Sierra Leone - Health Promotion in Freetown
Musa explaining to the children of the community how to prevent and recognize the symptoms of Ebola.
SIERRA LEONE 2015 © Alessandro Siclari
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FAQ: Our work

Answers to your frequently asked questions about Doctors Without Borders/Médecins Sans Frontières (MSF), its principles, and its programs.

For answers about making donations, please see our FAQ about donating.

For answers about the recruitment process, see our recruitment FAQ. You can also read our statement on our commitment to diversity, equity, and inclusion.

How long has MSF been in the US?

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 Sudan, South Sudan, Chad, and Ethiopia.

Is MSF based in France?

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

Is there a centralized governing body?

● 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.

What are your biggest challenges?


  • 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.


  • 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.

Where are your headquarters?

● 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.