Manual An Imperfect Offering: Dispatches from the medical frontline

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Born in Britain in , James Orbinski's family moved to Canada when he was seven years old. As a young man, he became a medic to learn how to help, and deal with, the suffering of others. From then on he was plunged into many highly demanding situations, including being Head of Mission for Medecins Sans Frontieres MSF during the Rwandan genocide; engaging with the politics of humanitarian work as the President of MSF; being in New York when the twin towers of the World Trade Center fell on September 11; co-founding Dignitas International an AIDS charity ; and finally, returning to Rwanda on the 10th anniversary of the crisis there.

In An Imperfect Offering, Orbinski not only tells his own inspiring story but is also remarkably provocative about what governments and agencies should and shouldn't be doing to help the world's poor and very sick. At the same time, he addresses what part each of us can play, so that we never lose sight of the dignity of those being helped, or deny them the right to act in their own lives. His conclusion is blunt and profound: There are times when I want to thi I read this book shortly after watching the documentary that followed Dr Orbinski's writing of it at the Global Health Conference.

There are times when I want to think about nothing else. This is a hauntingly honest account of the challenges of trying to do good in the world.

Nov 13, Joey rated it really liked it. I think this was the most difficult book I have ever read. Everytime I opened it, I knew my heart would race and heart would sink. In fact, I had to stop reading it before going to bed, becase I wouldn't be able to fall asleep for too long. This is the kind of book that slaps you across the face awareness. It is important to have this type of read, with events in Darfur and the DRC.

It wakes you up, makes you alive, and reminds you of what is means to be human. Also interesting political and his I think this was the most difficult book I have ever read. Also interesting political and historical accounts of some of the major recent conflicts across the globe, not to mention knee deep no forehead deep human stories. It also makes me want to be a doctor.

Feb 25, Elaine rated it liked it. This book highlights past and present humanitarian concerns. It is written by the former president of Doctor's Without Borders. He had some interesting stories about his time during the Rwandan genocide and enusing conflict in Zaire. He also highlights the responsibility of the UN and governments to invest more research and money into diseases that primarily affect the developing world. He has traveled extensively and the information he provides tells of what really goes on behind the scenes in This book highlights past and present humanitarian concerns.

He has traveled extensively and the information he provides tells of what really goes on behind the scenes in various wars and with big drug companies. Jul 31, Ruth rated it it was amazing Shelves: An Imperfect Offering is one of those rare books that not only breaks your heart but puts it back together again and at the same time, inspires you. James Orbinski has experienced the horrors of war, famine and genocide.

Despite that, he writes about the ordinary people he's either treated or worked with and the compassion and courage they each display. James Orbinski is a true humanitarian in every sense of the word. This is a tender and beautifully written book that you will never forg An Imperfect Offering is one of those rare books that not only breaks your heart but puts it back together again and at the same time, inspires you. This is a tender and beautifully written book that you will never forget.

This book was riveting and informative. Orbinski has a real flair for telling stories. I watched a documentary about him through Netflix and immediately ordered the book, which I read quickly over the course of a week. I learned a lot about places like Somalia and Rwanda and even more about international politics, humanitarianism, and the intersection and tensions between the two.

I've recommended this book to lots of other people because it's as entertaining as it is eye-opening.

An Imperfect Offering: Humanitarian Action in the Twenty-first Century

Apr 04, Mike rated it it was amazing. An Imperfect Offering is a deeply touching book, exploring the clash between politics and true Humanitarianism from many perspectives, ground level to Executive. The best parts of the book are the earlier ones, when Orbinski was hands on with teams in Afghanistan, Somalia, and Rwanda. Those are unflinching, and do a good job of not omitting some of the distasteful parts without calling them out or being preachy. Meeting a CIA spook in the backwoods of Zaire during a time when the US government w An Imperfect Offering is a deeply touching book, exploring the clash between politics and true Humanitarianism from many perspectives, ground level to Executive.

Meeting a CIA spook in the backwoods of Zaire during a time when the US government was officially hands off in Rwanda, the disillusionment of French soldiers after realizing they were protecting the perpetrators of genocide for their government, destruction of aid stations and the murder of Doctors and workers, and the politicization of aid In turn making aid workers state actors and targets are called out in turn. It never feels like it's lecturing you too much, simply laying out facts as they are seen and allowing you to draw conclusions. Unfortunately there's very little about Orbinskis stent as the head of MSF in the book.

Perhaps he felt it would be too boring, or there are too many bridges still in use to burn them down. Some insight into how such a large and prestigious NGO is run would have been welcome though. It drags the overall review down to a 4, but the rest of the book is absolutely fantastic. I was simultaneously struck by a need to intervene and confronted by my lack of appropriate skills after reading, and have given quite a bit of money to MSF in the following years. Mar 09, Juri Katchanov rated it it was amazing. Aug 16, Parksy rated it really liked it Shelves: He is a founder of the Drugs for Neglected Diseases Initiative, a not-for-profit pharmaceutical research and development entity focused on the diseases of the South.

He recently founded Dignitas, an organization focused on community based treatment, care and prevention of HIV in the developing world. Orbinski lectures internationally on humanitarianism and global health. Written in a very accessible, almost conversational style, Orbinski's memoir is nonetheless both hard-hitting and thoroughly detailed. Orbinski's goal is not merely to bear witness to both the best and worst that humanity can perpetuate on each other, although he does that effectively, but to bring attention to the fact that in recent years "humanitarianism" has become, in and of itself, less a matter of apolitical assistance and more a direct tool of political manipulation by those powers with Written in a very accessible, almost conversational style, Orbinski's memoir is nonetheless both hard-hitting and thoroughly detailed.

Orbinski's goal is not merely to bear witness to both the best and worst that humanity can perpetuate on each other, although he does that effectively, but to bring attention to the fact that in recent years "humanitarianism" has become, in and of itself, less a matter of apolitical assistance and more a direct tool of political manipulation by those powers with enough money to provide it to those developing nations who need it. Orbinski, with field experience around the world, experience as an administrator of an international organization and as a medical researcher, brings a unique perspective to the quandaries of providing assistance to human beings, regardless of the "side" of a conflict they are on, and while the inescapable conclusion he arrives at is that he must learn to manoeuvre in a political world in the attempt to be a humanitarian, he also reminds the readers that ultimately, wars are fought for people in power, and that ultimately the people who pay the cost are often sold out and sold short.

There are usually no "good guys", regardless of what the media would have us believe, and no easy answers. There are only human beings - and when we engage in or permit human beings to be treated brutally, regardless of they may or may not have done to "deserve" such treatment, the cycle of violence, greed, terror, brutality, and atrocities is enabled and empowered to repeat itself again and again. Warning - Orbinski pulls no punches and although he does not revel in ghoulish particulars he is not at all apologetic about detailing his experience; he states clearly his belief that part of his responsibility is to bear witness to what he has seen, and what he has seen are some of the most horrific eras and events our planet has witnessed in the last four decades.


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It can be hard reading, particularly if you have a vivid imagination. Consider whether you are prepared to deal with forthright and candid descriptions of people killing, maiming and brutalizing each other in vicious, bloody, merciless ways. Consider where you want to be reading this book if you think that your emotional reaction might be intense. There were times I had to put the book down and walk away from it because the images overwhelmed me, because I was sickened, literally, that we believe ourselves to be so evolved and intelligent and still we do such savage things to each other; at other times, I needed to put the book down because I was overwhelmed by the strength, the profound generosity of heart and spirit, and the tenacity of the people that Orbinski encountered and worked with.

It is a book that will make you think and will challenge your notions of what it means to be not only a humanitarian, but to be human. Mar 01, Amanda Dawabsheh rated it it was amazing. This book was phenomenal. It's raw, real, engaging, and sobering. Mar 01, Elena rated it really liked it Shelves: I find it useful when reviewing these non-fiction books to look at what they set out to do and how their are built to achieve it, and this loosely follows Orbinski's life to be successively the autobiography of a doctor, the report of a witness to some of the very worst chapters of history, the portrayal of the internal workings of MSF during a very small range of years, and a broader reflection and call to action regarding the role of humanitarianism and its frayed relationship with politics.

Wi I find it useful when reviewing these non-fiction books to look at what they set out to do and how their are built to achieve it, and this loosely follows Orbinski's life to be successively the autobiography of a doctor, the report of a witness to some of the very worst chapters of history, the portrayal of the internal workings of MSF during a very small range of years, and a broader reflection and call to action regarding the role of humanitarianism and its frayed relationship with politics.

Dr. James Orbinski Reads From "An Imperfect Offering"

With all that on its plate, it is unsurprisingly an uneven book. The first few chapters are peppered with portrayals of people, events and personal anecdotes. One concerns Bernard Kouchner, the polemic founding figure of the organisation, and is of particular interest to those interested in MSF itself: Still, not all stories are of the garden variety. I won't repeat them for shock value, but the bulk of the witnessing part regards Rwanda's genocide and later the refugees crisis and civil war in Zaire. His first missions in Rwanda, Afghanistan and Somalia are also covered.

The last few chapters tell of his work as president of MSF international's Council, and read like the end-of-year review of any similar organisation. He talks of conferences, politicians, and lobbies, many of whom he can't or won't name, and the campaigns for investigation and access to drugs for forgotten diseases, MSF's policy in Kosovo, Sudan and North Korea, the birth of Dignitas International, the legal battle between Big Pharma and South Africa regarding licensing and importing generics for TB and ARV drugs A common thread for it all may be the need to understand what humanitarian campaings are and what they must be, specially after Kosovo and the post wars.

It is a fact that the west hails itself as the bastion of human rights and uses that to deflect humanitarianism into war effort both to legitimise the wars it wages and as one more mean of warfare we'll give food only to those who collaborate But humanitarism needs to rely on politics and soldiers, both to create long-term solutions and to create working spaces for NGO.

This debate is not dead and won't die anytime soon. Its hipocrisy is well documented. It's a sad business and a shame, and it has already had dire consequences. Time will tell where we go next. Feb 26, CK rated it really liked it.

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This one sticks with you. A first-hand account of some of the most horrendous human tragedies of our day. Orbinski's writing is powerful and direct without being preachy. Dec 28, Vanessa rated it it was amazing. An Imperfect Offering follows the journey of Dr. During his time with MSF, Dr.

An Imperfect Offering: Dispatches from the medical frontline - James Orbinski - Google Книги

Orbinski found himself in the middle of some of the worst humanitarian crises of the recent past, from Rwanda, to Somalia, to Afghanistan. He was forced to confront unimaginable cruelty, injustice, and corruption, all of which lead him to question the 'apolitical-ness' of hum An Imperfect Offering follows the journey of Dr.

He was forced to confront unimaginable cruelty, injustice, and corruption, all of which lead him to question the 'apolitical-ness' of humanitarian aid. Orbinski clearly writes with a great deal of passion: He brings to light the stories you might otherwise never hear: He tells not only their stories, but their names, giving them a place in history and ensuring that they are not forgotten.


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This is certainly not a light read, but it is so worth reading. It catalogues some of the darkest moments in recent history, but it also highlights little moments of hope in the midst of those dark days. It demonstrates how a single person can make a difference, wherever they are and whatever skill-set they have to offer. It is both a call to remember and a call to action. It asks us to remember the past, and to take action to ensure that the same atrocities will not be repeated.

Mar 23, Kurt rated it it was amazing. An inspiring read underscoring Orbinski's unflinching commitment to humanitarianism in truly horrific circumstances. But I can live by my questions. As a humanitarian, I can act for a feeling of shared vulnerability with the victims of preventable suffering.

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I have a responsibility to bear witness publicly to the plight of those I seek to assist and in An inspiring read underscoring Orbinski's unflinching commitment to humanitarianism in truly horrific circumstances. I have a responsibility to bear witness publicly to the plight of those I seek to assist and insist on independent humanitarian action and respect for international humanitarian law. As a citizen, I can assume my responsibility for the public world - the world of politics - not as a spectator, but as a participant who engages and shapes it.

The larger force that can push back against the wrong use of power can be the force of a citizen's politics that openly debates the right use of power and the reasoned pursuit of justice. Catherine Lu, a political philosopher and my friend, has described justice as a boundary over which we must not go, a bond of common humanity between us, and a balance among people of equal worth and dignity.

In a narrative of grace and power, he displays the intense components of his remarkable life: He is undaunted in the face of the worst the world has to offer.

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He is determined to salve the wounds of humankind. He is a truly committed man, mind and soul throbbing with incandescent decency. He is a marvelous storyteller, and the stories he has to tell are some of the most powerful I have ever read. The Text Publishing Company. Small Publisher of the Year.