Episode: "Into The Crisis Zone"

Full name: Leslie India Lefkow
Nationality: USA
Profession: Human rights specialist
Birth Place: New Delhi, India
Hobbies: Reading (everything! I'm a dedicated fan of the New Yorker magazine, which is great to read when you're in the field: loads of short articles about totally diverse topics, a good distraction); Amateur window box gardening.
Years with MSF: Six years
MSF missions completed: Democratic Republic of Congo, Sudan (twice), Sierra Leone

What brought you to MSF or sparked your interest in humanitarian work in general?

You know, it’s easy for a lot of organizations to go to countries and hand out pills or food or build latrines and ignore the bigger picture of what’s happening, ignore the fact that those pills and food might be stolen the moment the patient leaves the clinic, or that women are regularly being raped at night behind those nice new latrines.

I became interested in MSF because MSF is not just a technical service provider, it’s also concerned with injustice, with trying to understand why and how people end up in these desperate situations, and trying to improve these situations, and that definitely attracted me. Of course there are also practical, selfish reasons why I joined MSF: I was interested in travelling and working in conflict areas, and MSF was a great way to do that because it’s often one of the only organizations on the ground in many places.

Is there any one moment that stays with you from your trip to Sudan?

Oh dear, there are so many…. One I’ll never forget was in the Nuba mountains. This is a place that was cut off from humanitarian aid for more than ten years, totally isolated, and civilians were terribly targeted—lots of bombing and shelling and horrible abuses.

But when I was there I asked this man about how people dealt with all these things, like being bombed. I was expecting him to say how terrible it was, and that the whole population was traumatized. Instead he said, “well, some people love it when there’s bombing! The blacksmiths, for instance. they go out and collect all the metal from the bombs and make hoes and other items.” I just sat there and sort of gaped at him and then started laughing, but I love that, how people are so resourceful and adapt to circumstances in ways you can’t even imagine if you haven’t experienced these things yourself.

How do you think your human rights work fits into MSF’s humanitarian aid?

People are often surprised to hear that MSF would employ legal or human rights advisors but you have to understand that even during wars, there are still laws that apply, and of course most of the doctors and nurses and others who work with MSF don’t know much about the laws of war and what fighting forces are allowed to do and what they’re not allowed to do. So one part of my work has been training and advising MSF teams on international humanitarian law.

The other thing is that over the past ten years, many humanitarian agencies have come to realize what MSF has known for a long time, that they cannot just provide assistance without looking at protection. In other words, it’s important to treat people for cholera or malnutrition or bullet wounds, but you cannot work in these conflicts as a humanitarian worker, among communities being killed and raped and abducted, and just focus on your programs and ignore these other things that are happening.

In a lot of the conflicts we see today, water and shelter and health care are crucial, but security is sometimes the top priority. The best humanitarian agencies know this and while they are often helpless to provide security themselves, they have a responsibility to raise these problems with those who do have the power to provide it—like local authorities, rebel commanders, governments, and sometimes the United Nations.

What we call the witnessing and advocacy role really is the second half of MSF’s work because MSF is working in abnormal situations with so much violence taking place – we can’t just ignore it. You can’t work in these places and just look at patients as a series of wounds and infections and disregard the context they’re coming out of, you have to ask, why are six-year-old girls coming to the clinic with bullet wounds? Why are people malnourished in an area that’s chock-full of fruit and grain? Why are refugees being forced to return to places they fled – what is wrong with this picture?

My work has been to help translate the anger and indignation over these events into messages and tools that can be used to try to show what’s happening and push people to address this kind of injustice. An MSF doctor or nurse can look at that child who’s been shot and know instinctively that that’s not acceptable, but sometimes they need advice on what’s the best way to deal with those situations.

How do you cope with the culture shock of bouncing between fieldwork that focuses on human rights abuses in the developing world and a relatively peaceful domestic life in the Netherlands and the US?

Well, I’ve moved around the world all my life—I think I went to about nine schools in at least five different countries as a child, so I’m sort of used to it. Still, it can be very disorienting—I usually enjoy the idea of going somewhere new and hate the idea of pulling up roots in the place I’m in.

I think one thing that helps me is reading: if I’m feeling out of sorts I tend to go back to the favorite books I read as a kid-- The Count of Monte Cristo is great for total escapism. It also helps a lot that my husband, my family and a lot of my friends have also moved around and so they can picture and understand some of what I talk about.

Do you have any mental exercises or routines that help you with this?

No, not really. I think that one of the reasons I don’t wear a watch is because I travel and work across time zones so much. I tend to be a bit late for appointments though….

What did your work with Sudan mean to you as a professional or personal learning experience?

I know I learned far more than I ever could give back, both professionally and personally. I think that’s what a lot of people don’t realize about humanitarian work. I think that often they see people who do this work as some kind of martyrs or heroes, but in fact it’s an unbelievable opportunity to learn, and of course you try to give something back, but most of the time what you gain far outweighs what you give.

Very specifically, what do you hope that your work accomplishes, in other words, ideally, what is the process by which research like yours in Sudan can influence the situation for civilians on the ground?
You hope that things will change, you hope that abuses will cease, or lessen. Of course, this is rare and incredibly slow and hard to measure, but sometimes you do see changes. You know, I sometimes envy the medical people. You prescribe a drug or clean a wound or deliver a baby and pronto, you know you’ve accomplished something, at least for that individual. It’s totally different doing advocacy work—you’re generally working against vested interests—warlords or governments who are getting something out of abusing people in places that are ignored or unknown to most of the world.

How can you convince them that it’s in their interest to change their behavior? If they’re doing these things out of ignorance—because they don’t know about the laws of war and how they’re supposed to protect civilians and not recruit children, then you can ask ICRC (International Committee of the Red Cross) to come and train them, or tell them that child soldiers are illegal.

But if they’re doing these things deliberately, like in Western Upper Nile, then the best that you can hope for is that when you tell people outside what’s happening—governments, publics, the UN—that they’ll apply pressure to stop it. But so often the political interest just isn’t there unless it’s an important country and the timing is right, so it can be discouraging, especially when it takes such a long time and you see so much waste. You need small achievements to keep you going, and these do happen.

Do you think that your research in Sudan did this, or is doing this?

Well the report certainly didn’t stop the abuses, I wish I could say it had. Honestly, it would have been naïve to expect that. I can tell you one thing that I’m very proud of though.

I heard that not long after the report was published, one of the local Sudanese newspapers in Khartoum actually published the whole report serially, in Arabic. I think this is one of the most important and exciting results I could have dared to hope for—to actually get accurate, in-depth information about what is happening in their country to thousands of Sudanese. This is so important because most people in Khartoum and in the north are almost totally cut off from what is really happening—the vast majority have never been to Western Upper Nile or anywhere else in the south, and they hear a different version that comes through the local media, which is mostly controlled by the government.

It’s also important because in the end, if there’s going to be real peace in Sudan, it will have to be the both northern and southern Sudanese who push for it and they will need to try to understand each others views of history and the war. It’s a very polarized society and there have been abuses by both sides that will take a long time to forgive, so it’s important to have independent records of what has happened.

What are your hopes for the population of the Western Upper Nile?

Well, peace is the most obvious one. This population has been through so much, you can’t go there and meet people and not feel your heart go out to them. But even aside from the war, I think this a population and a culture that is very special. It’s hard to express, but as an outsider and a visitor, I hope that when the war ends, they are able to make a graceful transition and keep the many fine aspects of their culture while entering the modern world, I guess.

Any other comments you'd like to share about Sudan or MSF?

Just the huge admiration I have for the many Sudanese I’ve met all over the country. That’s one of the weird things of being with MSF—I’ve probably been to more parts of Sudan than most Sudanese my age—most people are unable to travel because of poverty or conflict or ethnic origin, and I’ve been to almost every region, so it gives me a different perspective on the place and the conflict. And I hope that it won’t be too long before Sudanese have that same opportunity to get to know the many fine people in what could be such a marvellous country.