Whether New Orleans or Sudan, Storm Zones Pull This Doctor In

Peter Reynaud is a guy who likes to be in the thick of it.

Shunning a conventional practice after medical school, he worked in New York public hospitals in Spanish Harlem. He immunized babies in Chiapas, Mexico, and then treated bacterial skin disease in Guinea.

After agreeing to go to the Democratic Republic of Congo for the aid group Doctors Without Borders, he was vacationing at his brother’s place in New Orleans when Hurricane Katrina hit. Within days, he was volunteering at a triage center beneath a freeway underpass.

He spent four months working in the relief effort.

“I guess I like the sense of adventure,” said Reynaud, 48, who now spends his days in this tiny border village on the Sudan-Chad border instead of Congo, putting him smack in the middle of the Darfur conflict.

He has traded a white coat for flip-flops and carpenter pants. Instead of a black medical bag, he makes rounds with a backpack over one shoulder and a stethoscope around his neck.

Adventure-seekers should have no trouble finding satisfaction in Adre, which has come under attack by Chadian rebels three times during the last six months. The local hospital, operated by Doctors Without Borders since 2004, serves nearby camps for Sudanese refugees and also sees a steady stream of victims from military clashes and attacks by the janjaweed, the Arab militias fighting in the western Sudanese region of Darfur and, lately, in eastern Chad.

As far as he knows, Reynaud is the only American here. It’s the kind of village where the local pharmacy doubles as a motorcycle repair shop. There’s no public electricity or running water, but the hospital gets power from a generator.

“We have the basics,” he said.

In April, Reynaud and his colleagues awoke to gunfire on the edge of town, as Chadian rebels attacked Adre on their march to the capital. The doctors huddled inside a makeshift “safe room” until the fighting subsided.

The gunfire, he said, wasn’t the hardest part. “Living in New York and New Orleans, I’m used to that,” he joked. Far worse was receiving the urgent radio calls from the hospital, which was flooded with casualties.

“When it was safe enough to go to the hospital, it was like a scene out of hell,” he said. “Hands blown off. Legs shattered.”

Home for Reynaud these days is a 10-by-10 room at a guarded compound. For fun, there are a squawking transistor radio and one local pub, Madam Lola’s, for warm beer. But with a 6:30 p.m. curfew and long working hours, there’s not much time for nightlife.

What’s the attraction?

He says it’s a chance to get firsthand experience with diseases that most Western doctors only read about, such as malaria, a top killer in Africa, or leishmaniasis, a tropical disease spread by sand flies.

The lack of sophisticated equipment and technology gives his diagnostic and reasoning skills a workout.

“It forces you to rely on your training to find out what’s wrong with a patient, not use a test,” he said.

On a recent afternoon, a local man was brought to the emergency room, disoriented and unresponsive. Back in the U.S., Reynaud said, he might have ordered a CT scan. But after consulting with local doctors, it was determined the man simply had low blood sugar due to malaria.

Other advantages? Out in the bush, he doesn’t have to shave everyday and no one nags him about his smoking.

Days begin with a five-minute walk down Adre’s sand roads, past the donkey carts and grazing cows. First stop is often the feeding tent, which cares for malnourished babies.

“He really loves the job,” said Pierette Madibeye, a Chadian nurse. For months, Madibeye said, she unsuccessfully pleaded with hospital administrators for money to brighten the tent with some toys or decorations. Reynaud, who arrived in January, paid for some plastic inflatable animals and cartoon figures to hang from the ceiling.

Language was a problem at first. Reynaud had some high school French, widely spoken in Chad, and spent three years in Paris between his undergraduate degree from UC Berkeley and Louisiana State University medical school.

“But he spoke with a funny American accent,” Madibeye said. His skills are improving, but he makes his rounds with a translator.

Inside the green-and-white hospital are the more serious cases.

A 5-year-old child had a large tumor in his abdomen and needed surgery. At first, his parents refused, preferring to use a traditional remedy by an African doctor. Then, after they consented, the operation had to be postponed when the Doctors Without Borders anesthesiologist abruptly died of a heart attack, just a couple of days after arriving in Chad.

Reynaud was most worried about a 3-day-old infant who had not eaten since birth. The only noises the little boy could make were grunts, barely audible through the mask of one of the hospital’s two oxygen machines.

The closest X-ray machine is a three-hour drive away, and without that, a diagnosis would be difficult. Then, the baby started bleeding intestinally.

“There’s very little we can do,” Reynaud said. “We’re trying to prepare the mother. I don’t think he’s going to make it.”

Death here is common, and relatives rarely look for someone to blame. But for Reynaud, the limitations are frustrating.

“We deal with a lot of cases that we can’t help,” he said. “I try to remember that we’re here on an emergency basis. But the pain you feel when someone dies is the same, no matter where you are.”