The French medical relief agency, Médecins Sans Frontières (MSF), has always been viewed by other mainstream humanitarian organisations as the nonconformist of the relief world. This is not meant as a compliment. The great mantra of contemporary humanitarian action is co-ordination. The assumption is that private organisations like Oxfam, World Vision, and MSF must not set their policies by themselves, or even in consultation with the people on the ground they have come to assist, but must adhere to common frameworks for their actions that they thrash out together and in consultation with the relevant UN agencies such as the World Food Programme, the Office of the UN High Commissioner for refugees and Unicef. Only in this way, or so the conventional wisdom goes, can aid be effective.
From the Cambodian genocide through the Ethiopian terror famine of the mid-1980s to the tsunami today, MSF has argued otherwise. It has pointed out that, in practice, co-ordination often means subsuming the goal of humanitarian relief to other goals such as forging a durable peace or helping to secure a desired political outcome. These goals may be laudable, but the essential intuition of MSF is that all good things do not go together. The view at the UN or among most relief groups may be that humanitarian action is part of a “toolkit” of remedies available to the “international community” to deal with war-ravaged or failed states in the poor world, but MSF’s position has always been to insist that its priorities might not be peace, or development, or some decent political outcome in a Sierra Leone or a Kosovo.
Of course, as citizens, its workers might well subscribe to exactly those outcomes—the restoration of democratic rule in Sierra Leone, say, or a Nato military intervention in Kosovo. But as a member of an emergency medical relief group, this is not their role, not their responsibility and, in an argument that implictly turns the accusation of hubris back against those who routinely level it against MSF (this often means Oxfam), not their right because it passes beyond their level of competence. The MSF view is that emergency aid, above all the medical relief the group provides, is not an archimedean lever for peace-building or social justice, but rather something far more operationally and, by implication at least, morally limited—not charity in the 19th-century European imperial sense so much as the provision of what, in an earlier era, we knew as succour. In this, MSF is actually closer to the International Committee of the Red Cross than to relief organisations like Oxfam, the International Rescue Committee or Concern.
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