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

Passionate, worthwhile, and necessary, this book comes from the perspective of a doctor directly involved with all of the issues he presents.

Orbinski's book is by far the most accessible, intelligent, and nuanced look into Humanitarian Aid that I've come across. The work is without political bias; Orbinski's concern is for those people around the world who need help to simply survive and/or who are treated unfairly (primarily in respect to basic survival needs and medical care). His passion for both humanitarian aid and working For the future beyond simply the present moment is both touching and infective. As a doctor who worked with Doctors without Borders and one of the founders of Dignitas International, a foundation that works for show more the relief of treatable disease in poor populations that have little to no basic medical care or resources, Orbinski's presence in this book is not only central to story and action, but a more intelligent narrator than we could ask for.

Additionally, while I've read quite a few books that overlap in subjectmatter or concern, I haven't come across any book that did such a perfect job of balancing the overwhelming task of mixing narratives, introductory material, hard statistics, and personal voice. Some of the subjects and places Orbinski presents are places I've read quite a bit about, while with others, this was my first exposure--throughout, though, I never felt either lost in the subjectmatter understanding-wise, or bored by what I already knew. For anyone interested in learning more about Humanitarian Aid, this is the first book I would recommend, and without reserve. I would also strongly recommending it all the way through in order, and not simply taking on the chapters that you're interested in---Orbinski's treatment and understanding of his material is unparalleled, and his voice is integral to the experience of reading this book and retaining not simply statistics, but his larger narrative of understanding and humanity in today's world. The chapter on Rwanda is particularly at issue in this regard--while it is, by far, the strongest and most difficult chapter to get through, it is also integral to the larger arch of change and understanding that Orbinski goes through and presents to his reader. If you've read the material up through this mid-way chapter, you'll appreciate it much more than you would otherwise in just taking it on its own.

I cannot recommend this work highly enough. Even if you hesitate to read it, it is a necessary and intelligent book that deserves both time and consideration, without bias. show less

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 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 show more 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 show less

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.

This book tells the story of Dr. Orbinksi, a Canadian doctor, and his work in war zones and other areas of the world filled with violence and suffering. It shed new light on my understanding of what happened in Somalia and Rwanda. There are also dispatches from other areas. It could also be considered a history of the MSF (Doctors without Borders) organization in the 1990s.

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.

The best book I read in 2008.