Articles

Following an article co-written by members of the Swiss and Canadian sections of MSF, Fabrice Weissman presents a critical analysis of the arguments put forward by his colleagues. An analysis that could be useful to the entire movement, and to the humanitarian community as a whole.

In exceptional circumstances where the demand for care exceeds the supply, how do you decide who to start with? Triage is necessary where there is exceptional demand, leading to the use of a specific procedure to establish priorities. Interview of Jean-Hervé Bradol conducted by Elba Rahmouni based on the article “In a disaster situation: get your bearings, triage and act” published in the book La médecine du tri. Histoire, éthique, anthropologie edited by Céline Lefève, Guillaume Lachenal and Vinh-Kim Nguyen.  

On 12 January 2010, a high-magnitude earthquake caused numerous buildings in the city of Port au Prince in Haiti to collapse. Tens of thousands of people were killed or injured by falling blocks of concrete. The aftershocks from the earthquake, the predictions made by some seismologists and public rumours prompted fears of a repeat of the disaster. Houses, schools, churches, hospitals and business premises – all the places that had housed the capital’s residents and their main activities – had become lethal traps and a permanent threat. 

Confronted with a "totally unprecedented biological, social and political event", Jean-Hervé Bradol spoke with Mediapart about the difficulties of basing all prevention on behavioural measures: "It takes time for a society to fully acknowledge the existence of the event, which is unfolding as it tries to understand it.”

Michaël Neuman spent ten days in Libya with Médecins Sans Frontières teams working in detention centres for migrants. From his stay, he brings back the following impressions that illustrate the gloomy situation of the people who are held there, for months or years, and the even more difficult situation of all those subject to kidnapping and torture.

In this interview, different issues related to management at MSF are broached with Marion Péchayre, Director of Studies at the CRASH, such as the fragmentation of different components of our work, professionalisation drifting towards an attitude of control as embodied by the multiplication of management tools and the omnipresence of requests for validation, and the devaluation of the role of the individual against the promotion of a pseudo-scientific presentation of facts and projects.

How to intervene with the civilian populations in the middle of the war in Syria? Jean-Hervé Bradol, director of studies at Crash and former project coordinator for the northern part of Syria in 2013, testifies about the negotiations carried out in Syria in cities taken by groups affiliated to Al Qaeda or the Islamic State. This article was published on the Mediapart website on February 1, 2015.

Concerned about the fate of these two whistleblowers, particularly the founder of Wikileaks, Jean-Hervé Bradol and Rony Brauman, former presidents of Doctors Without Borders, demand that he receive treatment.

The cholera outbreak in Haiti in October 2010 was among the deadliest in modern history, with 800,000 people infected and 10,000 fatalities. And these are just the official figures. The actual death toll was far higher, as evidenced by numerous retrospective mortality surveys, and can only be expressed as an order of magnitude: to wit, several tens of thousands.   
This book recounts eight years of struggle on two fronts that the author shows to be closely linked: the field, with the implementation of measures of prevention and case management; the scientific debate, in the form of a shattering of the dominant environmental theory concerning the origin of the epidemic.

We’d like to share with you today some recommended reading around the issue of management, work, and ways of working. This choice will probably surprise some regular CRASH readers; isn’t this a far cry from the usual subjects of our critical analysis? Far from being chosen at random, the selection that follows in reality grew out of several years of reading.

First Published December 1, 1999 - Nonprofit and Voluntary Sector Quarterly (NVSQ) - Volume 28 Issue 1.

This article begins with a look at the role played by Médecins Sans Frontières (MSF) since its inception in 1971, and then looks at the challenges facing MSF today. It focuses on the confusion of humanitarian and political roles and on the goals MSF has laid out for itself to address this confusion. Humanitarian aid has become the favored response of governments to political crises, and governments have increasingly turned to NGOs to carry out their policies. In turn, NGOs have become increasingly dependent on governments for financial support. These changes have politicized aid delivery and made it difficult for NGOs to maintain their independence. In addition, as the number of NGOs increases and their activities become more specialized, there are pressures toward institutionalization and bureaucratization. To respond to these challenges, MSF has identified several goals, including maintaining organizational independence and flexibility and avoiding bureaucratization.

This article seeks to document and analyse violence affecting the provision of healthcare by Médecins Sans Frontières (MSF) and its intended beneficiaries in the early stage of the current civil war in South Sudan. Most NGO accounts and quantitative studies of violent attacks on healthcare tend to limit interpretation of their prime motives to the violation of international norms and deprivation of access to health services. Instead, we provide a detailed narrative, which contextualises violent incidents affecting healthcare, with regard for the dynamics of conflict in South Sudan as well as MSF’s operational decisions, and which combines and contrasts institutional and academic sources with direct testimonies from local MSF personnel and other residents. This approach offers greater insight not only into the circumstances and logics of violence but also into the concrete ways in which healthcare practices adapt in the face of attacks and how these may reveal and put to the test the reciprocal expectations binding international and local health practitioners in crisis situations.