In the rare free moments she has had this year between visiting Ebola centres in west Africa and pleading for support in front of the UN, Dr Joanne Liu, international president of Médecins Sans Frontières, reread The Plague by Albert Camus. Unsurprisingly, it had extra resonance this time. She was particularly struck by the narrator Dr Rieux’s statement that he keeps going because he has never managed to get used to seeing people die. Telling me this, she pauses. “I think today it’s one of our problems. Somehow we got used to death and then we dehumanised it. We account for conflicts in figures. Ebola is 13,500 infected, 5,000 people have died… People are losing their sense of empathy, their sense of wanting to do something.”
身为无国界医生组织(MSF)的国际主席，廖满嫦医生(Dr Joanne Liu)今年颇为忙碌，她不时要前往西非的埃博拉疫区，还要赴联合国(UN)请求支援，不过她还是忙里偷闲重读了阿尔贝•加缪(Albert Camus)所著的《鼠疫》(The Plague)。不出所料，这次阅读让她感触更深了。她尤其被书中的叙述者李欧医生(Dr Rieux)的自白所打动：他之所以能坚持下去，是因为他始终不习惯看到人们死去。说到这里，她停顿了一下，接着说道：“我觉得这是我们现在的一个问题。我们不知怎么就习惯了死亡，在对待死亡问题上变得没有了人情味。我们用数字来说明事故。埃博拉病毒已造成13500人感染，5000人死亡……人们正在失去同情心，没有了想要做点什么的心思。”
No one can accuse MSF or the woman who leads it of that. Since the current outbreak of Ebola was confirmed in Guinea in March, the organisation has worked with more than 6,000 patients, manning the front lines in west Africa for months before the world started to take notice. MSF realised this epidemic was different from previous ones almost immediately. “Our experience [with Ebola] is that it’s in a remote village and the chain of transmission dies very quickly . . . That’s it. It’s over in less than three months,” says Liu. “This was different because it was geographically spread.” But the international community didn’t want to know: “We were told that we were getting too excited and ringing the alarm when everything was under control.” Matters were complicated by the sheer number of global crises demanding attention this year. “There was South Sudan and the Central African Republic [CAR] . . . DRC . . . Ukraine . . . and then Gaza was a full-blown crisis in July.”
对于这种状况，没人能指责MSF或是这位女主席。自从3月份几内亚证实爆发了埃博拉疫情以来，该组织已经接治了6000多名病人，在其坚守西非前线几个月后世界才关注起这次疫情。MSF几乎立刻就发现，此次埃博拉疫情不同于以往。“根据我们的经验，埃博拉疫情一般发生在偏远村庄，传播链很快会中断……就是这样。疫情会在不到3个月内结束。”廖满嫦称，“而这次爆发的疫情并不一样，因为病毒能在地域间传播。”然而，国际社会并不想了解其中究竟。“我们听到的说法是，我们过于激动了，大惊小怪，其实一切都在控制之下。”今年国际上发生了太多需要关注的危机，这使事情变得复杂。“有南苏丹内战和中非共和国政变……刚果民主共和国……乌克兰……接着是7月加沙地带全面爆发的危机。”

MSF works in all of those places, with more than 32,000 staff in 67 countries last year. Founded in 1971 and largely privately funded, it provides independent humanitarian aid while bearing witness to what it sees on the ground.
MSF在所有这些地方都在运作。该组织成立于1971年，大部分经费靠私人捐助，去年成员总数超过32000名，遍布67个国家。MSF提供独立的人道救援，同时也现场见证各种灾难。
Liu only became international president in October 2013. It seems an understatement to say it’s been a tough first year on the job. “It has hijacked all my life,” she laughs. When thinking about how best to describe it, three words keep coming back to her. Challenging — there have been so many places needing attention. Overstretched — the whole sector has reached its limits. And gap — a hole has been exposed in people’s ability to respond. “We’ve been running behind a train that is moving faster than the response has been in west Africa since the beginning,” she says.
廖满嫦于2013年10月才出任MSF国际主席。如果说任期第一年是艰难的，似乎有些轻描淡写。“这份工作绑架了我全部的生活，”她笑着说。当她思考如何形容这份工作比较恰当时，脑海中不停地闪现三个词。挑战性——始终有太多地区需要关注。超负荷——这一领域已经达到了极限。差距——人们做出反应的能力暴露出了不足。她称：“我们就像一直跟在火车后头跑，与我们在西非做出反应的速度相比，它要快得多。”
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Liu was born in Quebec, Canada to Chinese immigrant parents. For her, MSF is a calling. As a teenager she read a book by a French doctor about his time with the organisation and that was that. “I remember reading that when I was young and saying, ‘Oh my god, this is a real life,’” she says. After her medical training she volunteered with the organisation repeatedly, spending time in the field from Darfur to Haiti and heading the Canadian branch. The opposite of self-promoting, she shows little interest in her own achievements: “I find myself a bit boring because I somehow always wanted to be MSF.”
廖满嫦出生在加拿大魁北克一个华裔移民家庭。对她而言，加入MSF是受到了感召。她年少时读过一本法国医生写的书，讲述他在该组织工作的经历。“我记得读那本书时我还很年轻，我说‘我的天啊，这才是真实的生活’，”她说。在接受过医疗培训后，她多次成为该组织的志愿者，在达尔富尔、海地等多个地方工作过，后来还负责加拿大分支。对于个人取得的成就，她非但没有夸夸其谈，反而显得不太乐意提起：“我觉得自己有点无趣，总是想着要当个无国界医生。”
Boring is not the word most would use to describe someone whose work, this year alone, has seen her travel to Syria, the CAR, Myanmar, the DRC and Sierra Leone among other countries, not to mention multiple trips to the UN and Montreal, where much of her life remains. Liu is a force to be reckoned with: the words flow out of her, punctuated only by the occasional “how you say” as she pauses to allow her French-English translation skills time to catch up with her brain.
因为这份工作，她仅今年内就去过了叙利亚、中非共和国、缅甸、刚果民主共和国和塞拉利昂等等许多国家，更别提还多次前往联合国和蒙特利尔（她主要生活的地方），对于这样一个人，多数人都不会用“无趣”来形容。与她交谈需要集中精神认真应付：她侃侃而谈，只是偶尔插句“你怎么说”做个停顿，给点时间让自己法译英的技巧赶上大脑思考的速度。
This is a woman who, while based in Switzerland, planned to spend her August holidays doing shifts in the Canadian hospital with which she remains associated as a paediatric emergency physician — “to keep a clinical hand in”. Ebola put a stop to that but she is determined to find somewhere to practise in Geneva. She laughs when asked how she fits it all in. “I feel that [in] any position of this kind of exposure and commitment, you have to accept that you won’t be as balanced as you would like. I always think of it as a privilege, an honour.”
常驻瑞士，却计划着利用8月份的假期在加拿大医院（她仍然是该院的儿科急诊医生）轮班——“要保持临床的工作”，她就是这样一个女人。埃博拉终止了这一计划，但她决定在日内瓦找个地方继续执业。当被问到如何适应这一切时，她大笑起来。“我觉得，处在这种要面对公众、肩负着使命的职位上，你就得接受一个事实，你没法做到像你希望的那样，各个方面都兼顾到。我总是把它看作一种殊荣，深感荣幸。”
Her relentless travel schedule has also served up some difficult insights. “Our humanitarian aid system is sick and needs to be fixed. It needs to get a reality check and get back humanity,” she says. She recounts with disdain a supposed DRC success story about a displaced woman with the resilience to support herself. It turned out she had become a prostitute. “I can’t believe that you’re giving me that . . . That’s resilience for you?” she says, then mentions another visit to a displaced persons camp in the CAR. “People were talking to me with their two feet in mud. And I said, ‘This is not possible, that in the 21st century we still have to see that.’ And that for me is really a call for how can we do better? . . . Can I stand on a spot where I don’t have my two feet in water?”
不停出差也使她得以深入了解情况。她称：“我们的人道救援体系出了问题，需要被修复。这需要进行一次现实检查，重新回到人道主义的宗旨上。”她以不屑的口吻讲了一个发生在刚果民主共和国的故事，一个无家可归的妇女，坚强地自力更生养活自己，被视为一个成功的援助案例，结果发现她已经当了妓女。“我不敢相信你就拿这个回报我……这就是你的坚强？”她称，接着又提到了在中非共和国一次探访难民安置营的经历。“人们跟我说话时，两只脚还踩在泥里。我说，‘这不可能，都21世纪了我们还能看到这种情况。’这使我认真思考，我们怎样做得更好？……我能站在一个不用把双脚踩在水里的地方吗？”
MSF is not necessarily the popular kid in the humanitarian aid playground. For one thing, it is unusual in having financial autonomy: 89 per cent of its funding comes from individual and private donors. The flexibility that such independence brings also ushers in critics. “Some people say that sometimes we’re a loner, and I accept that. And some people say we’re arrogant and it happens and I’m quite aware of that,” says Liu. “But it’s important to be self-sustaining because that’s what gives you the capacity to respond quickly.” In the case of Ebola, this meant arriving on the spot while others were still having meetings.
在人道救援圈子中，MSF未必是受欢迎的。拥有财务自主权是该组织与众不同的一个地方：其89%的资金来自个人和私人捐助者。这种因为财务独立而具有的灵活性也招致了批评。“有些人说，有时我们是孤单的，我同意这个说法。还有人说我们是傲慢的，确实是这样，我也相当清楚这一点，”她说，“但是自给自足很重要，因为这才使你拥有迅速反应的能力。”以埃博拉疫情来说，这意味着，在其他人还在开会讨论时，MSF便抵达了疫区。
Once in the thick of something, MSF stresses the importance of staff sharing what they see. So Liu stood up repeatedly in front of the UN and begged for boots on the ground, rather than mere promises. “I think that when people heard MSF say we were losing the battle, it was a bit of a shock for everybody.” Still, she feels it was the return home for treatment of two infected American missionaries in August that really woke people up. “All of a sudden it was knocking at our door . . . these were our neighbours, these were our colleagues, these were our people . . . And when it changed from them to us, then it got traction,” she recalls.
每到形势最紧张的时候，MSF会强调成员们分享各自见闻的重要性。因此，廖满嫦反复向联合国请求采取实际行动，而不仅仅是口头承诺。“我觉得，当人们听到MSF说我们正在输掉这场战争时，每个人都有点震惊。”然而，她认为，直到8月份两名受感染的美国传教士回国接受治疗时，人们才真的醒悟过来。“突然间，它就敲响了我们的家门……这些人是我们的邻居，我们的同事，是我们的同胞……而当‘他们’变成‘我们’时，才引起了关注，”她回忆称。
For Liu, the effect of such proximity was not surprising. Indeed, she thinks the closeness that most MSF workers have to situations propels them to act. For these doctors, it’s not just nameless people in a far-off country who are dying but the cousins of the nurse who has been with them since the beginning of the epidemic. MSF employs a ratio of about 10 national staff to every international member and Liu believes they are the true heroes. “To do it for four weeks [the average international staff placement] is straining but to be living with Ebola for the last eight to nine months, it’s really, really hard,” she says. “Most of our staff have either lost family members or friends, as well as living in the constant potential fear of being exposed.” Thirteen have died so far.
在廖满嫦看来，近距离接触疫情所产生的这种影响并不令人意外。事实上，她认为，多数MSF工作人员因为接近疫情，驱使他们采取行动。对这些医生来说，将死的不是在遥远国家的无名人氏，而是自疫情开始一起做事的那位护士的表亲。MSF从每个国际成员国聘请约10名医生，廖满嫦相信他们都是真正的英雄。“连续做4周工作（国际员工的平均安排）的强度很大，但在过去8-9个月里面对埃博拉，这真的很难很难，”她称，“我们多数人员不是失去了家人，就是失去了朋友，还要生活在可能暴露在病毒中的恐惧中。”目前为止，已有13人死亡。
Liu is fiercely protective of the people that she works with: “What makes MSF, the strength of us, it’s our people.” In April, the organisation lost four staff in an attack on hospital grounds in CAR, and the question of how best to work in increasingly dangerous contexts — Syria, Libya, South Sudan, Somalia among others — remains unresolved. “Hospitals being targeted, patients being targeted, ambulances being targeted . . . the last spot that was supposed to have a minimum of respect has been violated in 2014,” she says. She believes it critical that MSF maintains a hands-on presence. How precisely that can happen will be one of her focuses in 2015.
廖满嫦对一起共事的人有强烈的保护欲：“是什么成就了MSF，我们的力量，是我们的人。”4月，中非共和国的医院遭受袭击，该组织失去了4名员工，而在越来越危险的环境——叙利亚、利比亚、南苏丹、索马里等等——如何更好开展工作的问题仍然没有解决。她称：“医院成为袭击目标，病人成为目标，救护车成了目标……这些原本应受到最起码尊重的仅存之地，在2014年被侵犯了。”她认为，MSF保持亲临现场是至关重要的。如何确实做到这一点，将成为她2015年的工作重点之一。
And what about that Ebola train? Are we still running behind? “I think that what is happening now in some places is we’re jumping in the train and trying to get hold of the brake,” she says. “What has been the hampering, the hindering factor is fear . . . People are scared to deploy, scared of being infected.” Her hope is that the episode will teach the international community that someone needs to take responsibility before such a crisis escalates again in the future. “We all know that if the world had woken up in the spring, we wouldn’t be where we are today.”
那么“埃博拉列车”怎么样了？我们仍然跟在后面跑吗？“我想有些地方的情况是，我们跳上了火车，并试着控制刹车，”她称，“一直以来的障碍，造成阻碍的因素是恐惧……人们害怕采取行动，害怕被传染。”她希望这件事将使国际社会明白，有人需要担起责任，以防未来这样一场危机再次升级。“我们都知道，如果世界在今年春天能警醒，我们就不会处在今天这种局势。”
When we talked, Liu was about to get back on a plane to west Africa to reassess the situation. MSF is hosting trials there and she is determined to make sure that any new treatment will be accessible to those on the ground. (On her return she will speak out about the potential for a double failure, both initially and now in adapting the response.) For her, the most crucial thing is keeping the world’s attention. “It’s like when you’re sick and you have pneumonia and you’ve been given antibiotics for 10 days and then you start to feel better after three days and would like to stop taking your antibiotics,” she says. “We’re just getting ahead of the game. We need to finish.”
我们谈话时，廖满嫦准备乘机返回西非，对埃博拉疫情进行重新评估。MSF在那里组织试验，她决心确保任何一种新治疗手段将能被用于处在疫情中心的人。（回去后，她将阐述双重失败的可能性，包括最初的应对措施和现在的对策调整。）对她来说，最重要的事情是让全世界的人继续关注疫情。“就好像你生病，得了肺炎，医生给你开了10天的抗生素，刚治了3天你感觉有所好转，就想停了抗生素，”她说，“我们刚要在游戏中占得优势。我们要完成它。”
Alice Fishburn is the deputy editor of FT Weekend Magazine
本文作者为《FT周末杂志》(FT Weekend Magazine)副主编