Dr Siva Namasivayam, an anaesthetist from Whanganui, New Zealand, has worked with Médecins Sans Frontières (MSF) in places including Iraq, Yemen and Nigeria. He shares what keeps him coming back after nine assignments.
What led you to apply to work with MSF?
Like any normal person in this world, I was impacted by the suffering I saw that many people globally have to endure, either from conflict or inevitable natural disasters. With that came the frustration that not enough was being done. I had the skills and the experience to help, medically at least, but I had to find a way to utilise them. That is when I came across the great work being done by MSF and decided that it was time to walk the talk.
“I have this mantra: when someone’s life gets better, so does mine.”
You’ve now done nine field assignments – is there one that stands out for you?
I was sent on assignment to Mosul, Iraq, in 2017. Around that time there was a sense of joy and relief about the hope for the population that the conflict would be over, but in reality, the problems were still present. People continued to be hurt or killed. Even on the day of the Muslim Eid festival, it happened: among the victims of multiple car bombs who I saw arriving at our hospital that day were children, injured or killed, in their bright, colourful, new clothes.
As an anaesthetist in Mosul, I worked with the surgical team on both planned and emergency surgeries. The day would start early with ward rounds alongside the surgeons. Then I would move to the operating theatres, where I would administer anaesthesia or supervise the Iraqi anaesthetic doctors. In all contexts where I’ve worked, work hours are long – especially if we are dealing with emergencies, which were common in Iraq.
In 2015 I worked with MSF in Jahun, Nigeria, where we were providing maternity care including emergency obstetrics and newborn care. Many of our patients arrived at the hospital severely unwell and in the late stages of pregnancy, meaning most women had complications that put themselves and their unborn babies at risk. As anaesthetist, I worked to manage these complications pre- and post-delivery, and provide safe anaesthesia in the case of surgery. I also managed patients who required extensive surgery to repair vesico-vaginal fistulas. A fistula is a hole between the bladder and vagina or bowel and vagina, which can have many causes including obstructed labour.
What have you found most challenging, and most rewarding, about your role with MSF?
Performing highly complicated surgery in low-resource contexts is always a challenge, as we are often working with limited equipment and local staff who haven’t had the opportunity to gain the same level of training as we do in New Zealand. Part of my role is to ensure that local staff are implementing the clinical guidelines, protocols and standard of care that MSF adopts worldwide. Working as a team is highly rewarding – I enjoy being able to share my knowledge and skills with the very enthusiastic and hardworking local doctors. Yet nothing beats the smiles on my patients’ faces.
“In Jahun, many of our patients arrived at the hospital severely unwell and in the late stages of pregnancy, meaning most women had complications that put themselves and their unborn babies at risk. As anaesthetist, I worked to manage these complications pre- and post-delivery, and provide safe anaesthesia in the case of surgery.”
How have your skills from previous jobs proved useful for your MSF career?
As an anaesthetist, it is not uncommon to face highly critical scenarios. Throughout my working life, I have found that an effective team approach will enable the best possible resolution. From my very first assignment in Yemen, I adopted this approach, with a strong focus on building good team relationships and cooperation. It has served me well throughout all my assignments.
What advice would you give other anaesthetists considering doing this sort of work?
Go for it. There is so much you can do and believe me, you will make a difference – maybe not to the big picture, but to the lives of individuals. I have this mantra: when someone’s life gets better, so does mine.