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Hope in Hell: Inside the World of Doctors Without Borders Hardcover – September 12, 2006

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Editorial Reviews

From Publishers Weekly

This mostly admiring portrait of Doctors Without Borders/Médecins Sans Frontières (aka MSF), the nonprofit that won the Nobel Peace Prize in 1999, emphasizes the inner workings of the organization and is animated by interviews with mid-level staffers and by site visits to MSF projects in Angola, Afghanistan and Pakistan. In between, journalist Bortolotti traces the history of the world's largest independent medical humanitarian organization, whose genesis was the Biafran horrors of the late '60s. Histrionic founder Bernard Kouchner (whom Bortolotti didn't interview) left the group in 1979 after disputes about tactics; not until the early 1990s did MSF spread to North America. Only about a quarter of field volunteers are, in fact, doctors, and most staff are local hires rather than foreigners. MSF volunteers resist being described as heroic ("It's not noble; it's an attempt," one says) but acknowledge that the crucible of crisis does test character. Some stories (illustrated by stock-looking photos, including two color inserts) are grimly poignant: a middle-aged surgeon tells of relying on his lower-tech training to perform surgery in Sri Lanka and Liberia; a logistician describes how to negotiate with drugged-up child soldiers at a Sierra Leonian checkpoint. While Bortolotti could have been clearer, for example, on the mechanics of MSF's fund-raising apparatus, he notes that even critics of humanitarian aid admire MSF for attempting to intervene under seemingly impossible circumstances.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to an out of print or unavailable edition of this title.

From The New England Journal of Medicine

In 1971, I was 10 years old and growing up in Brooklyn, New York. I was never a good eater, and the summer of that year was no different. Every dinner at the small dinette was an interminable ordeal punctuated by my mother's insistent plaint, "Eat, Jerry. Don't you know there are children starving in Biafra?" Indeed, I did not know. Where was Biafra? Now, as I sit reading at my own dinette 33 years later, the Biafran crisis again rears its ugly head. It was partly in the flames of that conflagration that the humanitarian organization Doctors without Borders was born, a group that is the subject of Hope in Hell. The book describes the early history of Doctors without Borders, also known as Medecins sans Frontieres, and goes on to track the group's sometimes tumultuous internal political history as it developed into an organization that received the Nobel Prize in 1999 and became renowned for its accomplishments in numerous human disasters. Some attention is also paid to the mechanics of the association, from its organizational structure to its innovations in the field of disaster relief. These advances have allowed Doctors without Borders to respond faster and with more efficiency than do most other relief organizations. (Figure) The group's method of fund-raising -- primarily through private donations -- is contrasted with the methods of other organizations, which rely on large gifts from the United Nations or national governments. The different sources of funding in part explain the brash outspokenness and, some would say, self-righteousness of Doctors without Borders when the group decides that a certain situation is contrary to the accepted mores as it perceives them. Doctors without Borders uses the French word temoignage, or testimony, to describe such witnessing, and this advocacy has brought it into conflict with the various groups within the organization as well as with other relief organizations and sovereign nations. The criticisms that have been leveled at Doctors without Borders, partially as a result of temoignage, are discussed in Hope in Hell, although not in great detail. Nevertheless, Bortolotti's critique is consistent with his factual and objective portrayal of the group. There is very little hyperbole, which allows the reader to see the manifold ethical controversies inherent in war and charity. Most of the drama in the book appears in interviews with the group's field workers at various levels, including doctors, nurses, project coordinators, and can-do logisticians. These interviews describe life in the field well and bring out the complexities involved in human devastation and the response by Doctors without Borders. It is in the considerable space that Bortolotti gives to the emotions of the group's staff members that the book really shines. Having been on a mission to Afghanistan, I found Bortolotti's account, through his interviews, of the sentiments of volunteers while they were in the field and, even more importantly, after they returned to be authentic and inclusive. It was validating in a way that only confirmation of shared experience can be. The poignancy of the stories of volunteers, coupled with a revealing account of the inner workings of Doctors without Borders, makes this book informative and touching. Jerry R. Dwek, M.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS. --This text refers to an out of print or unavailable edition of this title.

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Product Details

  • Hardcover: 304 pages
  • Publisher: Firefly Books; Updated edition (September 12, 2006)
  • Language: English
  • ISBN-10: 1554071429
  • ISBN-13: 978-1554071425
  • Product Dimensions: 6 x 0.8 x 9 inches
  • Shipping Weight: 1.2 pounds
  • Average Customer Review: 4.6 out of 5 stars  See all reviews (23 customer reviews)
  • Amazon Best Sellers Rank: #881,693 in Books (See Top 100 in Books)

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Most Helpful Customer Reviews

10 of 11 people found the following review helpful By queenie on October 28, 2007
Format: Hardcover
This is a quick read which provides excellent insight into the history and development of MSF as well as its current organization and on-the-ground operations. The historical component is well integrated into the many personal stories of physicians, logisticians, and other critical team members of MSF in the field. This book does a nice job balancing the positive and negative aspects of MSF's mission and how it is implemented. Even with the fair number of criticisms of the organization, I am still eager to be involved with such a remarkable group of people.
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4 of 4 people found the following review helpful By Walter Lovelace on November 21, 2007
Format: Hardcover
Almost everyone has an opinion on MSF(Médecins Sans Frontiéres). The author Dan Bortolotti in "HOPE IN HELL" provides what is surely a complete and trustworthy account of this organization. The book will once and for all confirm that MSF is still the only fully independent relief organization which seeks to alleviate human suffering, regardless of how that suffering was caused: by dictators, war barons, corrupt governments, or even relief teams which have fled the field.

"Hell" in the title is perhaps missguiding. The majority of doctors, administrators and logisticians, regardless of having suffered from diseases and trauma brought on by witnessing ghastly cruelty, still go back for more.

Before commenting to anyone on MSF again, read "HOPE IN HELL". It will not only alter your opinion but probably persuade you to support a relief organisation which really makes a difference. You might even become one of the doctors, etc, who helped to make the difference.Hope in Hell: Inside the World of Doctors Without Borders
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4 of 4 people found the following review helpful By Eduardo Rafael Costa on May 7, 2013
Format: Kindle Edition Verified Purchase
I'm a medical student and MSF was one of the reasons that got me into medicine. At first, it all seemed like a great adventure, I would watch videos of missions and think of those people as heroes. And while I still think that they are very brave and I deeply admire them, this book was very enlightening about the people that work for MSF, how their work is done, how MSF came to be, and how hard and challenging it is. It is a very good book.

Humanitarian work is a great challenge. If you want to know more about MSF, in a more personal way, I also recommend Six months in Sudan, by James Maskalyk.
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21 of 29 people found the following review helpful By reader from Canada on February 4, 2005
Format: Hardcover
I would say that Hope in Hell is a good read and an interesting book but I have to say that the style is very impersonal, very repetitive, very introductory and does not do justice to the many MSF volunteers who were interviewed for the book.
It is impersonal because there is little more than a name and perhaps the country of origin given as the stories of volunteers are told. I read this book right after reading the Fast Food Nation in which the writer describes his interview subjects in a manner that enables the reader to have a mental picutre and develop a deep relationship with them.
Hope in Hell reads as an introductory piece of writting. Half way through the book I still thought I was reading the introductory chapter.
The sotries in this book were tragic and could've and should've been written in a heart wrenching style but the writer failed to write it so.
I would recommend it as a book to skim through but not a book worth purchasing and adding to your collection.
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1 of 1 people found the following review helpful By J. Lavoie on September 9, 2013
Format: Hardcover Verified Purchase
This book centers on countless medical humanitarians working in unsafe occupied countries, all because people (many times a mass majority) who have become victims are in need of grave medical care: Medical care which is not granted to them by their government. The giving of medical care is the intention of these organizations. It all started with a group from France called 'Medecins Sans Frontieres', and branched out to Doctors Without Borders, ect.

In so many cases, medical care givers with all types of skills are needed for victim survival--those who have been exposed to and are surviving the aftermath of war and other types of social conflict. Much of the time survivers soon turn into refugees, all living amongst one another, and that is when, what seems like the smallest health problem, quickly explodes into an epidemic of huge proportion for thousands of people.

Medical teams do their best to train the people of these communities for aiding with safe and proper medical care. While there, a health clinic is opened to treat all ailments, so any community members who are interested in learning are welcome to watch and learn for the future when they are on their own.

In many countries,(at very young ages) soldiers are recruited and become disfuntionally ruthless and barbaric. Their hearts are infultrated with hatred, and their minds are impaired with the local drug and/or alcohol of choice. This is a lethal combination which adds more fuel to the fire in places where the average person's life has already been significantly altered by these dispicable soldiers who are dictated to continue on inflicting inhumane autrocities.

Please read the book.
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1 of 1 people found the following review helpful By mindriots on February 13, 2013
Format: Paperback Verified Purchase
I'd been wanting this book for ages because as long as I can remember I've wanted to work for MSF. I really wasn't sure what to expect, and whether I'd still want to work for them once I'd read it! But I am happy to report nothing has changed...if anything, I'm even more driven!

In this book, Bortolotti provides insight into the "real" world of MSF and gives potential recruits like me a better understanding of what sort of situations one would be found in, as well as what to expect of life within MSF. It's eye-opening and based in reality, that's for sure. I also knew very little about how MSF began, and the structural organization, which this book provides information on. Bortolotti writes with fictional flare, which makes it more interesting than non-fiction can sometimes be. He appears to really know his stuff, and has gotten down to some of the nitty-gritty that others may choose to ignore; or to describe things that may have been lost in the romanticism associated with MSF's type of work.

I still want to work for MSF, and am grateful this book provided me with a better understanding and broader perspective of this amazing organization.
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