Médecins sans Frontières

views updated May 23 2018

Médecins sans Frontières

Rue de Lausanne 78
CP 116
Geneva, 1211-21
Switzerland
Telephone: (+41 22) 849.84.00
Fax: (+41 22) 849.84.04
Web site: http://www.msf.org

Nonprofit Company
Incorporated: 1971
Employees: 19,400
NAIC: 624190 Other Individual and Family Services; 813319 Other Social Advocacy Organizations

Médecins Sans Frontières (MSF, known as Doctors Without Borders in English) is one of the world's most well known, most active, and most outspoken independent humanitarian relief organizations. Founded in the early 1970s by a team of French doctors, MSF has since grown into a global operation. MSF's international headquarters is based in Geneva, Switzerland, while 19 national branches operate in Australia, Austria, Belgium, Canada, Denmark, France, Germany, Greece, the Netherlands, Hong Kong, Italy, Japan, Luxembourg, Norway, Spain, Sweden, Switzerland, the United Kingdom, and the United States. The organization provides emergency medical assistance in areas affected by natural and manmade disasters, but also develops long-term medical and related assistance facilities. These operations are conducted by the group's expatriate teams of more than 3,400 doctors, nurses, and other medical and logistical support staff, as well as more than 16,000 local staff members. More than 60 percent of MSF's interventions take place in Africa, while the Asian region accounts for nearly 25 percent of its actions. Since the late 1990s, MSF has broadened its scope of operations to include advocacy programs for selected issues, such as the Campaign for Access to Essential Medicines, launched in 1999, and the Drugs for Neglected Diseases Initiative, launched in 2003. A politically independent organization, MSF is largely supported by donations from more than 3.4 million individuals and private donors throughout the world. Approximately 14 percent of the group's funding is nonetheless provided by a number of governments, including those of Belgium, Canada, Ireland, Luxembourg, the Netherlands, Norway, Spain, Sweden, Switzerland, and the United Kingdom.

SPEAKING OUT IN 1971

MSF's roots may be traced to the student activist movement in France in the 1960s and, arguably, to the role of the International Red Cross, and its policy of silence, during the Holocaust. In 1968, a small group of French doctors, including Bernard Kouchner, many of whom had only just graduated from medical school, joined the French Red Cross in providing relief to Biafrans trapped by the Nigerian government's blockade of the region during the country's civil war. While there Kouchner and some of the other doctors witnessed what they considered to be a genocide committed by the Nigerian government, yet were frustrated by the Red Cross's policy of not speaking out, and its insistence on intervening only at the request of the local government.

Returning to France in 1970, Kouchner's group criticized the Red Cross as an outdated organization, and instead decided to form a new medical aid organization that rejected the Red Cross's political neutrality in favor of a focus on a moral imperative to provide medical assistance to victims of natural or manmade disasters. Kouchner's group initially called itself "Group d'Intervention Médicale et Chirurgicale en Urgence." In that year, a tidal wave that killed more than 500,000 people in Bangladesh led Raymond Borel, editor of the French medical journal Tonus, to form another organization, called Secours Médical Français, to provide volunteers there. By the end of 1971, Borel and Kouchner had merged their organizations into the single Médecins Sans Frontières.

MSF succeeded in building a base of nearly 150 physician volunteers during the decade. Part of MSF's initial success, at least in recruitment, was distinctly French, as French medical tuition was free, young doctors were not burdened by student loans, and were therefore free to participate in the MSF mission, in part through political commitment, as well as in the spirit of adventure. The group's original charter also included the concept of "witnessing," encouraging its members to speak out about the suffering and injustice they encountered.

At the start, MSF was characterized by a lack of formal organization, and, owing to the militant roots of much of its membership, a refusal to seek private funding. Instead, the volunteer group was forced to rely on other associations to provide the support framework for its medical relief efforts. MSF's first international mission highlighted the shortcomings of this model, following the devastating earthquake in Nicaragua in 1972, the group's team arrived three days late.

MSF had better luck in 1974, when it established its first long-term medical assistance program for the victims of Hurricane Fifi in Honduras. Yet the organization's reliance on other relief operations meant that it still could not live up to its declared intention of being "first on the scene."

Vietnam provided the next testing ground for the organization as it performed its first large-scale mission in the war-torn region, starting from 1975. The experience in Vietnam helped prepare MSF for its next operation, that of providing medical assistance to Lebanon as that country slipped into civil war in 1976. By adhering to a strict policy of neutrality, and attending to victims on both sides of the conflict, MSF established its international reputation for the first time.

The election of Claude Malhuret as president of MSF inaugurated a new era for the group. Malhuret, who was not part of MSF's first generation of members, sought to develop a higher degree of professionalism for the group, establishing a more coherent organizational structure, and develop new fund-raising methods. Malhuret also sought to steer the organization toward participation in longer-term relief efforts. Kouchner and other founding members opposed Malhuret's ambitions, in part because they feared the organization would develop into an overly bureaucratic operation, and lose sight of its original objectives.

COMPANY PERSPECTIVES

Médecins Sans Frontières (MSF) is an international humanitarian aid organisation that provides emergency medical assistance to populations in danger in more than 70 countries.

In countries where health structures are insufficient or even non-existent, MSF collaborates with authorities such as the Ministry of Health to provide assistance. MSF works in rehabilitation of hospitals and dispensaries, vaccination programmes and water and sanitation projects. MSF also works in remote health care centres, slum areas and provides training of local personnel. All this is done with the objective of rebuilding health structures to acceptable levels.

The conflict between the Malhuret and Kouchner camps came to a head during the Vietnamese "boat people" crisis of 1978, when thousands of fleeing Vietnamese were refused entry into Malaysia. Kouchner wanted the MSF to hire a ship to rescue the many thousands of people risking their lives trying to escape the country across the South China Sea. Malhuret and others opposed the idea, calling it a "band aid solution" that might cause more people to risk the crossing. Kouchner went ahead and hired the ship and succeeded in rescuing thousands. Nonetheless, he was unable to convince the majority of the MSF's membership to support the action. After losing a vote at the end of 1979, Kouchner left the organization and established a new group, Médecins du Monde. Kouchner, already an enormously popular figure in France, went on to become minister in the Socialist government there.

MATURING AS AN ORGANIZATION

In the meantime, Malhuret and Rony Brauman, who became MSF president in 1982, instituted a series of changes at the organization that led it into a new era of extraordinary growth. The MSF began to internationalize its structure in the 1980s, establishing sections in other countries, starting with Belgium in 1980. The following year, the Swiss section was founded, followed by the Netherlands in 1984, Luxembourg in 1985, and Spain in 1986. MSF also took advantage of its growing reputation, launching its first mail-based fund-raising campaign in 1982. By appealing to private donors, the group was able to maintain its insistence of full independence in its actions.

The increased funding enabled the group to put into place a more efficient logistical backbone, and during the 1980s the organization expanded to include a wider array of support staff. While physicians and nurses remained the heart of the group's operations, they eventually came to represent just 40 percent of the MSF's field staff. In this way, MSF was able to develop its own full-scale relief efforts independent of other organizations.

MSF also continued to improve on its ability to respond rapidly to crises. During the 1980s, the organization developed its first emergency kits. These were prepackaged kits containing medications, syringes, and surgical and other medical and related supplies so that relief teams could be on their way within hours of a disaster. Over time, the organization developed a variety of kits adapted to different needs, such as shelter kits (which included enough plastic sheeting and rope to provide shelter for 10,000 people), water purification kits, and cholera kits. The organization also supported its relief efforts with the publication of a number of guides for use by relief teams in the field.

Following the Soviet Union's invasion of Afghanistan in 1979, MSF launched its relief effort there, often conducting clandestine operations across the border in order to provide medical assistance to the warravaged country. MSF also entered Ethiopia in order to assist the population during the famine that struck that country in 1984. There, MSF spoke out against the Ethiopian government's often murderous population relocation program, which resulted in the organization becoming expelled from the country. Yet the organization's efforts bore fruit, when soon after the United States forced the Ethiopian government to end the relocation program. Similarly, when the civil war in Sudan had caused famine to strike the southern region of the country, MSF launched an international appeal for aid in order to highlight the crisis there. Then, in 1994, during the Rwandan genocide, MSF made its first ever call for military intervention.

NOBEL PEACE PRIZE WINNER FOR THE NEW CENTURY

The 1990s saw MSF expand beyond its European base for the first time. In 1990, the group's first North American office opened, in the United States, where the organization adopted the name Doctors Without Borders. The following year, the group opened a Canadian section as well. By 1992, MSF had opened its first operations in Asia, with the launch of its Japanese section. Through the 1990s, MSF continued to grow, with national operations established in the United Kingdom and Italy in 1993, Australia in 1994, and, by the end of the decade, in Germany, Austria, Denmark, Norway, Hong Kong, and Sweden.

MSF's position as one of the world's most active and most valued international aid organizations was recognized in 1999 when the organization was awarded the Nobel Peace Prize, one of only a handful of times when the prize was awarded to an organization, instead of an individual.

KEY DATES

1971:: Médecins Sans Frontières (MSF) is created by a group of French physicians including Bernard Kouchner.
1980:: First international section of MSF is created in Belgium.
1982:: MSF begins direct mail fund-raising campaign.
1990:: MSF division opens in the United States.
1999:: MSF wins Nobel Peace Prize and launches the Campaign for Access to Essential Medicines.
2003:: MSF becomes founding partner in the Drugs for Neglected Diseases Initiative.
2005:: MSF pulls out of Iraq after an attack on the International Red Cross in Baghdad.

By then, MSF had already begun to lay plans to expand its role beyond providing relief efforts. In that year, the organization announced that it was launching a new effort toward fighting infectious diseases, creating the Campaign for Access to Essential Medicines (funded at the start by the group's nearly $1 million Nobel Peace Prize award). As part of that effort, the organization began placing pressure on pharmaceutical companies to make expensive medications available to the developing world. Similarly, the organization became a founding partner of the Drugs for Neglected Diseases Initiative, created in 2003, which sought to encourage pharmaceutical companies to develop treatments for diseases affecting poorer regions. By 2005, the group had added to these efforts by launching new vaccination and nutrition programs as well.

While the MSF's mission had always exposed its staff to hazardous conditions, the mid-first decade of the 2000s marked a new period of danger for the MSF and other humanitarian organizations. In 2004, for example, the group was forced to pull out of Afghanistan after a member of its staff had been abducted (in 2002), and then five members were killed by a Taliban ambush. In 2005, the MSF left Iraq following an attack on the Red Cross in Baghdad. Nonetheless, Médecins Sans Frontières remained committed to its own neutrality, and to providing medical aid and relief assistance to victims throughout the world.

M. L. Cohen

PRINCIPAL SUBSIDIARIES

Epicentre; Etat d'Urgence Production; Fondation MSF; MSF Assistance; MSF Enterprises Limited; Médecins Sans Frontières–Etablissement d'Utilité Publique; MSF Foundation Kikin; MSF-Logistique; SCI MSF; SCI Sabin; MSF Supply and Urgence Développement Alimentaires.