“Wounded patients often fear for their safety in medical facilities, so it is essential to create a place of sanctuary for them, where there is no discrimination. We treat anyone who is injured, whatever their politics.”

BRUNO DUCHENNEHEAD OF MISSION, Burundi 2015

Armed Conflict: Latest MSF Updates

In conflict zones, Doctors Without Borders/Médecins Sans Frontières (MSF) does not take sides. We provide medical care based on needs alone, and work hard to try and reach the people who need help the most. If warring parties see aid organizations as being on one side of a conflict, we are less likely to gain access to those in need and more likely to be attacked.

One of the ways in which we are able to demonstrate our independence to different parties is to ensure that all our funding for work in conflicts comes from private individuals—we do not accept government grants.

Immediate Response

Fact: 

In conflicts, MSF does not take sides.

We provide aid based on needs alone.

Only highly trained, experienced staff can work in conflict situations.

Each mission has specific safety regulations.

MSF is safest when everyone in a conflict zone knows we are independent, neutral, and impartial.

Conflicts, be they international wars or internal disputes, can have many consequences.

Fear of violence or persecution uproots entire communities and, for those who stay, many are often left without access to medical care.

Conflicts normally lead to a rise in trauma injuries, but also lead to problems for people needing normal medical care, such as for complications with pregnancy or chronic diseases such as diabetes.

Psychological distress and mental illnesses also generally rise. Sexual violence is a frequent symptom of conflict.

We try to fill these gaps with highly experienced doctors, nurses, and logisticians who provide specialized medical care and logistical support.

Intense Violence

During times of intense violence, our teams often have to work with a great deal of flexibility. In 2011, with ongoing violence engulfing medical facilities in Misrata, Libya, an MSF team had to find a way to safely and quickly evacuate a large number of severely wounded patients from the city.

The team chartered a fast passenger ferry, stripping it of its seats so that plastic sheeting and mattresses could be laid and IV lines set up. “The violence caused an influx of wounded people and it was fortunate we could be there and get them onboard,” said Helmy Mekaoui, an MSF doctor who coordinated the medical evacuation.

Despite the rough seas, the boat safely arrived in Tunisia the following day with 20 ambulances waiting to take the 71 patients to the hospital.

MSF logistician Annas Alamudi said: “As far as I’m concerned, it was a successful operation and I’m glad we could help. There were sick people who needed to get out, and we got them out. Job done.”

Highly Experienced Staff

Working in a conflict zone can be an extremely frightening, stressful, and disturbing experience. Because of this, we only allow highly trained and experienced staff who have volunteered themselves to work in such situations.

Paul McMaster, a British surgeon who has worked extensively with MSF, still finds high-security missions challenging.

After returning from a mission in Syria where he treated the wounded in an operating theater set up in a cave, he said: “I've worked in many difficult places with MSF—war zones like Sri Lanka, Ivory Coast, and Somalia—but while in those countries it was dangerous on the ground, in Syria the danger always comes from the air.

“It’s a much more oppressive type of danger, having a helicopter hovering in the sky above you.”

Security

Although we accept that it is impossible to exclude our staff from every form of risk, we do our utmost to manage them through our strict security measures.

Before starting a new project, and throughout its run, we are continually assessing risks. Each field mission has specific and detailed safety regulations in place, outlining strategies and specific security measures and responsibilities.

Among these regulations, MSF holds a strict ‘no-weapons’ policy in all of our clinics, vehicles, and health centers. For the safety of our staff and patients, it is crucial that no armed people are in our hospitals. Naturally we will treat fighters who need medical help, whatever side they are on, but they and their associates must leave their weapons outside. The presence of anyone who is armed heightens the chances of our facility becoming a target of violence.

MSF Logo

MSF’s logo is widely recognized around the world and symbolizes for many our core principles of impartiality and neutrality. MSF offers assistance to people based on need and irrespective of race, religion, gender, or political affiliation. We give priority to those in the most serious and immediate danger. Our decisions are not based on political, economic, or religious interests. MSF does not take sides or intervene according to the demands of governments or warring parties.

Adhering to these principles when providing medical and humanitarian aid, explaining them to all parties to a conflict, and demonstrating them on a daily basis contribute to the protection of our patients and staff. We strive to ensure respect for the humanitarian values represented by the MSF logo.

Unfortunately, medical personnel and facilities are increasingly coming under attack and even deliberately targeted by warring parties in conflicts around the world, in violation of international humanitarian law and standards. MSF teams have suffered terrible losses from attacks in places including Afghanistan, Somalia, Sudan, Yemen, and Syria. We condemn attacks on health services and demand action at the highest levels to protect the medical mission.

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