Dreaming up a Borderless World

Dr. Richard Heinzl pokes his head out of the open front door of his home in an upscale neighbourhood in Oakville, a stone's throw from Lake Ontario and the yacht club. It all seems pretty conventional, just the sort of neighbourhood you'd expect a physician and past company CEO to live in.

Heinzl's home stands out among the street's gargantuan mausoleums and wedding cakes, legions of landscapers carefully pruning their poodle-like shrubs. His house is a tidy and modest bungalow, one of the last originals.

Heinzl takes me around to his large, slightly overgrown backyard and shows me the elaborate treehouse he made for his sons. "It's the first thing I've ever built," he tells me. We climb the ladder and settle into a couple of salvaged chairs, set our take-out coffees on an old peeling table and prepare to talk about his work.

"I never really wanted to have a job," he says.

It's a strange admission coming from the guy who, fresh out of medical school and against all advice, started the Canadian branch of Doctors Without Borders/Médecins Sans Frontières (MSF).

"What I really wanted was an adventure." Heinzl continues.

So much for conventional.

Heinzl is one of those people who, through a curious combination of massive preparation, and throwing caution to the wind, has managed to make his life an adventure. He says the preparation part started early on, finding out as much as he could about the medical field, talking with neighbours and family members who were doctors, always finding jobs in medical labs, volunteering at hospitals.

Throwing caution to the wind started early on as well. At seventeen he woke up one morning and decided to hitchhike from his family's home in Hamilton, Ontario, to the east coast of Canada. Heinzl says he just walked downtown, stuck out his thumb and away he went.

"I kept doing stuff like that," he laughs. "I would save up every summer—I would do a split. Half the summer, I made money. In my case it was at a hospital, working in a lab and pointed in the direction I wanted to go academically. The other half was free travel time and I'd go off to Europe with 500 bucks in my pocket and sleep in parks and see the world."

Wanderlust seems to run in Heinzl's family, and stories of his grandfather emigrating from Austria, and a trip his father took to see bombed-out Europe immediately after the second world war, sparked his imagination. "It just seemed like the coolest thing you could possibly do was travel the world," he says.

In fact, it was a random foray into war-ravaged Uganda some years later, and a chance meeting with a group of MSF doctors, that galvanized his idea of establishing MSF in Canada. Heinzl, then a young first year medical student at McMaster University, had arranged a work placement in Nairobi, Kenya. After spending several months getting through the straightforward medical work required by the faculty back at McMaster, Heinzl felt he wasn't getting to see the whole picture.

"At a certain point, halfway through, I still hadn't done the thing I wanted to do and that was to get to the poorest places in the world—at least in my head. So one day, I left and just went straight west to Uganda."

At the time, Uganda was a shambles. President Milton Obote had just been deposed after a vicious civil war between his government forces and National Resistance Army rebels led by Yoweri Museveni, Uganda's current president.

"In my pocket, I had a letter of introduction from somebody who worked at the UN, and I had the name and address of a Canadian couple who worked at the university in Mulago [in Kampala]. I got to the border and the most remarkable thing happened. There wasn't a border. I left the Kenyan side and there were people there checking passports, but on the Ugandan side, the door swung open and nobody was there. I walked, completely unchecked into a foreign country and hitchhiked a ride."

On the other side of the non-existent border, Heinzl noticed that people were extremely thin. Starving. Bomb-craters big enough to hide a bus forced his ride off the road and into the jungle every twenty metres. "I'd never seen anything like that before and I couldn't believe it. I could not believe what I was seeing—couldn't believe that this happened in humanity. You can try to prepare yourself, that that's going to happen, but until you feel that...for me it completed something—about just how bad it can get." He says it was that experience that cemented his ideas about health—and how war destroys all that is necessary for good health.

Heinzl says he remembers when he was around 18, a friend told him about MSF, that it was like the French Foreign Legion of medicine. "He told me, 'If you want to do medicine to the ultimate degree, you have to work with this group.'" Then, in Jinja, Uganda, on his way to Kampala, an old Land Cruiser rolled up, flying an MSF flag and carrying a bunch of Belgian doctors. They had been risking their lives in areas that were off limits in order to provide medical assistance.

"To me it was like—these people are normal—they're not wearing ties, they don't have stethoscopes around their necks, they're having fun. They're also working hard, but they're getting a ton out of it. It seemed to me that they were living a dream and I wanted that. I wanted to work in the rough area of international health. I really didn't know what that was, so I brought myself as close as I possibly could to that world so I could clarify stuff, so I could see what was there. And it confirmed that I wanted to do something there."

"We just went for it, even though everyone was telling us, 'take your time, do it the right way, have more meetings about it'."

It wasn't until he finished med school that Heinzl was actually able to get things rolling with establishing MSF-Canada. He rounded up two friends, Toronto lawyer, Jim Lane, and Marilyn McHarg, now incoming executive director of MSF-Canada, and the three of them began gathering support. They operated on a shoestring. Their office was half a table and a phone, lent to them by Peter Dalglish of Street Kids International.

MSF in Europe wasn't particularly supportive in those days. Heinzl recounts that early on, he was told that he couldn't just start up an MSF chapter in Canada when he hadn't even worked on an overseas mission. "So we said okay, we'll sneak over. And we did—I went to Mozambique and later Marilyn went over to Africa. We didn't know any better. We just went for it, even though everyone was telling us, 'take your time, do it the right way, have more meetings about it.'"

Finally, in 1990, they succeeded in establishing MSF-Canada and a year later, Heinzl became MSF Canada's first volunteer and headed off on a mission to Cambodia. Since then, he has been on missions to Iraq, Malawi, Vietnam, Thailand, and brief stints at head-office in Holland.

***
Of course, experiences like Heinzl's first eye-opening trip into Uganda have a way of raising more questions than answers, of shifting your perspective on what you thought you knew. For all his interest in international health, Heinzl suddenly wondered how a person could, in fact, make a difference in a situation like that. "Do vaccine programmes really work in places that are this badly off? Maybe you should just be a surgeon and try to save one person at a time. Or maybe it's all wrong. Maybe there's no role for us from the outside. Maybe we've got bigger stuff to do back home."

Heinzl admits that he struggles all the time with those questions. Nearing the end of an MSF mission in Cambodia—his first—he asked a Cambodian doctor he had been working with, "Have we done any good at all? Because it seems like things are getting worse—the problems are too big."

He says the doctor just laughed and, pointing at the sky, said, of course they'd done good. The last westerners who were here came in B-52s dropping bombs.

Over the years, the "Without Borders" tag has become something of a cliché. There are Teachers Without Borders, Engineers Without Borders, Grant-makers Without Borders, even Clowns Without Borders. Having travelled to 75 countries (and counting), Heinzl says that the people who first chose the name meant it. He says that travel has a way of breaking down the barriers between countries and allowing a person to see that in many ways, people are the same all over the world.

"I would say that travel really should be a part of everyone's education. It doesn't have to mean you go to a war zone in the middle of Africa, but after you finish your high school, or during your undergrad, or before you start grad school, or a career that's going to take up most of your life, go somewhere."

"People who go with the attitude that they're going to save the world—totally idealistic and giving—guess what? They're going to burn out."

Travel shakes us up and takes us out of our rooted ways, says Heinzl. It allows us to more fully comprehend the realities of what people in other parts of the world are experiencing, the good and the bad. It opens your eyes, gives you a new laser-vision that allows you to see the world in a whole new way. "I guarantee that'll be as valuable as any economics 101 course that you take or any text book you read."

Heinzl has seen more than his fair share of needless death, mothers lined up in the remote mountains of eastern Turkey, their dead children wrapped in blankets, waiting for the doctor to confirm what they already know. But he insists there is another side to humanitarian work that people don't often see: the incredible people; the life stories that you can't believe are real; there is camaraderie, challenge—and laughter.

"Some people think that it's all just giving and sacrifice with these humanitarian things," he says, "especially with MSF. A lot of us are just total jokers, we're just having a blast. Yeah, we're doing the good stuff, but we're getting so much out of it. We're having fun, it's a huge challenge. It's real in that sense. People who go with the attitude that they're going to save the world, totally idealistic and giving—guess what? They're going to burn out. It's not real. You can't sustain it."

These days, Heinzl is still working toward a borderless world, but not necessarily from inside a war zone. In recent years, he's been involved in developing online technologies to provide medical information and second opinions wherever they're needed, whenever they're needed. His passion is obvious when he talks about the difference between the old days out in the field with a handful of doctors and the few heavy text books they could carry with them, and the possibilities that exist now. The internet, he says is a great leveller, allowing valuable resources to be made available everywhere in the world at a low cost.

Images of diseased organs, results of blood work, medical histories, everything can be digitized and sent to specialists for analysis and second opinions, to and from anywhere in the world.

"This doesn't only happen in the big fantastic hospitals on University Avenue in Toronto. It happens partly there, but also in the Arctic, or the savannas of Tanzania. And with a satellite hook up, the Arctic and Tanzania are just as close, sometimes closer than being on a different floor of the Toronto General Hospital."

Long before the internet existed, he says, he and the other doctors who were working in the developing world, making do with little more than the resources and knowledge they carried between them, were dreaming up the internet.

Dreaming things up is what it's all about for Heinzl, from dreaming up a career as a doctor in international health, to dreaming up the idea of establishing MSF in Canada, to dreaming up a system for sharing medical knowledge between the most advanced medical centres and the most remote field hospitals. Ask him for his best piece of advice and he'll say: "Dream it up. Dream as big as you want. As wild and crazy as you want. As idyllic as you need it to be. Then take the concrete, rational steps you need to take to get to the dream."

Produced with the support of the Government of Canada through the Canadian International Development Agency.