On my application to medical school, I described how much I wanted to work in global health. I yearned to be a modern-day Florence Nightingale – a doctor who would fly to far-flung parts of the world and do good. Studying medicine at McGill provided me with a strong base of knowledge and a clear way of analyzing problems that I could use anywhere in the world. Dick MacLean and Brian Ward, two McGill doctors who worked in global health, helped me formulate a path leading toward my dream but I was diverted by a desire to pursue global health in Canada.
Early in my medical career, I worked in remote villages and towns in nine provinces and territories across Canada. Sometimes I was the only doctor in town. Faced with challenging cases and far from any hospital, I felt like I had the skills and logical approaches to work through most problems that I faced – be that someone with a broken bone, a woman in labour or a child with respiratory difficulties. I learned the art of telephone medicine when I couldn’t be face-to-face with a patient who lived in a tiny hamlet that only had a nursing station. Likewise, I called specialists who counselled me on managing atrial fibrillation or acute renal failure when the weather closed in and we couldn’t transfer the patient to a larger centre.
Twelve years into my career, in 2000, I applied to Médecins sans Frontières. My first mission was in Taliban-ruled Afghanistan where women and girls didn’t go to school or work outside of the home. They couldn’t even inherit property. These conditions are similar to those implemented by the Taliban in 2022. Despite these challenges, I wound up returning eight times over the next decade. I was drawn to the warmth and open heartedness of the people I met. Early on we adapted our programs to be consistent with Taliban rules. Our clinic had separate male and female sides. We never talked about family planning or contraception. Instead, we called it “birth spacing,” which emphasized how important it was for the health of both mother and baby to allow a woman’s body to rest sufficiently between pregnancies. During vaccination campaigns for measles and polio, even though most villagers hadn’t been to school and didn’t understand germ theory, they accepted our offer of a jab that promised to prevent their young from getting sick. On later trips, my teams built remote clinics and trained midwives. And during my last visits to the country, I helped the Afghan government improve maternal and child health nationwide.
One of my favourite memories of working in Afghanistan was modelling for men what an educated woman is capable of accomplishing, which inspired some fathers to send their daughters to school. I consider that effort as having a lasting impact even when current events in Afghanistan threaten to destroy many of the recent gains. My memoir, Hand on my Heart: A Canadian Doctor’s Awakening in Afghanistan that was published in 2023 describes my own growth while practising medicine in creative ways that valued and honoured cultural differences while striving to provide the best care possible – a vision that informs my work to this day.