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Responding to Complex Humanitarian Crises and Massive Abuses of Human Rights

Responding to Complex Humanitarian Crises and Massive Abuses of Human Rights

Reflections On the Legal, Political, and Humanitarian Framework


By: Joelle Tanguy

Date: September 16, 1998

Source: Tanguy, Joelle. "Responding to Complex Humanitarian Crises and Massive Abuses of Human Rights: Reflections On the Legal, Political and Humanitarian Framework." Doctors Without Borders, September 16, 1998.

About the Author: Joelle Tanguy is the U.S. Executive Director for Doctors Without Borders (also known as Médecins Sans Frontièrs, or MSF). She received her MBA from France's Institut Supérieur des Affaires, attended Stanford Business School, and has a background in computer science. After accepting her first assignment in Armenia, Tanguy continued with the organization. She has served in several locations where MSF has delivered aid.


Doctors Without Borders (Médecins Sans Frontières) has worked as an independent, nonpolitical organization since its founding in France in 1971. MSF volunteers, composed of medical and non-medical professionals and laymen, work alongside local volunteers in areas of Africa, Australia, Asia, Europe, and the Americas. The organization's work primarily rests with bringing medical aid to conflict-ridden areas and locations where adequate supplies and medical facilities are not fully functioning.

As Doctors Without Borders works to alleviate suffering in impoverished, war-laden, and underdeveloped countries, it also strives to stay outside of local and international political debates. The organization does this in order to provide the most aid without having to play favorites to party lines, but this sense of political autonomy does leave the organization reliant upon private donor donations. These donations support MFS's work, but are also dependent upon the relative success of field operations and of public knowledge of crisis situations throughout the world. For instance, mainstream media reports may neglect coverage of hostilities and social crises in areas that the United States or other Western nations do not have direct control or major economic interests in.

In 1998 and 1999, U.S. troops under the support of the United Nations entered Kosovo on a peace-keeping mission. Prior to UN intervention and U.S. troop deployment, U.S. media accounts did not pay particular attention to the escalating conflict between the Kosovo Liberation Army and the standing regime in Yugoslavia. Even after UN and U.S. intervention, media accounts still paid little attention to the area. This lack of coverage for world events, particularly those concerning tribal and clan rivalries, leaves organizations like Doctors Without Borders vulnerable. Since the organization relies upon donations, it needs the public to be informed and concerned about international events. When individuals do not know about crises in places like Kosovo, the organization must attempt to educate them on the need and purpose for medical supplies and food relief efforts.

Other instances that put organizations like MSF in jeopardy can be seen with Saddam Hussein in the 1980s. Saddam Hussein, then-leader of Iraq, used chemical weapons against the Kurds in 1987. The persecution of Kurds in Iraq had been ongoing, and the targets of most of the attacks were male Kurds. Hussein's government-sanctioned genocide went ignored by the United Nations. The United Nations refusing or neglecting to impose economic sanctions against Iraq for its use of chemical weapons, in this case poison gas, proves fateful for the support of the international community. Hussein's government continued to execute, imprison, and torture individuals who opposed his regime. Kurds and non-Kurds were routinely tortured and killed. Finally, after Iraq invaded Kuwait in 1991, the United States deployed troops to cease the hostilities. The Gulf War, a battle of about sixty days, ensued, and in its aftermath Hussein stayed in power and the United Nations placed economic sanctions against Iraq. These sanctions, while aiming to halt a destructive government, did more harm to the average citizen of Iraq than to the Iraqi government. The children and poorer citizens of Iraq were the ones who went without food, water, and medical supplies. The enforcement of humanitarian laws and the non-enforcement of these legislations created a protracted battle in places like Iraq. Reasons why the United Nations took so long in enforcing sanctions against Iraq for its treatment of Iraqis and Kurds is unknown, but effects of the sanctions solidify what non-governmental agencies continually claim. They report that sanctions do not always stop an oppressive government. Instead, they allow a government to maintain control through politically and economically oppressed people.



Two years ago, the United Nations classified 26 conflicts in the world as "complex emergencies" and quantified their impact: some 59 million people affected—the majority in Africa. Civilians accounted for 90% of the victims—half of those who died were children. To their side, relief teams such as those of Doctors Without Borders/Médecins Sans Frontières (MSF), attempt to alleviate the suffering.

CNN may portray our volunteers as physicians, stethoscope in hand, treating patients in a remote or besieged health-post, but the day to day challenge of humanitarian workers is not just in providing medical care. It also means to negotiate access to populations at risk and to fuel or confront media reporting on the crises we witness. It means to advocate for the respect of basic human rights and humanitarian law, and, hopefully, through our presence, to help in the protection of civilians.

The key message that our teams have learned, if not the intellectual framework that Médecins Sans Frontières sstarted with, is that effective humanitarian action demands an acute awareness of human rights and a vigilant sensitivity to the interaction of the humanitarian agenda with political, military, legal and economic arenas.

Building on the experience of our teams worldwide, I've identified three key issues that we need to address if we want the international community to successfully tackle the wave of "uncivil" civil wars and their appalling human rights records: the lack of an effective conceptual framework; the relativity of humanitarian law; and the ambiguous dynamics of the mediating actors.

LACK OF AN EFFECTIVE CONCEPTUAL FRAMEWORK First I would like to remark on the lack of an effective conceptual framework. As Rony Brauman points out in Humanitaire: Le Dilemne (Textuel, 1996), three concepts of peace have been developed and adapted at different times over the last three centuries.

The first one, that of Montesquieu, of the British Liberals, is that of "peace by commerce": that business interests will ultimately arbitrate the destructive passions of man. It is the classical liberal paradox that the sum of private selfishness provides for the public well being.

The second concept, which appeared in the 19th century, is "peace by reason." That is, that the progress of knowledge would fight ignorance, the real cause of suffering and violence.

The third concept, mostly illustrated in today's debate about the International Criminal Court on this the 50th anniversary of the Universal Declaration of Human Rights, was that of "peace by law," as guaranteed by institutions.

All three concepts still have strong footing these days, sometimes merge, but often conflict. When seeking to improve international crisis response, the lack of an all-encompassing policy framework is appalling and the divide between the various actors is great.

What is the point of a humanitarian actor using the concept of "peace by law" to argue for the protection of Rwandan refugees in the Democratic Republic of Congo? The massacres orchestrated with the complicity of the country's political leadership who should be made accountable, but the formula adopted by the member states supporting this leadership is that of "peace by commerce!"

How do the World Bank, the IMF, on one hand, and the UNHCR on the other hand, coordinate their response to complex emergencies when their conceptual frameworks are so different, and their approaches to the crises entirely specialized? They don't!

THE RELATIVITY OF HUMANITARIAN LAW My second comment is on the (unfortunate) relativity of humanitarian law.

The Geneva Conventions, the Convention against Torture, the Convention for the Prevention and Repression of Genocide, the UN Charter and a number of other documents seem to protect civilians. Yet during the Cold War, we watched as state and international institutions used the precarious balance of power to flaunt these conventions and never once enacted them against Brezhnev, Pol Pot, Argentinian or Pakistani generals. Even in the 1980's after the Cold War was over, when it came to Saddam Hussein—then a Western ally—using chemical weapons against the Kurds, the conventions were still ignored. And the same thing happened in Chechnya and Rwanda. The noble declarations of intentions, enshrined in the texts of humanitarian law, flourish in UN conferences and international fora, but the practice and logic of member states remain unchanged.

THE AMBIGUOUS DYNAMICS OF MEDIATING ACTORS And finally I must mention the third factor, the ambiguous dynamics of the mediating actors.

The mediating actors are partly represented around this room: the United Nations, the Member States, and the NGOs. Let's not also forget key local actors such as the military and political leadership, as well as intellectual and community leaders, regional leadership, and others. And, of course, catalysts at every stage are the local and international media outfits.

Let us take a closer look at the humanitarian actors: What is our true ability to work in total independence and strictly according to humanitarian principles? How much influence can donor countries buy with their funding of our humanitarian operations? You will never find it knowledged, but the "N" of non-governmental does not always stand strong!

Institutions established by the UN charter and associated agencies, have also become suspect of capitulating to the pressures of donor states rather than advocating for the causes enshrined in their mandates. A case in point was the move by UNHCR in 1992 to propose temporary protection as a response to asylum seekers from Bosnia, while these were mostly fully eligible to standard and full asylum procedures according to the convention. Repeatedly, in recent years, and especially in the Rwanda-Zaire-Congo crisis which is still a hot preoccupation for us, we have felt that the Executive Committee and key funding member states exercised undue pressure on the UNHCR that resulted in an agency policy in the field that offered little support to the refugee populations caught in violence.

Probably among the most fiercely independent NGOs, Médecins San Frontières has had to build a large base of independent, individual donors over the years, hoping that this general public support will not impose politically on our operational deployment. But, we often ask, can't we lose what we have gained in political independence, by our total dependency on whether the media brings a given crisis to public attention? When the US media editorial policy ignores Rwanda, the Sudan or Kosovo because of O.J. Simpson or Monica Lewinsky, what recourse is left to invite private philanthropy, stir indignation and stimulate action?

CONCLUSION To conclude, I should like to stress that these same three factors who hinder effective response to the crises—the lack of an effective conceptual framework, the relativity of humanitarian law and the ambiguous dynamics of the mediating actors—actually also make prevention quite a challenging task if not an impossible one. Let me quote some examples:

Even though our first appeal for the Balkans dates back to the fall of Vukovar, even though the fall of Srebrenica and the collapse of the so-called "safe heavens" had a rehearsal a year earlier with the bombing of Gorazde, even though the Bosnian disaster was "en marche" since the recognition of Croatia, how long did it take for a significant military and political involvement in Bosnia? And who is listening to the calls from Pristina today? The Kosovo is the issue of the day, but, like Bosnia, the international community will wait till it's too late.

Working in Kigali at the height of the genocide, we were first hand witnesses to the fact that the Genocide Convention might not be worth the paper it is printed on. Warnings that impunity would further fuel violence in the region, were ignored too, and the Western Rwanda—Eastern DRC region all the way to Kinshasa—is still in the grasps of civil war.

Working in Mogadishu, we were, again, first hand witnesses to the failure of a peace-enforcement mission. The US and UN military and political leadership had ignored the warning given by humanitarian actors who saw the writing on the wall with regards to the escalation of violence that finally ended the mission and sent the chills through the spines of the most eager interventionists.

But across the years, and despite these failures, we have retained our commitment. This commitment is often fueled and inspired by the special courage of those men and women whom we meet, who in the midst of war, when their societies are torn apart and they are facing great personal risks, still stand up for the values they uphold, and advocate for the respect of human rights and humanitarian law.

Our commitment is also forged by our volunteers in the field, who remain pragmatic idealists despite the complex realities they face in dealing with humanitarian crises around the world.

I will end on the words of one of these volunteers, Dr. Zachariah:

"… hat we saw in Rwanda proved to us that our bandages, our sutures, can never heal the deep wounds of Rwanda. What they need is justice. […] All those people, all those patients that I had treated have been killed. The lives we had saved were killed before our eyes.

"I lost my friends, my colleagues, everything. And this is why, when I was on the bridge that separated Rwanda and Burundi, standing on this bridge counting the bodies, watching the corpses of mutilated children and women, thinking of the thousands and thousands of bodies I had seen, I swore to myself that if there is a judicial system in this world, those people will pay for their crime."


Complexities concerning the application of humanitarian laws, political actors and agendas, and instituting peace accords and justice continue to perplex the role of humanitarian aid workers throughout the world. In March 2000, several relief organizations withdrew from the southern Sudan because they refused to allow rebel groups in the region to have control of relief agency operations. Eleven groups rejected the mandate of the Sudanese People's Liberation Army, and one of these groups was MFR. Adding complexity to the situation, U.S. considerations of sending aid directly to the rebels pointed to the dilemma of contradictory agendas in conflict zones. The promise of state-funded aid allowed rebel factions to gain a strengthened sense of superiority and power. While the U.S. relief plans stemmed from good intentions, the possible fallout of these measures was potentially catastrophic. With rebel forces controlling the relief programs, those in greatest need and those opposing the dominant rebel parties could be left without. Hence, organizations like MSF decided to withdraw from the area because its continual mission is to not entangle its relief efforts with politics.

Events like those in Sudan continually threaten the neutrality of humanitarian workers, and in the Middle East governmental investigative committees are forming to explore the patronage and personnel of non-governmental organizations (NGOs). Countries like Egypt and Israel have established offices to examine all humanitarian aid groups that want entry to the country. These offices examine the organizations funding and the background of its workers. These investigations of NGOs come from the rise in humanitarian aid organizations posing as neutral parties, when in fact they are politically oriented and government-funded. The Tunisian government committed such an act with its creation of Jeunes Médecins Sans Frontières (Young Doctors Without Borders). This group was composed of Tunisian spies and government actors who would frequent conferences hosted by humanitarian organizations. The group sought to gather information about neighboring countries so that it could use this knowledge to divide governments and instigate hostilities. The true identity of the Tunisian organization came to light when MSF began sending letters of protest to humanitarian conference organizers saying that the MSF was not affiliated with this newer organization.

Despite these conflicting agendas, humanitarian organizations still push forward. The United Nations and numerous governments throughout the world work closely with these groups to enable them access to war-torn areas. With the 2003 U.S. invasion of Iraq, the U.S. government approached the MFR and other humanitarian groups before the hostilities commenced. The United States asked if these organizations wanted to come into Iraq for humanitarian purposes—by asking these groups beforehand, policy leaders sought to mend the gap between aid workers and government initiatives. In 1999, Doctors Without Borders earned the Nobel Peace Prize for its continual efforts to bring non-political aid to individuals in need.



Bortolotti, Dan. Hope in Hell: Inside the World of Doctors Without Borders. Buffalo, N.Y. and Richmond Hill, Ontario: Firefly Books Ltd., 2004.

Terry, Fiona. Condemned to Repeat?: The Paradox of Humanitarian Action. Ithaca, N.Y.: Cornell University Press, 2002.


Redfield, Peter. "Doctors, Borders, and Life in Crisis." Cultural Anthropology 20, 3 (August 2005): 328-361.

Weiss, Thomas G. "Principles, Politics, and Humanitarian Action." Ethics and International Affairs 13 (1999): 1-22.

Web sites

United Nations Office for the Coordination of Humanitarian Affairs. "IRIN Web Special on Civilian Protection in Armed Conflict." 2003. 〈〉 (accessed May 6, 2006).

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