Rowan Gillies – Medecin Man

REPORTER: David Brill

In the eastern Congo Rowan Gillies the international president of Medicines Sans Frontieres, is doing what he loves best – helping those in need.

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This man was almost blown to pieces by a rocket-propelled grenade. He’s lost one leg but the doctors have managed to save the other. Now even dressing his wounds is traumatic for him.

ROWAN GILLIES: He’s just got no veins left because he’s had so many procedures. I’m just trying to get a vein, something we would normally do in Australia, but it’s all a bit much for him I think.

REPORTER: And do you get many like this?

ROWAN GILLIES: Daily, daily, there’s usually a big fight, you get three or four stumbling in the first week, three or four the next week, then it settles for a week or so, then you get another big fight, and you get more are coming in.

REPORTER: So the war is still definitely still going on?

ROWAN GILLIES: Oh yeah, there is a war going on here.

At 34 years of age Gillies heads an organisation that has people on the medical front lines in 78 countries. Gillies says MSF is not run like a typical business corporation it’s more like a group of highly skilled activists.

ROWAN GILLIES: People who are so committed, they’re not just going to give up because you argue in a different manner. It means internally we do discuss very strongly because people do have that belief in what’s happening.

Doctors Without Borders is a huge operation. Its annual budget is the equivalent of A$620 million. But Rowan maintains a simple philosophy.

ROWAN GILLIES: So we’re dealing with human nature, but I think the issue is how you respond to what’s happening in the world, how you respond to the suffering. Do you ignore it and say, “Look that’s fine, there are other people,” and just get on with your own life, or do you try and assist.

And I think the nature of humanity is such that if we lose our ability to have empathy for people that are suffering, then we’ve lost a lot of what it is to be human. So I think on a, I suppose, philosophical level, it’s very important to keep assisting people who are suffering. Not get angry at the state of the world, but do your best to improve the lot for the individual, for people.

Rowan’s next patient is also a victim of violence. She survived a militia attack that killed two of her colleagues – but has a bullet lodged in her neck.

ROWAN GILLIES: I’ve got no desire to operate on here.

REPORTER: Why is that?

ROWAN GILLIES: Oh, it’s right next to the neck, it’s gonna be close to the carotid artery. Yeah, it’s there and it’s not giving her any problems. I could maybe slip out the bit of bone that’s hurting her. It would be nice to get it out, but I think I would be kidding myself if I thought I could do it without certain risks.

He said he was running away from some fighting with his family of 10, and they were going along the road, and they got attacked by militias with machetes, eight of his family has died, his father is here as well. He’s had his arm almost severed, but he’s still got one bone left, so we’ll see what we can do about that.

He’s got a broken left arm on his humerus, and his right arm has been broken in about three places with machetes. That open wound is from machetes and he’s damaged muscles, damaged tendons and so on. And his back has been macheted through to his spine. Having said that, he’s all intact and doing alright.

REPORTER: So what are you going to do to him today?

ROWAN GILLIES: Just give him a good wash.

Educated at Sydney Grammar School, Gillies has the blue-blood credentials for a very different type of medical career. He has an honours degree from the University of NSW and both his parents are doctors. But he’s forsaken the BMW and the well-appointed consulting rooms for some of the world’s most blighted trouble spots.

ROWAN GILLIES: Money’s one thing, but enjoying what you do and getting satisfaction out of what you do is more important than – and some people get enjoyment out of different things. Back in Australia I still get a lot of enjoyment, and most doctors do, about treating their patients there.

The reason I come here is I enjoy the places, enjoy the context, I find it very difficult, but it’s also a challenge. As some people say, it’s like having a mirror in front of your face 24 hours a day. You really discover your weaknesses and you learn to live with them or change them a little bit, but the challenge is important and the satisfaction of assisting people who otherwise may not get that assistance.

MSF has spent years helping victims of violence in the Congo. An estimated 3.8 million people have died in this vast country. In the east, the government has no control over militia, who battle for power and rich natural resources. They regularly attack each other and innocent civilians.

The UN has 17,000 peacekeepers in the Congo and plenty around Bunia, but that’s not nearly enough to provide security for the locals. In a region steeped in bloodshed this 150-bed hospital, entirely funded by MSF, is an orderly and well-run place. It’s a safe haven for young and old, and employs 300 local staff. This hands-on work is fundamental for Gillies. The international president doesn’t intend to spend all his time in a comfortable head office in Geneva.

ROWAN GILLIES: I mean, I see going to the field as very much a part of this job when I took the job I made it clear that that would be part of what I was doing. The thing about this organisation is the focus must always be on what we’re trying to do, not on the institution. The focus is actually on getting the action done and if I don’t keep very close to operations and what is happening and for us it’s actually the doctor/patient relationship very much. If I don’t see patients for two years and I’m sitting at a desk, is my focus going to be worthwhile, is the focus of where the organisation is going, going to be in the right direction?

With over 30 years experience in medical emergencies, MSF has a reputation for telling it like it is, and maintaining their independence.

ROWAN GILLIES: When that gets rejected and when people call us their enemies and we’re targeted, we can’t work. And it may be that people say, “well you can work with a military escort,” then we’ve lost. If we work with a military escort from the coalition, we are on one side. We’ve lost our ability to be independent and some of the patients are not going to come to us, because they’re worried that we’re involved in the political side we’re either with us or against us – we’re neither. We don’t buy into that philosophy and we never will.

After a round of the wards, it’s back to the operating theatre again to help deliver this woman’s baby by caesarean section. She’s been in labour for 48 hours and the baby’s in distress. Both may die. Gillies and another doctor, Constance Hash, a gynaecologist from Germany, have to work quickly.

Now the doctors have to work fast to stem the mother’s bleeding and get her stitched up. Getting the baby breathing seems to be taking a long time. At last, the baby draws its first breath.

ROWAN GILLIES: The main thing is the baby’s alive and the mother has stopped bleeding.

REPORTER: Here you are bringing someone into the world and you’re also working on others who are trying to kill people.

ROWAN GILLIES: Yeah, it’s a bit strange, but to be honest, most of the guys we have here, I’m not convinced they are hard-core militiamen, the ones that have been shot. They are just young kids who are a bit mixed up, or are conscripted, or have no choice.

REPORTER But if you weren’t here?

ROWAN GILLIES: Oh, there would be a higher mortality and a lot more people getting sick, yeah, for sure.

REPORTER How does it make you feel, working in a place like this?

CONSTANCE HASH, GERMAN GYNAECOLOGIST: At moments like this, I am very happy. Because they are sick and we can really help – You can do an operation and save the life of a mother and child, it’s a good feeling. But unfortunately it’s not always like this. Sometimes we get out dead babies.

It wasn’t long before I found out exactly what Constance was referring to. This package contains a baby that was born malformed and lived only three days. It’s being laid to rest in this simple graveyard next to a refugee camp. With many other young children to care for, the baby’s mother simply doesn’t want to attend the burial.

While lives are being saved in the operating theatre just behind the hospital the emphasis is more on saving souls. Sunday in Africa means there’s always going to be a church service, even though there’s no actual church. The rear of the hospital has become a refuge for the local community, including those who’ve fled the fighting.

In this bitterly divided land, the minister urges his flock to accept a higher authority.

MINISTER (Translation): We who have been baptised, we who believe through faith, Jesus is calling us to give wholly of ourselves so we no longer have discrimination within ourselves.

But back in the ward there’ a very confronting scene, a baby is struggling to survive. It’s suffering from a blood disorder and can’t take any more transfusions.

DR MARCUS LUTHI: Now he is dying from this overwork of the heart.

REPORTER: And nothing can be done?

DR MARCUS LUTHI: Here, nothing can be done.

ROWAN GILLIES: We just have to wait and see because if you start something long-term…

While Rowan confers with his colleague, Dr Marcus Luthi from Switzerland, the family can only sit and hope.

DR MARCUS LUTHI,(Translation): She’s deteriorating even after the transfusion. Her condition is more serious than yesterday.

The child is too weak to resist any longer and it quietly passes away. The baby is carried outside where relatives will take it away for burial.

REPORTER: We’ve seen some pretty horrible things coming and going, day in, day out. I mean have you got the time to think about it, or do you think about it, or you’re just too rushed to move on to the next one?

ROWAN GILLIES: No, I think about it a lot. I stay awake at night thinking about it, actually. Yeah, a lot of the people, the patients stay on your mind. So you always remember them, and I still think back to my first mission, the people I worked with in Afghanistan, some of the patients I met in Afghanistan. So it doesn’t leave you.

Amongst the tragedy, the work of MSF goes on. Rowan is talking to his head office in Geneva. There are some weighty issues unfolding that the president can’t ignore. There’s a media campaign to be coordinated.

ROWAN GILLIES: Where are we going to have it? We’ve decided Barcelona? Barcelona?

MSF is also being sued by the Dutch Government for the cost of a ransom that the government paid to release an MSF worker. He was hijacked in Dagestan, part of the Russian Federation. And tsunami relief donations are pouring in – far more than the organisation can ever spend in the affected areas. They’ve asked for people to stop donating and it’s a controversial decision.

ROWAN GILLIES: 92 million euros – Jesus, it’s madness isn’t it?

REPORTER: So you’ve got the president’s hat on, Rowan?

ROWAN GILLIES: Yes, it’s snowing in Geneva at the moment.

REPORTER: How do you manage that side of it, plus being here in the Congo as a surgeon?

ROWAN GILLIES: I feel very guilty to be honest, because I really should be… I really enjoy it here and it’s essential that I come into the field as much as I can, but there’s some tough things at the moment, especially with the court case and especially with the tsunami.

I think we’ve raised $92 million, almost accidentally, for the tsunami, we haven’t really done much fundraising at all.

REPORTER: What was your decision not to go to Asia, to the disasters there, but still come here?

ROWAN GILLIES: Well the tsunami is pretty well covered, I think. I was getting a little bit sick of the coverage, just because it was every day, every minute every day. It’s phenomenal how big the tsunami is and what a big disaster it is. However, there are disasters that are ongoing around the world, and the Congo is a huge disaster. They say that 2 million to 3 million people have died in the last 18 years in this war. So it’s many more people that have died than in the tsunami, and this is continuing, it is ongoing.

I was intrigued by Rowan’s dilemma. Doctors Without Borders was now too flush with tsunami money.

ROWAN GILLIES: So now we have too much money. We’re probably always going to have too much money for this and our approach now is to write back to all the donors and we had to do this once before – and say, “Look, we will keep all our programs in the tsunami, We will try very hard to spend the money on that. However, we cannot guarantee that with that money and we’re happy to give the money back, or we’re happy to use it in an emergency program in another part of the world.”

And I’d never heard of a government suing an NGO before.

ROWAN GILLIES: We’ve got a court case about this kidnapping. The Dutch government is suing us for about a million euros, a bit less actually, for the money they paid. They say they tell us they paid for his release and so it’s a pain in the neck for all of us, because we’d rather be arguing about humanitarian issues, not about court cases and especially – It’s very strange a government taking an NGO to court for a ransom that they paid. But we’ll deal with that. That’s just a major issue I’ve spent a lot of my time on that.

We’re talking about the curfew tonight because things are getting more unstable at the moment. But at the moment in town it’s OK, just externally it’s very bad.

Late that night the team gathers in the gloom for a security briefing. The generator runs for only a few hours at night and has been switched off. And the news is not good.

SECURITY, (Translation): A village was attacked. It was 7km from Iga where apparently six people died. It hasn’t been confirmed, but the attack has. There was another attack on a village to the north on the road to Monvalout. And there apparently it is said that three women and a child were killed. Militias always kill women and children and put them on the road, so people stop them, then they can rob them and so on. We don’t know who dies what, under what orders. So we’re going through a fairly dangerous period because it’s so unstable. So that’s where we’re at.

The next morning Rowan’s up at sunrise and there’s still no electricity.

ROWAN GILLIES: Yeah, back to the hospital there was a lot of shooting last night and there was some instability yesterday, and a lot of rumours around. So hopefully, there has been no-one injured or killed. We’ll see what happens. We were speaking to a military commander yesterday actually while Angelo was chatting to him, his son came up and said, “Let’s get out of here. We’ve got to go.” So if the commander is running away, it’s probably not a good place to be. So we are putting everything on hold for a few days. We’ll see what happens. There is a big rumour in Kinshasa now, which is almost certainly not true, that their President has been killed.

I don’t particularly want to take water from the toilet to shave.

With rumours swirling, the UN peacekeepers are edgy and don’t want to be filmed. With the team heading off to work, I take a ride out of town to try and get a sense of what the countryside looks like. The UN has a presence here and it all looks quite peaceful, but appearances are deceptive.

Soon after I left the Congo nine peacekeepers were slaughtered in this area by militia soldiers. Meanwhile, Rowan and the team have been in the operating theatre for 2.5 hours, but he’s just stepped out to call Geneva once more. And there’s still controversy about the issue of spending the tsunami relief money.

ROWAN GILLIES: There’s still a lot of discussion in the French press about how the NGO is going to use the money for the tsunami and Marin, who I’m trying to catch, is going to be on the BBC in an hour’s time talking about it.

Now it seems they’ve run out of blood and they need some of Rowan’s.

ROWAN GILLIES: I think I’m about to go and give blood.

Rowan’s back on the phone to Geneva. There’s still five operations to do before the end of the day and he’s back to work before finishing his meal. The next morning Rowan is looking weary. He’s been at the hospital till well after midnight…

ROWAN GILLIES: It’s been a tough night. ..

and has 10 operations to do today. But even over breakfast, life and death intrude.

ROWAN GILLIES: We also had a lady who died just about an hour ago with HIV. I saw her last night and pondered whether to operate on her, and I decided not to. I thought I’d see what happened today and if she had an abscess today, I’d do an operation, but she actually died overnight.

The next stop for the MSF team is the refugee camp I saw when the baby was buried. They’ve come to talk with the camp director, but they come across another person in need. This woman has been blasted with a shotgun. Rowan is keen to help her but the operating theatre is full.

ROWAN GILLIES: We can try and fix it, but we’re still only doing emergency surgery, we’re pretty chock-a-block with just life-saving stuff, but it should be great to be able to just loosen her shoulder a bit.

I soon learn that this camp houses just a fraction of the Congo’s 2 million people, displaced by conflict. Gillies has seen many refugee camps and many a lot worse than this. But again, there’s a great empathy for the people here.

ROWAN GILLIES: They don’t know what’s happened back in their village. For me, the thing about camps is the uncertainty of the life, it’s just living day by day, waiting for things to get better, and really having no idea whether things are going to get better.

But with a storm threatening, we make our way on foot back to the hospital and just avoid a drenching. Inside I find this small group holding a rape counselling session. The woman has been raped by three militia at a roadblock they set up.

REPORTER: So what are you going to do now, are you going to examine her?

COUNSELLOR: Yes we’ll examine her and then we will give her some antibiotics against sexually transmitted diseases. Unfortunately she arrived too late to give her an anti-retroviral drugs we are giving this until 72 hours after rape to prevent HIV transmission.

There is an epidemic of rape in the Congo – it’s directed at all age groups, from young girls to old women. MSF is determined to alert the world to this situation. The hospital treats up to 50 women a week who’ve been raped – and that seems like just the tip of the iceberg. The situation is so bad it’s even got the female MSF doctors edgy.

COUNSELLOR: I don’t trust men here. Of course they must be here somewhere, next to us.

In the hospital compound, the rape crisis is being discussed.

ROWAN GILLIES: And the majority are with weapons, the men – the people who are raping them have guns as opposed to machetes. They have weapons, so it is always with weapons. It’s often multiple. There’s a degree of, I wouldn’t call it prostitution because it’s sexual favours for a carton of milk or US$1, that kind of thing. There is concern about child prostitution as well in the area.

As the discussion continues, another shocking aspect of the situation is revealed. The man in the blue shirt is Burn Koppel – a Dutch colonel working for the UN. He wants to hear the MSF assessment of the rape crisis. It seems women aren’t even safe from the men sent to protect them – the UN peacekeeper

BERN KOPPEL: Kofi Annan has made it very clear there is no excuse, there is zero tolerance for these abuses, sexual exploitation, for violence against women by peacekeepers. And it is one of the reasons why he sent a team to the DRC to investigate all these allegations and that’s why we are here for.

After an intense month in the Congo, Rowan has completed more than 3OO operations. Now he’s due back in head office.

ROWAN GILLIES: It’s quite unpleasant, quite unpleasant because they are very good people. I’ve had my fun and I’m leaving, and they are continuing with the work. So it also makes you realise that what we do is an, assistance and trying to get things going, but the bulk of the work is not done by us. It’s always unpleasant to leave.

Windy, cold Geneva seems more than a world away from the Congo. It’s Sunday and Gillies has a chance to unwind.

ROWAN GILLIES: It’s a good chance to relax, watch a bit of rugby and have a bacon and egg burger, and just take it easy.

The next morning, he’s in the office and straight to work.

ROWAN GILLIES: I’d be tempted to say that she won’t get a good story out of me because I haven’t got the skills to answer these questions.

Like the president, the nerve centre of this multinational organisation is surprisingly low key. Most of the staff are everywhere but Geneva. They’ve fanned out to the world’s trouble spots.

After a month in the field there’s several hundred emails to answer. And sitting here almost unnoticed it seems is a rather prestigious prize awarded to MSF in 1999.

ROWAN GILLIES: This is the Nobel Peace Prize which is a bit strange because we are not a peace organisation at all.

REPORTER: Who are you then?

ROWAN GILLIES: We’re a humanitarian organisation. It is different. Creating peace is a political aim and our aim is more of a human aim basically to assist people. But we’re very proud to have received it of course.

Rowan slips easily into the international president’s role.

ROWAN GILLIES: The thing is I don’t necessarily think we should have papers on governance we should have them on the issues. And the question – bombs and bread. It’s called bombs and bread.

But despite his good humour and enthusiasm it seems this committed Australian doctor would rather be working on the medical front line.

ROWAN GILLIES: Medical work is – I find medical work very difficult, but there are the rewards from it. They’re more I suppose what you would call the political side or organisational side, is you don’t get the same immediate gratification that you do from the medical work and so on. Just a basic doctor who works in the field. And there are many more people more experienced than me in this organisation.