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An Imperfect Offering: Humanitarian Action for the Twenty-First Century

A memoir by former MSF president that is also an urgent call to confront suffering in all its many forms

An Imperfect Offering: Humanitarian Action for the Twenty-First Century

USA 2008 © MSF-USA

Having seen things we hope never to see, confronted suffering and dispassion and evil we hope never to encounter, and faced deep personal torment, James Orbinski still believes in “the good we can be if we so choose.” His chosen medium for revealing this is stories from his own experience—a doctor’s indelible testimony from the front lines in Peru, Somalia, Afghanistan, Rwanda, Russia—embodied in which are warnings, hope, and lessons in how we can inject humanitarian activity into our lives.

Being political, he has discovered, is not only reserved for politicians; admitting and confronting imperfection is essential to compassion. With an eye for detail like that of the finest journalist and the empathy of the most committed doctor, Orbinski’s powerful voice is matched by the urgency of his message.

At a time of great political and moral uncertainty, An Imperfect Offering is invaluable reading for anyone who wants to assume their responsibility as a humanitarian and a citizen.


This book is a series of stories in which I ask, again and again, “how to be in relation to the suffering of others.” It is a personal narrative about the political journey I have taken over the last twenty years as a humanitarian doctor, as a citizen, and as a man. It is about the mutuality that can exist between us, if we so choose. I have come to see humanitarianism as a challenge to political choices that too often kill or allow others to be killed. At its best, politics is an imperfect human project. It is at its worst when we delude ourselves into thinking it can be perfect. Speaking is the first political act. In speaking, one inherently recognizes that “I am and I am not alone.” In this space lies our humanity.

See also: Triage: Dr. James Orbinski's Humanitarian Dilemma

Buy: Amazon