"How can we improve the aid we provide to victims of armed conflict?" asks Jean-Hervé Bradol, MD, in the opening pages of Civilians Under Fire, a new book released today by Doctors Without Borders/Médecins Sans Frontières (MSF).

Dr. Bradol, President of the international medical aid organization’s office in Paris, and several other medical experts from MSF try to answer this question by taking an introspective and self-critical look at the medical programs MSF ran in the Congo Republic (also known as Congo-Brazzaville) during a severe phase of the civil war that devastated the country from 1998-2000. Hundreds of thousands of people were displaced by the fighting, and many were killed.

In particular, Civilians Under Fire sheds light on the important ethical, medical, and practical considerations with which doctors and nurses struggled when making decisions about providing assistance to victims of rape, a group often overlooked by humanitarian organizations. The mission in the Congo Republic represented the organization’s first experience of setting up a specific program to assist the victims of sexual violence.

In the face of such massive displacement and a nutritional emergency in an atmosphere of extreme violence, MSF’s overall aid operations in the Congo Republic were impressive. But as Nicolas de Torrente, Executive Director of MSF-USA, notes in the introduction, "One of the main points conveyed in this collection of essays is that MSF could have, and should have, acted more quickly and assertively to address the specific medical needs of … the large number of women who were raped during this episode of the Congo Republic’s civil war."

These essays not only offer tremendous insight into the limitations of emergency assistance but also how aid workers must adapt their programs in a rapidly evolving situation to help those in most need. Such honest and sobering assessments make Civilians Under Fire a significant contribution to the study of humanitarian assistance, a book that will interest policy-makers, scholars, and general readers.

Most important, though, the book will prove to be an invaluable resource for those on the front lines of humanitarian aid work concerned with improving the quality of emergency assistance delivered to people whose lives and dignity have been shattered by war.

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