Who are they?

What can be said about men and women, professionally trained, who are willing to go to the worst places in the world-many terribly unsafe-and perform miracles for the poorest and the sickest among us? If these people are not heroes, who is?

Doctors without Borders helps people of all countries, regardless of political considerations. And their service is not merely a form of triage, an immediate reaction to immediate events; they also try to establish long-term care programs and facilities. In the modern world, there are few humanitarians so dedicated and so heroic.

What made the Organization?

Created in France, Doctors without Borders is also known as Medecins Sans Frontieres (MSF). It has achieved worldwide fame and recognition by providing free medical services to crisis spots around the world, both as the result of political oppression and from natural disasters. For this story, the group will be referred to as MSF.

MSF is not the first group to offer food and medical aid to those in need. Prior to its organization, a charitable group called Oxfam helped-and continues to help-alleviate suffering. Also, the International Committee of the Red Cross (ICRC), established during the American Civil War, was a primary source of aid.

The ICRC came under criticism for its perceived lack of response to the Nazi holocaust during World War II, and MSF co-founder Bernard Kouchner criticized the ICRC for its consistent neutrality, charging it with complicity in some situations.

The concept of the MSF began in the late 1960s during the Nigerian civil war. Rebels had created an independent region in the southeast area of Nigeria called Biafra. The Nigerian government blockaded the region, and France became the only Western nation to support the rebels.

Along with other doctors, Kouchner volunteered with the ICRC to help in Biafran aid, but he chafed about having to sign a volunteer agreement that he considered a gag order. Although he witnessed many atrocities during his service, he could not communicate with the rest of the world as long as he was associated with the ICRC. When he returned to France, he criticized the Nigerian government and the ICRC. He called for international support of the country and concluded, along with similar-thinking doctors, that a new organization was needed that would concentrate on victims without regard to political and religious boundaries.

MSF was founded by combining two organizations: the Groupe d’lntervention Medicale et Chirurgicale en Urgence and the Secours Medical Frangais (founded by Raymond Borel). MSF’s first aid mission was to Nicaragua in 1972 to help victims of an earthquake. Later, the organization would set up its first long-term medical relief mission after Hurricane Fifi devastated Honduras in 1974. The organization helped in hospitals during the Lebanese civil war in the 1970s, and assisted victims of the Khmer Rouge in Cambodia.

The group split on what they called witnessing (the need to talk publicly about problems and events they encountered) after the election of Claude Malhuret as the MSF president in 1977. Supporters of Kouchner believed MSF should speak out about what volunteers experienced during their relief efforts, while Malhuret’s supporters advocated that criticism of a government should be avoided. This debate is still going on within the organization.

MSF expanded its operations in the 1980s by engaging in aggressive fundraising efforts and setting up operational sections throughout Europe, Japan and Australia. These efforts at expansion were maintained through the 1990s and into the 21st century.

The organization also streamlined its methods of operations. An MSF team now visits a possible relief site before a field mission is established. They evaluate the level of safety and what type of aid is needed. A field mission is then set up, comprising a mission head, section coordinators (including logistics, security and vehicle maintenance), and actual surgeons and doctors to work directly with victims.

In the most visible area of medical assistance, MSF doctors and hygienists provide immediate care for the wounded, establish programs of vaccinations, treat victims of HIV/AIDS, work with local hospitals to improve sanitation (especially with providing clean water) and help with establishing long-term medical care programs to those traditionally ignored.

MSF also addresses the important areas of malnutrition brought on by war conditions. It does this through the establishment of Therapeutic Feeding Centres that monitor the nutrition of children and adults and provide direct help.

Besides actual treatment, MSF keeps careful statistics on humanitarian emergencies, so that information can be better communicated to the rest of the world. The activities of MSF may be greatly appreciated by the victims they serve, but they are often viewed harshly by the governments that the organization criticizes. Besides the dangers to volunteers from stray bullets, land mines or disease, MSF volunteers are sometimes killed or kidnapped for political motives.

“Occasionally, a government will expel an entire MSF field mission for exposing its atrocities to the world.”

The Legacy of the MSF

MSF has received praise throughout the world for its humanitarian activities and won the 1999 Nobel Peace Prize. As the group grew and gained international prominence, it established a reputation in some of the most dangerous areas of the world.

MSF arrived in Srebrenica in Bosnia-Herzegovina as part of a UN convoy in 1993, only 1 year after the Balkan Wars had begun. MSF was the only organization providing medical care to the civilians surrounding the war zones. It was forced to leave the area in 1995 under pressure from the Bosnian army.

In 1994, MSF was to experience one of its heaviest casualties when it joined the ICRC to help victims of the genocide in Rwanda. The combined effort made MSF move closer to the position of neutrality that had been maintained by the ICRC. Both groups suffered for their service, with the ICRC losing 56 and the MSF almost 100 of their local staff.

The MSF demanded a military intervention at the time, but this did not occur. Later, the MSF would still criticize the actions of some governments (such as Chechnya in 1999), but has shied away from calling for military action.

Possibly one of the most significant missions the MSF took up during the 1990s was in Sierra Leone, which was involved in a bloody civil war. Not only did the MSF volunteers help in the immediate treatment of war victims, it also established long-term care programs for after the war.

Ongoing missions of the MSF include providing humanitarian support in Kosovo and Chechnya; long-term care services in Colombia as the government battles the rebels FARC; efforts in Haiti to help in surgery and in rebuilding water and waste management systems; and its activities in the Kashmir conflict in northern India (including a major element of psychological support).

Africa has been keeping MSF very busy during the last few years with relief missions to battle the spread of HIV/AIDS in sub-Saharan Africa; providing aid to the Congo during its long-running series of civil wars; working in Uganda in the war between the government and rebel guerrillas; and establishing field missions in the violent country of Cote d’lvoire. As with other efforts, MSF combines immediate care with vaccinations, preventing the spread of disease and improving basic sanitary conditions.

One of the most recent and demanding programs established by the MSF is the campaign for Access to Essential Medicines. The campaign identifies essential medicines for a particular country’s needs and tries to supply enough to fight a disease common to a certain population.

Owing to the costs of prescription drugs, MSF has sometimes found itself without effective medications during its field missions and has created the campaign to encourage governments and pharmaceutical companies both to lower prices for essential medicines and to increase their supply.

Although the organization may have strayed from its founder’s vision of a humanitarian group that could speak out about what its volunteers witnessed, MSF has remained one of the most independent and productive humanitarian aid groups in the world, and continues to attract a core of committed volunteers to help in their sometimes dangerous activities.

Courtesy

You can find information on MSF’s history, activities and funding at www.doctorswithoutborders.com.

Books on the organization include Hope in Hell: Inside the World of Doctors Without Borders, Firefly Books, 2004; Touched by Fire: Doctors Without Borders in a Third World Crisis, McLelland and Stewart, 1998; Healing Our World: Inside Doctors Without Borders, Fitzhenry and Whiteside, 2006; and Doctors Without Borders, PowerKids Press, 2002.