Long ago an MSF (Doctors Without Borders) poster transfixed one junior doctor. Me.<\/p>\n
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It was black and white. Two figures, photographed from behind, dominate the foreground: a poor black child, desperately malnourished and in need (yet another African war?), being led by a white man (a doctor maybe?) to a makeshift clinic that is but a grass hut. In the background, a black man in sandals with x-rays in a plastic bag tries to talk his way past another black man at the clinic entrance. We know that with his guardian our little black child will get past the gatekeeper.<\/p>\n
It\u2019s all here: a dangerous place, a boy in need, a white hand reaching down, and salvation\u2014improvised and temporary\u2014ushered in. Back then poverty was far away. It happened to other people (people of colour, definitely needy, always weak) in dangerous situations they\u2019d inadvertently caused. Enter aid: strong and white and good. Not responsible, but caring. Reaching down. Helping . . . Enter me.<\/p>\n
Poverty was black and white: their<\/em> problems, our<\/em> aid. Their wars, primitive farming, illiteracy, excess children, backward traditions, religious superstitions, and poor work ethic solved by good governance, science, medicine, contraceptives, appropriate technology, education, economics . . . and the rest. I joined MSF, went to Colombia, immunised indigenous children there, fought plasmodia,<\/em> and learnt about the world and myself. My subsequent journey from working in medicine to development has coloured and nuanced that.<\/p>\n Working on community based adaptation (CBA) in Madhya Pradesh (Central India), I saw indigenous communities toppling domino-like: drought causing crop failure, forcing men to migrate, leaving vulnerable women whose malnourished children died. Cause and lethal effect. Nobody asked who caused the drought.<\/p>\n \u201cKya karna?\u201d<\/em> (What can one do?), they\u2019d say, shrugging.<\/p>\n At what point should I intervene? Medically treating malnourished children, implementing social programmes for mothers, establishing safe migration programmes for the men, or bringing in agricultural experts to introduce drought resistant crops? Should I work against drought?<\/p>\n A woman told me she\u2019d prayed and prayed: \u201cBarish (rain), barish, barish.\u201d<\/em><\/p>\n No rain came but (\u201cby luck,\u201d she said) a man did. Promising city jobs, he pressed 4000 rupees into her hand and took her girl. I listened aghast. That was a horseman of apocalypse (aka climate change) dragging her daughter off to a Delhi brothel. A horseman unleashed not by her (tiny) carbon footprint, but by mine.<\/p>\n Poverty is injustice personified. A few years ago my family of six lived in a Delhi\u00a0bustee<\/em> (squatter settlement) built, like any other human structure, on piled-up hierarchies. Three tottering floors up, our 2×4 metre \u201cpenthouse\u201d enjoyed light and air. In the windowless basement, Iqbal was baking bread from 4 AM. In 50\u00a0degrees. For 50\u00a0rupees a day. Was it his work ethic? Should I tell farmers eking crops out of arid land that hard work earned me my place in the sun? I\u2019ve never worked like that mother with a baby begging on my railway platform at midnight. And the barefoot Bihari* boy shrouded in toxic fumes, pouring tar from a barrel? I sit wordless in my hospital jeep as he makes my road.<\/p>\n Not guilty! I recycle, vote left, buy Fair Trade. I worked hard, studied philosophy then medicine. True manicured Cambridge lawns, then clean New Zealand hospitals, materialised magically (\u201cby luck,\u201d he said) around me. OK, meanwhile horsemen were dragging off indigenous girls, Bihari boys, and other human sacrifices\u2014but that was far away . . . Yet it was my<\/em> world\u2019s horsemen. Undeniably. “My verdict?” Guilty by association.<\/p>\n I can\u2019t sit wordless.\u00a0\u201cAll right,\u201d I say to anyone who blames \u201cthem,\u201d who presents the playing field as level, excludes poor people, or denies responsibility for their poverty and problems. \u201cIsolate yourself. Properly.\u201d<\/p>\n Not a wall, make a perspex dome. Keep your deathly shroud of CO2 inside. Play in there by yourself with your high-tech war toys and torture your own citizens. Keep your free market\u2019s unsheathed claws off the world\u2019s human and natural resources. Own these injustices\u2014and the rest\u2014and you\u2019re not involved. Otherwise accept that \u201cthey\u201d don\u2019t have enough because<\/em> we snatch too much. It\u2019s lethal cause and effect.<\/p>\n Every day I\u2019m reminded of how I\u2019m connected to poverty. The girl on the rubbish heap is picking through my values. Uncomfortably. Long after I press five rupees into his palm the beggar\u2019s unspoken \u201cWhy me, not you?\u201d lingers. Inescapably. Tying my laces reminds me I\u2019m cinched to women making shoes in Indonesian sweatshops. Involved. My mother\u2019s medical specialist in New Zealand is a Pakistani snatched from people with fewer doctors and far greater needs. Greedily. Elsewhere Nepalis, uneducated and unsnatched, travel their own risky roads. Some finish corralled in Qatar, building hotels and soccer stadia for our next World Cup. Some die. So it goes.<\/p>\n Uncomfortably, inescapably, greedily, I am involved in mankind. Participant and perpetrator. Back then that poster affirmed me as a doctor but, beckoning me out beyond my borders, it also tunnelled into my humanity. It still does.<\/p>\n
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