Off the cuff
Humanitarian Actors and Practices

MSF releases the podcast “MSF Speaking Out: The Hunting and Killing of Rwandan refugees in Zaire-Congo 1996-1997” describing the dilemmas, challenges and controversies faced by the MSF teams including: could MSF communicate publicly on the health condition of the refugees when its access to them had recently been denied? When it realised its teams were being used to lure and kill refugees, should the organisation cease its activities and condemn this manipulation?

This article was published on December 26th, 2022 on the Souk, the MSF associative website.
Accusing the mothers of malnourished children of being lawless fraudsters is a well-worn trope in malnutrition treatment programmes worldwide – and one that has resurfaced recently in Nigeria, stirred up by health workers and the media. These types of accusations obscure a series of tricky truths on the control of resources, the quality of malnutrition treatment programmes, and on the extreme precariousness in which many families live. We see all of this in northwest Nigeria’s Katsina state, where we are currently conducting the largest malnutrition programme in the history of Médecins Sans Frontières/Doctors Without Borders (MSF).

The Swiss editor Georg just published in open access a collection of articles edited by Sébastien Farré, Jean-François Fayet and Bertrand Taithe. This book is devoted to the emergence of humanitarian exhibitions either within wider events or in their own right, as an attempt to focus attention and make sense of the aid humanitarians provided. The book argues that this exhibition process was central to the narration of the humanitarian project. It did not simply represent humanitarian work, it helped shape its essential identity and sense of purpose. Entail the development of new ways of thinking about needs and emergencies.

 MSF releases in English, French and in Arabic the “MSF Speaking Out: Srebrenica” podcast based on the original MSF Speaking Out Case Study (SOCS) “MSF in Srebrenica, 1993 – 2003”.

“Humanitarianism in the Modern World. The moral economy of famine relief” published by Cambridge University Press, is an open access book written by a team of three people, whose aim is to provide a history of contemporary humanitarianism through the prism of famines. Norbert Götz, Georgina Brewis and Steffen Werther are treading on fertile ground, as the number of publications on the history of humanitarianism has multiplied in recent years. However, the contribution they present here is rich and original.

Myfanwy James is a research fellow at the London School of Hygiene and Tropical Medicine & DPhil (PhD) graduate from the University of Oxford. In this video, she presents her thesis entitled: “Instruments of Identity: Médecins Sans Frontières and Humanitarian Negotiations for Access in the Democratic Republic of the Congo (RDC)”. 

Within four months of the first notification of Ebola cases in August 2018, the Nord Kivu (and Ituri) Ebola epidemic had become the second-largest on record. Notwithstanding a rapid and massive mobilisation of resources, the outbreak continued beyond the most pessimistic predictions and the case fatality rate (the proportion of people with the infection who die from it) remained static at 66%. Despite numerous lesson-learning exercises following the Ebola epidemic in West Africa in 2014–2016, and despite the development of new vaccines and treatments, after 3,444 cases and 2,264 deaths it is difficult to claim that outcomes are better this time around.

In this article for the Humanitarian Practice Network, head of the Research Unit on Humanitarian Stakes and Practices (UREPH) for MSF Geneva Françoise Duroch and Crash director of studies Michaël Neuman discuss the implications and reasons behind the growing practice of staff profiling for MSF.

In October 2020, MSF organised a workshop in Dakar on staff profiling in operations in the Sahel. Profiling involves the selection of staff based on non-professional criteria, including nationality, skin colour, gender and religion. As such, it raises a number of ethical and practical concerns. As a result of profiling, US nationals have not been deployed in MSF operations in Colombia because of the risk of kidnapping, and Chadians and Rwandans have been excluded in the Central African Republic and eastern Democratic Republic of Congo respectively, because of regional conflicts. The use of profiling has increased in recent years in West Africa, as the threat of kidnapping of Westerners by radical jihadist groups has intensified.

Operational partnerships between two organisations are a practical approach to humanitarian responses. MSF considers such partnerships when the objective it is pursuing in a country is similar to that of an existing national organisation, and when there is potential for synergy between these two entities. I would like to take a bit of a detour by looking at an experience that is in some ways similar: when Che Guevara tried to lead the revolution in Congo - Zaire by supporting the organisation of the guerrilla movement in the east of the country.

The May 12th massacre at the MSF-supported maternity hospital in Dasht-e-Barchi (Afghanistan)  raises, yet again, the question of our limits with regard to risk. What is an acceptable level of danger for humanitarian aid workers? How do we set limits? Why would MSF decide to leave Kabul but remain in Herat, for example, or leave Afghanistan but remain in Niger, Burkina Faso, Mali, or Somalia, where the teams also face extreme danger?

In this paper, the two authors examine certain aspects of the French response to the epidemic in the light of the experience of Médecins Sans Frontières (MSF) in that field, primarily with respect to the relationship between the actors of the response and the beneficiaries.

In our first interview, Marion Péchayre discussed a variety of management-related problems at Médecins Sans Frontières: working in silos, the ever-growing number of management tools for monitoring, the endless validation requests, the vanishing role of the individual in favour of pseudoscientific presentations of events and projects, etc. This interview, conducted by Elba Rahmouni, focuses on solutions to these problems and hypotheses on how to improve our ways of working. Rather than offering set recipes, Marion Péchayre advocates an approach based on “practical wisdom” (a concept from the sociology of professions) and deliberative management that every individual and team can apply in their own way.