| Jonathan M. Spector, MD FAAP
Doctors Without Borders
Jonathan Spector is a Boston-based pediatrician, and member of the Section on International Child Health, who has actively translated his global child health interests into clinical practice with Médecins Sans Frontières, or Doctors Without Borders.
Dr. Spector first traveled to the field with Doctors Without Borders in the fall of 2002, immediately following completion of his residency. Earlier that year, the staunch UNITA rebel leader, Jonas Savimbi, was killed and Angola appeared to have ended a civil war that spanned three decades. The provisional peace treaty that was subsequently agreed upon paved the way for humanitarian access to vast regions of the country that had been cut off from the outside world for years. U.N. agencies and NGOs were stunned to find large populations of displaced people clustered in areas completely unsuitable for sustaining life, areas without adequate shelter or access to water and food. In many provinces, very high levels of severe malnutrition were the critical factor pushing child mortality rates well above the emergency threshold of 2/10,000/day.
Doctors Without Borders assumed a lead role in the major international relief effort that rapidly ensued. Dr. Spector worked in Central Angola, in the town of Bailundo, at a large nutritional rehabilitation center treating approximately 500 children at any given time. This Therapeutic Feeding Center (TFC) approach provides severely malnourished children with their full nutritional requirements and medical support. The TFC offers two levels of care: an intensive 24-hour treatment area for initial management of the complications of malnutrition, and a day unit where nutritional treatment continues and medical follow-up is administered. In his four months on mission, Dr. Spector also cared for children suffering from a variety of tropical illnesses including malaria, measles, tuberculosis, scurvy, and filariasis.
Dr. Spector then returned to the field with Doctors Without Borders last summer, this time to West Darfur, Sudan. The political context was different (armed government-sponsored militia driving rural villagers from their homes), but health effects on the pediatric population were strikingly similar. Extreme living conditions and chronic food insecurity had led to high rates of malnutrition, diarrhea, and respiratory infections. Dr. Spector again worked in a TFC and pediatric ward; daily census averaged 100 children with thirty discharges and new admissions each week. As is the case with many relief projects abroad, Dr. Spector was joined by only a few internationals and worked primarily with a large number of local staff consisting of physicians, nurses, nutritionists, cooks, drivers, cleaners, and watchmen. The meaningful personal relationships that he developed with patients, fellow staff, and the community-at-large conferred an additional sense of import to the work he was doing.
Between missions, Dr. Spector maintains an active link with Doctors Without Borders by participating in conferences, workshops, and fundraising events. He notes that the organization is always recruiting pediatricians and can be reached by phone at 212/679-6800, or at www.doctorswithoutborders.org.