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The single most valuable medical tool Dr. Lynn Amowitz took with her to Rwanda in January may have been her Swiss army knife.

Practicing medicine in an African refugee community "is very different than practicing medicine here," she said after returning to Rhode Island from a month in the Great Lakes regions of Zaire. "I only had my stethoscope and my brain."

Then she remembered her Swiss army knife and the iodine, the latter used for disinfecting the knife and wounds on the bodies of Hutus refugees.

Amowitz also delivered babies on roadsides. "I would tie off their cords with strings from my clothes and then use my knife to cut their cords."

That's a whale of a difference from the state-of-the-art, high-tech clinics and hospitals she is accustomed to as a research fellow and a clinical instructor for Harvard Medical School.

Assigned to Brigham and Women's Hospital in Boston, Amowitz is pursing a master's degree in epidemiology, more commonly known as public health.

This was her third trip to the African continent to care for refugees, but the first time she has been under the sponsorship of the American Jewish Joint Distribution Committee.

"Of all the non-government organizations which send workers to help these refugee populations, the International Refugee Committee and JDC are regarded the highest," Amowitz says.

"They both think in public health terms, and for the long term," she added.

The Joint, in addition to bringing in medical personnel for one- to three-month assignments, is building water and sanitation systems that will help avoid some of the diseases that challenge the medical teams.

Dr. Richard Hodes of New York headed the first Joint medical team that flew to Rwanda to treat refugees. The photo of him shown with this story was taken by Tipper Gore.

Besides delivering babies and tending to various wounds, Amowitz treated the all-too-common afflictions of the African continent: diarrhea, malnutrition, malaria and dehydration.

At her little headquarters building in Bukavu, Zaire, and at a mobile medical station near the Ayangugu crossing into Rwanda, Amowitz and her team of locally trained assistants treated up to 5,000 people a day, about half of the daily stream of refugees that moved along the roads, emerging from hiding places in the rain forest.

The refugees actually "have a good supply of food available in the rain forest," Amowitz explains. "But because they always are on the move, it is hard to collect the food. They are in very poor condition."

Much of the population is under age 5, and a substantial volume of them are orphans in the wake of the Rwandan civil war between the Hutus and Tutsis. In all, 80 percent are malnourished

There is little that the medical teams can do except treat emergencies. "The government of Zaire does not want these people hanging around," she says. "They want them to keep moving," partly because Zaire has its own civil war between its resident Tutsi population and other tribal groups.

When Zaire exploded in civil war, the Hutus, who originally had fled to Zaire from Rwanda because of the fighting there, either headed back to Rwanda or hid out in the rain forest near Bukavu.

"It is better to get them back to Rwanda," Amowitz said, "than for them to stay in Zaire, which doesn't want them and considers them the force of the region."

Amowitz says the Hutus are appropriately leery about returning to Rwanda, because they are the villains of the story. These Hutus are the ones who inflicted genocide on the Tutsis and moderate Hutus. It is their leaders who face the United Nation's war crime tribunal. They fear revenge, which is the African way of justice, Amowitz notes.

Why bother to treat people who have committed such heinous crimes?

"You really can't flush out the bad from the good," Amowitz says of the women and children who are mixed in along the road with warriors. "You can't tell who's who. You are there simply to take care of people, not political problems."