The first lecture out of three for this year’s Nitze Senior Fellow Public Lecture Series, entitled “Humanitarian Action and the Politics of Compromise,” was given on the evening of Oct. 18 in St. Mary’s Hall. This year’s Fellow is Sophie Delaunay, the U.S. director of the humanitarian organization Doctors Without Borders, which in its native French is Médecins Sans Frontières (MSF).
The main purpose of MSF is to send teams of volunteer medical staff into more than 60 countries, which are home to those who are “threatened by armed conflict, epidemics, malnutrition, exclusion from health care and natural disasters,” according to the lecture’s program.
Michael Taber, Assistant Professor of Philosophy and the Director of the Nitze Scholars Program, said Delaunay is “so grounded in the organization” that she has worked with for 18 years. He got the sense that “she enjoyed speaking to college groups” about her work, which made her a perfect fit for the position of the Nitze Senior Fellow.
Delaunay opened her lecture by commenting on how the field of humanitarian assistance has developed in the past decade, and gave two examples of how it has improved and declined. The best development in this area, said Delaunay, “is the number of lives we’re able to save,” and the worst being “the humanitarian circus of so many organizations latching on and creating chaos.”
She then went on to discuss three major patterns of humanitarian crisis: the proliferation of actions, a gradual shift to long-term development and the politicization of aid.
In regard to the proliferation of actions, Delaunay said that “never in history have there been so many sources of aid,” all of which have experienced tremendous growth. MSF, for instance, grew from a $1 million organization to one worth $7 million in just one year.
Delaunay used Haiti as an example to show how an unprecedented boom in humanitarian organizations is “never a guarantee of a good performance.” Haiti has the “largest concentration of NGOs [non-governmental organizations] in the world, yet 3,000 people there will die of cholera” due to miscommunication or issues between groups.
A shift towards long-term development, according to Delaunay, has been the result of “donors driven by the need to support a political agenda” that emphasizes the service of international needs, and so donors have shifted towards supporting global programs.
This goal of giving aid for the intent of long-term development, Delaunay said, is crucial because there is always a growing need. “The largest refugee camp on the border of Kenya and Somalia…is in disastrous conditions. We cannot meet all needs because of the constant arrivals of refugees. It has taken more than a year for international governments to respond to this tragic emergency.”
Delaunay added that the recurrence of measles outbreaks in Africa and Asia would have required MSF to vaccinate 4.6 million people in 2010, which she said is “too much for one organization. The humanitarian system is not completely functional at this stage.”
The politicization of aid, Delaunay said, is due to the fact that many issues have political roots. “As crises get greater visibility [to governments], the potential for confusion of political and military action is even greater.”
Delaunay used the U.S. military in Afghanistan providing aid “to win the hearts and minds of the people” as an example of the politicization of aid. She then spoke of how political figures can use the “instrumentalization of aid” like those in Somalia, who “limit aid to certain areas” in order to reward those who support the government and punish those who do not. These two examples, Delaunay said, are not considered humanitarian assistance, which “should be delivered on the basis of international humanitarian law” rather than arbitrary political motives.
In an age where “everyone calls themselves ‘humanitarian,’” Delaunay spoke of how MSF wishes to overcome such challenges and provide effective care” by preserving its core ideals: ensuring MSF’s independence, committing to medical ethics and high standards of care, and defending MSF’s space of work.
Part of securing MSF’s independence, said Delaunay, is securing MSF’s financial independence. The organization must be able to take action “without having to wait for the green light from the donors.” In doing so, MSF asks its donors to trust them in allocating funds, but Delaunay adds that donors can withdraw if they are not pleased with the transfer of their donation from one area of MSF to another.
Delaunay stressed MSF’s commitment to medical ethics and their unbiased care of people “regardless of who they are, where they are from, and what they are affiliated with.” The doctors of MSF are “animated with the same spirit as when they would work in a hospital at home,” although they are “constantly challenged to give quality care, address the immediate needs of individuals in a crisis,and advocate for more adaptive diagnostic tools.”
Maintaining a work space for MSF, said Delaunay, is based on the trust of the government of the countries in which the organization is working. “If our intent is not to give impartial aid, then our trust and our space is lost. We need to preserve the authorization to work and not be targeted by any groups. Distancing ourselves from the politics of a crisis is essential for not being targeted. We need to have a dialogue with all parties in a conflict in order to be known and understood by everyone who has power to harm or recognize our agenda of medical care.”
“I don’t want you to leave tonight thinking MSF has higher morals,” said Delaunay. “We don’t think humanitarian objectives are more noble than military ones. We never claim to bring peace. We keep our neutrality and distinguish ourselves from the conflict.” Delaunay admits that one would think such impartiality would never survive on the ground, but said that MSF has been forced to compromise their moral beliefs in order to maintain this ideal.
“We will never get the level of autonomy and access that we would like,” said Delaunay, who used a situation in Sri Lanka as an example of this autonomy being compromised for the sake of MSF’s mission. In 2009, tens of thousands in Sri Lanka were hiding during government bombings meant to drive out rebels. Delaunay said that when MSF criticized this violence, the organization was threatened with deportation. “We could either speak out and be expelled or keep a low profile and keep providing help to as many as possible.”
In Myanmar, Delaunay said that MSF’s independence of action was constantly limited by the country’s regime. However, this compromise brought benefits: more than half of the HIV patients in the country were treated by MSF.
Delaunay recalled a time when “compromise was unacceptable and would have undermined MSF’s credibility.” At a refugee camp in Zaire housing victims of the Rwandan genocide, MSF volunteers discovered that many of their refugees were actually perpetrators of the genocide. According to Delaunay, at that moment MSF “had a moral obligation to leave.” Similarly in North Korea, MSF’s aid was provided through a public distribution system that discriminated against certain members of the population, and MSF “had to leave even though people were starving.”
At the end of her lecture, Delaunay remarked that MSF will be releasing a book that explains how “being humanitarian is first and foremost about action, how MSF balances benefits in public choices, and how the organization is adapting to a changing environment.”
Sophomore Ashok Chandwaney noted Delaunay’s amiableness, “She spoke with a French accent and I enjoyed the stories she shared with us during the reception.”
Audience member Rebecca Prasher, a senior, said, “I think Sophie opened our eyes as to how volunteer organizations function, and as to how humanitarian acts can be used as weapons. She also made it clear that volunteer organizations such as Doctors Without Borders often walk a fine line with regards to how donors perceive them, and how MSF has to take into account so many varying factors when deciding to pull out of an area or not. Although we’d like to offer our help to those in need regardless of the situation, it’s much more complex than that.”