Egil Kristian Tynæs
Authors: Tony Sheldon
Journal: BMJ (2004)

When, as a 62 year old grandfather, Egil Tynaes chose to return to Afghanistan for the second time in two years he would have had few illusions about the chances of meeting the violent fate that eventually befell him. The 2002-3 Activity Report of Medecins Sans Frontieres (MSF), for which he volunteered, is blunt. “Afghanistan is neither safe nor stable,” it reads; humanitarian agencies' cars have been “held up and shot at.” Red Cross engineer Ricardo Munguia had been singled out as a foreigner and murdered in cold blood in March 2003.

However, this year MSF identified Afghanistan as the place with the greatest need for Dr Tynaes's skills, especially in treating tuberculosis. He was not a man to duck a challenge, if he felt that it was the right thing to do. As Norwegian colleagues testify: “When Egil's attention was called to a wronged human being or a patient in need of help, his reaction was simple and straightforward: he wanted to do something right then and there.” He was aware of the need as well as the danger, having spent five months in Baharak in Afghanistan in 2002 with the Swiss branch of MSF.

​DrDr Tynaes had an authority that grew from a sense of trust that he was able to build with his patients and the local population in spite of the cultural and linguistic differences. An outdoorsman, he took the chance to walk in the surrounding hills and visited the local bazaar, where he came into contact with the Afghan population. A great asset, too, in a country largely run by older men, was his age. He was twice as old as any other member of the MSF team. His grey hair and a beard offered the reassurance of familiarity in meetings with village elders.




Figure 1




Egil Tynaes qualified as a doctor in Munster, Germany in 1970. After brief spells in hospital medicine at the anaesthesiology department at Arhus University Hospital, Denmark, and the surgical department at Herdecke Hospital, Germany, he settled down to nearly 20 years as a general practitioner in Bergen, Norway.

However, at the age of 53 he sought another challenge, travelling to Tbilisi, Georgia, to work for a year in a primary healthcare project. It was the first of several foreign adventures caring for people in need.

He returned to Norway in 1995 and qualified to become a specialist in internal medicine, taking up a post as senior doctor at Bergen's municipal outdoor clinic. Here he ran its general clinic treating everything from minor injuries to psychiatric illnesses and severe heart conditions.

But in 2000 he left Norway again, this time to provide GP care during the winter months to a remote community in Greenland. His list of tasks, including dealing with complicated deliveries, abortion, psychiatric conditions, and minor surgery, only hints at the severe challenges he faced.

By the time he applied to MSF he was already over 60. He wrote that “those of us who live in the wealthy part of the world have a certain responsibility to people who live in poverty and are disadvantaged.”

Within months he was standing in quilted anorak and with backpack ready to leave for MSF Switzerland's mission in Baharak, a town in northern Afghanistan. He returned in 2003 and helped build MSF in Norway while awaiting his next opportunity. It came nearly a year later. It was Afghanistan again, this time the Badghis region in the north west. There the Dutch branch of MSF needed him to run a local tuberculosis programme along with general medical duties and training local medical staff in basic primary health clinics.

By now his experience was invaluable. MSF later praised his “creative solutions” and “original ideas” on how to improve care. By June 2004 the MSF team in Badghis had built up the polyclinic to deal with more than 1000 consultations a month. The tuberculosis programme was treating 45 patients and set to expand, while two weeks earlier a mother and baby clinic had been opened.

Dr Tynaes's mission was complete. His team held a farewell party and colleagues said he was happy having achieved his goal in Afghanistan to make a contribution to those less fortunate.

The next day, on a road near the polyclinic in Khairkhana, the land cruiser in which he was travelling was ambushed with gunfire and grenades. Dr Tynaes died along with four other MSF staff.

Nine days later, speaking at his funeral in Korskirken near Bergen, Norwegian colleague Atle Fretheim said: “Egil's goal was not to save or change the world. Egil's focus was the individual. His wish was to use his medical skills to make life a little easier for some people. The murder of Egil and his four colleagues was also an attack on part of what Egil stood for and believed in: the right everyone has to receive medical aid.”

Dr Tynaes leaves a wife, Kirsten; five children; and five grandchildren.

Egil Tynaes, former general practitioner Bergen, Norway, and humanitarian aid worker Afghanistan (b Lillehammer, Norway, 1941; q Munster, Germany, 1970), d 2 June 2004.