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Winter 2000
Doctor Without Borders
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Our hope is that with access to better information, doctors and nurses in Kosovo will be able to provide more modern care. We found, in the course of treating patients, that some practices that Americans consider routine - such as performing a breast exam in conjunction with a woman's normal pelvic exam - were completely foreign to our hosts. So we worked to introduce these concepts. And we tried to come up with protocols to help doctors and nurses better diagnose ailments: If a woman comes in and complains of abdominal pain and these other symptoms, for example, you should do X, Y and Z. Trying to help standardize care was a significant part of our work.

It was incredibly satisfying to help revive Kosovo's health-care system and to see how grateful patients were. One day in the late afternoon, a family came into one of our clinics bearing huge plates of buttery pastries and other treats. They had come to thank the doctor who had taken care of a woman during her pregnancy; she had given birth to a healthy baby a few weeks earlier. This kind of response was not unusual.

There were times, though, when it seemed that no amount of energy or good intentions could overcome the tragedy that had preceded us. I remember one patient, a very cute little blond-haired girl, no more than 6. She had an infection and had come to the clinic for a series of shots. The routine was clear to her: She pulled down her pants, stuck out her behind for the injection and didn't bat an eye as the needle went in. When it was over, she quietly pulled her pants back up. At first I thought, what a good patient, American kids don't act like that. But then it hit me: She was so stoic because the shot was nothing compared to what she had been through. I can't forget watching her walk down the lane away from the clinic, holding her father's hand and, on the other side, holding her rear end.

Older people, too, were profoundly affected by the war, and some wore their grief very visibly. On my first day at a clinic, an elderly woman came in with high blood pressure. She had lost two sons to the violence. Younger women tended to be more private about their sorrows, but it doesn't take long to realize that every lost son was probably also someone's brother, someone's husband, someone's father.

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