Like a lot of our staff, when I tell people that I work with Doctors Without Borders/ Médecins Sans Frontières (MSF)—and that I’ve worked in field missions in Afghanistan, Democratic Republic of Congo, Haiti, Syria, and elsewhere—they want to know more. What is it like to work “over there”? Where does the organization get its money? Do you take people who don’t have medical backgrounds? When do you open and close programs? How do you manage the security of your teams?
People who have generously supported our work over the years often have similar questions. People who come to work in the US office do, too. Whether they concern our field staff, our programs, our fundraising, or some other aspect of our work, they almost always translate into some variation of the big query: How does MSF work?
Last year, we used an issue of Alert to address some of the questions we hear most often. In this issue, we’re doing it again. The reason is simple: We want you to know. We want to be transparent about our work, to be accountable for our funding and our decisions, to be informative about our general approaches to field operations and our specialized approaches to specific issues—like viral load monitoring, say, or programs in Haiti.
It’s part of speaking directly to the people who make this work possible—something I am happy to be doing now in this forum, the opening letter of Alert, in this issue and the issues to come. In truth, we as an organization spend a lot of time explaining ourselves—because we want to be transparent, as noted, and because it helps our ability to carry out our programs in the field. We need to tell people—be they government officials, would-be patients, or parties to a conflict—what we are doing and why, to convey our sense of what it means to be independent, impartial, and neutral. We need them to understand that we are trying to provide emergency medical care where it’s needed most, irrespective of religion, nationality, ethnic group, or other affiliation.
In most places, explaining ourselves and our work helps us maintain the safety of our programs and personnel. Tragically, recent incidents where hospitals were attacked and looted in South Sudan and Central African Republic—where three staff members were also killed—remind us that there is still a great deal of risk involved in this work, and that the sanctity of our medical programs is not always guaranteed.
We need to do everything we can to avoid repeat occurrences, but the needs are so great in so many places that we cannot retreat. So we will continue to talk about How MSF Works, in this and in other places, because it remains one of the best ways we know of to help our teams provide lifesaving assistance to those who need it most.
Deane Marchbein, MD
President, MSF-USA Board of Directors