When borders fall | Josefina Martorell | TEDxRiodelaPlata

As an economist on the Doctors Without Borders team, Josefina reflects on what she learned about how she helps others. She is an economist, humanitarian worker, soccer player, and feminist. She currently serves as General Director of the Doctors Without Borders office in South America. She began her connection with the organization in 2011 when she traveled to support some of its most relevant missions, such as Niger, the Democratic Republic of the Congo, Central African Republic, and South Sudan. In each of these places, she experienced first-hand the achievements but also the challenges of bringing emergency medical care where it is most needed.

In Malakal, in a settlement
of displaced people in South Sudan,

I met Achuei soon after
arriving to my mission,

when I was accompanying
one of the nurses in their daily round.

Achuei was admitted
with acute malnutrition

to our field hospital.

She was 9 years old, but due to her size
I thought she was 4 or 5.

From the first time I saw her,
she was almost always alone in her bed,

crying but with no tears.

Her father had recently died in the war.

And her mom was admitted
with tuberculosis

to the tent-hospital next door.

Her grandmother took care
of her when possible.

We treat kids like Achuei,
with malnutrition,

with a therapeutic food,
a peanut-based paste

which has a lot of calories.

The thing is, even though Achuei
had to get this food

we noticed that her grandmother
was just giving her rice and bread.

That's why weeks went by,

in which I visited almost every night
to wrap her up,

and wait for her to fall asleep,

and Achuei didn't gain weight.

Her grandmother wasn't giving her
the key food

to treat her malnutrition.

When I found out that her grandmother

was selling this food
on the field I was outraged.

How could it be that this lady
was denying her granddaughter

her only chance of recovering?

We organized a meeting
with hospital caregivers and patients

along with a translator,

because the grandma just talked
Linka, a local dialect.

There she told us she was selling
the food in the fields

to buy rice and bread
to feed the whole family.

How wrong we were!

She was doing what she believed
was the best way to feed everyone,

but rice and bread don't work
to mitigate acute malnutrition.

So we told her why her granddaughter
needed that sticky paste,

which is a therapeutic food.

After that, we started to see her
visiting Achuei

with a plastic bowl
filled with rice along with peanut paste.

Apart from South Sudan,

I've been working for several years
with Doctors Without Borders

in the Democratic Republic of Congo,
in Niger, and in Central African Republic.

Almost all of them are among
the countries with lesser resources

where people are constantly
affected by poverty,

malnutrition, malaria,
among many other problems.

I'm an economist,

so my main function
was to financially coordinate

the missions I was involved with.

I had to make sure that all the processes
and procedures were fulfilled,

the approved budget was respected,

that all the bills
were paid in a timely maner.

And maybe it would have been
more comfortable,

easier and less weary for me
to stay behind the desk,

to just fulfill the tasks of my position.

But I had entered
this humanitarian organization

because I wanted to be close to people.

So since my first mission
I started looking for excuses

to get this proximity.

I still remember like today,

those mornings at the clinics
packed with people,

with the patients' little brothers
playing around,

mothers chatting,
preparing the food,

part of our staff
making the round, the tears,

snot and other bodily fluids
everywhere.

While I wondered how effective

that piece of soap
hung from a rope really was.

And I see myself lifting a little boy
too short to be reached,

and later ask myself if that
was the only real humanitarian action

I had done in the day.

When I was in Niger,
we had changed the approach

to malaria in children
under the age of five

after the past year which had been tragic
for the population.

A lot of people had died,
especially boys and girls

due to malaria combined with malnutrition.

So, we decided to get closer
to the communities.

Trying to be closer to people
and bring them a prevention tool

instead of waiting for them to reach out
to our hospitals and health centers,

almost always collapsing
the health system.

We started prevention campaign called

"Seasonal malaria chemoprevention"

consisting of an oral vaccine
that had to be administered to kids

for three days a month
for several months.

But at first, because
the communities knew nothing

and it was a new tool,

they didn't want to be involved
with this new treatment.

They preferred to be treated traditionally
once they got infected,

which had worked until then.

So we approached the communities,
we talked with them,

we told them what this campaign
of chemoprevention was about,

we answered their questions, their doubts,

we talked with the mothers
and with the leaders of the villages.

That day in the car we were: the driver,

the project logistics manager,
Abdulaziz, and me.

I was mostly going to pay salaries

but also to help in any way I can.

We had to deliver the doses

and we feared that very few people
would attend the place of vaccination.

After many hours of traveling
roads and dirt roads

until the roads end,

and we kept going through
the hills with the van

in the middle of the Sahel Desert,
we arrived.

To our surprise,

we saw long lines of mothers,
we didn't get to see where they ended.

They were holding their children tight

trying to get a shadow
under a burning sun.

The kids were scared,

or overwhelmed by the heat or impatient.

But that day of vaccination
was just the end of a long road.

It had been possible because
we had approached the communities,

we had talked to people,

we had spent long days in the desert.

That day I felt that I was part
of something larger.

Our paths had crossed and united.

But there's so much to do
in these communities

that I often wondered
if it was worth it.

For the more than 184,000
children in Niger

who were able to get the treatment
that year, no doubt it was worth it.

I'll never forget the hug with Abdulaziz

when the team deliver the last dose.

The satisfaction in our eyes,

the feeling of joy
of a mission accomplished.

A similar joy I felt again in Kikamba,

at the east of the
Democratic Republic of Congo.

When it rains there, the sky falls.

And as the roads, if they exist,
are dirt roads,

transportation get complicated.

I had to go with one of our nurses

to the health center on the periphery.

We had to travel for more than four hours
just to cover over the 50 km

that separated them from our base

and get to do
the weekly consultations.

People from nearby populations
were waiting for us.

Some had walked more than three hours

to get to this place
in the middle of the jungle.

They knew that every Wednesday

our team came by
for consultations of all kinds,

so that day they would come en masse.

When the medical team finished
to treat all the people of the day,

we set out on our way back to base.

But in the middle of the road

the van got bogged down
in a crater in the road

flooded for days and days
of constant rain.

Eastern Congo is one of most
conflictive places on the planet.

Several armed groups
dispute the territory,

looting and burning villages,
chasing after rival groups.

And it also has one of the highest rates
of sexual violence in the world.

That's why it's very dangerous
and it's totally discouraged

to travel after the sun goes down,

which was approaching at that moment.

The driver, the nurse and I
tried to free the van.

But such a machine is extremely
difficult to move for three people.

Before long, we observed
several people showing up

from both sides of the road.

We couldn't see who they were
for the darkness.

And the first thing I felt was fear.

But right away I realized
that many of them knew us.

And even I recognized a lot of men,

women and children we had been
at the office earlier that day.

They didn't hesitate to get
their hands in the mud

and help us dig up the van.

That day I could really feel
what it was to be accepted in a community.

We weren't just allowed to work there.

They also helped and valued us.

And thanks to them I felt safe.

Today I'm in Argentina
working again behind a desk.

But I don't forget all the years
I spent on the territory.

It's all those experiences,
my experiences,

the ones that shaped me and the ones
that turned into who I am.

It's Achuei's smile at Malakal's hospital.

It's the hug with Abdulaziz
at the end of the vaccination campaign.

It's the goodbye smile
of that child in Kikamba

after helping us dig up the van.

It's these memories and hundreds more
that keep pushing me forward,

giving me a reason to be and to do.

Today, being thousands of miles away
those people are still present in me,

reminding me that it's not about
individual work,

or about imposing our help.

It's mostly about working
together with the community.

To be able to learn from each other
and build together

the paths we want to tread.