The title of this piece suggests a question for theological discussion, but actually it refers to the title of the book we are reviewing this week, Hope in Hell: Inside the World of Doctors Without Borders. Written by Dan Bortolotti, a professional journalist, it is a graphic account of the work of this important humanitarian organization.

Founded in 1971 by a group of French doctors and journalists who were concerned that the world had grossly neglected a humanitarian crisis in what was known as the Biafra secession in Kenya, Médecins San Frontières came into being to provide medical and humanitarian care to oppressed peoples, regardless of race, creed, or political affiliation. In North America, it is more generally known by its English name, Doctors Without Borders, and internationally it goes by its French initials, MSF. Operating under a charter of principles, it responds quickly wherever there is need: warfare, epidemics, malnutrition, natural disasters, acute medical situations.

MSF operates independently of any political, military, or religious agenda; in an armed conflict it attempts to provide aid to all sides impartially, as it does today in Afghanistan and Pakistan. But it does insist upon its right to speak out in cases of neglected need or abuses of aid and to advocate for improved medical procedures. Only once in its history, in 1994, during the genocide in Rwanda, did it call for outside military intervention.

Over the years, MSF has become an enormous organization of more than 26,000 doctors, nurses, other medical professionals, and water and sanitation engineers at work in more than 60 countries. They often work in dangerous places, where other agencies refuse to risk personnel. They have fixed, precautionary rules: no overnight stays in the bush without a vehicle and driver on standby, no walking alone in the village after dark, always carry $50 "security money" in case of extortion or kidnapping, never leave the main road while driving.

A typical worker is James Knox, a young doctor from Australia who has a clinic in Cuimba, a village in Angola in Africa. He is the only professionally trained medical person in a wide area, and he handles an amazing variety of problems -- malnutrition, AIDS, malaria, sleeping sickness, accidents, parasites -- all without adequate diagnostic tools or other equipment. When he first arrived, the only place to wash his hands was at the town pump in front of the health center.

One can express a great deal of admiration for Dr. Knox, who could be building a professional career back home in Australia. But for reasons he sometimes finds difficult to explain, he is content with his work in Angola. You'll find this book full of inspiring and sometimes exasperating accounts of men and women at work in hard places around the world. Their presence in the field is the answer to the question posed in our title.

You'll find this book on the display table for your enlightenment. It ought to be read by anyone interested in overseas missions.