FAQ: Our work

MSF-USA was established in 1990 by the French section. They wanted to have a presence in the US in order to expand their international fundraising, recruitment, and advocacy (New York was chosen because of its proximity to the UN and media). The US office has since expanded their role in field operations and is now managing programs in Colombia, Haiti, Liberia, Somaliland, and South Sudan.

In response to the COVID-19 pandemic, MSF ran temporary operations in the United States from April to October. MSF recognized that there was a clear need for more support for the response to the outbreak in the US. In key sites around the country, we worked with local authorities and partner organizations serving vulnerable communities with limited access to health care. We have now concluded these activities.

MSF teams collaborated with local authorities and community-based organizations on a wide range of projects, including work with people who are homeless or housing insecure in New York; migrant farmworkers in Florida; Native American communities in the Navajo Nation and Pueblos; and neglected and marginalized communities in Puerto Rico. Our teams also worked with staff in nursing homes and long-term care facilities in Michigan and Texas to offer training in infection prevention and control measures and support for mental health and wellness. 
 
MSF works in more than 70 countries. We provide medical humanitarian aid where the needs are greatest, and often go to places where other organizations can’t or won’t operate. Historically, we have not run medical projects in the US, where there are significant public health resources and a large number of nongovernmental organizations working to meet the needs of neglected and underserved communities. MSF assesses the medical needs in the US periodically in response to natural disasters and other emergencies. In the past, we have not identified an area where the need for our medical assistance could not be met by another organization working in the US, or where our unique approach to responding to emergencies was required.
 
MSF’s regular work in the US includes communications to speak out about the suffering we witness, and to pursue direct engagement with the US government, United Nations, and other institutions in support of our medical humanitarian operations around the world.
 
We are also responding to the humanitarian crisis in Central America and Mexico, including projects to provide medical care for migrants and asylum seekers along the Mexican side of the border with the US. We have treated thousands of patients across the region who were detained and deported by the US.

MSF was started by French doctors and its first office was in Paris, but there are now 24 associations around the world.

● MSF has an International General Assembly (IGA), which is comprised of two representatives from each MSF partner section as well as two representatives per MSF Association.

● The IGA elects 12 representatives to sit on the International Board (IB). The IB is also comprised of the International President, the Vice President, the International Treasurer, and the Operational Directors. The IB has authority over issues such as resolving conflicts within MSF, opening and closing new entities, and holding sections accountable for implementing a shared vision.

● MSF also has several international committees that see to coordination among sections and sharing of information with regard to policy, management, communications, recruitment, and funding.

Financial

• Securing predictable and sustainable funding during an uncertain economic climate.
• Maintaining and improving the quality of our programs, especially those that also rely on international funding from large global institutions for such things as drugs, vaccines, and emergency food aid.
• Having the necessary reserves to allow us to respond to new emergencies as they occur.

Human Resources

• Securing experienced and committed field staff and retaining them, especially those who can work as coordinators.
• Finding qualified medical staff that can work on a range of medical issues including emergency surgery and rehabilitation, maternal and pediatric care, tropical diseases, chronic care, and mental health.

Operations

• Security—We work in areas of conflict where many actors are often involved. We need to constantly reinforce our neutrality to all parties in order to keep our teams safe. In the past 10 years, there has been a blurring of humanitarian aid and military interventions, where humanitarian aid workers have been directly targeted making it more difficult for us to work in certain high risk areas.
• Balancing speaking out with gaining access to populations; gaining access to people cut off from assistance in armed conflicts due to insecurity, government bureaucracies, and other blockages is not always easy to negotiate.
• Access to appropriate medications, vaccines, and therapeutic foods to treat malnutrition. Policies, pricing, and politics can pose barriers for procuring vital medical supplies. Outdated diagnostics and treatments make medical assistance in resource challenged settings difficult and expensive. Improved research and development for neglected diseases would not only help us save more lives, but would allow us to treat patients with a better and more efficient use of our resources.

● MSF has no real "headquarters." Although the organization was established in France, it has grown into an international association with 24 independent sections worldwide.

● Five of those 24 sections are the Operational Centers or "OCs," the offices that directly manage all of our field programs or "operations." The OCs are in Paris, Geneva, Brussels, Amsterdam, and Barcelona. The remaining sections partner with the OCs and support their program operations, communications, recruitment, and fundraising. For example, the US, Japan, and Australia offices are in direct partnership with the OC in Paris.