In warzones, MSF does not take sides. We provide medical care based on needs alone, and work hard to try and reach the people who need help most. If warring parties see aid organisations as being on one side of a conflict, we are less likely to gain access to those in need and more likely to be attacked.
One of the ways in which we are able to demonstrate our independence to warring parties is to ensure that all our funding for work in conflicts comes from private individuals – we do not accept government grants.
Conflicts, be they international wars or internal disputes, can have many consequences. Fear of violence or persecution uproots entire communities and, for those who stay, many are often left without access to medical care.
Conflicts normally lead to a rise in trauma injuries, but also lead to problems for people needing normal medical care, such as for complications with pregnancy or chronic diseases such as diabetes. Psychological distress and mental illnesses also generally rise. Sexual violence is sadly all too common in conflicts too.
During times of intense violence, our teams often have to work with a great deal of flexibility.
In 2016, fighting intensified around Mosul, Iraq, critically wounding many civilians. MSF quickly adapted to the rapidly unfolding violence by setting up surgical operations in abandoned buildings, shipping containers and inflatable tents.
“The objective of these hospitals is to treat patients severely wounded because of the ongoing fighting,” said Barbara Turchet, Médecins Sans Frontières Head of Mission in Iraq.
“For the most critically wounded in this area, offering care as close as possible to the front lines can be a matter of life or death. Among the first patients to be admitted were a family whose house was hit by a rocket.”
Highly Experienced Staff
Working in a warzone can be an extremely frightening, stressful and disturbing experience. Because of this, we only allow highly trained and experienced staff who have volunteered themselves to work in such situations.
Georgina Woolveridge, a doctor from Tasmania, recalls responding to a mass casualty event in Iraq where she was confronted with a severely injured toddler.
“An hour before, a call came through that a suicide vest had been detonated at a checkpoint and ‘a few ambulances were on the way’. Mechanisms were in place to accommodate the arrivals, but no training module could prepare me for the flood of human debris that was to ensue. Chaos descended and by the time (the toddler’s) stretcher was wheeled in we were engaged in a morbid game of Tetris with all the extra beds. We bunkered in for the worst.”
Although we accept that it is impossible to exclude our staff from every form of risk, we do our utmost to manage them through our strict security measures.
Before starting a new project, and throughout its run, we are continually assessing risks. Each field mission has specific and detailed safety regulations in place, outlining strategies and security measures and responsibilities.
Among these regulations, MSF has a strict ‘no-weapons’ policy in all of our clinics, vehicles and health centres. For the safety of our staff and patients, it is crucial that no armed people are in our hospitals. We treat fighters who need medical help, whatever side they are on, but they must leave their weapons outside. The presence of anyone who is armed heightens the chances of our facility becoming a target of violence.
In the many conflicts where we intervene throughout the world, our medical humanitarian teams assist people based on their needs irrespective of race, religion, gender or political affiliation. They give priority to those in the most serious and immediate danger. Their decisions are made independent of any political, economic or religious interests. They do not take sides or intervene according to the demands of governments or warring parties.
Adhering to these principles when providing medical and humanitarian aid, explaining them to all parties to a conflict, and demonstrating them on a daily basis contributes to the protection of our patients and staff as well as to recognition and respect of the MSF Logo.
Sadly, medical humanitarian principles are not always respected, and throughout our history we have suffered terrible attacks and tragedies in Afghanistan, Somalia, Sudan, Yemen, Syria, and more. We are outraged by all attacks on medical services, and when they occur we take action at the highest levels to demand adherence to International Humanitarian Law.