Working as an anesthesiologist in the Central African Republic

My daily routine was a mix of structure and constant, flexible availability. During the week, I started with the morning meeting, followed by ward rounds. Depending on staffing, this meant visiting one or all departments, from the emergency room to gynecology. If we were well-staffed, it went quickly. If the chief resident and the students weren’t there and I was solely responsible for the rounds, they could drag on until noon.

This was usually followed by ultrasound examinations, particularly in prenatal and gynecological diagnostics. Surgeries were scheduled for Tuesdays and Thursdays. These often involved several procedures in a row. In the afternoon, there was another rounds for new and critical cases, as well as the review of lab results. And then there was the unpredictable part: the 24/7 on-call duty. Especially at night, I was frequently called in for emergencies—for example, for C-sections or to attend to critically ill patients. How often these calls came in depended heavily on staffing levels. In addition to my medical work, I was also closely involved in organizational matters such as logistics, finances, and coordination.

In my free time, I’ve tried to find a balance to my busy workday by exercising, relaxing in a hammock, or enjoying a drink in town.

Over time, I’ve felt an increasing sense of confidence and recognition in my role. What I found particularly valuable was the appreciation shown by my colleagues—not just for my work, but also for my efforts to truly engage with local life. I spent a lot of time with the team outside the hospital, improved my Sango language skills, and tried to gain a better understanding of the culture and the country.

Sometimes I wished I had a little more anonymity.

There are many memorable moments that have stayed with me, like little mental snapshots:
the elderly woman who had suffered a stroke, next to whose bed her son had laid down his vest filled with ammunition;
the hospital guard who was terrified of his fever spikes and later incredibly grateful for the help;
a malnourished child who looked at my colleague Dana with admiration;
an unconscious woman who, during election season, was blessed with campaign flyers instead of a Bible;
or patients for whom the intensive work and planning paid off despite difficult conditions, or to whom we at least gave the best possible chance.

Unusual situations also stick in my memory. There was a young man who was considered “bewitched” and who felt much better after a simple IV and a little patience. And last but not least, the challenging moments when I had to make decisions with limited resources, or a ward full of crying children that demanded everything I had.

Yes, especially the question of the role of modern humanitarian aid and how it affects local structures. That’s an issue that continues to occupy my thoughts even after the mission is over.

The joy of feeling at home in different cultures. I’ve also learned that even with limited resources and without highly specialized equipment, you can still make a big difference.

Healthcare in the Central African Republic is heavily dependent on international support. Many services—especially those for vulnerable groups such as pregnant women, children, and people living with HIV—are supposed to be free of charge. However, this would not be possible without funding from NGOs and UN agencies.

Local hospitals often rely on revenue generated from the sale of medications. This leads to structural problems, such as a greater focus on economic constraints, and makes it difficult to achieve sustainable improvements in medical care. At the same time, this revenue is often not even sufficient to pay staff adequately or carry out necessary maintenance.

This makes external support all the more important until a self-sustaining healthcare system can be established. In Bossembélé, thanks to this assistance, the district hospital has become a vital resource for the local population. It is essential to sustain and further strengthen this progress.

If you’re thinking about going on a mission yourself, it helps to consider the perspective of the local people. Imagine you’ve been working for years in a hospital with established routines. Not everything is perfect, but a lot of things work well in day-to-day life. New colleagues from abroad join the team regularly. They are dedicated, motivated, and full of ideas. At the same time, they first have to get up to speed: with procedures, clinical presentations, communication, and the entire environment.

They often bring fresh perspectives, which is always valuable. Some ideas fit well and stick, while others may have been tried before or are difficult to implement on the ground. Especially when assignments are time-limited, there is sometimes little time to truly embed changes in a sustainable way.

From this perspective, it becomes clear that, in addition to expertise and motivation, continuity is a crucial factor. Projects benefit most when people are willing to commit long-term, listen, and understand existing structures before attempting to make changes. So, if you’re considering volunteering, ask yourself not only what you can contribute, but also whether you’re willing to first integrate into this new context and understand it. This ensures that your involvement in the local project will truly be helpful in the long run.