MSF ponders geo-politics and humanitarian aid
By KEVIN SPURGAITIS
For more than 30 years, Nobel Prize-winning Médecins Sans Frontières (Doctors Without Borders) has provided medical support to people caught in armed conflicts, natural disasters, epidemics and famine. More than 700 Canadians have volunteered with MSF Canada in more than 40 countries since 1991. However, the organization’s endeavours are now seemingly curtailed in conflict zones such as Afghanistan, Iraq and the Sudan. In these so-called ‘hot spots,’ humanitarian aid may be easily considered Western World intrusion — confused with U.S.-led military campaigns, observers say.
Volunteers have recently become the targets of militias and marginalized groups, making it increasingly difficult for MSF to respond to public health emergencies independent of political influences. In 2002, Arjan Erkel, the head of mission for MSF in Daghestan, was abducted by unidentified gunmen in Makhachkala. Two years later, the international humanitarian organization closed all medical programs in Afghanistan after five of its aid workers were shot and killed in a Taliban ambush, in the north-western province of Badghis. Contrary to Geneva Conventions forbidding the targeting of relief workers in war zones, volunteers with the International Committee of the Red Cross (ICRC) were also killed in an attack inside Baghdad. MSF finally ended its Iraqi mission in November, in light of the escalating violence in the country.
So are the lines between armies and aid workers blurred in 2005? Is MSF no longer sacrosanct? David Morley, Executive Director of MSF Canada talked to Kevin Spurgaitis about the global challenges faced by his and other NGOs.
Spurgaitis: While natural dangers remain, humanitarian aid workers are increasingly exposed to political instability, or targeted by particular groups. News about humanitarian aid workers posted in isolated parts of the world has been grim lately; kidnapping and assassinations are reported. Are some regions now too ‘hot’ for MSF?
Morley: (Some areas) have become worse in recent years because the Western Powers have been trying to do more things (anti-terror campaigns) after Sept. 11, 2001. Also, during the Vietnam War, humanitarian aid workers weren’t trying to get into Vietnam and Cambodia, for example. So maybe our desire to reach people has gone further … and created more risks.
Spurgaitis: In your June 2004 op-ed piece in the Globe and Mail, you wrote you were “outraged by attacks on defenseless humanitarian workers in Afghanistan, whose crime was bringing medical attention to people in need.” With MSF land cruisers clearly marked, are medical teams still confused with military targets?
Morley: Nobody is making a mistake. In the military tactic sense, you can tell the difference between one of our land cruisers and something that is a military vehicle. So those who are attacking aid workers know what they’re doing.
Spurgaitis: How do you feel about aid workers becoming targets then?
Morley: It’s very disheartening. It makes us sad … because all we are trying to do is just bring some medical care to people who wouldn’t have it otherwise. It makes us angry.
Spurgaitis: Regarding the U.S.-led war on terrorism in Iraq and Afghanistan, the current American administration openly dubbed humanitarian actors as “force multipliers” for the coalition military. U.S. soldiers have reportedly dressed in T-shirts, concealing their weapons and distributing food. Is the U.S.-backed coalition in fact co-opting humanitarian aid?
Morley: Our concern has been in places where military forces use humanitarian assistance for military and political ends. The worse of this has stopped (in Iraq), but when soldiers get out of uniform with concealed weapons, and help build schools and deliver equipment … they are doing good, but they’re just trying to win over “hearts and minds.” MSF is not a force multiplier. We’re just there to help.
Spurgaitis: Are humanitarian aid workers now synonymous with Western military powers?
Morley: … We are a Western-based organization and when a Western military intentionally tries to blur the lines between what is military and what is humanitarian, that doesn’t help us at all. It makes it more dangerous for our people and harder to help the victims of the conflict.
Spurgaitis: As a result, have MSF and other NGOs lost credibility as apolitical healthcare providers “without borders.”
Morley: NGOs will collaborate extremely closely with militaries, especially the Western ones. We have to dialogue and negotiate with them without going to ‘bed’ with them, because they control territories, whether it’s the American army or rebels in the Republic of Congo. But it does put our impartiality at risk …
Spurgaitis: Are MSF’s “missions of mercy” in the Congo, Chechnya, Haiti, Chad, the Palestinian Territories, Afghanistan and the Sudan now compromised as a result of geo-politics and changing attitudes towards volunteers from the Western World?
Morley: We find ourselves in the situation of trying to make it very clear to people that our aid is impartial and neutral … As the world has gotten smaller and geo-political conflicts have gotten more complicated, it’s difficult for us to distinguish ourselves. In some regions, some individuals think if you are not their friend, you are their enemy. We say otherwise.
Spurgaitis: More recently, in Banda Aceh, Indonesia, the government here sought to reassert control over foreign troops, relief workers and journalists in the tsunami-devastated region. Observers say the move, aimed primarily at U.S. troops, underscored the nationalistic country’s resentment of western forces operating there, even in a humanitarian effort.
Morley: It is extremely hard to negotiate access into Aceh as an aid agency. We were the first group able to work there only after lengthy talks. The Indonesian government continues to crack down on ‘outsiders,’ but there’s hope we will be able to continue.
Spurgaitis: Just how effective can MSF still be protecting life and health, in places not only without blood banks or modern health facilities, but those wracked with accelerated violence towards its health practitioners?
Morley: We are constantly perceived as legitimate military targets, particularly in the Middle East. When people choose to frame the struggles as East versus West, we tend to be seen as being on the Western side, because that’s where most of our volunteers come from. We get caught up in that stereotyping encouraged by American military We may get demonized and objectified … But we will still cross (boundaries), bringing help to people on both sides of the line.
Spurgaitis: Has your organization’s plan of action changed?
Morley: Of course, we’re now questioning if our programming is appropriate. In the last few years of this ‘cultural war,’ we have looked at our security carefully and have worked to ensure our volunteers are safe and unrestricted.
Spurgaitis: What pre-emptive or on-the-spot safety measures, if any, has MSF taken in these so-called hot zones?
Morley: We’re always thinking about our work during conflict. Our doctors and nurses have to help their patients ‘here and now,’ though. We choose to be shortsighted. We try to keep ourselves focused on the short-term, because if we can prolong life, alleviate suffering and restore dignity, it will hopefully empower the people in those societies to take more control and build a better future for themselves. It’s not our job to make that future.
Spurgaitis: MSF Canada President, Dr Joanne Liu, was once quoted as saying “conflict zones appear calm on the surface, but there’s a constant undercurrent of danger.” Working as many as 18 to 20 hours a day in the field, do humanitarian aid workers ever question their medical vocation — their work overseas?
Morley: The closer you get to the problem, the more depressing it is, sure. These are the environments in which MSF staff has chosen to work. It’s nothing new, it’s just more of the same. The dangers are increased because of the wars our own countries are involved in. But in many ways, it’s the same environment we’ve been working in for quite a while.
Spurgaitis: Will the status quo deter future expatriate doctors from practicing medicine abroad?
Morley: We still get many volunteers at MSF. Some of them are in scary situations, but it’s an incredible opportunity to do a little bit to alleviate the world’s suffering. They are not cowboys or foolhardy, but they keep on returning … Most of our volunteers want to double their efforts. Part of what we’re doing is bearing witness as outsiders. In addition to our medical care, our presence helps alleviate the severe abuses that often take place.
Spurgaitis: It’s easy to be pessimistic about your organization’s impact in the Developing World. These crises are so numerous and the problems are vast. What difference is MSF making in people’s lives under the present circumstances?
Morley: As a group, we get to see that our services do make a difference. Our colleagues and patients tell us our presence and medical care are still making a difference.
Spurgaitis: Is the world any closer to achieving the UN Millennium Development Goals — the halting of HIV/AIDS, malaria and other diseases; the improvement of maternal health; the reduction of child mortality and the eradication of extreme poverty and hunger?
Morley: We’re not a little bit closer. If all of the major industrialized nations committed 0.7 per cent of their GDP to foreign aid — the Pearsonian standard — we would be. If we were to make a concerted commitment, Canada could certainly make a difference. We’re not there yet.
Originally published in the Catholic New Times, May 2005
