An Imperfect Offering | Penguin Random House Canada
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An Imperfect Offering

Humanitarian Action in the Twenty-first Century

Publisher: Anchor Canada
National Bestseller

“As Albert Camus wrote, the doctor’s role is as a witness–to witness authentically the reality of humanity, and to speak out against the horrors of political inaction. . . . The only crime equaling inhumanity is the crime of indifference, silence, and forgetting.”
—James Orbinski

In 1988, James Orbinski, then a medical student in his twenties, embarked on a year-long research trip to Rwanda, a trip that would change who he would be as a doctor and as a man. Investigating the conditions of pediatric AIDS in Rwanda, James confronted widespread pain and suffering, much of it preventable, much of it occasioned by political and economic corruption. Fuelled by the injustice of what he had seen in Rwanda, Orbinski helped establish the Canadian chapter of Médecins Sans Frontières (Doctors Without Borders/MSF). As a member of MSF he travelled to Peru during a cholera epidemic, to Somalia during the famine and civil war, and to Jalalabad, Afghanistan.

In April 1994, James answered a call from the MSF Amsterdam office. Rwandan government soldiers and armed militias of extremist Hutus had begun systematically to murder Tutsis. While other foreigners were evacuated from Rwanda, Orbinski agreed to serve as Chef de Mission for MSF in Kigali. As Rwanda descended into a hell of civil war and genocide, he and his team worked tirelessly, tending to thousands upon thousands of casualties. In fourteen weeks 800,000 men, women and children were exterminated. Half a million people were injured, and millions were displaced. The Rwandan genocide was Orbinski’s undoing. Confronted by indescribable cruelty, he struggled to regain his footing as a doctor, a humanitarian and a man. In the end he chose not to retreat from the world, but resumed his work with MSF, and was the organization’s president when it was awarded the Nobel Peace Prize in 1999.

An Imperfect Offering is a deeply personal, deeply political book. With unstinting candor, Orbinski explores the nature of humanitarian action in the twenty-first century, and asserts the fundamental imperative of seeing as human those whose political systems have most brutally failed. He insists that in responding to the suffering of others, we must never lose sight of the dignity of those being helped or deny them the right to act as agents in their own lives. He takes readers on a journey to some of the darkest places of our history but finds there unimaginable acts of courage and empathy. Here he is doctor as witness, recording voices that must be heard around the world; calling on others to meet their responsibility.

“Ummera, ummera–sha” is a Rwandan saying that loosely translated means ‘Courage, courage, my friend–find your courage and let it live.’ It was said to me by a patient at our hospital in Kigali. She was slightly older than middle aged and had been attacked with machetes, her entire body rationally and systematically mutilated. Her face had been so carefully disfigured that a pattern was obvious in the slashes. I could do little more for her at that moment than stop the bleeding with a few sutures. We were completely overwhelmed. She knew and I knew that there were so many others. She said to me in the clearest voice I have ever heard, “Allez, allez. Ummera, ummera-sha”–‘Go, go. Courage, courage, my friend–find your courage and let it live.’
—From An Imperfect Offering

From the Hardcover edition.



I was having a coffee with Austen Davis, a smart, happy man and the general director of Médecins Sans Frontières, or Doctors Without Borders, in Holland. It was the year 2000, and I had just returned from the Sudan, where I had met with the foreign minister to protest...
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“Thoughtful and passionate.”
The Globe and Mail

“With vivid personal anecdote, Orbinski chronicles the struggle around humanitarian intervention in one hotspot after another across the planet. In a narrative of grace and power, he displays the intense components of his remarkable life: integrity, compassion and principle. He is undaunted in the face of the worst the world has to offer. He is determined to salve the wounds of humankind. He is a truly committed man, mind and soul throbbing with incandescent decency.”
— Stephen Lewis, Former UN Special Envoy

An Imperfect Offering is more than a memoir of life on the frontlines of disaster — it is a provocative and revealing meditation on what it means to be human. What do we do, and what should we do, in the face of unspeakable suffering.”
Ottawa Citizen

“James Orbinski has lived for years in the middle of the worst that humans can be, and somehow emerged with both his compassion and his desire to understand us intact. He is a marvellous storyteller, and the stories he has to tell are some of the most powerful I have ever read.”
— Stephanie Nolen, author of 28: Stories of AIDS in Africa

“In this complex era of massive abuses to human rights by governments in too many countries, it is suprising to read such a poignant book that describes, without fanfare, the constant ethical, moral, and even legal dilemmas that those in the field must confront hundreds of times a day. Clarity, compassion and commitment are presented in spades in this book about those who are fighting the lack of political will that too often fails to prevent man's inhumanity to man.”
— L.Gen. Roméo Dallaire, author of Shake Hands with the Devil: The Failure of Humanity in Rwanda

“The rich beauty of Dr. James Orbinski’s writing contrasts with the stark poverty and suffering of the people he has served…. This book exposes truths most of us would rather not know. Do not put it down…. See who you become after reading it.”
Canadian Medical Association Journal

“A powerful personal memoir from a courageous Canadian who has spent most of his adult life in front-line humanitarian work in the world’s worst conflict zones…. It’s also a hopeful story about the emergence of MSF as a new and independent agent of civil society, and the possibilities of making the world a better place.”
Edmonton Journal

“A highly personal and wrenching memoir.”
The Walrus

“Almost unbearably intense…. Orbinski’s writing is strongest and most compelling when he is recounting his actual experiences as a doctor.”
Winnipeg Free Press

“Orbinski pulls no punches…. With his vivid descriptions, Orbinski brings the stench of death and illness to his pages with unflinching realism, giving us detailed narratives of such shameful events as the ruthless genocide of over one million Tutsis in Rwanda, and the United Nations’ complicity in turning a blind eye to the horror.”
Toronto Star

"An essential text for our dire times. Orbinski plunges into the heartbreak, the maelstrom, the moral dilemmas of the genocide territories of the world — Rwanda, Kosovo, Sudan — and finds there enough courage and redemption for us all to feel that there is hope for our sad humanity."
— Ariel Dorfman

From the Hardcover edition.