In this Practitioner Profile, ATHA is joined by Michaël Neuman, the director of studies at Médecins Sans Frontières (MSF), Centre de réflexion sur l'action et les savoirs humanitaires (MSF-Crash). MSF-Crash conducts and directs studies and analysis of MSF actions with the purpose of inspiring debate and critical reflection on field practices and public positions. Michaël joined MSF in 1999, alternating between missions in the field (the Balkans, the Caucasus and West Africa) and positions at MSF headquarters (in New York and Paris as deputy program manager). His work has also addressed political analysis and issues of immigration and geopolitics.

In a new book published by MSF entitled, "Saving Lives and Staying Alive: Humanitarian Security in the Age of Risk Management," Michaël and his colleague Fabrice Weissman analyze some of the drivers of professionalization in the context of humanitarian security and its subsequent impact on humanitarian practices through a collection of MSF case studies.

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Below is an excerpt of our conversation:

Q: I wanted to dive right into some of the more recent news concerning the protection of aid workers in the field. On May 3, which at the time of this recording is just yesterday, the international president of MSF, Dr. Joanne Liu testified before the UN Security Council stating that attacks not only on medical clinics, but also on schools, places of worship, and markets had become rather chillingly routine and that medical facilities on the frontlines in a number of places like Afghanistan, South Sudan, Yemen and Ukraine are "routinely bombed, raided, looted or burned to the ground." Dr. Liu referred to this current state of affairs as a "deadly impasse." I wondered if you wouldn't mind sharing with us some of your initial thoughts on her testimony?

A: I think there's no doubt we've been facing... a lot of those attacks, in places such as Syria and Yemen, for instance, with the very shocking evidence of the Kunduz hospital being bombed last October. One of my reservations on those campaigns such as the "Not a Target" campaign that was initiated recently by MSF or the "Health Care in Danger" campaign by the Red Cross, or the "Protect Aid Workers" campaign by ACF, is that they might divert us from analysis of the context in which these attacks happen. What were these organizations doing at the times they were there? What was the state of their relationship with the different stakeholders? The role of humanitarian organizations is to act in war situations, so we make decisions that expose our staff and personnel. We have a responsibility to reflect on the circumstances in which incidents occur, going beyond just pure denunciation of the perpetrators. And I believe that whole dynamic of denunciation might come at the expense of thoroughly reviewing the incidents themselves.

Q: And on this topic, there was also a very compelling op-ed that ran in the New York Times on May 4 by a general surgeon named Osama Abo El Ezz who is the Aleppo coordinator for the Syrian American Medical Society. It's titled, "In Aleppo, We Are Running Out of Coffins" and paints an incredibly grim picture of the current situation in that city. In this piece he writes, "what was once the universal sanctity of medical neutrality has been eviscerated." In your opinion, how does the concept of "medical neutrality" hold up in today's conflicts and to what extent is it still valid or effective?

A: Well, I would be very worried to make a general statement on that question. As I've said before, the conflict in Syria is a very crude illustration of a conflict where multiple stakeholders and warring factions are actually violating medical structures on a daily basis. The responsibility of the Syrian government is particularly acute in that, but they're not the only ones. Last week in the attack that affected one of the hospitals that is supported by MSF and also the ICRC, one of the last pediatricians of the city of Aleppo died. Most of the doctors in Syria have left the country, many have died, including many staff working with MSF, and I think there has been a total disregard for impartial medical action in Syria. That is very, very clear. Whether that applies to other conflicts, well, it really depends. I don't think that we can say there has been a time where medical neutrality was ever protected, and as far as we go back in history, hospitals have been attacked during wars. It was the case in the Franco-Prussian war in the 1870s. Yes, war is a very dirty thing... the idea that IHL could be respected to a point where war becomes clean? I think [that is] absurd. It's delusional and it interferes with the political work that needs to be done on the field to negotiate and really protect some kind of space in our operations.

Q: I'd like to turn now to a new book that you and your colleague Fabrice Weissman recently published called "Saving Lives and Staying Alive: Humanitarian Security in the Age of Risk Management." This book is a collection of MSF case studies through which you analyze some of the drivers of professionalization in the context of humanitarian security and its subsequent impact on humanitarian practices. Could you tell us a little bit about why you decided to write this book and what you hope readers will take away from it?

A: It's research that got started a few years ago when MSF... got worried about a deterioration of aid security environments. We had some staff killed in Somalia from the Belgian section of Mogadishu at the end 2011, there were colleagues kidnapped in Kenya and Somalia. The threat of kidnapping emerged as being really, really problematic. Discussions around profiling of staff and remote management [were] gaining ground in the organization. We were also concerned by what was perceived to be a rise in security incidents worldwide affecting humanitarian workers and in addition to that there was a growing pressure to "professionalize humanitarian security." "Professionalize" meaning providing more training, having security personnel with specific experience and skills to actually manage security in the field and "professionalize" meaning building databases that could help us predict incidents that could arise from working in these war zones.