Doctors Without Borders – Part One

by Mark Lovett on December 1, 2008

From it’s original founding in 1971 by doctors and journalists in France, Doctors Without Borders/Médecins Sans Frontières (MSF) has continued to expand it’s presence around the world.  Today MSF has sections in 19 countries and conducts operations in more than 60 countries, focusing their efforts on those who are caught in life-threatening situations, whether due to armed conflict, malnutrition, epidemics or natural disasters.

“We find out where the conditions are the worst – the places where others are not going – and that’s where we want to be.” – Nicolas de Torrente, Executive Director

The hallmark of the organization is their independence, providing impartial assistance to those in need while reserving the right to speak out with respect to human crises and to draw attention to the many shortcomings or abuses of the humanitarian aid system.  They also take an active role in advancing medical treatments and protocols.

To maintain their independence, 89% of MSF’s over all funding ( and 100% of MSF-USA’s funding) comes from private sources, not governments.  In 2006, MSF had more than three million individual donors and private funders worldwide.

Sudan 2008 © Anne Yzebe, Doctors Without Borders

Sudan 2008 © Anne Yzebe/MSF

This independence allows MSF to bypass political, economic or religious interests within the area.  They also refuse to take sides in any conflict, instead dedicating their services to all who are in need, regardless of circumstances.

The Teams and Services

At any time there may be in excess of 27,000 doctors, nurses, logistics experts, administrators, epidemiologists, laboratory technicians and mental health professionals representing dozens of nationalities serving the MSF cause.  As a crisis unfolds, these staff members are dispatched based on availability and skill set, with each assignment often lasting between 6 and 12 months.

© Michael Goldfarb, Doctors Without Borders, Iraq

© Michael Goldfarb, Iraq

Services they provide depend upon the nature of the emergency at hand, but may include:

  • Basic health care, mental health care and surgery
  • Hospital and clinic rehabilitation and administration
  • Vaccination campaigns
  • Feeding centers for malnourished children
  • Construction of wells to provide clean drinking water
  • Supply shelter materials and blankets
  • Treatments for HIV/AIDS, tuberculosis, cholera, meningitis, measles and other diseases

MSF doctors perform surgery in volatile places such as Democratic Republic of Congo and Somalia.  Posted at a new project opened in Kismayo, southern Somalia in 2007, British surgeon Dr. Paul McMaster describes his work:

“We see lots of gunshot wounds in the abdomen, I just saw someone whose arm was shattered with a kalashnikov. The busiest day so far, I was working on a skin graft for a burned child, when a bomb went off. There were about 15 casualties. It took an hour and a half to get people triaged and stabilized and I worked into the evening on various operations from serious facial wounds to sutures.”

Logistical Expertise

Responding to emergencies is time-critical, and due to the fact that every emergency is different, a unique kit of medical supplies and equipment must be shipped to save lives as quickly as possible.  The composition of each kit is diverse, and may contain a complete operating room or the supplies needed to deal with scores of cholera patients.

Nicolas Tucat, AFP, Doctors Without Borders

Nicolas Tucat, AFP

Operating from the MSF logistics center in Bordeaux, France, they handle tons of medical supplies, water purification equipment, food, and hundreds jeeps.  Cargo planes can be loaded for take off on a moment’s notice, heading to wherever a crisis erupts.

Speaking Out for Justice

Beyond the efforts made to alleviate the pain and suffering of those in crisis, MSF speaks out against the root causes of this suffering and the many challenges to providing effective assistance.  These issues are passed on to governments and the United Nations, as well as media outlets and the general public.  MSF staff members are sent to speak at a variety of conferences, and they also arrange informational events and traveling exhibitions.

Through their Campaign for Access to Essential Medicines program, MSF addresses the need for lower drug prices and encourages the necessary research and development initiatives required to develop new treatments.  Much progress has been made recently as developed countries have stepped up their financial aid, but a statement on the campaign’s web site demonstrates that many are still in dire need.

“There are an estimated 2.1 million children living with HIV/AIDS, 90% of whom are from sub-Saharan Africa. Only 10% receive any treatment for the disease.”

The Dangers of Saving Lives

While situations involving famine, disease or the aftermath of a natural disaster are considered relatively safe, those operations which are based in the middle of armed conflicts place MSF staff in harm’s way.  Governments in many countries, especially Africa, are waging battles with political rivals, insurgents, rebels and freedom fighters – the definition often depending on whose side you are on.  Though the MSF staff is not supposed to be targeted by any warring faction, that is not always the case.

“On January 28, 2008, in what was an organized attack, a Doctors Without Borders/Médecins Sans Frontières (MSF) vehicle was struck by a roadside bomb while traveling through the port city of Kismayo in souther Somalia.  The blast killed Victor Okumu, a 51-year-old Kenyan surgeon; Samien Lehalle, a 27-year-old French logistician; and Mohamed Abdi Ali, a 28-year-old Somali driver.  Another member of the team was wounded in the explosion.”

To compound this tragedy further, MSF withdrew their 87 international staff members from 14 different projects across Somalia.  The situation in Somalia illustrates how complex the dynamics can be, with the country very unstable and its citizens suffering the effects of a 20+ year civil war.

The Lack of International Attention

Doctors Without Borders published a list of the Top Ten Most Underreported Humanitarian Stories of 2007, the details of which paint a bleak story of the many millions in crisis.  Sadly, these stories typically get just a passing mention in the media, regardless of the lives involved.

  • Humanitarian Aid Restricted in Myanmar
  • Displaced Fleeing War in Somalia Face Humanitarian Crisis
  • As Chechen Conflict Ebbs, Dire Humanitarian Needs Remain
  • Civilians in Sri Lanka Under Fire
  • Drug-Resistant Tuberculosis Spreads as New Drugs Go Untested
  • Political and Economic Turmoil Spark Health-Care Crisis in Zimbabwe
  • Conditions Worsen in Eastern Democratic Republic of Congo
  • Civilians Targeted in Central African Republic
  • Living Precariously in Colombia’s Conflict Zone
  • Expanded Use of Nutrient-Dense, Ready-to-Use Foods Crucial for Reducing Childhood Malnutrition

Plumpy Nut, Doctors Without Borders

The Plight of Refuges and Internally Displaced Persons

In many of these dire situations, especially those involving armed conflict, thousand are forced to leave their homes and relocate to safer areas.  Regardless of whether they stay in their own country or flee across borders, their plight is one of danger and uncertainty.

In 2007 MSF brought their outdoor educational exhibit, A Refugee Camp in the Heart of the City,  to Chicago, Dallas, Houston, Milwaukee and Minneapolis.  In 2008, this incredible exhibit, depicting what it is like to live in a refugee camp, arrived in Winnipeg, Edmonton, Calgary, Vancouver, San Francisco, Los Angeles, Santa Monica and San Diego.

The San Diego exhibit will be covered in Part Two of this series.

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