|At 4:15 a.m. the telephone rang in Dr. John McGills Minneapolis
home. He listened groggily to the caller from New York City. Wake
up, the woman told him he could hear her excitement weve
won the Nobel Peace Prize! McGill, a Burlington native and 1978
graduate of the UVM College of Medicine, is president of Doctors
Without Borders, the U.S. branch of Médecins Sans Frontières (MSF).
The 1999 Nobel Peace Prize went to the international organization
for providing medical care in out-of-the-way places to victims
of famines, wars, epidemics, and other catastrophes.
Following that galvanizing wake-up call, McGill went off to his usual days work as a senior associate physician in the Department of Emergency Medicine at the Hennepin County Medical Center. But it would be a day with another level of intensity layered upon the usual bustle of an emergency room. As he attended to the sick and hurt, McGill answered reporters questions, his office phone, cellular phone, and beeper perpetually buzzing with the sudden attention that comes with the Nobel Peace Prize.
If a medical school were to develop a specialty path for training physicians to take on the strenuous, high-risk, selfless work of Doctors Without Borders, John McGills life would be a good place to start. The son of longtime UVM College of Medicine faculty member Bishop McGill, physical challenge sailing, skiing, college football, windsufing is a consistent theme in John McGills life.
As a UVM medical student, McGills experience included work at clinics in Jamaica and Peru, where he learned to do without high-tech gear, working with just a patients history and a physical exam. One of the great things about the University of Vermont was the emphasis on being with the patient, that contact is so important we started our first year, grounding our medical practice and science in the patient, he says.
A world traveler at a young age, McGill began his medical career in Saudi Arabia in 1982. Soon, as war raged with the Soviet invasion of Afghanistan, McGills long association with MSF would begin. Traveling through Afghanistan as a college student, McGill had been fascinated by the culture. With the country under assault and in turmoil, he wanted to help.
Initially, MSF turned McGill down. The risk would be too great for him; the Soviets were hunting Americans. Recently they had ordered an Afghan village to turn over an American journalist, whom they wanted to parade as a CIA agent. Though the journalist had left the night before, the Soviets firebombed the town, killing three-hundred.
But McGill persisted and eventually MSF offered him a brief mission, too brief for the Soviets to learn an American was in the country. Accepting the job, he would be the first American doctor to work with MSF.
The MSF teamss journey began in Peshawar, Pakistan, a city thick with KGB agents. Dressed as Afghans, McGill and a team of five others left at 3 a.m. in separate buses to enter Afganistan. Among the MSF personnel, Juliette Fournot, a young French woman heading Afghan operations. She and McGill would become life partners.
Alexander the Great had crossed the mountains, so there were some blond and blue-eyed Afghans, McGill says. But since he spoke no Afghan languages, the American doctor, incognito with a turban on his head, kept his forehead pressed to the buss window, avoiding eye contact with the other passengers.
The next morning they crossed the border into the arid, pine-dotted landscape, the iron-rich soil red. On the road to the province of Wardak, they encountered blown-out tanks, tracer bullets, smoking villages, and dead camels lying in the road machine-gunned by Soviet helicopters. They hunkered down underground to ride out shelling. They fled into the night at the approach of Soviet soldiers on a remote highway, McGill telling himself, This could well be it, John.
Eventually, they made it to Wardak, motorcycled through the villages, and made plans for clinics.
McGill and Fournot would team on another MSF mission in Afghanistan in 1986. Their route would take them across eighteen-thousand foot mountain passes and across the plains on a twenty-nine day, five-hundred mile journey. They set out with ninety donkeys and eleven horses that Fournot, an expert rider, had painstakingly selected at bazaars.
MSFs greatest strength is logistics, says McGill. Most people think of the organizations huge center in Bordeaux, which handles tons of medicine, and hundreds of Toyota jeeps, and cargo planes that can take off on a moments notice, but I think of Juliette buying all these donkeys and horses, secretly shipping them up to the border, and remembering details like two sets of horseshoes for each animal, and all the nails.
By the time they reached their destination, Badakhshan Province, McGill, lean to begin with, had lost twenty-three pounds. But the rigors of the trip paled compared to what they would find in the villages where ailing Afghans would walk three days to reach the clinic.
Some villagers had up to one-hundred punctures from flying shrapnel, mud, stone, and splinters. In one shelled house an eight-year-old sat up, smiling. But when McGill pulled back the blanket, he saw a shrapnel wound in her lower back; she could not feel her legs. Under the primitive conditions, McGill worked to remove a patients injured eye, illuminating his surgery with a spelunkers battery-powered headlamp.
Amid the misery there were moments of hope. One night, guerilla fighters brought in a fourteen-year-old, his face torn apart by shrapnel. McGill worked on him for hours in a hut without electricity, extracting the bits of metal, putting flesh and bone back together. Months later, he learned the outcome of this impromptu operation: the boy had completely healed.
McGill went on to serve in Pakistan, coordinating the medical efforts of all groups working inside Afghanistan. But eventually he returned to the emergency medicine he loves and his home in Minnesota, where Fournot joined him. The couples eight-year-old daughter speaks fluent French and English.
McGill heads the U.S. section of Médecins Sans Frontières, which now has such branches in eighteen countries. The organization fields some two thousand volunteers, including about six hundred physicians, representing more than forty nationalities. U.S. volunteers currently number about 120. It doesnt seem like much for so large a country, but its harder to recruit in the U.S. because the average physician, just out of training, has a huge debt, McGill says. Despite the numbers, he says, the U.S. branch is a rising star.
MSF will treat anyone in need, but in wars the vast majority of victims we treat are civilians, says McGill, adding that volunteers also serve as witnesses, informing the world about massacres and other human rights violations.
Many volunteers are physicians in transition, perhaps waiting to start a new position, who can donate a month or even a year. McGill says volunteers need not be athletes, and cites a surgeon in his seventies, former department chairs, as well as younger doctors as an example of physicians currently in the field. We dont want adventurers, or strict moralists, he says.
At first, winning the Nobel Prize seemed abstract to McGill. Then I thought about the thousands of volunteers who have worked for people in need, and it brought tears to my eyes, he says. McGill hopes the prize will attract more volunteers, particularly good people willing to take on a succession of missions, creating a cadre experienced at providing medical care in third-world catastrophes.
McGill ticks off spots where MSF is currently active Afghanistan, East Timor, Peru, southern Sudan . In Kosovo, were putting roofs on homes, which we see as preventative medicine our guys are darned good at making things out of rubble, he says. In Africa, MSF volunteers are coping with a vast AIDs and cholera epidemics. In the sub-Saharan region, meningococcal meningitis has infected several million people.
On the board of Doctors Without Borders for ten years and president for four, McGill looks forward to eventually stepping down from his leadership role. Among his motivations, freeing the time to get back in the field, the desire that drew him to MSF initially.
A year and a half ago, McGill visited an MSF station in Uganda. On that short visit he dealt with a cholera epidemic, victims of motorcycle and automobile accidents, kids with meningitis. As he bounced back to Kampala on a rough road, McGill thought, I dont think I should be leaving Id like to get back there.
You have to accept that much of the work is not glorious, McGill says. But weve seen people go out seeming young and come back confident not boastful, humble even, but tested. He adds that the French have an expression that describes the sensation of many returning volunteers: You feel good in your skin.