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Off the cuff
Humanitarian Actors and Practices

How do humanitarian aid workers think and act?

This work focuses on how humanitarian organisations operate, including their members, self-portrayals, messages, practices and cultures.

MSF office
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Management at MSF

In this interview, different issues related to management at MSF are broached with Marion Péchayre, Director of Studies at the CRASH, such as the fragmentation of different components of our work, professionalisation drifting towards an attitude of control as embodied by the multiplication of management tools and the omnipresence of requests for validation, and the devaluation of the role of the individual against the promotion of a pseudo-scientific presentation of facts and projects.

MSF logistician Jennifer Bock and her colleagues unload 58 boxes one ton of medical supplies, mainly malaria testing kits, destined for the MSF-supported health centre in Boguila.
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To work

We’d like to share with you today some recommended reading around the issue of management, work, and ways of working. This choice will probably surprise some regular CRASH readers; isn’t this a far cry from the usual subjects of our critical analysis? Far from being chosen at random, the selection that follows in reality grew out of several years of reading.

Food distribution in Borno state
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Borno, Nigeria : a critical look at our operations

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. 

Ebola response in Mangina
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Ebola in the DRC: between operational trial and error and scientific uncertainty

Rebecca Grais, Research Director at Epicentre, MSF’s epidemiology arm, and Pierre Mendiharat, Deputy Director of Operations for MSF-France, offer their insights on the Ebola outbreak in North Kivu Province in the eastern Democratic Republic of the Congo (DRC). This joint interview in four parts (the outbreak, social context, treatments, and vaccination) aims to show how science and practice interact around each outbreak.

Ngala, Nigeria: Emergency aid to victims of violence and displacement
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Mortality emergency threshold: A case for revision

The crude mortality rate (CMR) is one of the most widely used indicators at MSF and the humanitarian sector to evaluate the severity of a health crisis within a given population. It is widely recognized that a CMR equal to or greater than one death per 10,000 persons a day signifies an emergency situation requiring an immediate response. However, the usage of the standard emergency threshold as “1/10,000/day” is very questionable: it goes against the official recommendations endorsed by humanitarian organizations and ignores the worldwide decline in mortality rates over the last 30 years.

young men during a medical visit
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ATHA Podcast: Michaël Neuman about "Saving Lives and Staying Alive"

In "Saving Lives and Staying Alive: Humanitarian Security in the Age of Risk Management" Michaël Neuman 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.

Queue pour la vaccination au camp de réfugiés Yida
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The numbness of numbers

We welcome Abby Stoddard, Katherine Haver and Adele Harmer's response to our critical article on the production and the use of security data in the humanitarian sector and to our book in general. In a field that has been very much lacking debate, if not controversies, we're extremely glad to see a various range of readers engaging in the discussion.