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On the front line: It's about motivation

BMJ 2007; 334 doi: (Published 01 March 2007) Cite this as: BMJ 2007;334:0703128
  1. Amir Shroufi, specialist registrar in public health1
  1. 1Institute of Public Health, Addenbrookes, Cambridge

Amir Shroufi attempts to answer that question which puzzles most of us-what motivates doctors to work “on the front line”?

Having recently undertaken a short placement for MSF (Médecins Sans Frontières) in Kashmir, I'm by no means an authority on humanitarian aid work, but I hope this piece will give any doctors considering this type of work an idea of what to expect. My role was as field doctor, with responsibility for clinical as well as public health activities in the capital, Muzafarabad. In that period I saw a wide variety of medical conditions, spending time most days in a clinic in camps that accommodated refugees and internally displaced people. In the camps, most of our patients were children, and respiratory and gastrointestinal disease predominated, although more exotic conditions did occasionally present themselves. We had a good range of basic drugs to prescribe, and with the help of MSF's excellent book of treatment protocols maintained clinics that were appreciated by the local people.

In addition to my clinical duties, I did some public health work. Measles has a high case mortality among refugee populations, and when we identified cases in one camp we had to identify the scale of the …

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