Chapter 1

Paul Whitaker sat in his shared office at New York-Presbyterian-Columbia and Cornell Hospital in New York City, going over his student loan situation. He’d graduated with honors from Harvard Medical School and finished his internship and residency at Johns Hopkins Hospital in Baltimore Maryland. He had been working at his current position for a year and it seemed he wasn’t making a dent in his student loan balance.

He came from a wealthy New York family. His father was a multimillion-dollar earning investment banker with JPMorgan Chase Bank. His mother was an operating room nurse where Paul was working at New York Presbyterian Hospital. His father told him he had to earn his way in life. Every bit of money his father was going to bequeath to him was in a trust that he couldn’t collect until he was thirty-five, or unless his father changed the terms of the trust. That’s how a rich kid from Scarsdale, New York owed two hundred thirty thousand in student loans. He was making 118k, but that isn’t what isn’t sounds like living in New York City.

He spoke to his father, and he said he’d investigate some alternatives for his son, and for him to come home for dinner and they would talk. James Whitaker wasn’t going to give in and make life easy for his son. He wanted to make sure Paul could make and handle money before he turned over his hard-earned fortune to him.

As asked, Paul arrived at their Scarsdale home at six-thirty for dinner with his mom and dad. His father handed him a packet that looked like a marketing portfolio with the red lettering that read Medecins Sans Frontieres, MSF [Doctors Without Borders]. James said to his son, “Turn to page 4 of the brochure.”

Paul did as instructed and read down the bullet points of benefits offered to physicians. It read, “Student Loan Forgiveness Program: Employment with MSF is considered Public Service and therefore qualifies for student loan forgiveness eligibility via the US Government’s Public Service Loan Forgiveness program (PSLF).”

Paul looked up and said, “Will they forgive all of my $230,000 debt?”

“It’s your lucky day, Son,” James replied, “the limit is $250,000 for signing a 12-month contract.”

“What’s the catch?”

“Well, they have had twelve staff members killed in Ethiopia this year. The job does have its hazards. That’s why the great benefit package, although the starting salary really sucks. They will only pay a starting salary for doctors of $2,039 per month. That’s only $24, 468 per year. What I will do, if you choose to sign a one-year contract with them, is pay you the difference to give you your current salary of 118k.

“As with all positions, as a newbie you won’t get the pick of the crop. But I would shy away from any place like Afghanistan. Besides giving you a better appreciation for life and empathy for the impoverished, it will also look pretty good on your resume.”

Paul studied the benefits package: paid vacation (25 days per year). Employer paid medical, dental & vision insurance for employees (not dependents), three-month extension of medical & dental insurance coverage post assignment just to name a few. It was an excellent benefit package. It was better than what he was now getting. Closing the booklet, Paul said as he set it aside, “I’ll give them a call tomorrow and set up an appointment.” I see that they have an office in New York on Rector Street.”

“Good choice, Son,” James commended. His mother, Marie, agreed and said, “We have a charge nurse who worked for them for five years. She said they are top shelf people and a great organization. She learned a lot in creative medicine having to do the impossible sometimes with little or nothing. It makes you a better clinician.”

The next morning, Paul called MSF when they opened at 9am. He spoke to Sally Childs, their chief recruiter, and set up an appointment for Thursday at 10am, two days hence. When he met with her, she was a tall, statuesque auburn woman of about thirty. Very attractive, smart, and savvy. As she looked over his resume, she commented, “Hmm, great credentials. The only drawback is that you’ve only been a practicing physician for a year. So, your specialty is pediatrics, correct?”

“Well, not exactly, Ma’am.” Paul replied, “actually a neonatologist.”

“Wow, even better.”

Sally stated, “The leading causes of infant mortality worldwide include preterm birth complications, the three major causes of neonatal deaths worldwide are infections (36%, which includes sepsis/pneumonia, tetanus and diarrhea), pre-term (28%), and birth asphyxia (23%). There is some variation between countries depending on their care configurations. Every year nearly 41% of all under-five child deaths are among newborn infants, babies in their first 28 days of life or the neonatal period. Three quarters of all newborn deaths occur in the first week of life. The majority - almost 3 million of these - die within one week and almost 2 million on their first day of life.”

“Yes, unfortunately, here in America, we lose sight of those statistics. With today’s modern technology, we routinely save micro preemies of about 26 weeks.”

“That’s the point. Your expertise in neonatal care would be invaluable to us. You said you read through our brochure booklet, so I guess you know what the starting salary is, right?”

“Yes, I saw it. What I am basically looking for is a student loan forgiveness of 230K.”

“We can certainly do that for you. Do you have any idea where you might want to work? Like I said, all the cherry jobs are taken by staff that have been with us for many years.”

“I haven’t thought that far ahead, just that I don’t want to go anywhere like Afghanistan.”

“We have a desperate need in South Sudan in northeastern Africa. There have been some skirmishes in Ethiopia and the Darfur area, but it is very intermittent. Refugee camps are bloated, and children are the worst for wear in places like that. You will be working primarily with the Dinka and Nuer tribes. Are you easily shocked?”

“I would say no.”

“Well, the Nuer tribe are the blackest, darkest-skinned race on the face of the earth. Unfortunately, many don’t believe or know, but the Nuer are one of the most hated and targeted tribes based on color. Skin color racism and discrimination by Africans against Africans is fueling the genocide in Darfur, Sudan. They hereditarily have Hyperpigmentation, which refers to skin that has turned darker than normal where the change that has occurred is unrelated to sun exposure. Since independence, the official language of South Sudan is English, replacing Arabic, but the Nuer traditionally speak the Nuer language. and English. So, communication should be passable. Is this a place where you might be willing to go there and work your first year?”

“Sure, I have no issues whatsoever about skin color.”

Sally chuckled and said, “On that note, would you be willing to sign with us today?”

“Give me your card,” Paul replied, “and I’ll call you by next week at the latest. I want to talk to the Chief of Pediatrics and discuss severance and all that.”

“Fine. I’ll wait for your call.”

They rose, shook hands and Paul left for the hospital.

Paul went directly and spoke to the Chief of Pediatrics about his issue with his student loans and possibly getting the debt forgiven by signing a one-year contract with Doctors Without Borders. He was told that if he chose to go that route, he would sign off and recommend letting him out of his current contract without any penalties with New York Presbyterian Hospital.

He called Sally Childs that afternoon and they talked. He said to her “I read on your website that if I am eligible to apply through the U.S. office and I met your essential requirements, I could submit my application online. Otherwise, I would be directed to the appropriate Doctors Without Borders/Médecins Sans Frontieres (MSF) office. So, where do I go or how do you want me to apply?”

“Because of recent events, like the one in Ethiopia,” Sally replied, “We normally have you apply online, after which, you would be screened by a Field HR Recruitment Officer within four weeks of submission. But we have an immediate need in South Sudan. I showed your resume to our resident recruitment officer, and he would like you to apply online immediately so that we can get authorization for the reference check and criminal background check. Because we are an international company; we have our own resources for these checks, and they can be completed in less than twenty-four hours. If everything checked out, you’d be interviewed and would be asked to attend Information Days here in New York. Information Days is a mandatory training for those wishing to be accepted into the MSF-USA pool.

“Normally, you would go into a pool and await assignment. This would normally take up to five months. But because of our immediate need, if you passed everything, you would be offered a position on a team in South Sudan working with the Nuer tribe. There would be some Dinka, but predominantly with the Nuer.

“If your interview goes well with Dr. Jose Ramirez, you will be given an information packet on the Nuer African Tribe along with the status information pertinent currently to the area of operations. I would expect to spend about two hours filling out the detailed application online. It will take about thirty minutes or so for the interview. I would allot about three hours total for the process. So, Dr. Whitaker, when would you like to come in? I will be better able to assure you that Dr. Ramirez is available.”

“How about day after tomorrow? I’ll fill out the application online this afternoon.”

“Excellent. I’ll look for your application. By the way, may I have your contact information? I’ll get back to you after talking to Dr. Ramirez.”

Paul gave Sally his information and disconnected the call. He made afternoon rounds and checked the schedule to see when he was on duty for the next couple of days. He started filling out the application, and by 4pm, it was finished. He digitally signed the authorizations for the checks and closed out of the system.

The next day, Paul received a text from Sally requesting he call the office. He called her about thirty minutes later and she said that everything checked out and Dr. Ramirez would like to see him the following day at 10am, which Paul agreed to.

The following morning, Paul arrived about fifteen minutes early, and Dr. Ramirez was shaking his hand promptly at 10am. They went over his application in detail, but the doctor from Columbia probed for more information.

“Dr. Whitaker.” Dr. Ramirez began, “we don’t get too many doctors with your specialty applying these days. I can only guess what you’re making,”