David Rieff on Doctors Without Borders
The following is an excerpt from David Rieff’s afterword to Humanitarian Negotiations Revealed: The MSF Experience:
There was never any room for compromise in the myth of the “French doctors”. Aid was a moral imperative, full stop. Like all doctrines founded on such an absolute (not to say absolutely self-righteous) conception, moral ambiguity was taboo, and the need for negotiation seen as, at best, a necessary evil. To be sure, most international relief groups, and certainly MSF [Doctors Without Borders], have moved beyond this kind of vulgar Kantianism which Bernard Kouchner once championed so insistently. Nonetheless, in the collective memory of modern humanitarianism, the comforting illusion endures that there was a time when relief NGOs were largely free to act as they saw fit, taking into account only the needs of the populations they sought to help, and the limits imposed by their own charters. Populations in danger, to use an expression that MSF made into a commonplace of the humanitarian lexicon more than a decade ago, were assumed to have the right to be helped but, just as saliently, international relief groups took it as read that they had an absolute right to help. In reality, humanitarian action cannot afford to be absolutist in, say, the manner of the human rights movement, which, because it is law based, is absolutist, at least in principle, or it is nothing. All effective humanitarian action is based on negotiating compromises with the relevant political actors, including of course insurgent groups, donors, and with other stakeholders (including beneficiaries, themselves never monolithic in their viewpoints or requirements), and trying to reconcile competing agendas, not only between NGOs but within NGOs as well. For a humanitarian organisation to believe and, far more importantly, to behave as if this were not the case is to court disaster, as a number of the case studies in this book painfully illustrate.
The need for compromise in almost every situation in which an organisation like MSF operates or is likely to operate emphatically does not imply that, where the compromises on offer are unacceptable from a relief NGO’s perspective, it is imperative to act anyway.
Rieff concludes with a discussion of how the MSF has negotiated with governments unfriendly or suspicious of them as well as those who seek to rein in their autonomy:
These examples—and, to Sri Lanka and Ethiopia, one could reasonably add the Sudanese government’s behaviour toward the humanitarian NGOs in Darfur—should make it clear that while the limitations put on humanitarian autonomy by the political and military goals of the global war on terrorism are real enough, they are scarcely the only challenge faced by humanitarian actors in the second decade of the twenty-first century. Indeed, if the contributors to this book are correct, then MSF has been more successful in securing a measure of autonomy for itself from the Americans, the Pakistanis, and the Tali-ban, than they have from strong states in the Global South where the conflicts that are occurring have little or nothing to do with Jihadism. Of course, this may not last, but if it doesn’t that will not be because the authorities in Colombo, Addis Ababa, and Khartoum, following a trend that began in Rwanda after the Rwandan Patriotic Front took power in 1994, have grown less exigent, but rather because ISAF or the Quetta Shura have grown more so. But the increasingly unfavourable relations of force between these governments and MSF can be seen in the association’s developing reluctance to make public state-ments—above all, those that involved generalising about the humanitarian situation, a demarche whose repercussions, once it has been undertaken are usually very difficult to control—lest it provoke retaliation from the regimes concerned. These concerns were entirely warranted, as is evidenced by MSF’s experience of having been expelled from Darfur and Niger, and threatened with expulsion from Sri Lanka, Ethiopia, and Yemen (in this last case not least for having dared to put Yemen on the list of what, in any case, was MSF’s extremely ill-judged annual “Top Ten Humanitarian Crises” media campaign). And they bode ill for the future, since there is every reason for other states wishing to bring humanitarian groups to heel, and having observed how effective such measures are, from taking similar steps.
Having said all that, the situation is scarcely hopeless. As several contributors to this book point out, there are very few governments or insurgent groups (even among the most militant Jihadis) who challenge the basic premise of international humanitarian aid or challenge its claim to at least some degree of political autonomy. Instead, as the Afghan case illustrates, the debate is over whether relief groups are, in fact, taking sides. The insistence of US government officials, from Colin Powell and Andrew Natsios during the Bush administration to Hillary Clinton and Samantha Power under Barack Obama, that relief NGOs not try to distance themselves but rather develop closer links to US and other ISAF forces has done a great deal of harm to the efforts of MSF and other humanitarian organisations seeking to work wherever the needs were most urgent, rather than where they would do the most good for the Coalition’s war effort. Nevertheless, MSF has succeeded to a remarkable extent in distancing itself from that project with the result that it has been able to operate in at least some Taliban areas. Surely the same approach can bear fruit in the future in other theatres of war. Is this enough? Self-evidently, it is anything but enough. But in a time when fanatics on all sides seem willing to accept nothing less than the total defeat and unconditional surrender of their foes, it may be as much as we have any right to expect. Sometimes just holding the line for one’s values as best one can, making the compromises that one must, and playing the long game in the full knowledge that relations of force are always changing, and not always for the worse, is no small victory.
