Medicine: Operating In Danger Zones

A small convoy of Toyota Landcruisers escorted by armed rebels threads its way over a mountain pass in northern Ethiopia. In the vehicles are members of a European medical team on their way to staff a hospital in territory captured by guerrillas. Thousands of miles away another medical corps travels with a caravan of packhorses through rugged terrain into Afghanistan. There its members will treat victims of the war between the Afghan resistance and the Soviet-backed government. At a headquarters building in Paris, shortwave-radio antennas turn toward Africa. A faraway voice reports that a cholera epidemic has struck refugees fleeing Mozambique's civil war. Within 48 hours, prepackaged containers filled with medical supplies are on the way.

Around the world, in war zones and areas stricken by natural disasters, a special breed of doctors and nurses are infusing the Hippocratic oath with new force, risking their lives out of a commitment to what Dr. Bernard Kouchner, one of the founders of the movement, calls "the duty to interfere." Volunteer medics are treating tribespeople for malaria and tuberculosis in East Africa, performing amputations on victims of land mines in Sri Lanka, building clean-water systems in El Salvador and operating surgical clinics, often under gunfire, in the Palestinian refugee camps of Lebanon.

Some serve out of a sense of moral mission, much like that which inspired Dr. Albert Schweitzer to go to Africa in 1913 to open a hospital at the village of Lambarene in what is now Gabon. Others seek adventure, challenge, an opportunity to hone their skills in a real-life laboratory where nearly every case is an emergency. Many discover that much of what they learned in medical school is irrelevant to the life-and-death crises and health needs of the world's poor, and go on to make a career of volunteer medicine.

"As a doctor, I feel one should go where one is needed," says Dr. Swee Ang, 40, a physician from Singapore who was working at the Sabra refugee camp for Palestinians in Beirut at the time of the 1982 massacre by Phalangist militiamen. After surviving the ordeal, she returned to Britain to marshal support for the Palestinians before resuming work at Bourj al-Barajneh, another refugee camp in Beirut. "I'd seen how the Palestinians had suffered," she says, "and to abandon them after that and not do something would have been a crime."

Dr. Christophe Paquet, 31, had just finished medical school in Paris in 1984 when he accepted his first assignment in Honduras. "It was a very strong experience," he says, "and I was hooked." After subsequent postings to Thailand, Sudan and India, he is now studying public health at the University of California, Berkeley, to further his international work. "In France and elsewhere we are becoming more and more specialized," he says. "It's not the kind of medicine that is needed in the Third World."

The volunteer medical movement is dominated by three Paris-based organizations -- Medecins sans Frontieres, Medecins du Monde and Aide Medicale Internationale -- whose aim is to bring medical assistance to troubled and neglected corners of the world, without regard to political orientation or government approval. The need these groups serve is illustrated by an M.S.F. poster showing a doctor examining a sick child. Beneath the photograph is the caption IN THEIR WAITING ROOM: MORE THAN 2 BILLION PEOPLE.