"In 1998, after a year-long research trip investigating pediatric AIDS in
Africa, Dr. James Orbinski was inspired to work with others to establish the
Canadian chapter of Medecins Sans Frontieres (Doctors Without Borders/MSF).
After working in Peru, Somalia, and Afghanistan in 1994, Orbinski agreed to
serve as the Chef de Mission for MSF in Kigali, Rwanda and arrived at the
centre of civil war and genocide. Confronted by indescribable cruelty, he
struggled to regain his footing as a doctor, a humanitarian and a man." --back
cover

This guys is awesome. A do-gooder! He has a ton of passion and it shows. Willing to take on things that I am too much of a wuss to do. I really admire his disre, and effort, to help others. He is inspiring. ( )

James Orbinski renders a painful but in some ways uplifting picture of his personal experiences with attending to individuals catastrophically injured both physically and mentally by the political wars in Africa. Be prepared to experience tertiary trauma. The uplifting part of this book is the fact that he and others like him risk their health and lives to bring care and comfort to individuals caught in the paroxysms of a continent in anguish. We kid ourselves that our world is more civilized than in the past. ( )

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. Dr. James Orbinski has experienced the horrors of war, famine and genocide. Despite that, he writes about the ordinary people he's either treaded or worked with and the compassion and courage they each display. Dr. James Orbinski is a true humanitarian in every sense of the word. This is a tender and beautifully written book that you will never forget. ( )

An Imperfect Offering is written by Dr. Orbinski, who is the former president of Doctors Without Borders (MSF), a humanitarian relief organization similar to the Red Cross which provides medical care in war zones - in fact MSF's founders were originally with the Red Cross when they broke away and founded MSF in 1970 due to an ethical disagreement about remaining silent (politically neutral) in the face of human rights abuses.

The 400 page book can be seen in three parts - the first is a memoir of Orbinski's early life and how he came to join MSF in the early 1990s. The second and longest (roughly ppgs. 37-300) is a detailed and gripping narrative of Orbinski's field experiences in Somalia, Afghanistan and Rwanda. Rwanda in particular makes up the core of this section, and is at the heart of the book. It is some of the best writing about the Rwandan genocide available, really important and amazing stuff. The last section is after Orbinski is elected president of MSF (in large part because of his service in Rwanda), wins the Nobel Peace Prize and is less in the field and more of an international political actor.

I've read 5 humanitarian memoirs, and they all struggle with the contradiction between the apolitical vs political - that is, are doctors simply to help the wounded and needy, or do they also support or oppose one side or the other in a conflict? The answer is yes to all. Orbinski understands this better than most, he knows it's impossible to be involved in a conflict without being a political actor. This is the books core insight. However I think the book is at its best simply as a well told story about a doctor working in third world conditions with limited supplies and support, overwhelming casualties, constant threats and dangers. In this sense it is dry on the edges (beginning and end) and meaty in the middle. It tries to be many things but is best as a vivid war memoir from the perspective of a humanitarian aid worker in some of the most infamous conflicts of the 1990s.

Update: See also the 90-minute film Triage: Dr. James Orbinski's Humanitarian Dilemma which follows the narrative of the book closely and visits many of the locations.

--Review by Stephen Balbach, via CoolReading (c) 2010 cc-by-nd ( )