The Prague Post Online: Tempo: Dora Tomíčková: The doctor's out

December 2nd, 2008

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Dora Tomíčková: The doctor's out

Answering the call for humanitarian aid in far lands

By Hilda Hoy
Staff Writer, The Prague Post
February 7th, 2007 issue

COURTESY PHOTO

Mozambique's critical shortage of doctors has been remedied in part by physicians like Tomíčková and the NGO Doctors Without Borders.

The parched Aral Sea basin of Uzbekistan and the steaming jungles of Myanmar are a far cry from the cobblestone streets of Prague. But that didn’t stop doctor and Prague native Dora Tomíčková from leaving her hometown behind to heed a medical call for help that came from abroad.

As a volunteer with international humanitarian association Medecins sans Frontieres (MSF), known in English as Doctors Without Borders, Tomíčková, 33, has spent nearly three years providing critical medical aid in far-flung corners of the developing world.

She returned in late December from 10 months of HIV/AIDS work in Maputo, the capital of Mozambique, where she helped administer antiretroviral drugs for HIV-positive patients.

It was demanding but rewarding work, she says. The days were long:She often saw a steady stream of patients from 8 a.m. until the early evening, with only time to swallow a quick cup of tea at lunch. Even after the patients left, the work continued, in the form of team meetings and Portuguese lessons. During her time in Mozambique, Tomičková became fluent.

Curiosity during college about working in humanitarian aid has given this doctor rewarding work from Uzbekistan to East Africa.

Though she’s been back less than two months, plans are already under way for her to set out again. She expects to head overseas by the end of February, though her destination is still up in the air.

Though the work is challenging, the reward is worthwhile, she says. “As a doctor, you really make a connection with people. I’ve realized that I can really reach out and help people and do something.”

The organization, known internationally by both its French and English names, was founded in 1971 by a group of French doctors who had worked with the Red Cross in Africa before deciding to form their own aid group. In the decades since, MSF has garnered a worldwide reputation for both excellence and activism, and in 1999 was awarded the Nobel Peace Prize.

At any given point, MSF has some 2,500 doctors like Tomíčková stationed in the world’s neediest countries.

Though her recent career has been extraordinary, Tomíčková followed a typical path into medicine.

A soft-spoken brunette with a penchant for travel, she grew up in Prague and decided in her teens to become a doctor not out of any humanitarian calling, she confesses, but out of pure curiosity about the inner workings of the human body. While earning her degree in internal medicine at Charles University, she came across some MSF pamphlets and the seed of an idea was sown.

“I wanted to know what it was like to work in a humanitarian setting,” she says. “I like traveling, and I wasn’t afraid to live in the developing world. I was open to anything.”

The recent Maputo assignment proved less politically hazardous than Myanmar, but meant the challenge of widespread HIV/AIDS.

But it wasn’t until four years later, while working at a hospital in Tábor, south Bohemia, that she made up her mind and contacted MSF. Within the year, she’d quit her job and given up her flat and was on her way to Uzbekistan.

New beginnings
If MSF could have its way, more Czech doctors like Tomíčková would take that leap. That’s why Jan. 24 it officially launched its new office in Prague, the first in a former Eastern bloc country.

About MSF

In Prague
Lékaři bez hranic: Vlašská 28, Malá Strana
www.lekari-bez-hranic.cz
Worldwide
Headquartered in Geneva, Switzerland
Operates more than 300 aid projects in 70 countries
Approximately 2,500 volunteer doctors stationed abroad
Approximately 23,000 native staff employed
For more information, visit www.msf.org

“Our main reason to come to the Czech Republic is because we need volunteers. We need doctors, nurses, logistical workers,” said Reinhard Dörflinger, president of MSF Austria, at the launch. “The last few years have taught us that having a delegate office in Prague … will help us have more influence on recruiting in Central and Eastern Europe.”

Previously, Czech professionals interested in MSF were required to travel to Vienna, home of the closest branch office, for an interview at their own expense. Now the sign-up process for Czechs will be easier, Dörflinger says.

More importantly, the office will be able to raise local awareness of the work that MSF does. As part of its outreach, staffers and doctors will hold monthly information sessions in Prague, Brno and Bratislava.

“We know that medical education here is especially good and that Czechs and Slovaks are adventurous in terms of traveling … and have great cultural abilities to adapt,” says Richard Walker, director of the new Prague office. “The recruitment market here is very positive.”

It seems Czechs and MSF are well-suited to each other, Dörflinger says. A majority of the international recruits coming through the Vienna office last year were Czech.

“I think there’s a long tradition here of having a civil society … and a tradition of NGOs,” he says.

One of the reasons Tomíčková chose MSF, she says, is its good reputation for the treatment of volunteers. The organization actually shies away from terming its doctors “volunteers,” preferring instead to call them expatriates, because the former term implies no compensation, says Walker.

In actuality, MSF covers all expenses, including pre-departure vaccinations, visas, airfare, food and accommodation, and also provides an allowance to help cover fixed costs back home, like a mortgage.

In the field
Though Tomíčková had spent some time abroad before, each of her three MSF assignments was a unique and new experience.

Her first mission took her to Uzbekistan, where she helped establish a treatment center for locals with a drug-resistant strain of tuberculosis.

Though she had no idea what to expect, the availability of electricity and running water was “luxurious,” she says. The clinic and laboratory facilities were nearly on par with Western standards.

Things got tougher the next time around. After a few months back in Prague, she set off for Myanmar, where a military junta notorious for its human rights violations maintains an iron grip on society. There, living and working conditions were more primitive and the clinic focused on such serious diseases as malaria, tuberculosis, HIV/AIDS and syphilis.

But perhaps most challenging was the political climate, she says: “The military junta was not very happy with our presence.”

Balancing the need for both cooperation and professional distance was her biggest challenge in dealing with Myanmar authorities. “You have to find a way not to insult them, but still be able to work with them to get what you need.”

In fact, maintaining distance and independence is a key component of MSF’s philosophy. As a result, they refuse to accept support, financial or otherwise, that could create a conflict of interest.

In Myanmar, Tomíčková says, MSF had to turn down a building offered to them by the junta for use as a clinic.

Because of its refusal to be beholden to anyone, MSF has the freedom to speak out on injustices it witnesses.

Other aid groups like the Red Cross don’t have that luxury because their mandates require them to cooperate more with local governments and practice only “silent diplomacy,” office director Walker says.

Tomíčková herself speaks freely of cruel forced labor practices in Myanmar, and criticizes the regime’s harsh prison system. MSF doctors were barred from visiting jails to treat HIV-positive prisoners, she says.

And, for the past nine years, the organization has compiled an annual list of the top 10 neglected humanitarian crises. This year, the list includes the civilian toll of Tamil violence in Sri Lanka and the medical fallout from years of violence in Somalia. MSF has also spearheaded a campaign against pharmaceutical giant Novartis, petitioning the company to abandon its legal challenge against medicine production in India.

Closer to home
In Mozambique, Tomíčková lived and worked in a city with a 20 percent HIV-infection rate. Working with those patients has turned her eyes toward the future.

The job was so inspiring that she plans to continue in this field on her next mission and will likely work in infectious diseases when she eventually settles back in the Czech Republic.

Although she loves working overseas, she and her boyfriend, Oliver Šafránek, also an MSF doctor, will likely return to stay someday.

“It can be very hard to leave family and friends and have to go somewhere completely unknown,” Tomíčková admits. “You have new colleagues, new friends; you have to adjust to a new lifestyle, maybe even a new diet.”

It’s also been stressful not having a home base to return to: When back in Prague, the good doctor stays with her parents.

But even after MSF packs up and goes home, its legacy continues around the world.

“As much as possible, the idea is to train local staff,” Tomíčková says. “So that, one day when MSF leaves, the work can continue.”

Hilda Hoy can be reached at hhoy@praguepost.com

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