In a country with a solid medical infrastructure and faced with a large-scale international mobilisation, what is the place of MSF in Ukraine and beyond? "We are not currently in the front line of emergency care provision," write Thierry Allafort Duverger and Michael Neuman, who see our work in limited areas, particularly with those "left behind," and in the longer term.
War and humanitarianism
The film Empire of Silence, directed by Thierry Michel, examines the massacres committed in the Democratic Republic of the Congo from 1996 to the present. In this blog, Marc Le Pape introduces the film’s structure, some of the principal witnesses to the mass executions and some of the military and political actors responsible for them, and Congolese reactions to their impunity.
The comic book "Le Grand Voyage d'Alice" was drawn by Gaspard Talmasse and published by La boîte à bulles on November 17th. The preface of this comic book was written by Dr. Jean-Hervé Bradol, former president of MSF and director of studies at the Reflection center of MSF (MSF-Crash). The book won the MSF prize at the Carnet de voyages Festival in Clermont-Ferrand, held from November 19th to the 21st.
In his book, La Traversée. Une odyssée au cœur de l’Afrique, Patrick de Saint-Exupéry challenges the reality of Hutu Rwandan refugees’ hunt and massacre facing the advancement of the Rwandan Patriotic Army and their Congolese allies in 1996-97. This systematic exercise of denying reality – especially the denial of the Mapping Report written by the Office of the United Nations High Commissioner for Human Rights (1143 pages, published in June 2009) – but also this denial of Human Rights Advocacy groups’ investigations, and those of journalists’ witnesses present in DRC at the time – does not spare MSF’s teams who came to help these refugees in 1996-97. However, as a front-line witness of the Tutsi genocide in Rwanda, MSF was also one of the organizations noticing the intense violence perpetrated by the new Rwandan political regime in Zaire / DRC back in 1996 and 1997, mostly against a population constituted at three-quarters of women and children.
Over the last few years, Rwanda, the Democratic Republic of Congo (DRC) and Syria have been places where situations of extreme violence took place. As witnesses and investigators of such, the authors of this book shed light on three key-moments that marked these tragic episodes: the investigation, the intervention of emergency relief teams and the implementation of justice procedures leading to judgement.
This article was first published in Issue 2, Volume 2 of The Journal of Humanitarian Affairs.
How can a medical humanitarian organisation deliver emergency assistance in Syria when there is nowhere in the country where civilians, the wounded and their families, medical personnel and aid workers are not targeted? Not in the areas controlled by the government, nor in those held by the Kurdish Democratic Union Party (PYD), Islamic State of Iraq and the Levant (ISIL) or the different rebel groups. So what action could be taken, and how? Remotely or on site? At the very least, we had to decipher the diverging political and military agendas, and then adapt, persist or sometimes just give up. In this article, I will present the full range of methods used to acquire knowledge and obtain information as well as the various networks used to carry out this venture. I will also show how Médecins Sans Frontières’ operations became a balancing act, punctuated by episodes of adapting to the various difficulties encountered.
On the 31st January, a symposium was held at Sciences Po in support of Fariba Adelkhah and Roland Marchal, researchers at Sciences Po's Center for International Research (CERI) who were arrested in Iran on June 5, 2019. Roland Marchal was released on 20th March 2020 in exchange for an Iranian engineer detained in France. On 6th May Fariba Adelkhah was sentenced to 6 years imprisonment for "propaganda against the political system of the Islamic Republic, and collusion to undermine national security". The researcher was offered conditional release on condition that she terminates her research, but she refused.
The symposium brought together diplomats, journalists, humanitarians and researchers, with the aim of "nourishing reflection about prisoners and hostages, from a political, legal and ethical point of view". Fabrice Weissman presented the experience of Médecins Sans Frontières in the face of kidnappings.
War Breaks Out: Interpreting Violence on Healthcare in the Early Stage of the South Sudanese Civil War11/22/2019
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.
This article discusses the policy of absolute secrecy on abductions adopted by aid organisations. It argues that the information blackout on past and current cases is to a large extent a function of the growing role of private security companies in the aid sector, which promote a ‘pay, don’t say’ policy as a default option, whatever the situation. The article contends that secrecy is as much an impediment to resolving current cases as it is to preventing and managing future ones. It suggests abandoning the policy of strict confidentiality in all circumstances – a policy that is as dangerous as it is easy to apply – in favour of a more nuanced and challenging approach determining how much to publicise ongoing and past cases for each audience, always keeping in mind the interests of current and potential hostages.
In 2016, the Operations Department commissioned a critical review of the operations carried out between 2015 and 2016 in Borno State by MSF France in the north east of Nigeria. In response, and with the help of Epicentre, Judith Soussan and Fabrice Weissman from CRASH produced a detailed historical account of the analyses made of the situation by the teams, capital and headquarters at the time, as well as the objectives they set themselves, the actions they undertook, the obstacles they encountered and the results they achieved. As part of this project, some of the directors and operations managers who had been involved in these operations took a retrospective look at their own practices: were they late in responding to the catastrophic situation in the IDP camps in rural areas and on the outskirts of Maiduguri, the capital of Borno State, in 2016 and, if so, why? What conclusions can be drawn a posteriori about the operational choices made and the effectiveness of MSF intervention strategies? And, to take things a step further, what does this experience teach us about how MSF functions and how our teams work? Interview with Isabelle Defourny, Operations Director at MSF-OCP. By Elba Rahmouni.
Oases of Humanity and the Realities of War. Uses and Misuses of International Humanitarian Law and Humanitarian Principles06/28/2019
The rehabilitation of international humanitarian law (IHL) has become a priority for those who think that the horrors of contemporary wars are largely due to the blurring of the distinction between civilians and combatants and for those who think that campaigning for the respect of IHL could result in more civilised wars. Similarly, respect for humanitarian principles is still seen by many as the best tool available to protect the safety of aid workers. In this text, I argue that both assumptions are misled. The distinction between civilians and combatants, a cornerstone of IHL, has been blurred in practice since the late nineteenth century. In addition, humanitarian agencies claiming to be ‘principled’ have been victims of attacks as much as others. History and current practice tell us that neither IHL nor humanitarian principles provide safety or can guide our decisions. Accepting their symbolic value, rather than their unrealised potential to protect and solve operational dilemmas, would free humanitarian agencies from endless speculations.
The situation in Yemen is often presented as the world’s worst humanitarian crisis, long ignored by the media, and requiring assistance vital to the survival of almost the entire country. Cholera outbreaks, famine, and destruction are invoked to support that argument. In reality, however, the situation of the country’s 25 to 30 million inhabitants is impossible to know with any accuracy. Nor do we know exactly what is happening in Yemen in terms of aid, although the amount of funding is very large. Noting these diagnoses and its field teams’ perspective on certain points, Médecins Sans Frontières has launched an effort to better understand this field of action using a quantitative and qualitative approach. A review of aid organisation documents and a series of interviews with aid actors in Yemen – in Houthi areas, in particular – has yielded a number of different conclusions.