December 12, 1999
December 12, 1999
by Joelle Tanguy and Fiona Terry
What Doctors Without Borders/Médecins Sans Frontières (MSF) stands for, in the community of humanitarian actors, is a humanitarianism concerned with advocating against injustice and indifference, and with asserting basic rights and quality of assistance for vulnerable populations.
On Neutrality and Impartiality
MSF, from the outset, chose to step away from the classical Red Cross approach of a "silent neutrality" and sought to put the interest of victims ahead of sovereignty considerations. MSF's determination to speak in public when faced with mass violations of human rights, including forced displacement or forced repatriation, war crimes, crimes against humanity, and genocide, is a defining principle of the organisation.
This aversion to silence stemmed from the post-Holocaust debate in Europe, influencing the intellectual generation that presided over the birth of the "Sans Frontières" movement. Often the sole witnesses to violations, MSF volunteers consider themselves accountable to international civil society and humanitarian principles, rather than to governmental or multilateral financial backers of aid. As a consequence, MSF's testimony ("temoignage") is raised in public rather than in closed diplomatic circles.
Far from rejecting the principle of impartiality, MSF adopted as a fundamental principle of its operations the provision of aid in proportion to need and without discrimination—the very tenants of impartiality. And since true impartiality requires operational independence from economic and political pressures, MSF has also inscribed independence—and financial independence—as a key principle and operational reality, with the majority of its funds raised from individual private donors throughout the world.
MSF has not abandoned or rejected the principle of neutrality either, defined as "not taking sides with warring parties". While it worked on the US-backed side of the Afghanistan conflict and in refugee camps inhabited by asylum seekers fleeing totalitarian systems, MSF was actually one of only a handful of aid organisations which worked in both the Salvadoran (left-wing guerrilla) and Nicaraguan (Contra) controlled refugee camps in Honduras, recognising that victims occur on both sides of a conflict, regardless of the "goodness" of the political ideology espoused by either side.
And in the mid 1980's, MSF was simultaneously expelled from Ethiopia by Soviet-backed Mengistu and from Guatemala by a US-backed government eager to send away potential witnesses to the violence. Rather than "siding" with one or other party to the conflict, MSF has, at times, judged that the victims are more in need on one side than another, and designed its missions based on the "proportionality" principle embedded in impartiality.
Faced with massive human rights violations, misuse of humanitarian assistance, or a totalitarian regime, MSF may exclude working with one party to the conflict, as was the case with the Khmer Rouge in the Thai border camps. But this position is less an expression of political preference than a determination to claim and operate within humanitarian space. Such "humanitarian space" entails the ability to independently assess the needs of the population; retain unhindered access to the population; conduct, monitor and evaluate the distribution of aid commodities; and obtain security guarantees for local and expatriate aid personnel.
The ideology and control mechanisms of the Phnom Penh regime until 1988, of the Khmer Rouge along the Thai border, of the extremists in the Rwandan refugee camps in Zaire and Tanzania from 1994-96, obviated the possibility of obtaining humanitarian space. Instead, the aid itself became a tool in the further oppression of the civilian populations. As Rony Brauman argued about the Cambodian crisis, "The choice, then, was not between a political position and a neutral position but between two political positions: one active, and the other by default".1
Thus if neutrality is defined as remaining silent, even when confronted with grave breeches of fundamental humanitarian principles, MSF is not neutral. However, as long as neutrality is defined, as "not taking sides with warring parties", MSF upholds a spirit of neutrality throughout its operations.
On Humanitarianism and Politics
MSF volunteers bear witness to the situation of populations in danger they assist. This "temoignage" seeks to combat indifference to the plight of populations and to signal the need for local and international responsibility to uphold basic humanitarian and human rights principles. As Alain Destexhe writes, "if humanitarian assistance is to be worthy of its name, it must work in parallel with efforts to meet the demands of justice and respect for human rights".2
Most "humanitarian crises" are fundamentally political crises with humanitarian consequences. All the ambiguities of intervention lie in this essential link. Humanitarian agencies are caught between governments seeking an alibi for their political inaction, and media tending to focus on human tragedy rather than its political roots. Refusing to act as a relief-service provider contracted by state or multilateral financial backers, MSF seeks instead to be both a humanitarian actor and an agent of change: to do so often requires highlighting the political responsibilities of the local and international community.
On Aid Fuelling War
Humanitarian intervention can also fuel the crises it seeks to alleviate, and all the more so since the number of NGOs and their funding multiplied in the 1990's. Aid can be taxed, hijacked, looted, racketeered. Interventions can be manipulated to build internal or international legitimacy, to freeze military gains, to sustain ethnic cleansing, to enforce population displacement, to support famine policies.
When confronted with the dilemma of fuelling a war economy3 or sustaining political or military strategies, MSF strives for a lucid and responsible approach that might involve minimalist programming or even abstention, but remains essentially concerned with preserving humanitarian space. Every situation requires careful analysis.
As Brauman writes: "From a moral stand point, weighing the pain inflicted against the pain avoided is an impossible endeavour. Despite all contradictions attached to the act, striving to save lives and alleviate distress remain fundamental. Humanitarian action cannot be considered as the "small change" of larger political considerations. But to recognize that humanitarian aid could have perverse effects and lengthens the war, leads one to at least ask the right questions on the type of program to design, on the control to exercise, on the level of aid to channel".4
Hence once the emergency needs of the population have been met, MSF has reduced or even withdrawn when humanitarian aid had a strong chance of prolonging the war. This was the case in the Rwandan refugee camps in Zaire and Tanzania, from which MSF withdrew in late 1994.5
On Contemporary Crises
There's never been a "golden age" of humanitarianism. Humanitarian aid has always been fraught with tremendous political and ethical controversies. In our experience, while it is clear that the context has changed, aid organizations have always been faced with these types of intractable dilemmas. In the 1980's for example, feeding the Khmer Rouge along the Thai-Cambodian border was one instance; watching aid used as a tool of the brutal forced migration policies of the Mengistu regime in Ethiopia was another. William Shawcross' exposé in 1984 of the dilemma of "how to feed the victims without also providing aid to their tormentors"6 and Jean-Christophe Rufin's 1986 book on the "humanitarian trap"7 attest to the debates within MSF and other humanitarian organizations. These debates shaped much of our approach to the crises of the late 1980s and 1990s.
The dominant discourse on contemporary crises frequently invokes a "new complexity", characterized, by "an increased disregard for humanitarian law", "direct targeting of civilians", and "the protracted nature" of conflict. We challenge the notion that this "new complexity" derives from a tendency towards increased barbarity. Two instances of genocide fifty years apart, two famines, in Mao's China8 and in today's Sudan, illustrate this well. Aspects of conflict have changed with the end of the Cold War: the fragmentation of armed movements, in particular, increases the difficulties of identifying reliable interlocutors, and the distinctions between state and non-state, private and public, political and business initiatives are increasingly blurred.9
But rather than a causal emphasis, the "complexity" associated with contemporary crises better reflects the response of the multiplicity of actors present in the heart of conflicts. The increasingly blurred distinction among these actors has led to a confusion of roles and increased manipulation and misuse of aid. Humanitarian aid, once a tool of states to promote foreign policy objectives, has become a tool with which to avoid foreign policy engagement. And aid organizations, although lamenting the "humanitarian alibi", are lined up to receive more government funding.
On Broadening the Humanitarian Mandate
Far from aiming to resolve conflicts or even calling for an end to war, MSF's political humanitarianism is concerned with advocating against injustice and indifference, and with asserting basic rights and quality of assistance for vulnerable populations.
Various pundits and practitioners advocate for a broadening of humanitarian action into the political realm. In our opinion, the involvement of humanitarian actors in such matters as conflict resolution initiatives risks diluting the primary responsibility of humanitarian aid to alleviate suffering. Moreover, it will further shift the responsibility for the resolution of conflicts and the respect of international legal conventions from accountable political institutions to the private sphere. Is this where we want to lead humanitarianism?
Joelle Tanguy is a former Executive Director of Doctors Without Borders/Médecins Sans Frontières (MSF) in the United States. Ms. Tanguy has led emergency and refugee operations in Somalia, Uganda, eastern Zaire (Congo), Armenia, and Bosnia—often amid political and military turmoil.
Fiona Terry is the President of Médecins Sans Frontières in Australia, and a PhD candidate at the Australian National University. She has led emergency relief activities for MSF and UNHCR in Northern Iraq, Somalia, Liberia, Rwanda, and in the Rwandan refugee camps in Tanzania.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)