been there since nine three because we haven't found a 0:18:24.400 --> 0:18:27.840 political solution to what happened. We wish we could leave, 0:18:27.960 --> 0:18:31.960 but every year there's more needs, so or there's sustained needs. 0:18:32.760 --> 0:18:38.720 Where you talk about AIDS, which society has been attempting 0:18:38.760 --> 0:18:43.480 to deal with the AIDS epidemic for h thirty five years, 0:18:43.520 --> 0:18:47.040 now more than thirty five years. What needs to change 0:18:47.200 --> 0:18:50.960 for AIDS to turn around? No, I think there is. 0:18:51.880 --> 0:18:55.199 There's been a deceleration in a few areas. But the 0:18:55.320 --> 0:19:00.720 reality is what we're facing is people have forgotten about 0:19:01.080 --> 0:19:04.520 about it. There was a full generation who were really 0:19:05.160 --> 0:19:12.280 aware about AIDS and how it was transmitted, and and 0:19:12.359 --> 0:19:16.080 now there's the new generation didn't go through the eighties 0:19:16.080 --> 0:19:20.320 and nineties, so safe sex is not as much of 0:19:20.359 --> 0:19:22.840 an imperative as what it was in our generation. There 0:19:22.920 --> 0:19:27.000 someone else's problem. Yes, So that's interesting because the fastest 0:19:27.080 --> 0:19:32.000 growing population that is getting infected or young adult nowadays. 0:19:32.080 --> 0:19:35.919 So I'm talking about I know the figures for for example, 0:19:36.000 --> 0:19:38.040 for Canada, but we know that that there's the young 0:19:38.359 --> 0:19:40.719 and the developed world. Yeah, yeah, it's just because that 0:19:40.800 --> 0:19:44.320 new generation didn't go through for us. You know, the 0:19:44.359 --> 0:19:47.959 real issue for a's right now. It's it's about making 0:19:47.960 --> 0:19:51.480 sure that that is going to stay as a priority. 0:19:51.920 --> 0:19:54.639 A disease has been in the landscape for such a 0:19:54.680 --> 0:19:58.160 long time, to keep the imperitive, to continue to find 0:19:58.160 --> 0:20:01.440 the right tools and treatment. The is still looking for example, 0:20:01.920 --> 0:20:06.080 for combined therapy in surrupt for children that is palatable 0:20:07.320 --> 0:20:11.160 after so many years. Still we're fighting for that. We're 0:20:11.200 --> 0:20:14.720 doing that work. Well, we are somehow I msself doing 0:20:14.760 --> 0:20:18.680 it through our research and development developing your own drugs. 0:20:18.720 --> 0:20:21.600 We have actually have helped the creation of what we 0:20:21.720 --> 0:20:26.280 call Drug Fund Elected Disease Initiative, And what they do 0:20:26.440 --> 0:20:30.359 is they developed combined therapy of our existing drugs or 0:20:30.480 --> 0:20:34.199 developed new drugs from the Elected Disease And so we 0:20:34.280 --> 0:20:37.840 have asked them to look into combined therapy for children 0:20:37.960 --> 0:20:42.120 formula for AIDS. UM. I'm assuming you don't do any 0:20:42.119 --> 0:20:45.600 work in the United States, or do you MSF is 0:20:45.600 --> 0:20:47.800 in the United States. Well, we have looked into it. 0:20:48.280 --> 0:20:50.640 One of the things that we've been on the regular 0:20:50.720 --> 0:20:54.720 basis questioning ourselves is about check as disease. And because 0:20:54.760 --> 0:20:59.520 of the immigration pattern here, there's a lot of people 0:20:59.560 --> 0:21:03.280 from out America that I have this disease. But described 0:21:03.280 --> 0:21:07.760 the disease. It's a disease that basically has no huge 0:21:07.800 --> 0:21:11.080 effect when you get infected initially, but down the road 0:21:11.720 --> 0:21:16.040 you've got heart failure. It's through a type of mosquitoes. 0:21:16.359 --> 0:21:19.959 But and it's it's the family of of of the parasite. 0:21:19.960 --> 0:21:22.360 This is the same family of the sleeping sickness. It's 0:21:22.400 --> 0:21:26.560 it has he has like similarities. Tell me in the 0:21:26.600 --> 0:21:29.400 time that we have left, um, where were you when 0:21:29.440 --> 0:21:32.000 you heard about condos? Where where were you at the 0:21:32.040 --> 0:21:37.120 time that that attack occurred. I was in a plane 0:21:37.760 --> 0:21:41.440 and actually I was just lending and I was coming 0:21:41.480 --> 0:21:46.760 back from from South Sudan and and basically I got 0:21:46.760 --> 0:21:49.239 the message through email because people couldn't reach to me. 0:21:49.280 --> 0:21:51.399 I wasn't a plane and all that. So, but I've 0:21:51.440 --> 0:21:54.679 heard that our hospital has been attacked and wouldn't know 0:21:54.840 --> 0:22:02.040 that the number of casualty, And so I think for 0:22:02.040 --> 0:22:04.240 for the audience, I think we we we have to 0:22:04.280 --> 0:22:11.720 be clear that conduced was a tragic, unprecedented event for 0:22:12.600 --> 0:22:17.760 MSF Doctors Without Borders organization in forty four years of existence. 0:22:18.640 --> 0:22:22.840 We never had such a big loss in terms of 0:22:22.880 --> 0:22:30.960 patient and staff in one attack. Conduce for me, and 0:22:31.000 --> 0:22:32.840 I think for many of my colleague there's going to 0:22:32.880 --> 0:22:35.680 be a pre CONDUCD in the past Conduce. And I 0:22:35.800 --> 0:22:39.359 know Conduced fairly well because I was there during the 0:22:39.359 --> 0:22:44.440 winter of twenty fifteen, actually visited our project, and because 0:22:44.600 --> 0:22:46.800 there was some weather issue, I end up staying there 0:22:46.840 --> 0:22:50.560 for almost ten days, so I end up rounding patient, 0:22:51.200 --> 0:22:56.160 getting to know our staff, and I remember distinctly about Conduced, 0:22:57.080 --> 0:23:02.960 how impressed I was and and how I thought Conduced 0:23:03.000 --> 0:23:06.040 was so special, And I remember my words when I 0:23:06.080 --> 0:23:10.480 came back, I said, Conduced is the jam of the 0:23:10.520 --> 0:23:18.560 northeast Afghanistan. We have managed to create a medical, humanitarian 0:23:18.680 --> 0:23:24.080 neutral space where everybody from both sides I think that 0:23:24.160 --> 0:23:27.000 it's safe to come and be cared for, and they 0:23:27.080 --> 0:23:29.399 know they're going to get high level of care. And 0:23:29.480 --> 0:23:33.080 both sides were coming, Yes, both side were coming. And 0:23:33.160 --> 0:23:37.160 it was not this little bush hospital. It was existing 0:23:37.200 --> 0:23:41.399 since twenty eleven. We had a hundred beds. We scale 0:23:41.440 --> 0:23:43.600 up our r c U to AID beds. It was 0:23:44.200 --> 0:23:50.119 better occupancive more than most of the time and people 0:23:50.160 --> 0:23:53.520 were walking days to come and be care in our 0:23:53.640 --> 0:23:56.680 trauma center because they knew it was one of the 0:23:56.800 --> 0:24:01.080 good place to be cared for. And so I remember 0:24:01.160 --> 0:24:06.159 because it was so striking. We managed to create this 0:24:06.359 --> 0:24:10.520 atmosphere where we have the surgeon, the intensive is the physio, 0:24:10.560 --> 0:24:15.239 third prisonmental health together every day doing rounds together and 0:24:15.359 --> 0:24:19.120 rounding the hundred patients together. We managed to do that. 0:24:19.800 --> 0:24:24.080 We had as well um digital X ray. I remember 0:24:24.119 --> 0:24:26.320 in the morning we will review all the admission of 0:24:26.359 --> 0:24:32.080 the night before. It was really an impressive center. And 0:24:32.119 --> 0:24:33.879 for some reason, I remember that I thought it was 0:24:33.920 --> 0:24:35.880 so special that I just said, I don't know how 0:24:35.880 --> 0:24:38.480 long it's gonna last. And I've been with him SF 0:24:38.520 --> 0:24:41.280 almost twenty years now and I've seen so many trauma 0:24:41.320 --> 0:24:44.120 center that one was special. Who we built the facility, 0:24:44.200 --> 0:24:46.879 someone had built it, a new occupied it or msfort 0:24:46.880 --> 0:24:48.879 built build it, and it just built it. There was 0:24:48.920 --> 0:24:50.919 only like a sort of a central building. But we 0:24:50.960 --> 0:24:53.159 had to read the roof and everything and make it 0:24:53.400 --> 0:24:57.959 a hospital basically. Ah And that's what we did. In 0:24:58.080 --> 0:25:03.000 twenty eleven, after few years of negotiation with both parties 0:25:03.320 --> 0:25:07.440 and the local authorities, the Afghans and the Americans back 0:25:07.480 --> 0:25:10.199 there was the two tribes there exactly, and when you 0:25:10.200 --> 0:25:12.919 would have these people come to the facility both sides, 0:25:12.920 --> 0:25:17.160 as you say, would you separate them? It's a different necessarily, 0:25:17.240 --> 0:25:19.680 And that's interesting. That's interesting you asked this question because 0:25:19.720 --> 0:25:21.560 I asked the same question when I went there, because 0:25:21.560 --> 0:25:23.760