Orbinski on humanitarianism, dignity, and hope

Two days ago I had the privilege of meeting and hearing Dr. James Orbinski at the 2009 Frobese Day, an educational conference held at Abington Memorial Hospital each year. Dr. Orbinski is the former head of Medicins Sans Frontiers (Drs without Borders), current head of Dignitas, professor at U. of Toronto, author of An Imperfect Offering, and central figure in the documentary, Triage. Of interest to me was his work in Rwanda during the genocide.

On a personal note, I found him very engaging. When I was introduced to him, he didn’t do the usual handshake and move on. He really engaged me about Rwanda and what work we did and plan to do there and gave a number of encouraging comments that went above and beyond the call of duty. I guess that is one of the characteristics you need if you are a person who goes into distressed areas. You need to connect to the people, figure out what they need and what can be done, and then do it.

First, an assortment of observations presented:

• There are about 6.8 billion people in the world. Some 3.8 billion, or about half, subsist on less than 2 dollars a day
• 1.1 billion go to bed hungry each night. This number grows by about 100 million each year
• Nearly all famines are the function of political conflict rather than acts of nature
• There has been a 24% increase in food prices in impoverished areas. One of the key causes is the increase of developing biofuel. Food is more valuable if it can be made into fuel.
• The World Food Bank is begging for about 23 billion dollars to feed this number of poor. It can’t get it. But, 13 TRILLION dollars has been recently expended to prop up a collapsing international economy.
• In 2000, it cost 15,000 (a year, I think) to provide an individual in Africa the antiretroviral meds needed to survive. Today, with political pressure, it costs 99 dollars
• The drug companies say that it costs 1.6 billion dollars to bring a drug from a new chemical to market (through research & Development). While they do not reveal how it costs this much, it is clear that part of the costs they factor in is the income they expect to make on the drug. So, if you expect to make 10% on your investment, can you really consider that a cost to develop a drug. Apparently, they do
• A recent nonprofit just released three new drugs dealing with neglected diseases in Africa. The costs to bring these drugs to the market was 100 to 300 million dollars. And, the companies selling them are indeed making a profit

A couple of his key ideas:

• Dignity cannot be granted; it must be acknowledged via engaged collaboration and solidarity
• Solidarity is not pity but active compassion
• Hope is not some naive utopian dream, it is “what we do”
• We all need to be political. The first act of politics: speak the truth; The second act: listen
• The worst form of suffering is suffering alone
• We must see it, acknowledge it, give voice to the voiceless and thus allow for dignity even if we cannot solve it
• Optimism and Hope are two distinct concept. Optimism is confidence that one’s actions will work for the best. Hope is confidence that the action you are about to undertake is the RIGHT one no matter the outcome
• We need those with daring ideas, with visions of possibilities. That is all there is. Hope, is in his estimation, in himself–that he will do the right thing.

While I do not agree with his definition of hope, I do agree that we need more people to move from insight (that a problem exists) to action (that I can do something of value in a hopeless situation). Folks like Orbinski certainly put many of us to shame.