Working without borders
And I like the idea of without borders because I think that Médecins sans Frontières is breaking a lot of borders, and not just geographical ones, but in terms of healthcare and disease control and things like that, and doctors, the role of a doctor, all that, Médecins sans Frontières has gone way beyond our traditional understanding of that.
Unfortunately, more and more borders are also being raised. I think humanitarian space is much less accepted now. Gone are the days where you can simply arrive and just look for interlocutors and start working. Now, we find as an organization, our humanitarian space is increasingly restricted to the point where we’re persecuted, hounded out of a country, et cetera, et cetera. And so I’d say that over the years, the 20 years I’ve worked for the organization, there are more borders, and so therefore, it’s even more important to be without borders.
As regards to healthcare, yes, I think we are on the innovative edge of the spectrum. That’s clear. We’re in a position to try and test new protocols and certainly drugs as well. We’ve got some big drug tests going on at the moment linked to tuberculosis in third world settings. There’s a lot of innovation going on, and so we definitely challenge borders. That’s clear. But we also respect them.
The focus is on the patients
We’re 99% financed by private individuals who give their funds with no political allegiance whatsoever. So that’s unlike, for example, the United Nations, which is absolutely politically funded.
Oh, absolutely, yeah.
But we want to maintain our independence and neutrality. And so that’s one thing. Where does the funding come from? The funding absolutely allows us to be as neutral and impartial as possible.
And secondly, whenever we work, the focus is on the patients, regardless of where they come from, their gender, their ethnicity, their political affiliations, their sexuality, their anything. And so anyone who’s a patient is a patient, is a patient, and we try and we do this by working on both sides of the front line. If there’s a conflict situation, for example, in Sudan at the moment, as you know, there’s civil war in Sudan, and we’re on both sides, absolutely in the areas where the control, we’re on both sides of the front line. Transparently so.
And also in terms of how we present our healthcare to try and make it as inclusive as possible, and to ensure that no particular population feels in any way excluded. When we do our witnessing our témoigner, as we call it in French, then when we speak out, we speak out from the point of view of the patient, not from the point of view of any political affiliation.
Innovative transportation with donkeys
That’s a good example of innovative use of transport options that are locally available. And so our standard ones are the Toyota Land Cruiser. That’s the tool of humanitarians everywhere, but there are places where that doesn’t go. And so for example, in Ethiopia, rainy season challenges. And so I engaged a fleet of donkeys for ambulance transport because at the time we were dealing with nutrition malnourished children, and most of the cases weren’t time critical for the transport from the outreach centers to the centralized hospital. In other words, the patients could comfortably bumble along at donkey pace for six hours. And that was okay because we sheltered from the sun and the elements and it was reasonably comfortable. And that was in fact a more comfortable and easy way of transporting patients from diverse different areas out in the rural community towards a more centralized therapeutic feeding center.
And so we innovative, it’s not that innovative to use donkeys. People have been using donkeys for millennia, but you see what I mean? I mean, it’s a change of the usual way of doing things. And along with that came of course, welfare of the animal was very important to us in the same way that welfare of the car is important when you’re using cars, and I built, it sounds silly, but a logbook for donkeys. I engaged a local vet, et cetera, and so as much care and thought went into the management of that fleet of donkeys as it went into the management of the fleet of vehicles that we had as well.
So yeah, so I think access. You talked about neutrality and impartiality and independence. Access is a very important part of that. And if the patients can’t get to the healthcare facilities, then we go to where the patients are. If they need transport, and if the transport can’t happen in Ministry of Health ambulances, then we start running transport services as well.
Nobel Peace Prize
I read the description on the website for the Nobel Peace Prize, and the descriptions corresponds very much to what you’re saying about the way you work and what your goals are. That’s a major accomplishment. That was a long time ago. 1999.
Yeah, yeah. And I think why the messages haven’t changed since 1999 is because we have a charter since 50 years, which has been slightly updated to make sure it fits with the time, but it remains a one-page document, the MSF Charter, which is still as relevant today as it was 50 years ago when it was written, and we stuck to that over time. It’s really our mission statement and it’s very useful, and so we stick to that and it’s all good.
Support for migrants and refugees
We’re very heavily involved in support to migrants and refugees and all over the world. I mean, will it be, for example now in Chad because of the civil war in Sudan, people crossing the border from Chad into Sudan again, as they have been doing in the past? I was there myself in 2005 and saw it happening. There was a war going on back then. But not only also in Europe. There’s obviously the whole route that people take traveling out from Africa and Asia up into Europe, often heading into England, and often we see people along the route, and we’ve got, because we’ve got multiple projects along the way, we’re heavily operational in Italy, Bosnia, Serbia, France, in the UK as well. We’re busy, we’re operational in the UK to try and ensure that these people have healthcare because they often don’t.
Fighting misinformation on social media
It’s definitely got worse. Social media is an intensifier of disinformation, misinformation, so I’d say that’s how it’s got worse. And I think there’s been a breakdown in trust in general in all kinds of different areas, but also towards doctors. I mean, the position of your average doctor in society, there’s less trust, put it that way, but not only in doctors, also in teachers in other professions as well. And so we’ve got a whole project, we call it the Dismiss Projects; Disinformation Misinformation project. And yes, we’ve got communications departments and teams to work and counter and put out the message as we have for years, but I think what it really comes back to is we want to maintain our integrity about the information that we communicate.
There’s two ways of doing that. The first is to let the patient speak for themselves and give them a platform to speak, and so it comes directly from the source as opposed to speaking on their behalf or having [foreign language 00:07:30] or spokespersons on their behalf. And so we try to do that. The default situation is that. When you look at the MSF websites, what I hope you’ll see is patients speaking out about what they’re experiencing rather than MSF staff interpreting what they think the patients are thinking.
Healthcare messages with fun for kids
We work a lot with the influencers. For example, everything around HIV/AIDS out of [inaudible 00:07:54]. We worked with local influencers in Congo who were present on TikTok, Instagram, social media, et cetera, to pass messages. We filmed a great song. It’s really good fun and people dancing. There’s healthcare messages, et cetera, around messages, the healthcare messages around HIV/AIDS.
Well, a lot of theater. There’s an awful lot of theater groups, where in Liberia, I hired a local theater group to spread a message about if you are a victim of sexual or gender-based violence, come to the clinic, and the medium which we use are designed to be accessible to all of our patients, and as 50% of our patients are children, to them too. Absolutely.
MSF Academy for Healthcare
Beyond that, when you look beyond children to young adults and teenagers, we’ve been training for years healthcare professionals, but now we’ve taken it to a next level in the last seven or eight years, and we’ve opened the MSF Academy for Healthcare, which not only provides training, but also provides certification because we work with local universities. For example, we took 50 midwives from Sierra Leone, and they went to Ghana because there’s no midwifery school of the particular type we were looking for in Sierra Leone. There was a better offer of education in Ghana. So they went there for two years, graduated, and then came back to the hospital in Sierra Leone where they’d been recruited and started working there. But the difference is that they’ve not only got the learning, which they would’ve got anyway because we train on the job, but they’ve got the formal recognition and the formal certification that empowers them.
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