Peace Talks Radio Host Paul Ingles talked with Suzanne Ceresko, Head of Mission, Doctors Without Borders.
INGLES: Of all the places that you’ve worked facilitating missions, are there a couple of moments or people who sit clearly in your memory that define the importance of what you continue to do with Doctors Without Borders?
CERESKO: Yes, something that has really stuck with me is when I worked in Syria in the summer of 2013. I went into the country as a project coordinator to open a clinic for internally displaced people in the North of the country.
INGLES: When does it mean when you classify them as “internally displaced”?
CERESKO: Internally displaced people are people who haven’t crossed an international border.
INGLES: But they’ve been moved from their homes.
CERESKO: They’ve been moved from their homes, yes.
This is a very simple way to put it, but essentially, once you’ve crossed an international border, you should be recognized as a refugee and when you’re displaced within your own country, you’re considered an internally displaced person or and IDP. Often times, IDPs can face additional challenges because they’re not afforded the same status as refugees.
In Syria in 2013, I had a mission to set up a health clinic within a camp for internally displaced people in the North of the country. We had decided that we would staff this clinic with an all Syrian team because it had become clear that it would be difficult to have an international team at this project site. We also thought that this wouldn’t be an issue to find an all Syrian medical team because the Syrian health system is quite strong and there are a number of trained medical staff. It’s not the kind of challenges we face in places like South Sudan where there is a very small medical school and it’s hard to find enough doctors.
We put out the call for a nurse, a doctor, a pharmacist, cleaners and guards and every position was filled except the position of doctor. I knew why this was a challenge in discussing it with our national staff in Syria and the few doctors that we had working with us who were national. It became clear to me that the depth of challenge that the doctors were facing because people had been kidnapped, people had been imprisoned, doctors had been killed, doctors in particular were being targeted in that environment. Applying for a job working as a doctor in that part of Syria wasn’t something that anyone wanted to do.
INGLES: What’s your understand of why particularly they were targeted?
CERESKO: Because the war became very politicized and because of patients who had served in another role, the medical ethics weren’t honored.
INGLES: So applying an apolitical oath of medical care was –
CERESKO: Following medical ethics was politicized in that context.
We started to spread the word locally because we had done what we normally do through our regular networks to advertise this position. We started speaking to local community leaders and asking if anyone knew a doctor and we weren’t able to find one.
We were seeing more and more people arrive into this IDP camp. It was the first time that I thought that I was potentially going to fail at a mission that I had been assigned to because we always managed to find a way to reach the people that we to reach and to do what we need to do.
Then what happened was that the chemical attacks occurred 200 miles to the south of us outside of Damascus and even though we were far away, it became clear that that could happen anywhere in the country.
The towns near where I was working went into days of formal mourning. The staff had to explain to me what was happening; why the shops were closed and there was no one in the street.
It was during this time that a retired doctor who was living near the camp came forward and applied in spite of the risks. He said he didn’t want to stay at home any longer and be in his garden. The people who worked in the camp got a doctor who had 40 plus years of experience. The bravery of our staff in Syria is just incredible. I’ve heard from our staff in Syria that he is still working there.
These ambulance drivers and doctors and nurses and cleaners, my colleagues in Syria, I’m just in awe of what they do and their commitment to medical ethics. We have staff like that all over the world. I’m speaking directly to our Syrian staff because I got to know a number of them when I was working there. There are moments like that that really stick out for me.
INGLES: I don’t think that people think about this too much, what we’ve been talking about is the politicizing of the availability of health professionals to address often times political atrocities that are making these places flash points. This is really a big part of Doctors Without Borders needs is to be able to go in there and mobilize and find the people who, as you say, largely are local, but it’s not always easy because I bet in a lot of these missions this is an issue, right?
CERESKO: Yes, and it has become a larger issue in the last ten years where humanitarian space isn’t being respected and the Geneva Convention isn’t being respected. We said this following the bombing our hospital in Kunduz that war has rules and to be able to work in these places, we need to have safe medical spaces. These spaces are essential in these areas where a population has needs that aren’t being addressed. Sometimes we’re the only medical organization that’s able to operate in these areas and we need to be able to do that.
INGLES: When you’re here in our home headquarters of New Mexico to speak with audiences, I know it’s a difficult conversation to have, but I’m sure when you get in front of people, they are asking you about this October 3, 2015 bombing in Afghanistan where 42 people were killed, 30 were injured. Where were you when you heard that news?
CERESKO: I was in the Philippines working as a Head of Mission and I was of course saddened and shocked and appalled, as all of my colleagues were. The other thing that I saw very quickly a few days following that; I was at a national monthly meeting of the different national NGOs and international NGOs and the outpouring of compassion from our counterparts and the impact that they felt that this attack made on their own work and on humanitarian space was profound because everyone needs to have safe humanitarian space to be able to do the work that MSF and so many other organizations are doing.
INGLES: This has got to be the worst case of carnage in your organizations’ history.
CERESKO: It is.
INGLES: You spoke to this a moment ago, but let me ask the question this way; regardless of the ongoing legal outcomes of this event, what can be said about the lessons of this incident?
CERESKO: What we’re hoping is that we can get assurances from all parties that we’re able to continue our work in Kunduz and provide the essential medical services that we were providing in that area and that we can work safely in Afghanistan and all over the world.
INGLES: Generically, you are going into places where war is still actively happening in many cases. Not in every case, but in very many cases. One of the challenges I’m seeing is that you can say that you’re not political, but there must be an effort to communicate and connect with the warring parties to identify facilities, purpose, clarity about your mission, why you’re there, that’s a big part of the logistical challenge isn’t it? Is part of the challenge is outreach to all sides regardless of politics, regardless of who is right and who is wrong and who’s side you’re on?
CERESKO: Well, a really important part of operations and an important part of my work when I worked as the project coordinator and working as a Head of Mission is communicating our neutrality to all parties involved in the conflict and to the population and to all of the different local authorities.
INGLES: How do you do that in certain ways? What are examples of how you connect?
CERESKO: We make sure that we are speaking to everyone regularly and that everyone knows that we see patients at our hospital. Also by the quality and the consistency of our medical care, by being very transparent about the services that we’re providing and that we see everyone in line, of course, with the rules of the Geneva Convention. Also, like a hospital in the U.S., when a patient turns up in an emergency room, they aren’t asked what they were doing before. People are given medical services. It’s very transparent. We operate in a very transparent way, but also make sure that we’re communicate with everyone about what we’re doing.
INGLES: Does it happen sometimes that you are trying to connect with some faction in a war-torn area where they say they don’t care what you’re doing and they’re not going to honor that?
CERESKO: In those kinds of cases, that would be an area where we would be unable to work. We can’t work in places where our medical space wouldn’t be respected and the services that we want to provide to the population wouldn’t be respected.
INGLES: That’s what was so shocking about this Afghan situation.
INGLES: Don’t get me wrong with this question, but I would imagine, because I was moved, that that bombing in Afghanistan of your facility must have represented a sad but true uptick in awareness of what you’re doing and support for what you’re doing. Is that true?
CERESKO: Definitely. I can tell you that while I’ve been on this tour, so many of our supporters have expressed incredible compassion towards our organization and towards the loss of our colleagues and our patients and our caretakers and we’re definitely very moved to hear that that recognition of this difficult event for our organization.
INGLES: So Doctors Without Borders began in 1971 and then nearly 30 years of work helped it earn the international reputation and recognition of winning the 1999 Nobel Peace Prize. While many would applaud Doctors Without Borders for the humanitarian work around the world on basic principles, can you help us connect the dots since our program is about peacemaking and conflict resolution around the world? How do you envision that Doctors Without Borders’ work links to peacemaking or peacekeeping in such a way that the Nobel Prize might be awarded to it?
CERESKO: Well, sometimes I do like to refer to the speech that James Orbinski gave, who was our president at the time when we were awarded the Prize. He does say that “humanitarian action is more than simple generosity and simple charity, it aims to build spaces of normalcy in the midst of what is abnormal.”
In the areas that I’ve worked in that have been areas of conflict, I have seen the services that we provide as essential havens in those areas that medical structures and medical services are to be provided to everyone regardless of what the context is and where they live. Our work is purely humanitarian in that sense.
INGLES: When I think about it, I think about the hierarchy of needs, Maslow’s hierarchy of needs which puts health right on the bottom line. If there is ever going to be peace of mind, peace in the world, you have to address those basic needs of shelter and health and certainly that is the mission, as I understand it, of Doctors Without Borders; you find a need that is disrupted to a population on a very basic level and start working it.
CERESKO: Yes. We definitely view that work as purely humanitarian. Another part of Dr. Orbinski’s speech said that “silence has long been confused as neutrality and has been presented as a necessary condition for humanitarian action.” From its beginning, MSF was created in opposition to this assumption. I think this is something that’s important for those of us who work in the field with the organization is to know that we do have that opportunity to speak out when it’s appropriate and when it’s justified. That’s something else that we can do as part of the service that we offer to the patients who we provide care to.
INGLES: In a very real way, once you decide on a mission, I would think you would want the world to know where you’re working and what the need is and why you’re there. I would guess that the Nobel Prize offers a platform for that in a way that is both helpful to the population where you’re working and for your work in general.
CERESKO: It certainly is and it has given us the opportunity to speak out and to be heard on larger issues.
Peace Talks Radio Host Carol Boss talks with 5 returned Peace Corps Volunteers (2006)
CAROL BOSS: How does the Peace Corps create peace?
JOSEPH GARCIA: Peace Corps - through our reputation and the work we've done over these past, forty-five years - could possibly be the salvation of US foreign policy, in my opinion. From my study, experience and research, I've realized that what's going on with the United States, in regards to our foreign policy, is that a situation has developed where a lot of people, with very little international experience, are at the forefront of US foreign policy. They aren't educated in the histories, languages and cultures of these countries. Thus, Peace Corps (counters that) lack of understanding, lack of education...
DAVE DAVENPORT: America's image in the world, as far as I can imagine, is at an all-time low. It just could hardly be worse. My hope for the Peace Corps is that it is able to expand more into some Muslim countries. I really think we need to get Americans abroad, learning about other cultures, religions, languages and creating a much more positive image of our country abroad.
LAUREN KOLLER: To add on that, I was in my rural community in Panama when a very weathered, old man walked down the path and said, "Do you know what your country did today? They just declared war on Iraq." That, in a very humiliating way, was an example of how, as volunteers, we are the face of the US. We are left to do the explaining for issues and situations that come up which are completely out of our control. As Joseph says, in terms of diplomacy, volunteers are doing a lot of the "grunt" work.
BOSS: How about a couple of stories about the impact your work had on the people and communities you have lived and worked with?
KOLLER: I just finished in June 2005 and in December I returned. When I was in my community in Panama, we had submitted a proposal and received funding to build a local community center, a municipal office. When I returned in December, I saw the building. Everything was great. I was asking someone about the day it was completed. They told me how well everything went. They stopped and asked, "Laurena, where you there that day? Had you already left?" I had actually gotten up to speak at the inauguration, helped cut the ribbon. The ironic, but wonderful part about that was that they didn't remember if I was there, which meant it was something so important to them, and that they felt so much a part of - not something someone implanted and then left. It was integral in the community's development process. It was a wonderful feeling. It was not what I was doing; it was what people were motivated to do for themselves.
DAVENPORT: I went back to Thailand last year with a portion of the Peace Corps called the Crisis Corps, which is designed for former Peace Corps volunteers to go back, in times of crisis, to the countries where they had served. I went back, with several others, to Thailand, following the tsunami. I started going around a camp with a young Thai woman who was working on her Master's Degree in psychology. These were families, jammed into little, tiny rooms, thirteen feet by eighteen feet. All of their possessions were on the floor. The walls were terribly flimsy; there was no place to hang anything. I realized, visiting those families, that, for a very small amount of money and with a little bit of effort, our group could put together shelves, clothes hangers, simple things to help people store their belongings off the damp floor. In every room in the camp, we put a long, eight-foot shelf with a clothes rod underneath it. We built cabinets and shelves. I honestly had the feeling that we were doing something that, in a small way, made their day-to-day lives a lot better. I felt very happy about it.