Médecins Sans Frontières
When armies go to war or civil conflict erupts in a far distant land, there is, far too often, the inevitable aftermath of rebuilding the remnants of shattered lives and destroyed communities.
Médecins Sans Frontières (MSF) is one organisation whose experience of such theatre goes beyond the evening news. Recently I had an opportunity to chat with Jenny Cross, Field Resources Officer with MSF for a Q&A of what life is really like for those who risk life and limb for their fellow man.
Jenny Cross, Field Resources Officer with Médecins Sans Frontières
I understand that you recruit doctors and nurses (as well as field support staff) to join Médecins Sans Frontières (MSF). If we can focus on doctors for a moment - can you please give me a general profile of a doctor working in the 'field'?
Duties in the field for a doctor depend on the project and situation of the country. Generally doctors are involved in clinical activities, supervision, and training of national medical personnel, with some administrative duties. This is similar for other medical professions, like nurses, midwives, and other health specialists.
What qualifications and experience do they need to have? What about their psychological status (given the experiences they are likely to encounter).
Médecins Sans Frontières requires at least two years' professional experience post-graduation. The two-year minimum relates to the field position they would fill. Normally those qualified as specialists seek to work with Médecins Sans Frontières in the area of their specialty, in which case the requirement is for two years' experience in that specialty.
If a health workers wishes to join MSF, how long must they commit?
We find that people need at least nine months (particularly for their first time in the field) to contribute to the community they are working in and to gain just as much back for themselves. In the case of Surgeons and Anaesthetists the minimum duration of a placement can be much shorter (6 to 8 weeks) however, Finance / Administrative staff contracts can be longer (12 months). These different placement lengths correspond to the specific needs of the field and to the location where these staff are based.
A malnutrition emergency in the Central African Republic. Photograph - Masaya Noda.
What is the catalyst for MSF's involvement in humanitarian work? (Who makes the decision to send workers to a particular region/country?)
Médecins Sans Frontières medical teams will conduct an evaluation of medical needs on the ground before making a decision to open a program. It is only if the medical needs are not being met by the government of the country or by other organisations, that we will begin work. By its definition, humanitarian action saves lives and alleviates suffering of people caught in acute crises. In countries where we decide to work, one or more of the following crises is occurring: armed conflict, epidemics, exclusion from healthcare, malnutrition or natural disasters.
What are some of the (security and personal) risks involved with this work?
Many of the countries where our field staff is placed are enduring conflict, or are in post-conflict phase, and security therefore is often an issue. However, working with Médecins Sans Frontières is not reckless. Médecins Sans Frontières maintains extensive risk-management procedures and security guidelines for every project. Field workers are briefed on the country security situation before going to the field, and upon arriving at the project site are given specific security protocols. Adherence to our field guidelines for personal and team conduct and safety is not negotiable.
Has MSF suffered any casualties since its inception in 1971?
The nature of humanitarian work can at times be dangerous. Since the inception of Médecins Sans Frontières, the organisation has experienced a number of casualties, some accidental, some targeted. For example, in February this year, two of our staff were killed in Pakistan. Riaz Ahmad and Nasar Ali, both from Pakistan, were tragically killed on their day off. They had come into work as they had heard that there were large numbers of people wounded in the fighting who urgently needed assistance. Their ambulances, which were clearly identified as medical vehicles, came under fire. During the attack, another Médecins Sans Frontières worker was injured in the leg.
The Australian branch of MSF was formed in 1994. How many doctors/support staff have you committed to the 'field' in that time?
Since Médecins Sans Frontières opened its office in Sydney, more than 600 Australians and New Zealanders have fulfilled more than 1,200 positions in the field.
How is MSF funded?
Médecins Sans Frontières Australia accepts no funding from government sources. More than 30% of our activities are in armed conflict situations where our neutrality, impartiality and independence of political affiliation has enabled us to reach those who are most vulnerable and in need of humanitarian assistance.
There are other international branches of Médecins Sans Frontières who do accept a small amount of funding from their governments. Médecins Sans Frontières Belgium, Canada, Ireland, Luxembourg, The Netherlands, Norway, Spain, Sweden, Switzerland and the UK have all accepted government support in the past. The majority of our international funding comes from private sources - in 2008, private donations constituted 89.9% of our income. More than 3.7 million individual donors and private foundations made this possible.
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Does the funding allow for the purchase of medicines and vital equipment or are the medical supplies donated? Can you give me a 'ball park' figure for the budget required for this humanitarian work?
Yes, the funding allows for the purchase of medicines and equipment. As a rule, we do not accept donations of medical equipment. All our supplies are shipped from operational bases in Europe in bulk where we save money by using a single storage and distribution centre. This approach also allows us to keep tight controls over the supplies and equipment we use.
The total income for Médecins Sans Frontières in 2008 was €675 million euros.
Consultation by one of our doctors with a child with HIV/AIDS in Zimbabwe. Photograph - Michael G Nielsen.
On a positive note, how is MSF changing the lives of people around the world?
The nature of Médecins Sans Frontières' work means our teams make a direct impact on millions of people. Our medical care means that millions each year receive treatment that they may not otherwise have been able to access - this could be a vaccination against meningitis, life-saving antiretroviral treatment for HIV/AIDS, surgery for war wounds, treatment for cholera or simply, the safe delivery of a child. The work of Médecins Sans Frontières is vast - working in over 60 countries, our teams provide a variety of essential healthcare. Importantly, this healthcare is provided to our patients regardless of their race, religion, gender or political affiliation.
Can you tell my readers of a personal experience that touched your life in a significant way?
Hospitals and health clinics in less developed countries are amongst the most confronting places I've visited. I am in awe of health professionals who can adapt to working in these challenging environments that are so different to what they are used to back home. Médecins Sans Frontières' medical workers probably have many examples of making a difference, helping a patient, maybe even saving a life. I am not medical. My background is project management and my field experience is in HR, finance and administration. Payroll, visas and work permits, monthly accounts; it hardly compares to the crucial activities of my medical colleagues.
But my work is a necessary element of all Médecins Sans Frontières projects and has given me numerous positive experiences. Many of Médecins Sans Frontières' national staff have not had the educational or work opportunities we take for granted, and so a large part of our role is support, up-skilling and training. I have a lasting memory from my field placement in Sudan which, to me, captures a contribution 'non-medicals' can make. After weeks of explaining and demonstrating, then much practice of a particular administrative process by one of my team, the penny dropped so to speak. His face lit up with a huge smile as he realised he understood and could do this task by himself. "I am learning from you", he beamed at me. It is one of the most important things someone has ever said to me.
