Mamadou M’Baiki health centre in Bangui, CAR

Review "Saving Lives and Staying Alive: Humanitarian Security in the Age of Risk Management"


Kevin McMahon is a Ph.D. student in International Conflict Management at Kennesaw State University. His research interests include evaluating how mobile phone technology and big data are transforming traditional conflict management practices.

Kevin MacMahon's review of "Saving Lives and Staying Alive: Humanitarian Security in the Age of Risk Management" (Michaël Neuman and Fabrice Weissman, London: C. Hurst & Co, 2016) is published in the Journal for the Study of Peace and Conflict (2016, pages 69-70).

This past May 2016, when Médecins Sans Frontières (MSF) surprisingly pulled out of the World Humanitarian Summit in Istanbul, some observers agreed with the organization’s premise that there was a real failure taking place in the global humanitarian delivery system. In a new publication by MSF, Saving Lives and Staying Alive – Humanitarian Security in the Age of Risk Management, the authors richly explore one aspect of the operational contact zone that is undergoing severe stress in humanitarian operations: safety.

In the past decade, risk management practices have expanded deeply into the daily operational lives of corporations and governments thus changing the methods with which many services and goods are delivered. Real time communication capabilities between headquarters and remote agents, along with advances in data analysis, have shifted the decision-making power from the field to the professionals in home offices. This phenomenon has now started to get traction in the humanitarian space due to pressure from government sponsors, donors, insurance companies, and some executives in the organizations themselves. However, its applicability in the environments that humanitarian agencies find themselves today is in question. In this volume, MSF responsibly depicts the trends, the areas of success, and the many spaces where the fog of war has to be accepted and decisions must be left up to the field.

MSF is the right organization to describe the walk of this tightrope. They have experienced the death of workers, both domestic and international, as well as successful and unsuccessful resolution of kidnappings (some of whom are still held). They have limited and mitigated the negative outcomes while still delivering aid in the most dangerous parts of the world. Surprisingly, once adjusted for the larger scale of expanded operations, it is not statistically evident that today’s operating theatre is indeed more dangerous than in the past, which alone is a testimony for the investment and skill that MSF and the other major deliverers have made in applying best practices to protect their most valuable assets. It is however impossible to completely eliminate risk. The culture of the volunteers themselves has shifted away from the bravery icon of the fearless doctor of the past, to today’s field workers and staff who are constantly weighing the utility of what can be accomplished now against the uncertainty of the status of whatever local authority has promised them some measure of safety and independence.

As we begin to read this volume in the relative comfort of academia or within our practitioner organizations, we nod approvingly to the new appointments of security-focal point chiefs and the creation of comprehensive incident databases. The calming certainty of ‘green-yellow-red’ codes work expeditiously in both the board rooms as well as in the reader’s minds.

But then the MSF vignettes begin, leading us through the subtleties of individual cases, continent by continent, from hospitals clinging to independence in Syria to kidnapper negotiations in the Caucuses. Questions begin to emerge. Is there something innate, akin to unfettered bravery, in the international aid worker’s world view? Does this uniqueness require abject restraint to be imposed on them by administrators thousands of miles away? Do today’s instant communications give the home office a false sense that they have the right pulse? Are the anti-western themes prevalent enough that international workers should be pulled first or is that an unethical stratification? When does the balance of risking a life to save a life get so skewed as to withdraw, and who makes the call? Is the weight of procedures and documents suffocating the mission’s ideals? In a mere one hundred and forty-three pages, this book in turn prods, demands, challenges, and finally, through the examples depicted, assists the reader in forming their own mosaic from which to answer.

In a particularly illuminative chapter, Neuman interviewed Delphine Chedorge the MSFFrance coordinator for the Central African Republic operations. One of the largest deployments in the MSF family, the CAF organization employs 300 international and over 2,500 national workers. It also had four workers killed since 2007. The vastly different personal contacts that she used to gauge risk levels included missionaries, gang leaders, government ministry staff, the ears of her own workers, local power brokers, other NGO’s, and the French army systems.

These disparate pockets of intelligence often all triangulated or coalesced enough that she was able to maintain a current picture depicting the degree of fragility of the operational environment. To stay behind the bunker was safer from a short term stand point, but being out in the community (both for the coordinator and the staff) yielded superior information albeit at some day to day personal risk. Information alone wasn’t enough; respondent actions were sometimes required. She once embarked on radio, poster, and newspaper ads proclaiming the neutrality of her mission and demanding the safety of her staff. Contingency plans were made and executed, including the successful evacuation of twenty-four staff by road and boat in the matter of three days. In cases where MSF vehicles were borrowed at gunpoint, she was still able to get them returned days later (after they had been used in combat). Curfews were constantly being adjusted to reflect the facts on the ground. When a hospital patient was lynched inside a facility, she proclaimed that the grounds were officially neutral and any other violation would force them to cease all operations, to everyone’s detriment. A picture emerges here that her power levers were in the nuances, and the validity of her hourly decisions was superior to those in the district offices.

As artificial intelligence, cell phone usage, and the monitoring of social media progresses, the tendency to develop and rely on automated systems is going to grow geometrically over the next decade. This is a timely book that prepares the reader to authoritatively enter into these discussions. Initially, I thought the book was written as a push back against both the manuals of human resource departments and board’s acquiescing to the demands of insurance risk adjustors. Now I understand that it was written for all of us with an interest in the field. The decision to yield to bunkerization and out-source the safety framework to the data-security professionals or alternatively rely on the skills, contacts, and experience of the staff on the ground is going to continue to weigh on global humanitarian organizations.

Journal for the Study of Peace and Conflict


To cite this content :
Kevin McMahon, “Review "Saving Lives and Staying Alive: Humanitarian Security in the Age of Risk Management"”, 24 novembre 2017, URL :

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