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Papua New Guinea -The first I saw of the country from the airplane was green, lush forests, mountains, lonely rivers running through unsettled land.

Port Moresby was chaotic, hot, humid, dusty and green all at the same time. However, I only observed a minor bit of it since my cognitive abilities were at quite a stand still after all that travel-related sleep deprivation. I received several briefings at the MSF office on the day of my arrival, but only two things stuck to my mind: 1. Always double check MSF Labor terms and conditions when the national staff asks you questions regarding job terms, and 2. The orange I was served by Head of Mission was the most delicious one I've had in my whole life. 

Luckily MSF continues briefing its field workers thoroughly throughout the first weeks of a mission so I was able catch up.

Tari - a rural, little town in Papua New Guinea's Southern Highlands has become my home. Here MSF runs an emergency surgical program and a Family Support Center, my work place, where survivors of domestic and sexual violence receive medical and psychological care. The level of domestic and sexual violence in PNG is epidemic. Official data is hard to obtain due to lack of research, but it is estimated that around 70% of all PNG women face physical abuse during their lives.

Around half of PNG women are raped in their lifetime. The numbers are horrific, and the numerous individual fates feel overwhelming. At the Family Support Center we daily see women who have been beaten and chopped by their husbands, raped by family members or strangers, raped by their husbands, chopped by the husband's co-wives. We see school girls who have been brutally raped. A while ago MSF's international president Dr. Unni Karunakara visited our projects in PNG and said that the levels of violence are unique outside a war-zone or state of civil unrest and described the situation as an ongoing humanitarian crisis.

 As one can imagine, seeing such traumatized clients is emotionally very challenging, but in the end also extremely rewarding. 

There’s something about finding the balance between empathy and necessary emotional distance in order to avoid mental exhaustion. So far I feel I have been quite successful in this balancing. However, there have been a couple of moments where I’ve struggled.

One instant took place a week ago when one of the Family Support Center nurses told me about ongoing clan fights in a nearby village. She told me that the other fighting party also included some children. As per my understanding child soldiers are not at all common here, but this anecdote affected me deeply. I walked over to the MSF office and cried and debriefed with our logisticians (turns out, these logisticians make good counselors too). I cried over children having to experience something children should never experience, over children being exposed to such traumatic circumstances, over lives that might be lost way too young. Sometimes one just does not have enough defenses.

 

Another thing that affected me happened the other day and was quite different from the one described above. It was just a little moment. I was joining my counselor on our daily awareness sessions in the hospital area where we talk about intimate partner violence, sexual violence and MSF’s services to survivors of violence. We were standing in the out-patient area and my counselor was talking to the crowd in Huli language.

 

I had time to glance over the public. I saw women carrying their babies in traditional billum bags, men with painted faces and wreaths on their heads, old women with muddy feet after having walked two hours to get to the hospital.

My gaze was drawn to a young, obviously poor mother who had come to the hospital with her baby. The baby’s foot was injured. The mother had stabilized the little foot with a piece of cardboard from a food package and a dirty cloth. The sight of this hit me. I felt this enormous empathy for the woman who did all she could to help her baby with the small resources she has. I felt sadness over the social injustice in the world; I felt sadness for her baby receiving so much less social services than a baby born back at home in the states.

These feelings are challenges for me personally. If I let it all in, if I let it all affect me with its whole strength I will be burned out quickly. But on the other hand I am very glad they do affect me. That is what is the heart and soul of this work.

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