Dr. Seth Queller was there to perform cleft-pallet surgeries at the clinic attached to the university. His dean claimed Seth’s French-language skills and his medical specialty would make it fairly easy for him to work there. He was already realizing this was not worth it that there must be another way. If there were any lingering doubt this was not worth it – it was about to be eliminated.

The president of the university sent his personal driver to get Seth from the airport, and it was this meek, young man who now waited for him. Standing there in an immaculately pressed yet noticeably over-sized dress shirt, way-too-pleated pants, and shiny, pointed shoes. Dr. Seth Queller didn’t know who he was looking for, but the driver easily identified Seth as his man. He was one of only 15 who got off the flight, and one of three white people. Seth was also the only person who didn’t have a colleague/driver/family member greet him as he passed the policeman slouching next to the clearly out-of-order ATM. The driver took Seth’s bag and led him past a metal detector from a previous era, now sitting only as a testament to the incapacity to repair such equipment in-country. They walked out of the domed structure, past the police and the soldiers with AK-47’s, large guns dangling tripods, and what he would soon learn were Rocket-Propelled-Grenade launchers. What struck him most was how scratched up and poorly taken care of the RPG looked, all scuffed and marked. He couldn’t help but think if he carried an armament like that he’d be more careful with it.They walked beyond the Toyota trucks with wooden benches lengthwise through the box to carry the soldiers. Beyond the cluster of white Land Cruisers, each with a huge antenna mounted on the front bumper, right next to the winch. Several had the flag of the Red Cross hanging limply, half-way up the antenna, the Red Cross logo also on the doors, and a massive logo covering one of the two spare tires on the back. Apparently, wherever they were going, they wanted people to know what side they were on. Onesphore the driver led him to a 10-year-old SUV that looked like it had previously belonged to someone who listened to a fair bit of late-90’s gangster rap. Burundi imported cheap, used vehicles from all over the world. This one had come from Dubai, and it showed. The gold-trim, ground-skirts, and custom grill looked out-of-place on a vehicle used to chauffeur around a short, svelte man in charge of a struggling Christian university. But then again, the university president’s penchant for shiny suits made that dissonance somewhat disappear. But the president of the university was not there, a slight not unnoticed. He would be repeatedly shoved to the side over the next few days. Kicked down a social pecking-order that neither recognized nor appreciated his talents, his publication record, his title, his reputation or the software. Not once introduced with his usual title he’d heard from podiums and by colleagues introducing him at parties, ‘Dr M. Seth Queller, Chief of the Bombardier Center for Facial Reconstruction, and associate professor of pediatric craniofacial plastic surgery.’ None of that seemed to matter to anyone here as he was routinely introduced as “a visiting doctor”.

A ‘doctor.’

Not even surgeonprofessor or anything with a shred of respect to it, but merely, ‘doctor.’ As if he peaked as some kind of nondescript med school grad that spent his days in a small clinic seeing runny noses and hemorrhoids.

But now this visiting doctor had bigger problems. The clinic where he was supposed to work was completely and utterly unprepared for his arrival in every conceivable way. The Bloc Opératoire (if one could even consider it an Operating Room) was a small, single room with a bed, a light with florescent bulbs, and a few carts clearly donated several years ago. There was no running water in the OR, or anywhere else in the hospital except for a few sinks upstairs. The power would shut down and a minute or more would pass until the generator kicked in. Anything resembling surgery would not be possible.

But there was a bigger reason why he could do no surgery. There were no patients. None. Somehow the Dean had been too busy running the medical school to notice that one of his Burundian colleagues who was supposed to be screening patients handed the task over to a group of three interns. One of those three fled to his native Rwanda just a day later as tensions continue to mount between the two countries. The remaining two found everyone they talked to were put-off by the cost, so they gave up.

To say Dr. Seth Queller was furious would be a disservice to his ability to generate impressive levels of anger. He volunteered his time, to come to this god-forsaken place to do surgeries for free, and the stupid students somehow didn’t get the memo that the procedures would be offered to them at no cost. So now here he was, completely and utterly wasting his time.

“Get me on the next flight out of here,” he demanded. “I don’t care about the cost, or even if it’s on my preferred carrier – just get me out of here.”

“My dear brother” the president replied

“Seriously,” Seth thought to himself “if that guy calls me brother or dear one more time…”

“Actually,” the president continued, “there are only so few flights from our capital because of the current problems.”

In less than ten minutes of conversation with this man his penchant for using ‘actually’ as his default translation for the French word actuellement instead of the English world connoting the same meaning – ‘currently’ – was almost enough to make him snap.

“There are now only the flight that you just came on – which is actually leaving now. It comes every Friday and Sunday.”

Trapped. Completely trapped for the full five days.

The university sat in the middle of one of several areas that people referred to, almost kindly, as an ‘opposition neighborhood.’ The capital city had only a decade earlier been divided along ethnic lines, and much of that division still showed in the political allegiance of those in various quartiers of the city. He had seen nothing like this neighborhood in his life. Not even close. Seth traveled to Africa one time before, about 5 years prior, to Cape Town to receive an award one of his papers garnered from the International Academy of Pediatric Surgery. He flew in, was picked up by a driver, spent two nights at a resort on the coast, received his award, enjoyed a few grand meals, and left. He knew this had not been an exposure to ‘typical Africa,’ but he assumed several neighborhoods he drove past on his way to the airport gave him a sense how ‘the rest’ lived. This, however, was an entirely other universe. The only narrative he could connect this to were images on CNN with the words ‘military coup,’ ‘famine declared’ or ‘genocide’ superimposed on the bottom of the screen. There was one fundamental thing wrong, something that didn’t sit well with his white-privileged sense of those kinds of places. Crossing the street from the university to the clinic for the third time as they tried to figure out what happened to his cleft-pallet cases, he realized what it was. The people were not menacing, or threatening, but rather they looked rather normal, and many of them even happy.

“What do these people possibly have to smile about?” he wondered as he tried to keep up with the Dean Whickham as he darted across the dusty road, weaving between three-wheeled moto-rickshaws.

Seth had nothing to smile about here. Oppressively hot, sweaty, dusty, nine hours jet-lagged, only a bottle of room-temperature (that is, hot) local bottled water since he got off the plane a few hours ago.

“I’m sorry Dr Whickham, but this appears as though it’s just not going to work out – I’m afraid this has all just been a waste of time.” he said to the mid—50-year-old physician wearing cargo pants, sporting a safari hat, and sandals. A walking stereotype of a middle-aged lawyer from Minneapolis taking a once-in-a-lifetime trip to Kenya to see animals. “I’ll let Dr. Builllon know we tried, and maybe we can send one of my colleagues out if you can find a way to arrange the program…”

“You know Jacque and I go way back,” he interrupted.

It was shocking not only that this random doctor would know his Dean but that he would call him by his first name. It was unbelievable that someone who clearly couldn’t get a job and came over here on a religious crusade would even know of one of the leading experts in his field.

“Did you go to medical school together?” he asked, thinking of the only place they may have crossed paths.

“No no, he went to John’s Hopkins, I certainly couldn’t have gotten into there,” he said with a laugh.

Well, at least he knew his place.

“We published a few papers together…”

“Really,” he thought “this guy does research?”

“When we were on the certification board together…”

This guy sat on a board? This seemed unbelievable. As in, he did not believe him. So he pressed him, “What board?”

“Plastics,” the man replied. “From ’98-04.”

“You’re a board-certified plastic surgeon?” he asked, sounding more surprised than he intended to.

“Yeah – well I do a lot more general surgery here, but that’s what I started my career in. Jacque and I published several papers on post-operative recovery for maxillofacial interventions.”

Now he was more than surprised, he was shocked and confused. How did someone with board certifications, who published work that Seth was familiar with…

Suddenly, It was all coming together. This was “the” Whickham of the paper he knew almost by heart as ‘Whickham & Builllon, 1990, New England Journal of Medicine.’ Assuming this man could be that Whickham was so inconceivable Seth had not even considered it.

“I actually talked to Jacque last night – he told me you’d be coming, and that if anything went sideways, you’d probably say that. So I’ve set up something else for you.”

“We’ve got another hospital upcountry,” he continued as if the phrase ‘upcountry’ was supposed to mean something to him. “It’s not as big as this one, but we’ve got a great old doc up there who could use some help in the OR.”

Well if this guy who published in top-tier journals 25 years ago called someone else ‘old’ – he couldn’t imagine. “The hospital is not much to look at – but some good work is being done up there”

“Like this ‘hospital’ is something to look at?” he thought, barely capable of keeping the judgement to himself.

He remembered the decent looking resort hotels that sat on the lake, mere minutes from the airport. He’d get a driver to take him there, spend five days getting caught up on email, review data for his next paper, and call it done. However, if the committee that forced him to be here in the first place, found out he spent his time with his laptop pool-side at the only decent hotel in the country, this whole ordeal would be wasted. In fact, things would probably be worse, and he would have taken this horrific trip for less than nothing.

Besides, “How much worse could it be?”

He was about to find out.