‘Medicine is a vocation, not a job for the faint-hearted’by Clare de Lore
Northland’s medical officer of health is leaving these shores for the bright lights of Paris and another challenge with Médecins Sans Frontières.
Although 53-year-old Mills describes herself as a “bit of a wimp”, she has repeatedly put herself in the line of fire and disease in a medical career that has spanned three decades and several continents. Her work with MSF (aka Doctors Without Borders) and Save the Children has taken her to some tough places – South Sudan, Zaire (now the Democratic Republic of the Congo), Mozambique and Papua New Guinea.
At the end of this month, Mills is leaving New Zealand again, this time for a global leadership role in Paris with MSF, an NGO she knows well, having been medical director of its Amsterdam office for several years, directing teams in numerous trouble spots. MSF, which won the Nobel Peace Prize in 1999, has about 30,000, mostly volunteer, medical staff working in dozens of countries.
The daughter of Anglican vicar Murray Mills and his teacher wife Judy, Clair has four siblings, including her twin, Stephanie, the communications director for the primary teachers’ union, the NZEI, and well known for her Greenpeace work.
Clair and Stephanie were born in Whangarei, and after several moves, the family settled in Hamilton during their high school years. Clair loved French, English and playing the piano, but took a science path to differentiate herself from her twin, who was doing an arts degree.
When did you realise medicine was your calling?
Stephanie was doing arts for School C, so I did something different – chemistry and physics. I wasn’t that good at those – my French and English marks were what got me into medical school. Don’t get me wrong, I was smart enough to get into med school, but I was quite keen on music and I had thought if I didn’t get into medical school, I’d go down the arts path. It wasn’t until I got to the clinical years that I really thought, “Yes, this is what I want to do”, because I like talking to people and listening to them. Medicine is a nice combination of science and arts.
What’s the attraction of working in the gritty area of public health and sometimes in conflict zones?
I wouldn’t be very excited about working in public health if there weren’t some decent challenges. That applies to working here in Northland to some extent and in regard to my new job. MSF is the kind of organisation I like, with a lot of internal debate and discussion about humanitarian issues as well as innovation and research. Obviously there are some insecure and difficult places to work, but we also have some big TB programmes in Eastern Europe. And some HIV programmes in the more stable parts of southern Africa.
Is there a common thread in the work you’ve been doing in Northland and overseas?
The common thing is being interested in trying to make sure people who have the least get a bit more. I am someone with an enormous amount of privilege, and it is important to remember that. A manager once said to me, “The nice thing about you, Clair, is you always think about it from the patient’s point of view”, and I thought, “Well, why wouldn’t you?” Too often services are designed around the needs of the specialist or the health staff, not the needs of the people. I remember saying to someone once, “I can get my hair cut on a Saturday morning or Thursday evening and it doesn’t cost me any more than a Thursday morning, so why can’t I have a smear done at those times and not pay more?” GPs are the most heavily subsidised business in the country and it is not good enough.
You’re not impressed by the attitude of some of your colleagues.
Some of them have a big sense of entitlement. As doctors, we should be prepared to be professional and take on leadership roles without thinking we should be paid for every hour we work. Medicine is a vocation, not a job for the faint-hearted; I know this is a bit of a minority view these days. People are entitled to good working conditions, but it is the sense of entitlement and not even recognising their own privilege that I find objectionable.
Northland is one of the country’s poorest areas. What’s it been like in your time as medical officer of health?
When I started, I was shocked by the level of institutional racism and inequity and lack of urgency in addressing it, or even acknowledging it existed in many places. I worked in Whangarei as a house surgeon and as a GP, so it’s not like I didn’t know the north, but I had done more study since then and seen more of the world; the normalisation of things that shouldn’t be normal bothered me and I still find it difficult. Kids grow up so quickly. I have been here six years and kids born six years ago – their formative years are over and what have we made better for them? Hopefully, they won’t get rheumatic fever, but there is still so much more to do in terms of child poverty or intergenerational poverty, and there is a need for economic development.
How is the rheumatic fever problem now?
In Northland, every kid at school knows about rheumatic fever and sore throats and takes that message home to their parents. That has been successful. It hasn’t changed the poverty or the housing, but there are a lot more throats being swabbed. GPs are taking twice as many [swabs] as they used to two years ago. There is much more awareness and treatment of sore throats.
You were called in to sort out the delivery of healthcare in Sierra Leone during the Ebola epidemic. How do you look after yourself in a situation like that?
My biggest concern with Ebola was not so much for me. I did, of course, go into the treatment centres and work with patients, but I was medical co-ordinator for the programme and my biggest fear was staff getting infected. It was hard to manage. You don’t want to get it yourself, of course, but you can control that to a large extent; you can’t control what happens to everybody else.
Why was the Sri Lankan mission so frightening?
I am more frightened of guns or things that fall out of the sky and hit you on the head, such as shells, than I am of Ebola. I am a bit of a wimp all round. I had a team member who’d been through the siege in Sarajevo, and she slept through the shelling in Sri Lanka while I sat on the doorstep in the middle of the night wondering what the hell I was doing there. It comes home to you when you see shelling victims coming into hospital, so again it is the sense of responsibility for other people I find more worrying than my own safety.
You’re leaving Matapouri for Paris. How are you preparing for the job?
I am trying to read a book I thought sounded interesting, but it is far too intellectual for me. It is called How the French Think. I assumed it was about the peculiarities of French life, but it is by an Oxford intellectual, Sudhir Hazareesingh, and it’s about the philosophical and intellectual history of France. I feel incredibly ignorant, because I don’t know anything about Descartes and hardly anything about Jean-Paul Sartre. It’s made me think more about the strong intellectual side of France.
How’s your French?
I am trying to read in French – I need to improve my French. I worked in Congo for three years, so I got quite fluent, but it is Congolese French and I also have some Belgian-isms. It is going to take me six months to get comfortable. International meetings tend to be in English, but the Paris office is French-speaking and meetings are in French. One of the reasons I am keen on the job is to improve my French.
Do you read in English when the French gets a bit much?
I try to read New Zealand writers, and just read Glenn Colquhoun’s latest book about doctors. It is called Late Love: Sometimes Doctors Need Saving as Much as Their Patients. I liked his poetry first and I like the way he writes about some of your inadequacies as a doctor.
What are you looking forward to about the move to Paris?
I live in a most glorious place [Matapouri], but it is a long way from the city. There are some city things I really enjoy and will get to do in Paris, such as going to concerts and art galleries and being a bit anonymous. Here, everyone knows who I am.
What will you miss most?
It is home, so it is people and place and the sense of familiarity, and having a swim on my way home from work. But it is only a three- or four-year contract. I am totally a Kiwi, so I can’t imagine living away from New Zealand long term. I would always come home.
This article was first published in the April 15, 2017 issue of the New Zealand Listener.
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