Surgery no matter what is impressive. In a place like South Sudan, with barebones technology, intense heat and undertrained local staff it's no longer impressive but simply heroic. When I was there (Dec. 2006 - Apr. 2007) Ler Hospital was the surgical referral centre for the entire South Sudan mission. A majority of the cases were thus from the other MSF projects with a steady trickle from the surrounding region. The surgeon, Carmen Orlotti, occasionally assisted by Dr. Philip D. Almeida, could deal with everything from fractures, amputations, spear wounds, general trauma to complicated obstetric cases.

Highly technical medicine like surgery can sometimes be poorly understood in a place like South Sudan and the skepticism can increase when the surgeon is a woman. The acceptance and commitment of her staff and the near universal appreciation from patients are a testament to Carmen's character as much as her competence. It is a paradox that you meet just as few humanitarians doing humanitarian work as you do doing any other job. The true examples are few and far between and when you do finally brush up against one you feel very very lucky.

These are photographs of one such example. There's nothing gruesome but some are graphic so proceed with caution.