Adventure Medic Editor Rowena Clark speaks to Damien Brown, author of Band Aid for a Broken Leg: Being a Doctor With No Borders (and Other Ways to Stay Single).
Damien Brown is an Aussie South African, living in London. An Emergency Medicine trainee, he is currently studying at the London School of Tropical Medicine. His first book Band Aid for a Broken Leg: Being a Doctor With No Borders (and Other Ways to Stay Single) has just been published, and is a catalogue of stories and experiences gained by Damien during his time working in Africa with Medecins Sans Frontieres. He was placed predominantly in Angola and what has now become South Sudan, working as a doctor in small but intensely busy NGO medical clinics or hospitals. His book is borne out of the ups, downs, frustrations and love for the work he carried out over this time. It is the genuinely thought-provoking recurring sense of reflection that is the backbone of his work that, for me, is what makes this a book to read. If you have worked with NGOs, harbour a wish to be a part of the global humanitarian workforce, or are simply interested in those who do, Band Aid for a Broken Leg will allow you a glimpse into that world. A refreshingly open approach is maintained throughout, with neither the hyperbolic depictions of heroism nor the dank cynicism seen in so many other portrayals of this career. I had a chat to Damien about his work, both on and off the page.
RC / You started off writing a blog whilst in Africa – what inspired you to make the transition from blog to book, and how did the process come about?
DB / The book actually ended up being nothing like the blog at all. I went home after South Sudan to Australia, and during the three months I had off work, I was encouraged by friends and family to turn my experiences into a publication. Initially I sent my first attempts based upon the blog to publishers, but was swiftly rejected! So I redrafted things and removed the blogs to make a more coherent book, and spent the next 18 months doing more redrafting and getting rejected, all the while working in medicine. The reason for writing the book changed along the way: initially it was partly therapy and partly the challenge. Then there was the anger I felt about some of my experiences, and my writing style reflected that; but finally I realised that the individual stories of the kids, the local people and the healthcare workers were what would make the book—and ultimately is what made me want to stay working in the field, anyway. In the end though, I took the advice from an editor I had contacted to take a year off, and ended up hiding from the world in Bali to re-write the entire book.
It was incredibly hard. I had no formal training in it, and the complexity of cobbling a story together from these experiences was enormous. I rented a house with gorgeous views at the edge of a rice paddy, and avoided all distractions from friends and family. I’d get up early in the morning and would be at my desk until the evening, with the occasional day or two off. It was a solitary experience, but not a lonely one, and there’s no way I could have done it if struggling with work or ED (Emergency Department) exams.
Many times I was going to chuck writing the book in, but in the end the story really came together and was picked up by a publisher. The whole process took 3 years.
RC / Can you see yourself writing more in the future?
DB / It was a hell of a thing, and cost me 3 years of my social life! But I loved the process and I’d love to write another book. The material would need to be solid though, and it’d need to have an element of humour. There was so much rich material for this book, and I’d love to do something similar; I don’t think I’ve got the desire to write a novel. Maybe something else in medicine…
RC / What would be your advice to our readers considering writing a book on their own experiences?
DB / Separate yourself from what’s on the page and don’t take rejection personally. Limit your social network and online accounts and take yourself away somewhere – you have to commit wholeheartedly. Find your tone and work out how you want to address the reader. Retain your honesty: if you try to use hyperbole, over-familiarity or false humour, people will start to lose faith. Take all of your inevitable rejections as a learning opportunity.
RC / What would be your advice to our readers for starting work with MSF or another NGO?
DB / Make sure you get as broad a range of medical experience as you can get. Do paediatrics! Do obstetrics! I’d suggest leaving it until at least your 3rd year out. Then again, don’t leave it too late: you’ll have narrowed your range of skills, and you’ll have many other commitments and obligations you can’t get away from. A diploma of tropical medicine is worth its weight in gold.
RC / What did you do for downtime in Africa, to relax after the mayhem at work?
DB / The work conditions are challenging, but as medics we’re already used to coping with that – the sleepless nights etc. However, the make or break factor on missions is the living conditions and the people you live with. On my longest posting, we all got on very well for the most part, so I was really lucky. I think part of how I coped with everything was writing my blog too. It started accidentally, and was borne out of therapeutic writing at the end of a day, to try and make sense of the chaos. I also spent a lot of time listening to tunes on my iPod. Walks in town were amazing, and it’s where my doubts would disappear: seeing happily playing kids, a functional town, the sun setting. I’d suddenly realise again that it was a privilege to be there, seeing these incredible people coping, no hint of anyone moping.
RC / How did you manage to rein in your own cultural influences, and avoid the inevitable altercations with staff and patients?
DB / Great question! That was really, really hard. Life is so valuable there, yet at times so cheap; a guy could be so incredibly involved in his family and the community, yet shoot someone over a cow. I just didn’t understand it, and making sense of it took years; making peace with it took years. I feel that a big gap with NGOs is the lack of time, or lack of direction, to read, read, read about the place you’re going to before you arrive. And I think that If you don’t go to bed at some point out there and have serious questions about the these things you’re surrounded by, you’re not being honest with yourself. We’re so preconditioned in our ideas and work habits as doctors in Australia, the UK, USA etc, and it’s very difficult being immersed in cultures where things don’t run the way we expect they should. Accountability can be absent on the surface at times, which is tough. I really struggled with finding the balance between being understanding of such things, whilst still trying to run a safe and efficient hospital. On one hand I was loathe to act as a neo-colonialist-type boss, yet on the other I was responsible for all patient care. It was a difficult position to be in. But ultimately I was just a guest in someone else’s country; I had to remind myself of that. I wasn’t there to change things, just to help out. I think the greatest advice I’d give would be to encourage everyone to use all of the resources they can, both before they go and while in the field. I emailed colleagues all around the world for advice, and for more than a little counselling!
RC / What’s the one lasting memory, included in the book, that you dine out on?
DB / Being caught in a gunfight as I stepped out of the shower, with only a little towel around my waist, and subsequently having a panicked few moments as I debated whether to run for the concrete safe room or bolt to my mud hut to grab underwear first. (I chose the underwear.) Or when I realised that I’d not had a single opportunity to ‘socialise’ with any single, available girls in months, and finally three gorgeous girls turned up out of the blue to visit another mission… and I discovered, to my complete dismay, that they were deeply religious and not in the least bit interested in any of us.
I think though that the greatest memories and stories in the book genuinely come from the everyday encounters. For example, the kids who ran around the MSF complex, fighting over balloons that had been left by another worker. Or when these same kids built an entire mini-replica of the compound from mud after the rains, and wouldn’t let me go on my rounds until they’d shown me every little mud door that opened, or the mud cars that rolled on straw axles, or the numerous mud cows and mud people they’d made. They were so happy and inquisitive despite such shitty circumstances. And for me, that was the thing about the whole experience: there was so much beauty, and hope, and resilience, and optimism, and it was all juxtaposed against an often tragic, violent background. It’s a humbling thing to witness.
RC / And lastly… if Band Aid for a Broken Leg was turned into a film, who would play you?
DB / Matt Damon, but I’m holding off for him to go bald.
Photo of Damien by Kristian Gehradte Photography.
