MSF works in conflict zones, after natural disasters, during epidemics, in long-term care settings, and more.
"We know from experience that for every international doctor or expert deployed, you need ten locals to really make a difference. Any international response is just the tip of the iceberg."
Doctors Without Borders/Médecins Sans Frontières (MSF) works in roughly 70 countries around the world, each with its own unique circumstances, but MSF missions generally originate according to a common set of practices designed to make sure our resources and expertise are used in the best way possible.
When a crisis breaks, we act fast to gauge the needs, mobilizing MSF staff already in the area or sending in an emergency team. In reality, these two groups often work closely together and we can begin treating people even as we develop the full plan.
In Haiti, for example, our staff already working in the country treated the first victim of 2010’s earthquake within five minutes, even before the emergency team deployed. This is because we have emergency supplies—from surgical kits and inflatable hospital and cholera kits—ready at all times, as well as cash reserves for disaster response.
This means we do not need to wait for institutional donors to release money or a crisis to catch the public consciousness: we can act where and when the need is greatest.
Evaluations and Explos
We are alerted to crises in many different ways, and impetus for assessment missions can come from various sources, including:
- MSF teams already working with the people affected
- Local government
- The international community
- Humanitarian organizations such as the United Nations Department of Humanitarian Affairs (UNDHA)
- Local and national NGOs
- Media report or information on social media
Once the information has been checked and validated, we send a team of medical and logistics experts to the crisis area to carry out a quick and efficient evaluation (or exploratory mission, also known as an "explo"). This might be conducted by staff already working in the area or specialists deployed from our headquarters.
The Emergency Team
The emergency team is a group of people with extensive field experience in key areas, such as medical care, logistics, crisis response (including conflict and natural disasters), and management. They are on stand-by 24/7 and can be deployed within hours of an emergency breaking. They are often responsible for the initial assessment and can stay for months to provide the first life-saving care while a longer-term project is put in place.
The team assesses the situation, the number of people affected, and the needs, and sends a proposal back to the relevant MSF headquarters office.
When the proposal is approved, staff at MSF headquarters start the process of selecting personnel, organizing materials and resources, and securing project funds.
Initiating a Project
Once the project plan has been drawn up and confirmed, technical equipment and resources are sent to the area.
In large crises, planes fly in all the necessary materials so that the work can begin immediately (though trucks, boats, or other measures are often needed to transport the material from the planes to the project sites). Thanks to set protocols, specialized kits, and our logistics centers, MSF can distribute material and equipment within hours, so everything is ready for the response team to start work as soon as they arrive.
In some countries that are prone to crises, or where some sort of crisis seems like it could soon occur, MSF keeps emergency supplies on standby in warehouses.
To reduce costs, if speed is not of the essence, MSF ships the majority of material and drugs by sea.
The Team in the Field
An average field project team has between four and 12 international volunteers working in collaboration with up to 200 local staff.
Field operations are managed by a country manager and a coordination team. This often includes a medical coordinator, a logistical coordinator, and a financial coordinator who are typically located in the capital city of each country where MSF works.
They oversee the project and act as liaison between MSF, local authorities, partners, and other non-governmental organizations (NGOs). They report regularly to the Operations Departments at their headquarters.
Funding a Project
The vast majority of MSF’s money—some 90 percent—comes from individual donors who give in small amounts. Private and unrestricted funding frees us from the strings that may come attached to money from governments or large institutions. It also allows us to act quickly.
Money is collected through MSF offices in 25 countries. All of the money is pooled and used to fund MSF actions across the globe, from fundraising to front line services. Over 86 percent goes directly to our field projects.
We keep around 25 percent of our funds as cash, ready to spend on emergencies. This means we do not need to launch a fundraising appeal before we launch a humanitarian response. We act first, based on need, and build our fundraising strategies around the realities on the ground.
International staff receive a small sum for their commitment to MSF, while the national staff are paid a wage. We keep costs down by using generic medications, buying in bulk, and carefully managing our supply lines.
Running a Project
MSF projects generally have a life span of between 18 months and three-and-a-half years, but we have been in some areas for decades in one form or another, while other responses have lasted just a few weeks or months, long enough for the emergency phase of a crisis to abate.
There are clear differences between an emergency response and a long-term health care project, but they all follow roughly the same process, as described here.