Changing the world is possible if people approach challenges armed with practical knowledge, compassion and a recognition of human dignity.

That was the message Dr. James Orbinski - former president of Medécins sans frontières/Doctors without Borders - delivered at the University of Manitoba on Oct. 28.

Invited by the U of M's World W.I.S.E. Resource Centre (which connects students with international learning opportunities and promotes global citizenship), Orbinski used his lecture to reflect on his 20-year career as a humanitarian doctor - one that has seen him bear witness to profound human suffering.

In 1991, Orbinski co-founded the Canadian chapter of MSF - the international charity that provides emergency medical services to people trapped in situations of armed conflict or natural disaster. His work with the organization took him to various global hot spots, including Rwanda during the 1994 genocide - a 14-week period during which 800,000 people of Tutsi ethnicity were slaughtered.

"Bodies literally filled the streets. The gutters literally ran red with human blood," he said.

Respect for human dignity is at the heart of humanitarianism, said Orbinski, who accepted the 1999 Nobel Peace Prize on behalf of MSF. He shared the story of a nine-year-old Rwandan girl he met who had survived the genocide because her mother had hid her in the family's latrine; through the hole, she watched as her parents were hacked to death by machete-wielding militia members.

"Dignity begins in seeing the sameness of self in the other," he told the audience.

"When you see the suffering of others as separate, you might choose to take pity on them or take charitable action. However, when one sees others as equal in worth and dignity, compassion leads to solidarity."

Orbinski, who currently teaches medicine and political science at the University of Toronto, also spoke about the power of politics to create transformative social change.

He recalled participating in an act of civil disobedience in South Africa in 2000, organizing with others to publicly - and illegally - begin importing AIDS drugs to South Africa. At the time, brand-name antiretroviral drugs cost patients $15,000 US per year for life, putting them out of the reach of many of the world's poor people. Rich nations, meanwhile, were slow to import generic drugs to developing countries.

Pooling limited resources, the coalition was able to access generic drugs for less than $200 US per person.

Orbinski described the action as "a way to shame pharmaceutical companies and governments that support profit over the rights of human beings."

He estimated that about four million people in the developing world now have access to life-saving medicine, up from just 40,000 only 10 years ago.

"However imperfect, change - just change - is possible," he said. "People who were going to die a terrible death now have a hope in hell."

Orbinski has helped co-found two other organizations: the Drugs for Neglected Diseases Initiative, a global non-profit agency that develops medicines for diseases ignored by profit-driven research (two anti-malarial drugs have been launched so far, with another 17 drugs currently under development); and Dignitas International, an academic/non-governmental organization that promotes community-based care and has been delivering treatment to 12,000 men, women and children with HIV/AIDS in Malawi, Africa, since 2004.

"How did (this) happen?," he said, explaining his involvement in these efforts. "We saw the dignity of the patient. We refused to accept the unacceptable, saw possibility and acted to create an alternative."

Orbinski has written a best-selling book, An Imperfect Offering: Humanitarianism in the 21st Century, and was also the subject of an award-winning 2008 documentary called Triage: Dr. James Orbinski's Humanitarian Dilemma. (A free screening of Triage takes place at 9 a.m. on Sat., Nov. 7, at the University of Winnipeg as part of this year's Global Justice Film Festival.)

He emphasized the need for people to consciously choose to do things differently, noting that throughout history, social movements have emerged because "someone dared to believe the impossible.

"Ideas have always been more powerful than economies and armies," he said. "It literally is up to us.

"Hope is not an idle feeling," he said. "It's a powerful force that can fuel the courage for change."