FORT KENT, Maine — Dr. Peter MacLaren Toussaint remembers the injured Sri Lankan boy and his family like it was yesterday.
It was 2002 and Toussaint was volunteering with Medecins Sans Frontieres — known as Doctors Without Borders in this country — in Sri Lanka. The youngster had stepped on an active land mine, a byproduct of years of civil unrest in the area.
“I can still hear in my mind the child shrieking,” Toussaint recalled during a recent interview. “There must have been 100 people with him and they all wanted me to amputate the injured leg. The child was crying, the crowd was wailing and there was such turmoil.”
Saying he is “basically a coward” who did not want to amputate the leg and lacking necessary equipment like X-ray machines, the Fort Kent surgeon instead placed the child on intravenous fluids, cleaned the wounds, administered medications and sent the child to a larger, better-equipped hospital about an hour away.
“I never saw him again,” Toussaint said. “To this day I don’t know how he did.”
Toussaint is being honored by the University of Maine at Fort Kent with its Distinguished Service Award during the campus’ commencement on Saturday, May 12.
Commencement exercises begin at 1 p.m. in the UMFK sports center. Former UMaine System Chancellor Terrance MacTaggart will address the graduates and receive an honorary doctorate degree.
Toussaint may consider himself “a coward,” but his actions and dedication to medicine are about as far from cowardly as one can get.
The 60-year-old physician, humanitarian, health care advocate and volunteer earned his medical degree in 1970 from McGill University in Montreal before returning to practice medicine as a surgeon in his hometown for close to four decades.
Volunteering with Doctors Without Borders was a lifelong dream, he said.
“As a child I read about a physician from the United States who had gone to Africa to work,” Toussaint said. “That started the fire in me [and] when I graduated from medical school, Doctors Without Borders had just begun and I sort of kept an eye on it ever since.”
In May 2002, Toussaint traveled to Burundi to work in rural hospitals in the southern tier of that country.
“There was only one regional hospital serving 250,000 people,” he said. “I was the only surgeon in that area.”
Against the near constant sounds of gunfire, Toussaint worked with a skeleton crew of international medical volunteers with few supplies, no X-ray machine and virtually no laboratory facilities for testing blood.
“All we had was a rapid test for malaria,” he said. “Routine blood tests were impossible and [treating] fractures was based on visual inspections since there were no X-rays.”
As the only surgeon for hundreds — if not thousands — of miles, Toussaint said he knew he had to stay healthy if he wanted to help people.
“Malaria was a constant threat, especially in that neck of the woods because of a resistant strain that was there,” he said. “I brought my own mosquito netting, washed my hands all the time, and even though Lake Tanganyika was right there and seemed inviting, I did not go in because you could contract schistosomiasis.”
Sterile conditions were unheard of. Toussaint said open wounds — most often caused by gunshots in the war-torn area — were treated very differently than back home in the United States.
“Whenever I was confronted with an open wound, like in the abdomen, I would close only the muscle layers,” he said. “Five days later, I’d close the skin layers.”
By doing so, Toussaint explained, white blood cells at the periphery of the skin near the wound would work to digest any infection-causing bacteria.
“Antiseptic was in such short supply they would just keep diluting it,” he said.
Nursing staff was in very short supply, as well. It was not uncommon for a patient’s family to set up camp in the already crowded, multibed hospital rooms to help care for the individual.
Needed medications were kept in unlocked cupboards above the patients’ beds and it was up to the family members to administer them.
“The family would sleep under the patient’s bed,” Toussaint said. “You’d look outside the hospital and see them cooking over an open fire in the courtyard and there were chickens running around all over the place.”
Lack of sterile conditions in the homes, on the battlefields or in the hospital often lead to infections, and Toussaint described the grisly conditions in the operating room.
“They had water to flush out the floor of the OR, which had blood and pus mixed together on it,” he said. “It went into a trough that led outside the hospital and was used for fertilizer.”
Doctors Without Borders maintains a neutral stand in all conflicts where they volunteer, so Toussaint would operate on both government soldiers and rebels, in addition to “children caught in the crossfire,” he said.
“I got a bit of debriefing in New York City when I first volunteered, but that did not even come near to describing what I saw,” he said. “In Paris I got more debriefings and was told I could die [because] there was a civil war going on.”
Toussaint said at the time he figured he had gone that far, he might as well keep going.
“Most people go and come back,” he said. “I was curious about how things went there and figured I would give it a try.”
Years of war had taken their toll on the people of Burundi, Toussaint said.
“The people had been battered by civil war for so long our being there seemed not to make a difference to them,” he said. “They were just sort of shattered by threats of rape, ambushes and shootings.”
It was not uncommon to see a truckload of soldiers depart the town in the morning and return later that night, all the soldiers dead or wounded by gunfire.
In addition to treating battlefield wounds, Toussaint said there was a steady stream of cesarean sections and patients with HIV.
That same year Toussaint reported for volunteer duty in Sri Lanka, a country in the midst of its own civil war.
While there, Toussaint said his biggest fear was not the gunfire, but the army of baby king cobras that roamed the hospital and grounds at night.
“The babies are more venomous than the adult snakes,” he said. “And an adult king cobra bite can bring down an elephant.”
Toussaint also has spent time in Bolivia working to train doctors on the procedures for removing gallbladders.
“We were working with Andean Indians,” he said. “That is a population with the highest incidents of gall bladder cancer in the world.”
Toussaint is an advocate for universal health care and served on former Gov. John Baldacci’s Blue Ribbon Commission on Health Care.
He was a director and past president of the UMFK Board of Visitors, serves on the board of Fish River Health and is an advocate for disaster preparedness and was the principal author of the emergency management plans for Eagle Lake, Fort Kent and the St. John Vianney Parish.
Toussaint and his wife, Janet Nadeau — his childhood sweetheart from Fort Kent — have established a nursing scholarship in memory of his parents, Dr. Leonide and Georgette Toussaint.
In 2009 Toussaint earned a masters of business administration from the University of Massachusetts at Amherst.
“I thought it would help me approach things in an ordered and logical manner,” he said with a laugh. “It didn’t work.”
Toussaint said he is honored UMFK chose him for the distinguished service award, though a bit mystified.
“When they called and told me, I asked if they had the right person,” he said. “But I have a lot of respect and a lot of admiration for UMFK and I really appreciate the honor.”