Medecins Sans Frontieres - There is still Hope for this World
Medecins Sans Frontieres – Doctors Without Borders
It is once said that there is no greater love than of one willing to lay down his life for another. How profound this statement is for what more can a man give to his brother other than his life? This man can attempt to give his time. Yet what are a few hours, few days in comparison to a life time. He may give up his assets his money, but even these things can be replaced. The man can serve through his efforts. Yet, he loses nothing from his labor other than the time he spent working. Therefore, nothing can stand in comparison to the sacrifice of life and nothing other than love can motivate a man to freely forfeit that blessing for the sake of another. It is no wonder Americans are so patriotic and endear their beloved soldiers – men and women who voluntarily sacrifice their lives and to ensure the safety of their families, friends, and country. There is no greater love, because life irreplaceable.
Unfortunately, few people ever give themselves completely. Few people ever give themselves at all. This is evident from the desire to change the channel whenever we see commercials advocating donations to Africa. Though no one would ever say it, we inwardly argue in our defense. What did these African kids ever give me….? Though simplistic, this is the logic that justifies why many doctors won’t outsource to 3rd world countries. Seeing a starving child in a newspaper article just isn’t motivating enough to risk their lives, their success, or their comfort. But thanks be to God there are doctors who look past the trivial desires of their own life and willingly pursue places of danger, disease, and disaster to care for those in need. They shine like stars in the midst of darkness because they love people more than they love themselves. Unfortunately as bright as doctors desire to shine, there is much darkness in this world – much pain, much sorrow, much disease, much death. We live in an age where 21,000 children die EVERY day from hunger and disease. We live in an age where families have six, seven, eight kids in hopes that just one may make it and survive into adulthood. This is our world. This is our pain. But do not discount the lighthouse where they stand. So long as there is light, life will continue to spring forth.
Profile of the Organization and Problem:
Medicins Sans Frontieres (MSF) is one of the very few organizations that responded to the cry of this world, even its beginnings were manifested from a passion for humanity. During the Nigerian Civil War of 1967, Biafra had separated from Nigeria and gained its independence from its oppressive mother country. However, this political separation was only in name for in reality it was still shackled by the heavy hand of Nigeria’s military. Raids of the countryside were common place and civilians were often the ones who suffered the most during the war. Biafra continued to fight and defend itself from the larger, more equipped, and better supported Nigeria. But despite these, deficits, Biafra was successful in hampering Nigeria’s infiltration into the country. It was a stalemate. However, the standoff did not last long after Nigeria’s change of tactics and support from the United States, Soviet Union, and United Kingdom. In 1968 Nigeria blockaded Biafra, ceasing the movement of any weapons, goods, and foods into the country. Though the absence of weapons and goods did not have a significant impact on the Biafra, the lack of food resulted in the deaths tens of thousands of people – soldiers, men, women and children. The devastation and need was evident, yet the Red Cross which was stationed in Biafra did little to aid the people because the organization was afraid that its involvement would endanger its staff and feared political bias.
Bernard Kouchner and a number of doctors volunteering under the French Red Cross umbrella were distraught and frustrated with the organization’s passiveness. They then were determined to form a new humanitarian organization that would not be limited by politics, religion, and race or afraid to work in volatile areas. As a result, Medicins Sans Frontieres was formed in 1971 to supersede the limitations of the Red Cross. This new freedom not only allows the organization to work on a worldwide scale but also gives MSF the ability to maintain is independence from any higher governing body. Separation from typical humanitarian organizations that are often hindered by a chain of command is extremely significant because it simplifies the process of administering care. How quickly is aid given if volunteer workers must first request an approval from the headquarters, ensure that the aid would not upset any political ties, and then wait till the area is safe enough to proceed to action? There is no time for such matters. Death, disease, and war do not wait for organizations to get settled in before escalating beyond control. Therefore, it is impeccable that MSF have the independence to counter disaster with great urgency.
Another principal of MSF is to “provide care on the basis of need alone, and push for increased independent access to victims of conflict.” Unlike similar organization that may provide aid to a single race or are influenced to serve a single side to a political conflict, there is really no other criterion that the organization looks for when it chooses to serve in an area. Their approach begins by determining if there is a need and if so, how to serve most effectively. Therefore, it is understandable that MSF primarily serves in areas of danger, disaster, and disease because these are the places where care is most desperately needed. In the past year the organization has worked on over 400 different projects to provide aid around the world. Recently, it has sent a team with vaccines to treat cholera in Africa where it runs rapid in the villages. The workers exposure to immediate danger is not as high when treating epidemics since the volunteers themselves are immunized before ever administering vaccines. However, it is an entirely different story when MSF becomes involved in areas of natural disaster and war. Attempting to treat areas with high mortality rate and possibility of danger towards workers makes the MSF unique as an organization. When other humanitarian efforts cringe at the possibility of conflict and danger, MSF dives into the very eye of the tornado.
In 2010, Haiti was hit with 7.0 magnitude earthquake that caused the death of 310,000 people and left over a million people homeless. The infrastructures of entire cities were torn apart and the death toll was climbing. Even the centers that MSF had previously built to provide care were severely damaged by the earthquake. Without these facilities, the organization did not have enough supplies, work space, and man power to effectively treat the areas that were most affected. MSF was just unprepared by the amount of destruction for the devastation caused by the earthquake. However, it is interesting to note that although the teams on the ground did not have much to work with, their presence prior to the earthquake made it easier for reinforcements to be deployed throughout the country. Days after the earthquake, MSF provided supplies and equipment and worked as the primary relief effort in the country. Even as Haiti’s neighbors, the United States was slowly mustering money, supplies and volunteers, the organization was already in the thick of the disaster, providing temporary shelter and aid to the homeless and injured. Its ability to work with such speed and efficiency all draws back to MSF’s simplistic independence and grounding in multiple countries around the world.
Unfortunately when dealing with war, nothing is simple. Political pressures by current governments and the violence of rebel armies constantly threatens the lives of many MSF workers and their ethics on political impartiality. How can any human with some sort of conscious remain indifferent to blatant infringements of natural liberties? …child soldiers, sex trafficking, drug enterprises. Sometimes it is necessary to choose a side in order to preserve the lives of the afflicted and denounce the attack of the aggressor. The acknowledgement of this truth only solidifies the fact that there is a contradiction in the organization. Further evidence to this discord is realized during MSF’s experience in the decade long Somalian revolutions of the 90s. Somalia’s last stable government was toppled in 1991 and since then different military regimes and tribal leaders have assumed control over the country. Assassinations and night raids have become a cultural norm and people live in constant fear of being killed or kidnapped. Currently the government uses the military to suppress the rebel force and the rebel force is doing everything it can to topple the government. This cyclical violence has scared the country and the people are often the victims of the war. It is no wonder the people turn to non-profit humanitarian organizations like MSF that provide refuge for those in need. Who else can they cling to? The government that should protect the people is very body that oppresses them. As a result, MSF took the responsibility to protect the people and provide refuge. However, it is important to note that making this decision did not come without consequence. For MSF is no less immune to the affects of war than any other person. In the past year, dozens of reporters and doctors working under MSF have been murdered on the field and countless others have been injured. Yet, despite the danger, risk, and losses accumulating in the country, MSF continues to stand by their principals and vows to stay in Somalia. Before the staff ever stepped foot in the country, workers are well informed of the danger but they still are willing to go. They go when no one else will.
It is amazing that even death cannot deter MSF’s fidelity to humanity. However, the nobility of MSF’s call did not begin on such grounded foundation. It was only through the organization’s experience working in Rwanda that it had transformed into the freedom fighting force it is now. In 1993, the Rwandese Patriotic Front (PRF) began a civil war against the extremist revolutionary government, which resulted in an ethnic genocide. Hundreds of thousands of civilians were caught in the massacres and the MSF had to retreat to the safety and protection of the International Committee of the Red Cross. The extent of the violence really hampered MSF’s operation to aid the people, but despite these initial setbacks, the two organizations were able to adapt and cooperate as one unit; they were able to keep all the major hospitals functional! However, as the war progressed tensions were brewing because MSF was defending and aiding the ethnic persecuted along with everyone else caught up in the violence. As a result, 56 members of the ICRC and almost 100 members of the MSF were tragically murdered…Both organizations were infuriated and MSF called upon the French military to intervene on its behalf. Weeks later after the tragedy, MSF was approached by the media on how the events affected MSF as a whole. All the leaders gravely pointed to the fact that "One cannot stop a genocide with doctors." The Rwanda civil war of 1993 had changed MSF forever because its decision to call upon the military broke the very nature and principals of the organization. It is a humanitarian and it had no authority to call upon foreign military, regardless of the circumstance. What made matters worse is that the French army actually caused more harm than good and weakened support in the country. Thousands of people died as the French military tried to form and facilitate massive refugee camps. The heavy concentration of people caused massive cholera epidemics and many people died from starvation. The decisions of the MSF and the affects of its choices necessitated an amount of accountability on all humanitarian organizations to ensure that none would over step its boundaries. As a result, the Red Crescent Movement and Disaster Relief Program were created to ensure that no humanitarian organization would be allowed to use military leverage to suppress other countries. They are only allowed to advocate humanitarian efforts. Although MSF is now more restricted, it continues to speak out against injustices and acts peacefully to expose the need for change in certain governments.
Along with MSF’s initiative to provide medical care and speak out against injustice, the organization is involved in other humanitarian efforts that most people are unaware of. It is a common misconception to believe that MSF is comprised of only doctors. Yet how are the Doctors supposed to facilitate a clinic, catalogue the changing disease patterns, distribute food, teach the locals how to practice hygienic protocol, order more supplies, provide transportation, all while administering drugs and surgeries to victims of war, disease, and disaster? It is impossible. As a result, every team that is sent to the mission field consists of a number of professionals, known as logisticians, who are responsible to provide the doctors and medical staff with all the tools necessary to efficiently aid the people. The logisticians are the foundation upon which doctors can grow. For how much good can a million doctors do if there is no one to house them, supply them, and maintain the facilities that they work in? Therefore logisticians are just as important the doctors themselves. They may not be as highlighted in the news reports yet there presence is essential to the success of the organization.
On a mission field it is often found that epidemics and disease are secondary problems that branch off a more basic issue of malnutrition and unclean water. Doctors are unequipped to fix these issues. However, logisticians consist of engineers and managers who are equipped with the skills to prevent disease in the first place. Many sanitation engineers work to build wells that pump water free of water-born pathogens. They also teach the locals more hygienic ways to dispose of waste that keeps their water supply clean. Basic changes such as water control and even education can go a long way in keeping a community from chronic disease.
Another unique team member that is incorporated into many of the MSF’s field mission is a statistician. His role has direct impact on effectively reducing the spread of disease in 3rd world countries. Statisticians collect data on mortality, rate of malnutrition, and regional diseases they find among their patients. This job seems morbid. However, the data that the statistician collects is extremely important because the information determines how much supplies are necessary AND it helps the doctors predict the geographical movement of certain diseases. This information is gold because doctors will seasonally know when and where care is needed most. Therefore the organization can prepare even before problems arise. MSF’s abilities and success at a mission field is greatly improved by the help of logisticians because their skill set focuses on every angle of need – from education to surgery. MSF is prepared to support life in all its complexity.
Even after understanding and hearing of all the amazing mission projects that MSF works in, it understands that many people just have an instinctive fear when they consider donating to any non-profit organizations. People want to know “exactly” where there money is going to and want to be confident that there money going to waste. Unfortunately, many organizations refuse to disclose this information and expect the donor to have faith that the money is put to good use. This type of relationship is exactly why people are afraid to give because there is really no guarantee. They fear the unknown. However, MSF is true to their promise as a non-profit organization and backs up their claim by making their finances transparent to the public. For example, all the MSF offices are required to combine their accounts and the accumulated revenue will be open. In 2008 alone the organization collected $979 million, 85% of which came from private donors and the other 15% from a combination of government and international agencies. Yet with almost a billion dollars to spend, how is the money used? It can be assumed that with so much support and an excess in giving, workers would fly first class and stay in 12 star hotels. However, MSF in all its success remains humble and respects the sacrifice that donors make to give. Therefore, flying economy and decent hotels are just a few examples of how the organization tries to be frugal with the money. In regards to the service projects, fundraising, and administration, 87% of the $979 million dollars is spent on direct field programs, 12% on fundraising, and 1% on administration. The demographic of these finances show the overwhelming emphasis on direct care over any criteria.
It is also important to recognize that MSF’s use of the money is really characteristic of the organization itself. Only 1% is used for administration costs where as 87% goes straight to programs and service projects that support and aid victims of war, disease, and disaster. Therefore it can be considered that MSF is just a tool. It is an avenue where money from stable countries can be effectively and efficiently placed in areas of greatest need. I really respect MSF’s transparency with its donors. In the article it even stated that if a donor chooses to specify a particular program that his money will support, the organization will honor that decision and place it exactly where it is requested. Examples like these really portray the relationship and the organization hopes to have with its supporters.
Although MSF has escalated into an internationally acclaimed organization that has centers in over 60 different countries and works around 400 projects a year, it is still not safe to assume that the organization is effective. Whether great or small every organization must be judged at face value to see if their success truly reflects their impact on their mission field. For over forty years MSF has been speaking boldly through its actions around the world and abides by the ideal that “third world countries should not be limited to third world care.” Aid can also be provided efficiently and effectively. These principals have inspired thousands of doctors to work in dangerous areas without the expectation of compensation. The whole organization is based on complete sacrifice of oneself for the sake of another. Sometimes complete sacrifice means exactly what it entails. These doctors are motivated to serve people even until death. However, naturally this sort of conviction does not make any sense. Doctors spend 9 to 15 years in college (not including the 14 years from kindergarten to high school), invest thousands of dollars into their education, and dedicate the majority of their life to continued learning of new technology, research, and techniques to be a better doctor. After all of this it would be expected that they would reap the benefits of their labor. Who in their right mind train themselves with so ardently to become a doctor and not choose to exploits its rewards? However, love has a funny way of messing with logic. Sometimes love can blind a man from seeing the flaws in people and others times love is the only thing that can reveal what it means to live a purpose driven life. Unfortunately, love is not the cornerstone of many non-profits. As a result, few organizations are willing to risk their volunteers and few volunteers are willing to endanger their lives. But MSF breaks the social norm and sees that the risk is worth the cost. This is the key to MSF’s effectiveness. They do whatever it takes to be there for those in need. This is evident for their willingness to be present during the earthquake of Haiti even before the United States came into the picture. This is evident in their presence in Africa as they fight to contain widespread epidemics of Cholera. Most notably this is evident from its presence in war torn countries, places where no other humanitarian organization would dare step foot. It is in these places that MSF can be a force of significance because the organization often stands alone when aiding different people groups. If they were not present in the city of Pibor of Southern Sudan there would not be another hospital for another 100 miles.
MSF affect on humanity and the acknowledgement of its success is further reinforced by winning the Nobel Peace Prize. However, the only problem that I have found to be of great concern stems from MSF’s principals. If any organization were to have issues the worst place for it to be is in its foundation because everything builds on the grounding of what comes bellow it. MSF states that it is impartial politically, religiously, and ethnically. This is its slogan. However, after the Rwanda tragedy of 1993, MSF has changed and continues to denounce inhumane governments, civil war, and rebel fighters. Though its active involvement in recognizing violence, this is not being impartial. To say the Syrian government is oppressing the people and forcing them away from the public hospitals is by nature taking the side of the people and getting politically involved. This is a major problem because MSF misrepresents its ideals by the way it contradicts itself. Therefore, MSF must either revert to true impartiality and work solely to serve those in need or it must change its principals to how it has transformed as an organization. Other this flaw, MSF has been successful in reaching people in need on an international level and the amount of support given by donors just brings further evidence to the MSF’s success and effectiveness in reaching its mission field.
After researching MSF and learning of how well rounded the organization is in administering care as well as providing other necessities through the work of logisticians, I am just imagining what impact the organization could have if it incorporated missionaries within the team of doctors, engineers, statisticians... for what good would it be if you recognize the body but disregard the spirit? It’s like giving a man a fish. If you give a man a fish you feed him for a day. This is similar to providing aid to a person so that he may make it through the day. But if you teach a man how to fish you feed him for a life time. This is similar to giving a man the gospel so that he may be sustained for eternity. Having a member share the gospel to people while caring for their physical needs would make MSF truly complete in every way because it would treat the mind, body, and soul. After seeing how dramatically MSF has changed, I am sure that if it is God’s will, the organization can easily change again.
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