A Conversation with Sophie Delaunay, Executive Director, MSF-USA

January 31, 2013

This article is part of the Winter 2013 issue of the MSF Alert newsletter.

Why does MSF stress that people in leadership positions have field experience?

MSF is governed by an Association made up of individuals who express their solidarity through the delivery of medical care in the field. Our Board of Directors is very connected with the Association, because the board is itself composed of former field staff and Association members elected by the broader MSF Association, which is largely composed of people in the field. It’s important to ensure that throughout the organization, the decisions that we make are driven by field considerations and that those decisions benefit our operations first and foremost. To do this, you need executive level people who know the constraints and the needs of the field. It doesn’t mean that we don’t want to include external perspectives, but this ethos is important. For me, I don’t see how I could do my job without field experience, because donors and external partners constantly ask about our operations and our operational choices. Being able to speak from experience in the field helps me give credible responses.

How do you balance managing day-to-day operations and staying prepared to respond to new emergencies?

Emergency is in MSF’s DNA. Whenever there is an emergency, everybody has an intuitive way of focusing their priorities. You realize that there are always some things that can be put on hold. I experienced it when I was completely focused on our post-Hurricane Sandy operations for a few weeks last fall. I had a lot to catch up on afterwards, but dealing with emergencies forces you to adjust.

What are some priorities for MSF-USA in the coming years?

We want to continue providing a critical amount of resources to the overall MSF movement, providing financial support and supporting human resources with the expertise we can offer, and in areas like communications and advocacy as well. We also want to further strengthen the medical expertise that we provide to operations. This will translate into the development of a new health information system, which will be a very big dossier. We will also continue to provide expertise in areas like antibiotic resistance and neglected tropical diseases. The ultimate goal is to improve the quality of our care and develop therapeutic or preventive approaches that are more adaptive to the needs in the field.

Are there areas where MSF has to improve?

Plenty. One major focus of the US Board should be to continue challenging operations on quality of care. We do a decent job of trying to assess our impact and learning from our mistakes and practices, given how complex it is to operate in unstable and resource-limited settings. It’s not enough to know that the treatments we’re using are working, though, or to know the number of people we’ve treated. We need to go further, to measure the quality of care that we’re delivering and its impact on the long-term well-being of the person who receives it. What is the survival rate? What kind of coverage do we achieve? Are our approaches as adapted to the context as they should be? We need to answer these questions, especially as we engage more in chronic disease care.

Does that include working on methods of handing over projects if or when MSF leaves?

There are already things in place designed in that spirit. There is the fact, for example, that 90 percent of our staff is national staff , or Ministry of Health staff, trained by MSF. This creates conditions for continuity. I also think the way we are approaching the health information system, for example, is very promising. Next year, when we start to implement the new HIV database we’re working on, we will set up platforms that are compatible with the platforms put in place by the Ministries of Health in the countries where we have our largest number of patients. Making sure we create something that Ministries of Health can use is an imperative.

You worked in several field projects. Do you miss being in the field?

Of course. It’s the most interesting part of the job. That’s why I worked with the Board to ensure that I can go to the field for one month every year. This year, I went to China for two weeks. Last year, I spent one month with our program in Central African Republic. The previous year, I was in Pakistan. I go to the field because it helps me rejuvenate myself in this position and helps me perform my job here.

 

Related:

• A Conversation with MSF-USA Director of Development Jennifer Tierney
• Why Do You Send So Much Mail?

Tags: How MSF Works