MSF responds to abuse allegations during Ebola outbreak in Democratic Republic of Congo

Malnutrition emergency: mobile clinic in Ranobe

Madagascar 2021 © iAko M. Randrianarivelo/Mira Photo

In late 2020, a media investigation revealed multiple accounts of abuse involving employees of organizations responding to Democratic Republic of Congo (DRC)’s tenth Ebola outbreak from 2018-2020. One of the accounts indicated abuse linked to Doctors Without Borders/Médecins Sans Frontières (MSF), prompting us to conduct a full-scale investigation and take action.

Despite the public allegations reported by the media, our teams had not received any reports of abuse by staff working in DRC during the Ebola response. The media investigation pointed to widespread abuse among the organizations engaged in the Ebola response, yet MSF’s internal abuse prevention and management units were not informed of any concerns. This raised important questions about whether there were flaws in our reporting mechanisms—and, if so, what needed to be done to remedy them.

MSF is committed to preventing, addressing, and reporting abusive behaviors, including publishing annual data on reports and investigations that are conducted by our abuse prevention and management units. We believe that publicly addressing such issues is important, and so we are now releasing the results of our most recent investigations in DRC.

A two-fold response

Following these media reports, we conducted an internal investigation as well as an ethical review of staff practices in emergency situations and the effectiveness of our reporting mechanisms.

MSF’s internal investigation, which was completed in October 2021, was carried out by a dedicated team based on information received from other international organizations involved in the Ebola response. This in-depth review was undertaken to survey MSF teams on staff practices in emergency situations such as an Ebola outbreak; the effectiveness of MSF’s mechanisms for preventing and managing abuse; and, more generally, the ethical issues facing individuals and our organization in emergency situations.

To facilitate this review, 628 people employed by MSF during the tenth Ebola epidemic in Beni health zone in North Kivu province were invited to respond to these questions. Out of this group, 23 preparatory interviews were conducted. Additionally, 219 anonymous questionnaires were filled in, returned, and validated, and 90 in-depth interviews were held in Beni, Goma, and Kinshasa.

This response enabled us to identify and address 24 reports of personal abuse—13 of which concerned sexual abuse, with most of these involving sex in exchange for jobs. So far, we have investigated 15 reports of personal abuse—sexual or otherwise. Three were found to be admissible and led to sanctions; one was well-founded, but the alleged perpetrator could not be identified with absolute certainty because the person had since left MSF; two were unfounded; seven were closed due to lack of information or because we were asked to do so by the complainants; and two were found to involve other organizations and have been handed over to them. MSF’s internal investigation process is ongoing for the remaining reports of personal and property abuse, and it will take a few more months to conclude them.

Moving forward

While the review found that MSF is seen by its staff to take abuse seriously and attempts to mitigate it, there are still obstacles to reporting abuse. While some issues are internal to our organization and must be dealt with one by one, others relate to the local environment and our work with communities. We need to be aware of them and take the necessary steps to address them.

We need to: 

  • Better protect the most vulnerable employees, such as those in lower ranking positions, who are less likely to use reporting mechanisms 
  • Set up awareness-raising initiatives related to abuse that are adapted to the communities we assist 
  • Improve the gender balance and expand the diversity of our teams, especially in management posts and among recruitment teams
  • Be more vigilant with our recruitment processes when quickly hiring large numbers of people in emergency situations
  • Foster open dialogue about the issue of abuse with organizations we assist or work with

Between April 25 to June 25, 2022, these lessons guided MSF’s response to the Ebola outbreak in Equateur province, which was DRC’s fourteenth outbreak of the disease. Although few staff—only around 30 MSF employees—were deployed in the province, specific awareness and prevention sessions were held for our teams as well as health workers from the facilities we support. MSF’s Behavioral Commitments were included in the partnership agreement with the Ministry of Health. The mechanisms for reporting abuse were reiterated on several occasions. It was made clear that, in the event of any abuse, all those aware would be required to take immediate action.

We continue to encourage debate and the exchange of ideas among MSF staff in DRC and elsewhere in order to develop further concrete solutions. This dialogue will enable us to make structural improvements to prevent, identify, and take disciplinary action to ensure that abusive behaviors have no place within our organization.

MSF aims to make a positive contribution to efforts to root out abuses in the humanitarian sector. We hope that transparent reporting and constructive engagement will enable more people to speak out, ensure further resources are made available to prevent and sanction abuses, and stamp out the perception of impunity for those responsible for such acts.