Across Careers and Continents: Volunteering with MSF is just part of the journey for Pierre LaPlante.

"Take advantage of what life has to offer."

"Celebrate life."

"Live life to the fullest."

These phrases in part illustrate the life view of Pierre LaPlante, a registered nurse who did not start out to be one. Born in a Catholic, military family in Massachusetts, but raised throughout the US and around the world, LaPlante's first degree was in theology, and he began his working life as a teacher of religious education. While teaching, LaPlante developed an interest in healthcare. In 1971, looking for a place where he could get training and real-life, hands-on experience in healthcare, he enlisted in the US Navy as a hospital corpsman. After a short stint off the coast of Vietnam, in 1973, LaPlante returned to the United States.

After working for 15 years as a Licensed Vocational Nurse in California, he graduated in 1989 from the State University of New York and became a registered nurse. LaPlante credits nursing with giving him a means to access the world and taking him on his greatest journeys. "If you had asked me when I was young," says 55-year-old LaPlante, "I would never have believed I would have been a male nurse, but it has dominated my life."

Hitting the Road (Again)

In 1990, LaPlante, a newly minted RN, took his nursing north of the border into Canada (he holds dual US/Canadian citizenship). While working as a float nurse at Vancouver's St. Paul's Hospital, LaPlante read an article about Médecins Sans Frontières (MSF), which at the time was seeking volunteers. He had never heard of MSF before, but the work sounded valuable and interesting, so he sent them his résumé and asked to be put on file.

Nothing happened.

A year and a half later, at 6:30am on a Tuesday, LaPlante (who was employed full-time and about to begin his second day of graduate school at the University of British Columbia) was called by the Amsterdam branch of MSF. They asked if he wanted to go on a 4.5-month contract as a medical advisor in Rwanda. He is frank in relating his initial dazed response to the call: "F*** no, it's 6:30 in the morning."

Nonetheless, later that day, after polling his classmates to see what they thought he should do, he found himself asking for a leave of absence from work, subletting his apartment, and informing his parents of his decision. Two days after the initial call from MSF, LaPlante was on the flight to Amsterdam for an orientation before heading to Africa.

Rwanda was entirely a case of learning by doing. LaPlante arrived, had lunch, and then immediately had to start work unpacking supplies and setting up a pharmacy for camps being established for internally displaced Rwandans – 40,000 of them, initially. His first thought: "I'm not a pharmacist!" In addition, LaPlante had overall responsibility for three camps on the west side of the major road running through the country. "I had to handle all incoming emergencies. I had to help with a census of displaced persons. I had to learn medical French and all about nutrition and tropical diseases. I had to learn conflict resolution on the spot. And I had to learn the politics." On top of this, LaPlante was responsible for directing and monitoring Rwandan nursing teams attending the three camps.

He went on to have two more assignments with MSF. In 1993 he did a four-month placement as a medical coordinator in Somalia, working on a project to rebuild healthcare infrastructure at a regional site and managing several outpatient clinics. Between 1995 and 1996, he worked an eight-month stint as a head of mission in Burundi, responsible for opening and staffing a 50-bed rural hospital and integrating its services with the regional health centers.

When asked which accomplishment he is most proud of, LaPlante speaks of his Somalia experience. At each of the outpatient clinics (they ran between five and eight clinics at a time), there were two local healthcare workers. MSF staff provided in depth training about the 10 diseases endemic to the area, including symptoms, transmission, and treatment. But MSF strives to create systems that local governments can sustain. And since having a registered nurse at each clinic to supervise the two healthcare workers was too expensive for impoverished Somalia, LaPlante implemented a North American solution: a float nurse. One registered nurse would travel to the clinics, spending one week at each site, reinforcing and continuing the education of each clinic's two workers. The program is still working.

Want to work for MSF?

LaPlante stresses that MSF cannot use volunteers who want to "save the world" or, worse, "pad their résumés." They need creative, strong people who are professional, yet aggressive. They need people who are flexible and can accommodate cultural diversity, rapidly changing situations, and varying professional standards. They need people who are willing to make a radical change in their lives and enter a place of conflict and social upheaval to bring a service to suffering people.

So, as one imagines, working with MSF was an adventure. "You work with real people in real situations. There is a lot of limit testing, as you see the world at its most vulnerable," LaPlante says, "You need to stretch yourself professionally, personally, ethically, and spiritually."

He gives examples. In Rwanda, he was travelling in an MSF caravan with the Rwandan Minister of Health, and it was getting dark. They knew they should be off the roads, but they were between camps. They were stopped by a ragtag group of military men – drunk, shoeless, and very well armed – who were considering shooting them for no particular reason. These people happened to be Hutus, but so was the Minister of Health. They eventually talked themselves out of the situation. But it's one sign of a growing problem. As LaPlante says, increasing geopolitical instability and poverty, combined with a feeling that one has nothing to lose, means people will attack anyone. Moreover, referring to the October 2003 attack on the Red Cross headquarters in Baghdad, he asks, "Terrorist groups do not sign international conventions. And if they will attack the Red Cross, who will they not attack?"

In Somalia, he had an AK-47 pointed at him by the outraged brother of a pharmacist whose hours he had to cut in half only because he couldn't afford to pay her full-time.

And there's the surreal. Because of the work they do and recognition they've received (most notably the Nobel Peace Prize in 1999), and particularly because of their feather-ruffling mandate of temoinage (literally meaning "witnessing," but in general meaning "speaking out") MSF has a certain international cachet. In Burundi, LaPlante was dining at the American ambassador's residence – with other ambassadors and the papal nuncio – sipping wine and dining off exquisite tableware. As if this wasn't strange enough for a simple registered nurse who doesn't normally move in such circles, about 500 meters away bombs started going off and citizens began streaming from the city. But the diners weren't disturbed. Life goes on in the midst of turmoil.

"In Africa," says LaPlante, "I lived in 'white men's homes' and had a maid. But I worked six to seven days a week, 10 to 16 hours per day. I didn't have time to shop at the market, and, if I did so, it might be a security risk."

Helping Others on Their Journey

LaPlante interspersed his first two placements in Africa with completing a Master of Public Health degree from Boston University and working a contract as a Regional Health Promotion Officer in Canada's Northwest Territories. Since finishing his last posting with MSF in 1996, he has worked primarily at Mount Sinai Hospital in Toronto. and completed a Master of Health Science degree in Bioethics at the University of Toronto.

But the time has come to move on again: LaPlante left in June 2004 to begin a one-year contract in Saudi Arabia. Why? It's an adventure. It's a new place to be of service. He believes in being exposed to new things. He wants to continue the journey. And it will help him in his next endeavor: LaPlante will be applying for a PhD program at McGill University in Montreal. The degree would be in nursing, with a cross connection in Islamic studies, as he would like to write a thesis on palliative care in the Muslim world. Why this topic? Because it's a new field and one that he feels could use development. With AIDS patients in North America and traumatized refugees in Africa, LaPlante says, "I have encountered death at all ages."

All this makes sense based on his peripatetic career path. LaPlante believes that the things he has seen and experienced have given him a sensitivity to others, which allows him to do what he sees as his job as a nurse: "to bring what I've got to where you're at to enhance your journey – whether you are at the start or the end."

And after the PhD, whither LaPlante? Let's let J.R.R. Tolkien take it from here:

The Road goes ever on and on

Down from the door where it began.

Now far ahead the Road has gone,

And I must follow, if I can,

Pursuing it with eager feet,

Until it joins some larger way

Where many paths and errands meet.

And whither then? I cannot say.