Fort Smith’s new permanent doctor, Dr. Sarah Giles, has treated people in crisis and war zones on three continents, in some of the most tumultuous places on the planet.
In her fourteen months working for Médecins Sans Frontières (MSF) – translated in English as ‘Doctors without Borders’- Dr. Giles served in dangerous and politically unstable places including Myanmar (formerly Burma) where she worked in concentration camps treating some of the million Rohingya people being held there, a Muslim minority persecuted by the government for over 60 years. She was the only foreign doctor working with three local physicians to provide much-needed medical assistance, until MSF was kicked out by the government.
In South Sudan in central Africa, where civil war rages and child soldiers are common, she worked with the Nuer population, one of four foreign doctors in a MSF hospital that included 211 staff. The hospital was overtaken by the war and they had to flee to Ethiopia for refuge.
She was sick after that “with five different diseases and parasites,” and spent time in and out of hospital. She returned to Canada and stayed with her sister in Ottawa to recuperate. Once she regained her health, she answered the call again and headed for another trouble spot to serve with MSF.
In Pakistan next, where she said “ransom kidnapping of local doctors is common,” all the international MSF staff were confined to a residence on the hospital premises.
In all those situations danger was ever-present and she and her colleagues were at risk and vulnerable.
“When we fled for Ethiopia, we were in boats and people with machine guns looked like they wanted our boats,” she said. “Seven bullets were fired through the operating room wall in Pakistan. The offices in Myanmar were firebombed after we left.”
Dr. Giles describes MSF as the third-largest medical charity in the world after the Red Cross and the United Nations. She said each placement involves a large organization with field staff, administrative personnel and all the roles one would find in any hospital.
“We need clean water, sanitation, labs, finance and medications. For every one doctor we might have 40 other people. We might be working in tents or mud huts or a concrete building, whatever is available. The doctors get the glory but we are part of a large team.”
She said the circumstances are never safe because they are almost always in crisis or war zone situations. When an operation is set up, it first has to be carefully vetted by project coordinators, and they negotiate deals with all sides.
“We are offering a service that both sides need and they know it,” she said. “We are neutral. We negotiate that humanitarian space.”
MSF does not have guards, they have ‘watchmen’ who are not armed, “because somebody will always have a bigger gun, and we need acceptance in order to do our work.”
The situations are always fluid and it is essential to be wary and constantly watchful.
“There is a constant, ongoing conversation. We have to have good quality information. In South Sudan, I think we had better intelligence than the local United Nations force.”
A long, roundabout way from Toronto
It takes a special person to put their life in danger for months at a time to help others. Dr. Giles says she works for MSF “because of the challenge” and “because I care about people.” She could only supply one photograph of herself from her postings in other parts of the world “because images of the situations or other workers might compromise their safety.”
Those unforgettable experiences are her recent past. She is from Toronto but left there at age 19 to attend Dalhousie University in Halifax where, after eight years of study, she attained her MD. During that time she worked in the North on several occasions. The first was in 1998 when she was a lifeguard on the local beach in Colville Lake. She lived in a rundown wooden shed and drew her water from the lake, not the usual experience of a young student. In 2003 she worked as a medical student in the Deh Cho, centered in Fort Simpson and serving people from the communities in the region. After finishing her residency in family medicine, she served in northern Ontario in fly-in, mainly Aboriginal communities. Now she is back in the NWT “because she loves it,” but that is slightly qualified.
“Every doctor who works in the NWT is here by choice. I could be paid better and work fewer hours if I worked in Ontario. I am here because I love the people, the outdoors and the challenge.”
Opinionated and gutsy
As one would expect from someone so courageous and dedicated to serving humanity who chooses such a demanding lifestyle, Dr. Giles is very opinionated and has no qualms about saying what she thinks. She is principled, working for those in need, caring little about the money. She said she got paid $1,300 a month working for MSF and chose to pay $1,000 a month for a disability insurance policy, leaving a take-home pay of about $300 to cover all expenses. Now she donates a piece of her salary regularly to MSF.
One can try to imagine some of the horrors Dr. Giles encountered and the depth of her experiences, as removed as they are from the Canadian way of life, but to hear her stories, that is not possible.
“I saw infanticide. I saw the effects of women thrown from roofs. I saw women and children who had been shot. I saw women my age die in childbirth. In Pakistan, which has the eighth-highest infant mortality in the world, we often saw three neonatal deaths a day.”
For her that puts the perceived needs of people in the North in perspective.
“As much as people think there is a need here, there are places where people have nothing and no one,” she said. “Canadians in general have no idea how lucky we are. We are extremely fortunate. People in this town do not appreciate the resources that are available to them.”
What the future has in store
In addition to being a permanent doctor in Fort Smith, as part of her contract, she will do sessions as an emergency physician at Stanton Hospital in Yellowknife. That will likely be for a few days each month. She will be well-suited to the role, having experienced that type of work in the worst of circumstances, plus she will know many of the communities where those patients are from. She likes that it will keep her skills finely-tuned.
“I will see acute cases there which will keep me on my toes for the work I have to do here (in Fort Smith).”
Dr. Giles has no long-term plans, and no idea how long she will stay in Fort Smith, but she does plan to take periods of time off to do more stints for MSF. Asked where that might be she replied, “In some war zone or crisis. There is no shortage of those these days.”