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'Real Medicine' : In World's War Zones, Volunteer Doctors Race to Save Lives--and Hope

September 27, 1993|JOCELYN Y. STEWART | TIMES STAFF WRITER

Crouched in the bushes on the side of a road in southern Mogadishu, Dr. Broderick Franklin prepared to face death.

Months before, Franklin had left the comfort of his home in Washington, D.C., and headed for Somalia, where he treated the victims of war and famine, sometimes seeing up to 60 patients a day at Mogadishu's Digfer Hospital. Now, caught in the middle of a chaotic gun battle between his Somali escorts and bandits who wanted their cars, it seemed his desire to help would cost him his life.

"I was ready to cash my chips in," said Franklin, a member of the Los Angeles-based International Medical Corps. "I was thinking, 'It's been a good life. Does it have to end this way?' "

Franklin survived the ordeal, thanks to another group of Somalis who found him and arranged for his safe passage to a U.N. facility. By the next morning he was back at Digfer Hospital caring for patients and dealing with the more mundane aspects of working in a war zone.

"Nothing ever made me say, 'I'm going home,' " Franklin said. "Even when a gun may have been pulled on me or when I became totally frustrated at having to combat a million flies in the hospital."

From a suite overlooking Century Boulevard, in the shadow of Los Angeles International Airport, the IMC has sent hundreds of medical personnel like Franklin to war-ravaged countries since 1984, beginning with Afghanistan after the Soviet invasion.

Despite the danger, doctors, nurses and other medical personnel have left the relative safety of American hospitals and headed off to nations such as Angola, Afghanistan and Cambodia. Most simply want to help the victims of war-ravaged nations. Others want to see the world.

Whatever their reasons, these medical workers find themselves faced with the seemingly impossible: trying to save lives and heal broken bodies while surrounded by mass destruction and bloodshed.

But providing much-needed medical care to war victims is only part of IMC's mission. The medical personnel and administrators also have established public health-care programs that focus on immunization and health education, and in some countries a chain of health clinics. To ensure that the programs will outlive IMC's stay in any country, the organization also trains local doctors and health-care practitioners.

"It all goes back to self-sufficiency," said Nancy A. Aossey, executive director and president of IMC. "While we get involved in giving direct relief, the thrust of everything we do revolves around training the local population to do for themselves what they are very capable of doing. They just need expertise in certain techniques--and resources."

Over the years, the organization has sent nearly 350 doctors, 166 nurses and many physician's assistants and other medical personnel to war-torn nations. The program also sends public-health workers, who run the health education components of the program, and logistics specialists, who oversee the day-to-day operation of the program, such as transportation, room and board. Currently, IMC has about 60 people working abroad.

"They have developed a particular niche for themselves," said Andrew Natsios, a former assistant administrator with the U.S. Agency for International Development and current vice president of World Vision. "There are very few private voluntary organizations that will do this kind of work. . . . It's very risky business."

But IMC is no stranger to danger.

In 1984, Dr. Robert R. Simon, then an associate professor of medicine for the Division of Emergency Medicine at UCLA, read an article about the impact of the Soviet invasion on the health-care system in Afghanistan.

"Where there were 1,800 doctors before the war, only 200 remained," said Simon, who is now chief of emergency services at Cook County Hospital in Chicago. The rest of the doctors had been either executed, imprisoned or exiled.

Outraged at the deaths and by the fact that "the world wasn't responding," Simon decided to go to Afghanistan.

"The rural health-care system and hospitals had been destroyed," Simon said. "It was basically done to force people to leave the country, to depopulate--and it worked. One third of the entire population went into refugee camps."

Using his own funds and other private donations, Simon created IMC after several well-established relief agencies told him they could not oversee a clinic he set up on his visit to Afghanistan.

"The charters of most international relief organizations will not let them work in places where the governments don't want them to be," he said.

IMC assists those most in need of medical care and training--whether the government wants them there or not. It is a private, nonprofit organization that receives funding from individuals, corporations and foundations, as well as from the USAID, the Office of U.S. Foreign Disaster Assistance, the World Health Organization and the European Community.

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