New MSF Case Study on Response to Rwandan Genocide

Roger Job


Twenty years after the Rwandan Genocide, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) has published an in-depth examination of its response to the crisis, part of a new series of case studies providing insight into MSF’s public advocacy over the last 40 years.

The first of the new “Speaking Out Case Studies,” Genocide of Rwandan Tutsis 1994, examines MSF's internal debates during the systematic extermination of Rwandan Tutsis between April and July 1994, when an estimated 800,000 people were murdered in 100 days. The slow reaction by the UN Security Council to categorize the massacre as “genocide” resulted in a 10-week delay of intervention.

The publication reflects MSF’s public attempts to mobilize governments to stop the murders. The case studies are part of a project that provides unprecedented insight into MSF decisions during humanitarian crises of the past 40 years, published online at

"The case study reveals publicly the constraints, dilemmas, and internal questioning for MSF's field and headquarter teams during one of the most agonizing moments in the organization’s history of medical humanitarian work," said Dr. Joanne Liu, MSF international president.

On several occasions, MSF communicated strongly to force states to stop the extermination of the Tutsi population, rather than use aid as an alibi for inaction. On June 17, 1994, MSF called for an armed intervention, stating: “you can’t stop genocide with doctors.”

The case study draws from internal field reports, press articles, and transcripts from the testimonies of MSF field staff. Additional video footage from MSF and the media illuminate the dynamics, dilemmas, and disagreements underlying MSF's response to the crisis.

Some of the deepest questions MSF faced included: Could MSF, as a humanitarian organization, remain silent when confronted with genocide? Was it acceptable to call for armed intervention, an action that could lead to the loss of, as well as saving of, human life?

Three more case studies, soon to be released, cover the period of 1994–1997, when the humanitarian consequences of the genocide affected refugees and host populations. These studies document the disaster that unfolded in camps in Zaire and Tanzania when more than one million people were under the tight control of "refugee leaders" who were also responsible for the genocide, the abuses committed by the new Rwandan regime during and after the genocide, and the hunting and killing of Rwandan refugees in Zaire by rebel forces supported by the Rwandan army.

"While the Rwandan case studies investigate MSF's own dynamics and operational challenges in response to the genocide, they also bring back all the human loss, and for MSF as an organization, the brutal loss of several hundred Rwandan colleagues,” said Dr. Liu.

Hospital of Nianza, a patient with bullet wounds is being treated. Rwanda, July 1994
Roger Job