© Erwin GUILLERGAN

© Erwin GUILLERGAN

Dear Friends, Hi! Salam no (that means peace in Amharic)! It's been quite a while since I have written you all. I have here in Abdurafi, Ethiopia – the farthest and the most isolated part – for the past 4 weeks now. I am all alone in the -project: the PC had just been evacuated because of glandular fever and the ex-pat nurse has to go back to England because of family problems. It has so far been okay, I mean, being the project coordinator and all. It's a new thing for me so there is a lot of room for mistakes and of course, improvements. I have had the opportunity to manage the hospital in Vanuatu, but here, it's a different ball game.  Anyways, if there's one thing which would make me feel bad, it's the patients and not the "office work". I think from this perspective I could say with much conviction that WE ARE VERY LUCKY. We worry about the trivial things everyday – what kind of food we want to eat, where shall we go after work, our mobile phone credits, what kind of outfit best needed for this occasion, so on and so forth. Here, I have seen a lot of young men and even children walking hundreds of kilometers to work in sesame, sorghum and cotton farms. Their average daily wage is approximately 3 US dollars, and they stay in these farms in the direst of conditions. No clean water to drink, not enough food, and no medicines for malaria and other diseases.
© Erwin GUILLERGAN

© Erwin GUILLERGAN

The other day, I had a referral from the local Bureau of Health because of a young man who had fever of more than 2 months, enlarged spleen and severe emaciation (his BMI was less than 13%). The only property he has is the clothes on his back – he doesn't even have anything on his feet. I could never forget the look on his face when he died. There is that look of hopelessness – something which I could not describe, but something which I can truly feel. Something which you can taste. Here is someone in front of me who left his home and family to earn some money, dying without his family knowing. Dying, without someone saying a prayer for him. He will be buried in an unmarked grave, along with hundreds of migrant workers from all over Ethiopia. As a doctor, I try to separate myself from the harsh realities of my job. At medical school, we were told to keep the doctor-patient relationship strictly professional. It would be better to treat patients if you have little emotional baggage. Here, I can't help but empathize with every sick person who comes to the clinic. Why? These are people who bet on their lives to earn some money for themselves and their family.  Sometimes, they loose their bet. That is one hard price they have to pay. I am sorry if this letter is a bit depressing. I guess there is no other way to tell the story. I'll try to make it up beat next time, promise! Miss you all! Erwin
Filipino doctor Erwin GUILLERGAN joined MSF in 2006. From May 2006, he worked in Ethiopia to provide Kala Azar treatment.

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