From international NGOs to UN agencies, from donors to observers of humanitarianism, opinion is unanimous: in a context of the alleged ‘clash of civilisations’, our ‘humanitarian space’ is shrinking.

Humanitarian medicine is made up of a wide range of practices with few obvious connections between them. Battlefield medicine and surgery, rural dispensaries in remote areas, campaigns to raise awareness about health problems in poor countries, emergency teams in disaster situations, vaccination campaigns, health education, help for marginalised groups in affluent countries and public health advice are just some examples of actions that fall within the scope of “humanitarian medicine” when they are carried out by organisations and in circumstances that can be classified as “humanitarian”.

It seemed appropriate to assemble these texts now, at a time when the history of our AIDS missions is compelling us to formulate new goals. 

Four hepatitis E epidemics have occurred in the areas in which we operate since 2000, prompting a reflection on the quality of the water produced and distributed to their populations by humanitarian organisations.

The ‘War crimes and politics of terror in Chechnya 1994-2004’ case study describes the constraints, questions and dilemmas experienced by MSF while speaking out during the two Russian-Chechen wars and the following years of ‘normalization’. 

This study started out looking at the shift to a post-conflict situation in Katanga; the intention was to describe how MSF’s sections negotiated the transition from war to post-war.

Four years after the Nigerian crisis, many things have changed in the nutrition field. This Cahier du Crash aims at considering this evolution and explore new possibilities for action for MSF.

Medical Innovations in Humanitarian Situations explores how the particular style of humanitarian action practiced by MSF has stayed in line with the standards in scientifically advanced countries while also leading to significant improvements in the medical care delivered to people in crisis. 

Tout a commencé par une évidence : il allait devenir médecin. Guérir les autres. Etre utile. Pour y arriver, la route est passée par un engagement politique intense, des emplois de garde-malade et d'infirmier de nuit. Puis, tout jeune médecin, Rony Brauman s'est retrouvé seul responsable d'un hôpital de brousse.

This study sheds light on the mechanisms producing the official data used by humanitarian aid decision makers. It views Early Warning Systems (EWS) as tools that facilitate consensus between the decision-makers involved in the allocation of food aid, enabling them to reach institutional agreements. 

To embark upon a study of this theme is to enter a field strewn with contradictory representations linked to a highly sensitive issue – the limits of our responsibility – that has generated endless disagreements and debates on our “identity” and the existence or nonexistence of a role for MSF “beyond care”. 

Twenty years after the charity concerts for the Sahel Nigerien politicians, institutional donors, aid agencies and humanitarian organisations clashed on the nature and substance of the crisis affecting Niger in 2005. Identifying the causes of, and adequate responses to, the situation also gave rise to profound disagreements. Having set up their most ambitious emergency nutrition programme to date, Médecins Sans Frontières found itself at the forefront of these controversies.