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.

Though independence and innovation are both highly valued concepts, Xavier Crombé questions in this article - thanks to MSF's experiences in Niger in 2005 - the possible interactions between them.

MSF is an independent organisation that carefully protects its autonomy. In this article, Xavier Crombé draws the connection between this founding principle and the issue of security for humanitarian actors.

This article questions the independence of humanitarian action in Afghanistan, at a time when aid initiatives from military forces blurs differences, and when NGOs financed mostly by institutional funding risk becoming mere "implementing partners" of an aid policy driven by a political agenda.