South Sudan 2014 © Valérie Batselaere/MSF
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Promoting a work environment free of harassment, exploitation, and abuse

June 17, 2019

Doctors Without Borders/Médecins Sans Frontières (MSF) promotes a working environment free of harassment and abuse. Our leadership is unequivocally committed to fight abuse and to reinforce mechanisms and procedures to prevent and address it. All staff are expected to abide by the MSF movement's behavioral commitments and our guiding principles as stipulated in our charter.

In early 2018, MSF published a statement on the actions we had taken to combat abuse and harassment, the challenges we faced, and the number of cases recorded in 2017. One year on, we have compiled a short update on progress so far, including figures from 2018. We hope that this reporting will help maintain a constructive focus on this important issue.

One of the most significant challenges we identified is of underreporting—and the need to do more to ensure that our staff and patients are aware of, and trust, our reporting mechanisms. While the 2018 figures show an increase in the reporting of incidents of unacceptable behavior compared to 2017, we still believe this picture to be a significant underestimate. This is likely due to a combination of challenges around both underreporting and data gathering. 

Our statement last year set out a number of ongoing measures to improve the detection and prevention of unacceptable behavior. These included training, workshops, field visits, and the production and distribution of leaflets and audio-visual materials. In 2018, MSF continued to carry out activities in all these areas; allocated increased staffing for MSF teams responsible for addressing abuse and harassment; developed new tools for improving awareness, prevention, and detection of unacceptable behavior; and improved data-gathering and sharing across the MSF movement. It is worth acknowledging that an increased public focus on this issue likely contributed to increased awareness and reporting.

In 2018, MSF had over 43,000 staff working in our medical humanitarian field projects around the world. (The following figures relate to complaints from the field and do not include the additional 4,000 staff working in MSF headquarters.) In 2018, we saw a significant increase in the number of complaints from the field recorded about all types of inappropriate behavior, a total of 356, up from 182 in 2017*. We hope that these figures are an indication that an increased focus on the issue has encouraged more people to come forward.

Out of these 356 complaints, after investigation 134 were confirmed as either situations of abuse or of inappropriate behavior (compared to 83 in 2017). This includes 78 cases qualified as abuse of all forms, including sexual abuse, harassment, and exploitation; abuse of power; psychological harassment; discrimination; and physical violence (compared to 61 in 2017). MSF dismissed 52 members of staff for all forms of abuse (58 in 2017).

Of the total 78 cases of all forms of abuse in 2018, 59 were confirmed after internal investigation as cases of sexual abuse, harassment, or exploitation (up from 32 in 2017). MSF dismissed 36 staff as a result of those cases (up from 20 in 2017).

There were also 56 confirmed cases of inappropriate behavior, a category that includes mismanagement of people; inappropriate relationships; inappropriate behavior not in line with societal standards or affecting team cohesion; and the use of drugs, alcohol, and other substances (up from 22 in 2017).

In all confirmed cases, measures were taken in proportion to the severity of the act.

It is worth stressing that this is still not the complete picture that we would like to have. While we have improved data-gathering since last year, we still have more work to do to address both this issue and the challenge of underreporting. We continue to urge staff, patients, and anyone else who comes into contact with MSF to report incidents of unacceptable behavior.  

*Note on changes to 2017 figures: Due to improved data collection and compilation, MSF has updated its figures for 2017. As a result, the total number of complaints for 2017 is found to have been higher than previously estimated: 182 as opposed to 146; the number of confirmed cases has also risen slightly. The above comparisons use the updated 2017 figures, but for the purposes of comparison the original figures remain available in last year’s statement. Please note that some cases in 2018 are still being investigated and have not yet been qualified, so the figures may change slightly.