Médecins Sans Frontières (MSF) works in circumstances that are often hard to predict and which make supply choices difficult. Its goal is to provide uninterrupted treatment to its patients. Calculating the quantity of drugs to order involves finding the right balance between the demands of patient care, the shelf life of drugs and the level of waste that MSF is willing to tolerate in terms of expired or oversupplied medicines, given the specific circumstances in a crisis area. At the same time, not all the unused drugs in MSF projects are wasted. As a matter of policy, once MSF determines that it no longer needs them or cannot use them before expiry, it donates non-expired drugs to other NGOs or health ministries that can use them.

Damien Moloney joined MSF as a logistician in 2008. He has worked in Mozambique, Sudan, Kenya, Haiti and Niger. He recently finished an assignment in Chad, providing logistics support ahead of the anticipated ‘hunger season.’ Here, he talks about how an episode of ER changed his life forever.

Why did you decide to work with MSF?

I'm probably one of the only people in the world to say an episode of ER changed my life. I was watching a rerun of the show and two doctors were off working with MSF. It was all very dramatic: running from rebels, dodging exploding grenades and bullets. I'd done a lot of rescue and first aid work in the United States, and thought maybe the organization might be looking for someone with my skills. So I looked at the website and the more I read, the more impressed I was. I applied, was interviewed, and waited. And waited. When I finally got a letter I was so nervous, I couldn't bring myself to open it. Eventually I did and I remember doing my happy dance around my living room. I'm still smiling about how happy I am to be working for MSF.

You have just completed your sixth field placement with MSF. What has been the most challenging aspect and why?

There are lots of hard things about working for MSF: dealing with unforeseeable delays, country bureaucracy and red tape as we wait for lifesaving equipment and medication; walking around a refugee camp of 90,000 people knowing we live a life of luxury and privilege; going to work all day in 50 degree heat; digging ditches and putting up tents, only for the rain and wind to destroy them overnight, and having to do it all again the next day; watching children die from preventable diseases like tetanus; and watching them suffer from malnutrition when we have an over-abundance of food in the developed world. All these things, and about a thousand others. But – and it’s a huge but – I wouldn't change what I do for anything.

What has been the most enjoyable aspect for you?

There are a thousand difficulties working for MSF and a million joys. Possibly the most amazing thing is the staff, both international and national. We have the honour and privilege of going into a country torn apart by war, disaster or maybe drought and hunger, and together with local staff we make a small but significant difference. When I see a desperately sick kid come into the hospital, and see the mother’s worried face while the doctors and nurses treat her child, I know we will all do our best, just for that mother and child. The result isn't always happy, but when, whether it’s three weeks or three months later, that mother and her child walk out of the hospital, I know everyone – from the doctors and nurses, to the logisticians who made sure the oxygen was working, to the cleaner who swept the floor, and all the way back to the office staff in headquarters who sent us to the field and the generous donors who make our work possible – contributed to the health of that child. And while we may not be able to save the world, we saved the life of that one child, and for that mother, we saved her flesh and blood, her world. And that joy is impossible to replicate.

What exactly does a logistician do?

Imagine a doctor or nurse or surgeon in the field treating a patient. What do they need to help that patient? A building, to start with, so I work with local staff to build one. I've helped put doctors in tents and under trees with nothing but shade cloth over them, and I've worked to build a massive container hospital and complicated operating theatres. They need medication, instruments, beds, fans, so I order them. The logistics team makes sure cars, radios and computers work, makes sure there is electricity and clean water in the hospital and the house and that medication is kept cold. Sometimes I cook a barbeque and we all sit and chat and laugh over a beer and for a couple of hours, remember where we came from and why we do what we do. And the next day we do it all again!

What personal skills does someone need for this type of work?

Patience – lots and lots of patience. We have lots of patients; it’s the other kind you need! The ability to work hard, in the heat, in the dust, a long way from home. The ability to deal with frustration and despair. The ability to work and live in a team with different people and tolerate their foibles. You need understanding and tolerance, and at the same time the ability to stand up for what you believe in. Speaking another language helps, especially French or Arabic. For a logistician, knowing anything about electricity and construction will help. Mostly, you need to be able to search for, then at least offer a solution to, any number of problems that arise.

Are you planning to continue working with MSF?

I wish there was a nice way to put this, but I'm an addict! I can't imagine doing anything else. I'll be a logistician until I'm too old to bang a nail or crawl under a Land Cruiser. I get a physical sensation of joy from what I do. Not every day, and not all the time. But this is the most rewarding job I can imagine.