Friends, as you’ll see in these pages, and as you likely know already, Doctors Without Borders/Médecins Sans Frontières (MSF) works in many locations where resources are limited, logistics are challenging, safety is of great concern, and circumstances don’t exactly lend themselves to the kind of advanced medical care to which many of us are accustomed. Some of our teams, for example, work knowing that they won’t have a steady supply of electricity. Or that security conditions could curtail their mobility. Or that rains might wipe out roads, making it necessary to use planes, motorbikes, or even donkeys to transport materials.
We accept that these conditions are part of our working environment; after 40 years of doing this work, we expect it. But we still aspire to provide the best and most effective medical care possible. In 2012, we brought this aspiration into the hospitals we established in war-ravaged Syria and into the expansive projects we set up to care for Sudanese refugees who were streaming into South Sudan. It holds when we work with neglected populations and neglected diseases, and it holds when we run services that address specific gaps in care, like the burn unit we run at Drouillard hospital in Port-au-Prince, or maternity programs in Sierra Leone and Burundi. Where we can, we also develop, refine, and institute practices that broaden access to care—decentralizing services for HIV/AIDS patients, for instance, or offering treatment for people co-infected with HIV and tuberculosis under one roof.
Some of the examples given above are further explored in the case studies offered in the pages that follow, each of which, in one way or another, highlights something integral to this organization’s identity: MSF is, at root, a medical organization that searches out ways to deliver medical care to people who need it and otherwise would not get it. We constantly remind ourselves of this, because it is all too easy for an organization to veer away from its central purpose towards issues outside its area of expertise. You might even consider this document a record of the conversation we have amongst ourselves on a regular basis—and part of the effort to keep patients and our medical and humanitarian ethics at the center of our efforts. We are proud of this work and we stand by it. At the same time, however, we know we must continue not just tending to patients, but also advocating for changes in policy and practice that would benefit many more people who currently need help—pointing out gaps in the availability of medical treatments and medicines, for instance, or lobbying for more global health funding and less restrictive trade agreements. And, as we look ahead, we aspire to take additional steps to measure, ensure, and improve the quality of the care we provide. We stand ready to adapt when necessary, to learn from past experiences—successes and shortcomings alike—and to go beyond the numbers of how many people were treated for a given disease, or in a given situation. We are thus challenging ourselves to find ways to better track and understand both the efficacy and the long-term impact of the care we deliver.
This allows us to improve the services we provide. This approach also, we believe, allows us to be a prominent voice calling on humanitarian groups and institutions to think about the effectiveness of what they do, not just the volume of it, and to consider the results of projects, not just the splashy inceptions.
We remain forever cognizant that little of this would be possible without your support. Reflecting on our work and being ready to adapt our responses when needed is part of our ongoing effort to best serve our patients and to make ourselves accountable as an organization. Looking back at 2012, and ahead into this year and beyond, we will maintain this commitment, and continue striving to use our medical expertise and experience to reach and assist as many people as we can. Thank you for being part of this effort.
Deane Marchbein, President, MSF-USA
Sophie Delaunay, Executive Director, MSF-USA