Médecins Sans Frontières (MSF), also known as known as Doctors Without Borders, is known across the world as a provider of emergency humanitarian aid in response to war, disease, natural disaster, and exclusion from healthcare (“About MSF”). They push to be ethical, moral, and impartial, but the problem is, there are still people behind the decisions that the organization makes, and it begs the question: who gets to define what is ethical? MSF also treads carefully in order to respond appropriately to crises, but again, what entails a crisis? There is a danger in trying to define these convoluted components of humanitarianism, since the determinant is given the power to ultimately determine the value of a life.
When I search up the definition of “ethical”, the following results show up:
- following accepted rules of behavior : morally right and good
- involving or expressing moral approval or disapproval
- conforming to accepted standards of conduct (“Ethical”)
All of these definitions require ethics being “accepted” or “approved”, but it is virtually impossible to gain 100% approval on anything. Individual people make these decisions, and as seen in the article by Mirian Ticktin Where ethics and politics meet: The violence of humanitarianism in France, there are nurses who read files and meet with people in order to decide if their illnesses warrant citizenship. Like gatekeepers or admissions officers, these nurses are allowed to make a subjective decision, even when their backgrounds and past experiences can easily shape their compassion and who they choose to help (Ticktin). This leaves an incredible amount of room for variability, but can a standard be set on these decisions? Is it truly humane to allow citizenship to one suffering person, while ignoring another?
Similarly, MSF responds to international crises, but there has been uncertainty—even within the organization—about what appropriate responses to these issues are. As with almost all humanitarian aid, there are those two dreaded words: unanticipated consequences. MSF knows that a quick and temporary response to an emergency is crucial, but they have to leave as soon possible since dependence on this aid often hinders a country’s own progress. As said by an MSF administrator of Ugandan projects, “We don’t want to put a foot in the [local] hospital or we’ll be there ten years later” (Redfield).
Unfortunately, that’s exactly what happened in Syria.
In 2011, MSF responded to the Arab Spring in and around Syria by operating medical medical facilities and running field hospitals and clinics. Four years later, MSF is still involved, but is facing an entirely new problem: hospitals largely run by the organization are facing air strikes, and MSF members are being abducted by the Islamic State (IS). Six hospitals have been forced to close, and four ambulances were destroyed (“Syria”). Tens of thousands of people in and around Syria are in desperate need of aid, but MSF and other international organizations are severely restricted in the humanitarian aid and healthcare they can provide. The result is poor and unsafe conditions for refugees who must live in overcrowded spaces, subject to psychological distress. In order to tackle this issue, MSF brought in psychologist and psychiatrists to carry out consultations, but it is clear that problems are compounding onto each other and that thousands of people are still suffering (“Syrian Refugees”).
So then, what is the job of MSF and international organizations? Radfield’s Doctors, Borders, and Life in Crisis distinguishes between two Greek terms for life: zoe and bios. Zoe entails the simple act of living or being alive, while bios represents a life with a narrative, and perhaps in their current state, MSF can only provide refugees the simple act of living. Can it be called humanitarian if the people who are “saved” live in fear, uncertainty, and distress? When is it time to change our mindset from “this is all we can do” to “what we’re doing is not enough”?
- Compassion currently plays a role in decision making (with France’s Illness Clause and Syrian refugees). Is there any possible way to remove compassion from the equation or ensure decisions are impartial?
- In humanitarian work, is it enough to simply keep someone alive? Who holds the responsibility of keeping people physically alive and who holds the responsibility of ensuring these people have human dignity? How do we define dignity?
“About MSF.” Médecins Sans Frontières (MSF) International. N.p., n.d. Web. 05 Nov. 2015.
“Ethical.” Merriam-Webster. Merriam-Webster, n.d. Web. 05 Nov. 2015.
Ticktin, Miriam. “Where Ethics and Politics Meet.” American Ethnologist 33.1 (2006): 33-49. Web. 5 Nov. 2015.
Redfield, Peter. “Doctors, Borders, and Life in Crisis”. Cultural Anthropology 20.3 (2005): 328–361. Web.
“Syria.” Médecins Sans Frontières (MSF) International. N.p., n.d. Web. 05 Nov. 2015.
“Syrian Refugees Need Humanitarian Aid.” Doctors Without Borders Canada/Médecins Sans Frontières (MSF) Canada. N.p., 14 Aug. 2012. Web. 06 Nov. 2015.