Nathalie, psychologue

On bulletin boards in several MSF compounds I saw the above notice, a simple handwritten sign with the name and number of a psychologist [I've changed the number because hey, this is the Internet.] Obviously, dealing every day not only with extreme poverty and its health-related consequences of disease and malnutrition, but also conflict-related injuries such as gunshot and machete wounds and burns, can take its toll psychologically.

I didn't speak on this subject with anyone I met while I was in the D.R. Congo, but I read about it in Dan Bortolotti's "Hope in Hell", a good book I quoted from yesterday. Bortolotti interviewed a number of people about the psychological effects of their experiences in conflict zones, and one story stayed with me.

He writes about a nurse who served in Africa who on her return to the tiny community in northern Canada where she worked and lived, had trouble adjusting. Substance abuse was a major problem in the community, and the nurse was frustrated not only that many health problems were to a great extent "self-inflicted", but also that people had little understanding of their relatively privileged circumstances.

She said, "I really had a problem with the drinking-related stuff – people calling me inn the middle of the night, getting yelled at, cursed at. I remember having no sympathy for my patients and really having to cover that up, because that could have got me in trouble ... I just wanted to take them by the shirt and shake them and say, 'You're so damn lucky. You have a life, you're relatively healthy, you don't risk being shot every day, you can be vaccinated for meningitis.'"

Bortolotti then goes on to quote from an e-mail the nurse sent to a colleague who had been in Burundi with her: "We had a murder here last Tuesday. First one in five years – not too bad for a community of 850. As I performed CPR on this man's lifeless body, I was surprised to note how detached I felt. He'd attached someone and then got stabbed in the chest – both of them were screaming drunk. Later, when we pronounced him dead, I felt no empathy for the man, nor for the family. No sadness. The two nurses I worked with that night were quite freaked out. When they offered us 'debriefing and counseling' the next day, I almost laughed ... It is snowing and dark now at 3 p.m. Nothing to do but walk the dog and visit friends. It is true, nobody really wants to hear about Burundi. I am talking on the local radio this Tuesday. I will keep it very simple. I would love to tell them how fortunate they are to live in a country with such great access to health care, even if it sucks by Canadian standards."

For the most part, it's true. "... nobody really wants to hear about Burundi ..."