He was not alone. Many other young doctors like him were eager to do something more than treat patients in clinics all day. The timing of MSF’s establishment is a crucial part of understanding why it, and other humanitarian organisations of its kind, was so well received — Europe was emerging from an ugly, beleaguered past and ready to become a global source of comfort. Rufin explains this point beautifully. “For centuries, Europe was the place where there were wars, famines and epidemics. It was only late in the 20th century that Europe started to be at peace, rich and protected, and started to become generous. Before that, after two wars, we were only receiving aid, but after the 1960s, we could start to give as well. Most people involved in associations like MSF had been political activists and, at the end of the Cold War, felt deceived by their own political ideals. So, humanitarian action was like ground zero, or level zero, of what they could do without political involvement. The Cold War did not permit institutions dependent on public funds — like Red Cross — to provide aid. There was a possibility to be useful at the time and so a very small organisation became very large because they were responding to what was then a new world situation.”

In the late 1970s, MSF underwent a change in leadership that also reflected the growing differences of opinions within the ranks. While Kouchner believed that documenting and broadcasting the suffering in a particular country was the most effective way to solve a problem, incoming president Claude Malhuret felt that MSF should avoid criticism of the governments of countries in which they were working. Debates raged over the future of the organisation, and those who disagreed with the new leadership opted to leave MSF.
These days, his passion for the written word keeps him most occupied. Rufin’s past as a doctor actively colours his present in a most unique way, I discover. “When I started to write novels — which is more than 20 years ago — my problem was that, as a physician, writing fiction was difficult. When you take the Hippocratic Oath, you swear that you will see everything, know everything, but you can never talk about it. So, when you start writing, you look at things in your memory and you start to think how you can use them without breaking your oath. Speaking and writing about the present is a huge problem for someone with this background, so my first novel was based on the past. I changed contexts and time periods so I could be open and honest, but without breaking my oath.” I ask whether he would ever return to practising medicine one day, and he admits that he misses it, although a return to MSF is highly unlikely. He has, however, watched the organisation grow with much pride, although he admits that it has not quite evolved fast enough for the change of tides its birthplace of Europe has been experiencing of late. “Europe was for a long time consumed directly by war and, for 50 years, there was a kind of blessed period in which the continent has been at peace and able to help the rest of the world. Organisations like MSF were very relevant at this point. Since 2010, terrorism has come back to Europe; refugees have started to come back to Europe — the problems are no more far away, but right next door,” he says thoughtfully. “These organisations have been created to act in remote countries, and yet today, the issues are in our own homes. For that, they have not adapted very well. They are important in their fields, of course, but their time has passed in a way. “Public opinion is less interested in something happening far away. When you advertise about sending funds to the Rohingyas, people will go down to the street and see refugees right in front of them. So, what’s more important is in their own communities, their own lives. I think we are facing a humanitarian crisis at this moment.” It sounds like MSF could still use perspectives like his. He laughs, shaking his head. “I still list my profession as doctor; I think you can have different experiences in your life, but you can be trained professionally in only one thing. I don’t know if at my age I can train to be a pilot or a racing car driver, and then actually go and race cars... What you train to be when you are 20 is who you will always be. I’m a doctor with different experiences, even as a diplomat. Now, I am a doctor who writes books, but who knows what will happen after this?” Rufin sets a great example of someone who has never let his professional training get in the way of his life’s calling — what you do with your existence on earth is limited only by your own beliefs, so it feels like the lesson here is to be open to opportunities when they come knocking and have faith in the decisions you make along the way. Anandhi Gopinath is an assistant editor of the Options desk at The Edge Malaysia