Blog post by Michael Lawson, MSF Canada.
Support for this blog and #hcldr project by: Wendy Lai, Wayne Leung, Isabelle Jeanson, and Chris Houston, all Médecins Sans Frontières Canada
Doctors Without Borders/ Médecins Sans Frontières (MSF) is an international medical humanitarian organization that focuses on providing medical care in complex emergencies. Our primary goal is to deliver lifesaving treatment and to alleviate the suffering of people affected by conflict, disaster or neglect.
The nature of MSF’s work takes our teams around the world, from remote areas cut off from medical care to dense population centres affected by health emergencies that local authorities cannot (or will not) manage themselves. We run programs in close to 70 different countries, including conflict zones such as Afghanistan, Syria, Yemen, South Sudan and Democratic Republic of Congo. Our activities include care for refugees and internally displaced people, and treatment for survivors of sexual violence, vaccination campaigns, severe acute malnutrition and outbreaks of infectious diseases. We treat neglected tropical diseases such as kala azar, and challenging conditions like multi-drug-resistant tuberculosis (MDR-TB). Our programs include HIV therapy, cholera treatment, obstetric care, mental health and trauma response in war zones, to name only a few.
MSF works in a lot of places where others fear to tread. This can have serious security consequences: Our teams have faced incidents of armed robbery, looting, kidnapping and even direct attacks. Given that the patients who need our care the most often live in places affected by poverty, conflict and uncertainty, there will always be risks associated with our work. But MSF cannot carry out that work if its teams are under threat, and so — for the sake of our personnel and for the people who depend on us for lifesaving care — we must take every possible precaution to mitigate risks and protect our staff and patients. And while there are many crucial steps that must be taken to ensure the security of our projects, they are founded upon the principles of neutrality, independence and impartiality.
MSF insists on the principle of neutrality in our humanitarian work. We do not take sides in political disputes or in active conflicts, and we treat anybody who is sick or injured. In many of the contexts in which we work, there is often the presence of an international stabilizing force, which can be seen as a belligerent in armed conflict, or as an occupying army; in order to maintain our neutrality, we do not work in partnership with such forces, nor do we receive funding from such groups.
MSF is also impartial in our work. We treat patients based on medical needs and urgency, without consideration of race, religion, sex, or other discriminators. As with neutrality, we take impartiality very seriously. This is part of what ensures our independence. We decide on our activities based on our own determinations of need. We do not have, and cannot be perceived as having, any ulterior motive of profit, political gain or religious proselytizing. Patients receive the medical care we provide, including necessary medications, completely free of charge. The vast majority of our funds come from private donors from around the world who have trusted us as an organization to decide for ourselves where we need to act and what we need to do.
In these and other respects, MSF is responsible for living up to our own principles in such a way that maintains our security. This also requires transparency: about where we work, the nature of our medical programs and how we are funded. We have a strict policy of weapons being prohibited in all of our facilities. We work hard on local acceptance: People in the communities where we work know what we are doing and why, and are aware that our medical care is open and free of charge to them and their loved ones should the need arise.
But MSF also relies on internationally accepted legal frameworks for our ability to do the work we do in conflict zones — in particular, the protection provided by international humanitarian law as enshrined in the Geneva Conventions of 1951 and their Additional Protocols of 1977. These conventions, which establish the rules of war and have been signed by 174 countries, delineate the humanitarian space in which organizations such as MSF can deliver essential care to people affected by conflict. They are important international treaties that protect civilians, aid workers, medics, and injured or sick combatants who can no longer fight. They cover both international and non-international conflicts. As MSF International President Dr. Joanne Liu recently said, “Even war has rules.”
But respect for those rules is continuously being eroded. In 2015 alone, MSF facilities have been attacked in places as varied as Sudan, Syria and Central African Republic. In early October, U.S. forces bombed MSF’s trauma hospital in Kunduz, Afghanistan, killing 22 staff members and their patients. All were deliberate attacks on hospitals, in violation of international humanitarian law — not simply by guerrilla forces operating outside the realm of conventional warfare, but by military commanders accountable to government signatories to the Geneva Conventions.
Millions of people around the world live without access to essential healthcare. They suffer from injury, malnutrition and preventable disease, often as a result of violence, conflict and neglect. MSF believes that healthcare is a universal human right, and works to bring such essential care to people wherever they need it most.
MSF will continue to deliver essential care everywhere around the world where its dedication to the principles of neutrality, independence and impartiality help to provide its teams with the security it needs to carry out its work. But without a firm commitment to international humanitarian law on the part of the world’s states — and to the Geneva Conventions they have already signed — the provision of that care may continue to be at risk.
This week on @HCLDR we host the wonderful people of Médecins Sans Frontières.
The chat welcomes Dr. Wendy Lai as the voice of MSF, tweeting as @msf_canada
Please join us and the #hcldr community on Tuesday October 27th at 8:30pm Eastern (for your local time click here) where we will discuss the following topics:
T1: How do humanitarian principles relate to public health? Are they universal, or a Western European philosophy?
T2:What should be the standard of care in low-resource settings?
T3:How do you maintain access to healthcare in a conflict setting? In a low-resource rural setting? Or anywhere?
T4: What lessons can we learn from MSF and apply in our own organizations?
Resources
“Doctors Without Borders leaves Ebola-free Liberia region”, Global News, December 11 2014, http://globalnews.ca/news/1721217/doctors-without-borders-leaves-ebola-free-liberia-region/, accessed October 21 2015
“Ebola: Doctors Without Borders Shows How to Manage a Plague”, Brad Wieners and Makiko Kitamura, Bloomberg Business, November 13 2014, http://www.bloomberg.com/bw/articles/2014-11-13/ebola-doctors-without-borders-shows-how-to-manage-a-plague, accessed October 21 2015
“The Things You Don’t Forget – An MSF Nurse Describes Her Experience Treating Ebola Patients”, Doctors Without Borders, November 10 2014, http://www.doctorswithoutborders.org/article/things-you-dont-forget-msf-nurse-describes-her-experience-treating-ebola-patients, accessed October 21 2015
“The Reach of War: Chronicling a Day With Doctors Without Borders”, Olivier Laurent, Time, August 13 2014, http://time.com/3811238/syria-refugee-doctors-without-borders/, accessed October 21 2015
“The Big Dilemma Facing Doctors Without Borders”, Smithsonian.com, April 2013, http://www.smithsonianmag.com/innovation/the-big-dilemma-facing-doctors-without-borders-4946758/?no-ist, accessed October 21 2015
“My personal experience with Doctors Without Borders aka Medecins Sans Frontieres”, HospitalNews, February 1 2005, http://hospitalnews.com/my-personal-experience-with-doctors-without-borders-aka-meacutedecins-sans-frontiegraveres/, access October 21 2015