FARAI CHIDEYA, host:
Now, from Kenya to Sudan and a check up on the medical conditions in Darfur.
Dr. Jill John-Kall is the medical director for International Medical Corps, a U.S.-based relief agency. She's worked in Africa for several years and she's worked in a lot of areas struck with famine and disease. She's dealt with people exhausted from walking mile with little water or food as they try to reach refugee camps. Dr. Jill, as she's fondly known, has a passion for helping others. And she described her mission to bring aid to Africa through medicine.
Dr. JILL JOHN-KALL (Medical Director, International Medical Corps): I grew up in a family with doctors and we spent a lot of summers in India where my parents are from. So I did get to, you know, see poverty firsthand. But I also got to see my family kind of giving back to the community. So my dad, who's a medical doctor - my aunts and uncles, you know, they would see patients for free. And I think, subconsciously, I kind of grew up with that. And then when I went to med school, and then during my residency, I kind of felt that I could do something to make a bigger impact on people that needed doctors out there, so.
CHIDEYA: There's a great story in a recent article about you that tells about you and a women during Ramadan - the Islamic holiday. She was a breastfeeding mother.
Dr. JOHN-KALL: Yeah.
CHIDEYA: Tell us about that situation.
Dr. JOHN-KALL: I think that was when I was working with Sudanese refugees from Darfur and I was in Chad. What we started seeing in the clinic during Ramadan was that a lot of women would come in fainting. But that was because they weren't eating anything, but yet they were also breastfeeding. And it was difficult for us to explain to them that because you're breastfeeding, number one, you don't have to fast; and number two, you need to eat because you're breastfeeding. And if you are not properly, you know, nourished, your child can become malnourished. But as a foreigner, it was difficult for them to kind of really believe what I had to say, even if I was a medical doctor.
So what I did was I went to find one of the religious leaders in the camps. And he did kind of like a teaching session on the rules of Ramadan and he encouraged women to eat when they're breastfeeding, that it wasn't against the laws of Islam. And once he did that, we found that women started eating. You know, I felt really good about that because I was happy that even the community could get involved in their own kind of care.
CHIDEYA: When you speak to Darfuris, how do you navigate cultural differences among them and that might have to do with situations like that where you come in with all of your medical knowledge, with all of your broad history and say I'm going to help these people, and sometimes they may have a different understanding of what constitutes good medicine?
Dr. JOHN-KALL: One thing that has helped me out in the past is that, you know, I've worked in other countries before with other cultures - myself, I'm Indian - so I think when they meet me, they can understand that, you know, I'm not here to say I'm better than you. I'm here actually saying I want to help you.
As far as International Medical Corps goes, one thing that we do try to do in all our programs is get community involvement. So for example, we'll go out there and we'll say, well, these are the things that we think that we should do for you, but what do you think. You know, and they come back and they tell us things like, okay, so you think blankets are important right now but actually they need mosquito nets because malaria season is coming.
And it's good to have a community link because we can't be everywhere all the time. You know, so we're depending on these particular people in the community to come back and tell us. And the community, I think, really responds to that because it gives them ownership. It gives them a level of responsibility to have - you know, take a hand in their own care.
CHIDEYA: Paint us a picture of what you do on the day to day. What is the temperature like? What does it smell like? How many people do you deal with who are administrators? How many people do you treat?
Dr. JOHN-KALL: On average, I would say some of our clinics see up to 250 people a day and that's just with two or three doctors there. The first thing we do is we triage. So we look at, you know, out of 200 people who are the really sickest people that need to be seen. We also tend to prioritize under five children because they're really kind of prone to crashing quickly if they're sick. So we kind of weed out those people and receive them first. However, depending on the security situation, how late it is, we may have to turn out people because it's also important for us to realize the security of our team.
CHIDEYA: When you say security situations, what kind of situations have you bumped up against?
Dr. JOHN-KALL: Our teams have had actually quite serious security issues. They have had their vehicles taken from them. They've been shot at. They've had guns held to their heads. I mean, it's been really difficult for them out there. And I give, you know - not just IMC - but I do give all the relief workers a lot of credit for being out there because, you know, you can go weeks and feel completely safe. And then it just takes something, you know, the smallest kind of trigger a reaction that might get you into a position where you're not safe at all.
CHIDEYA: Have you ever had a moment where you said, oh my gosh, I'm going to die or I could die, I can't take this, I've got to get out of here?
Dr. JOHN-KALL: Absolutely. And I think any relief worker would tell you honestly, yeah. We've all have those kinds of moments. And they're scary and, you know, you try to get passed them as much as possible by focusing on the good that you're doing and the beneficiaries that you're serving and stuff like that. And sometimes, you might have a dream where things come back to you later on. You know, but you kind of look at what you can accomplish and focus on that and move forward.
CHIDEYA: This may come from a different angle, but I think about the health care situation in the U.S. In fact, we had Michael Moore on recently about his documentary "Sicko," and there's a lot of debate around what the government should do especially now that the presidential race is heating up, what proposals people have on the table for health care in the U.S.
Are we - and I'm just going to be honest here - spoiled, whiny babies because most people can find, at least, emergency care? How would you compare people's attitudes towards health in the U.S., towards access, and the challenges you face out in the field?
Dr. JOHN-KALL: I think, for sure and myself included, I think we do tend to take things for granted. Whereas, you know, places like Darfur, people are dying of preventable diseases and not only that's preventable but, you know, they're easily cured. You know, you don't hear of that many people dying of meningitis in this country. You know, you don't really hear about people dying of pneumonias in this country. You just go to the doctor and, you know, he or she listens to you and gives you antibiotics and you're fine. But these are the things that really are killers out there.
The other issue for us is vaccines. In this country, every kid goes to the pediatrician and gets their shots. It's just a normal way of life where you don't even think about it. Whereas, in places like Darfur, you know, getting vaccines out there and getting children vaccinated is definitely a challenge. But it's so important because something like measles can kill so many kids, you know, but it's preventable. All they need is their shots.
CHIDEYA: Tell me about the mandate of the International Medical Corps, which is the group, of course, that you work for. What exactly are you trying to do? How broad is your mission?
Dr. JOHN-KALL: I think the reason I find the International Medical Corps stands out among all the other agencies is because we do two things very well. Number 1 is we do emergency response. And number 2, we also look towards development, because it's very hard to kind of just go in there and say, I'm going to treat you for this and we just do emergency response. But then when we leave, we're going to leave a huge vacuum because the country that we're in may not have the capacity to actually, you know, continue our programs.
So what we do is we go in there and, you know, we respond to the actual emergency. But in the meantime, we do a lot of capacity building. We tend to rely more on the national staff than the expat staff like myself. And the reason why we do that is because when we leave, we want to make sure that our programs are sustainable.
CHIDEYA: So if you are someone who's listening to this and you hear about humanitarian efforts like yours, what could you suggest to people who want to help and who may not know that much about what's going on or who's in the field?
Dr. JOHN-KALL: The first thing that would say is to get educated because it's one thing to hear, like you and I on the radio and just talking, but it's another thing to really kind of get a feel of what you're donating to or what you want to know. If somebody recently asked me why I'm out there and I don't think that, you know, the work that I do everybody else can do it, and nor do I think that's a bad thing. However, I do think that every individual can make a difference. You have a voice. Use it to help those who actually don't have a voice.
CHIDEYA: Well, Jill, thank you so much.
Dr. JOHN-KALL: Thank you very much for having me.
CHIDEYA: Dr. Jill John-Kall is the medical director for International Medical Corps, a U.S.-based relief agency. You can read more about her organization and how you can help at our Web site, nprnewsandnotes.org. Transcript provided by NPR, Copyright NPR.
