The urgency and constraints inherent in certain disasters force Doctors Without Borders/Médecins Sans Frontières (MSF) to take risks or otherwise be resigned to great suffering, disability, and avoidable death. While abandoning ineffective habits and official protocols may lead to the provision of less effective care, cause harm, and squander resources, failing to take the initiative means accepting a critical medical situation.

The authors of this book describe and analyze the emergence of new medical practices in humanitarian situations: in other words, how can we create a momentum for change benefiting affected populations? Taking advantage of lessons learned can help us better understand how to operate in specific settings, with the goal of replacing the non-therapeutic practices that doctors and political decision-makers too often tolerate, citing the poverty and ignorance of affected populations or under the pretext of complying with international recommendations, economic constraints, and public authorities.

This book is a group effort rather than a collection of articles written by experts working independently. The authors are seven doctors, a pharmacist, and three sociologists. They based their work on a review of MSF archives and publications, along with interviews with former and current managers who were or are involved in the process of bringing medical innovation to humanitarian settings.