Encyclopedia of the Developing World

(Note: Sample material is taken from uncorrected proofs. Changes may be made prior to publication.)

Doctors Without Borders/Médecins sans Frontières

Médecins Sans Frontières (MSF) is a private, non profit international humanitarian aid organization that provides emergency medical assistance to populations in danger in the field, most of the time following a humanitarian crisis. MSF was born out of the exasperation of a group of French doctors working in desperate conditions in the Biafra War in Africa in the early seventies. One of the founders was Bernard Kouchner (who later had a political career in France and was Health Minister in 1993, and Special Representative of the Secretary General of the United Nations - Head of the United Nations Mission in Kosovo in 1999-2001). This group of doctors believed that all people have the right to medical care regardless of race, religion, creed or political affiliation and that the needs of these people supersede respect for national borders. They were determined to create a movement to deliver independent humanitarian aid wherever it was needed, particularly one that would speak out about the plight of the victims it helped. MSF was created in 1971, and started the movement of "French Doctors" - non-governmental organizations that provide humanitarian assistance on the ground in an impartial and independent manner. "French Doctors" refer to organizations such as Médecins du Monde (Doctors of the World), Handicap International, Action Contre la Faim (Action Against Hunger). MSF was the first non-governmental organization to provide both emergency medical assistance and publicly bear witness to the plight of the populations they served. It remains the world's largest independent international medical relief agency.

MSF has developed to its current position as an international humanitarian movement with offices in 18 countries and ongoing activities in Africa, the Americas, Asia, Australia and Europe. The success of MSF in France captured the imagination of other doctors across Europe. Operational "sections" of MSF sprang up in Belgium, Switzerland, the Netherlands, Luxembourg and Spain. This expansion continued with the creation of support sections in Australia, Austria, Canada, Denmark, Hong-Kong, Italy, Japan, Norway, Sweden, Germany, United Arab Emirates, the US and the UK. Each year, more than 2,500 volunteer doctors, nurses, other medical professionals, logistics experts, water/sanitation engineers, and administrators join 15,000 locally hired staff to provide medical aid in more than 80 countries.

To be able to speak and act freely, MSF remains independent of any political, religious or economic powers. The majority of all MSF activities are paid for with private donations. Other sources of funding are provided by the European Union (Office of Humanitarian Affairs), national governments and international organizations such as the United Nations Office of the High Commissioner for Refugees. In 2002, the total income of Médecins sans frontiers, for all its national sections, was estimated at 366 million Euros (approximately 450 million USD), of which over eighty per cent was from private income.

The organization intervenes in a variety of humanitarian crises such as armed conflicts, epidemics and natural and man-made disasters. Interventions are also undertaken with populations that are particularly marginalized and vulnerable due to social or geographical isolation (such as inmates, women in prostitution, street children, ethnic minorities and the elderly). The organization brings health care to remote, isolated areas where resources and training are limited. The type of programs run by MSF include assistance to people affected by armed conflicts, assistance for refugees and displaced population, medical assistance to victims of violence and food and nutrition assistance. MSF works in the rehabilitation of hospitals and dispensaries, vaccination programs and water and sanitation projects. MSF is also active in remote health care centers, slum areas and provides training of local personnel. In countries where health structures are insufficient or even non-existent, MSF cooperates with authorities such as the Ministry of Health to provide assistance. MSF provides primary health care, performs surgery, rehabilitates hospitals and clinics, runs nutrition and sanitation programs, trains local medical personnel and provides mental health care. Through longer-term programs, MSF treats chronic diseases such as tuberculosis, malaria, sleeping sickness and AIDS. In 1999 Médecins sans frontiers received the Nobel Peace Prize for its actions.

In carrying out humanitarian assistance, MSF seeks also to raise awareness of crisis situations; MSF acts as a witness and will speak out, either in private or in public, about the plight of populations in danger for whom MSF works.

MSF offices worldwide facilitate the organization of gatherings for individuals and groups who want to speak in their home communities. MSF also mounts exhibitions and, from time to time, releases publications with the aim of raising awareness. In some instances MSF has decided to denounce abuses and misuse of humanitarian relief in the field, and has even withdrawn from countries when it considered that it could not provide assistance in situations that were satisfactory. In June 2004, following the murder of five of its staff, Médecins Sans Frontières became the first major aid agency to quit Afghanistan since the fall of the Taliban. The reason of this withdrawal was that the Afghan government failed to act on evidence that local warlords were behind the murder of five of its staff and MSF considered that the framework for independent humanitarian action in Afghanistan had ceased to exist.

It is part of MSF's work to address any violations of basic human rights encountered by field teams, whether perpetrated or sustained by political actors. It does so by confronting the responsible actors themselves, by putting pressure on them through the mobilization of the international community and by issuing information publicly. In order to prevent compromise or manipulation of MSF's relief activities, MSF maintains neutrality and independence from individual governments.

Clémentine Olivier

References and Further Reading
Olivier Weber, French doctors, Robert Laffont (1999)

Médecins sans frontières, In the shadow of "Just Wars": Violence, Politics and Humanitarian Action. Ed. by Fabrice Weissmann. Ithaca, NY : Cornel University Press (2004).

Humanitarian Studies Unit, Reflections on Humanitarian Action: Principles, Ethics, and Contradictions, London : Pluto Press (2001).

K. Anderson, "Humanitarian Inviolability in Crisis: The Meaning of Impartiality and Neutrality for U.N. and NGO agencies following the 2004-2004 Afghanistan and Iraq conflicts", 17 Harvard Human Rights Journal (2004) p. 41-74

Y. Danieli (ed.), Sharing the Front Line and the Back Hills: International Protectors and Providers: Peacekeepers, Humanitarian Aid Workers and the Media in the Midst of Crisis, NY: Baywood (2002)

H. F. Carey, "States, NGO's and Humanitarian Intervention", in J. Carey, W.V. Dunlap and R. J. Pritchard (ed.) International Humanitarian Law, NY: Transnational (2004), p. 123-174.

See also:
Health Care; Humanitarian Relief Projects; Non-Governmental Organizations (NGOs); World Health Organization (WHO)

Sample Entries