Médecins Sans Frontières and Some Gratuitous Comments about France (2/2)

Given my research interests and teaching responsibilities, I particularly enjoyed the chapter on genocide. Bortolotti devotes a few pages to the debacle of humanitarian relief in Rwanda, namely the refugee camps in Goma and Bukavu (Congo) where Hutu killers walked with impunity to continue their murder spree. It's a story I know well from readings on the genocide, most notably Philip Gourevitch’s We Wish to Inform You That Tomorrow We Will be Killed With Our Families, a book I highly recommend for those of you interested in this tragic event.

To its credit, MSF, including members of the original French branch, criticized the cozy relationship between President Mitterand and the Hutu regime. The genocide certainly tested the organization’s resolve to remain impartial in a conflict. Sometimes MSFers resort to témoignage when the international community is oblivious to such evil. Témoignage refers to MSF’s right to speak out when governments violate human rights and nobody otherwise would know. Medical assistance is obviously MSF’s focus, but it’s not averse to advocacy, especially during the Rwanda genocide of 1994, which marked a watershed in international aid. “If humanitarian agencies ever felt that their presence among people in crisis was an uncomplicated act of goodness,” writes Bortolotti, “that notion died in Rwanda.” MSF-France felt compelled to do something it had never done before or since: call for a military intervention.

The refugee camps became a base of operations for Hutu killers. Perpetrators used relief money to fund their murderous objectives. One thinks of Bosnian Serbs commandeering UN buses to transport Muslim males from Srebrenica to various killing sites. In Zaire (the former name for the Democratic Republic of the Congo) the génocidaires were able to regroup so that they could ultimately return to Rwanda and finish the job. It’s bad enough dealing with the medical crisis, let alone MSFers wondering whether the patients they’re treating for cholera or dysentery will take up a machete again once they’re back on their feet. One doctor working with MSF-Holland commented that he had to put aside this knowledge and just operate under the Hippocratic oath.

Bartolotti describes a heartwrenching scene that brings to mind the movie “The Killing Fields,” which depicts international reporters trying in vain to secure a passport for Dith Pran as the Khmer Rouge have surrounded the French embassy.  MSF-France staff decided it was getting too dangerous to carry out their work in Rwanda, so they headed for the border.  The expats couldn’t bring the Tutsis on their team with them, so they had to leave them in Rwanda to their fate.  Later the expats would argue vehemently with each other whether this was the right decision.  In another grim scenario, MSF personnel at a hospital witnessed to their horror Hutu militants pulling patients out of their beds and butchering them.

MSF has also been critical of the United States for blurring the lines between military interests and humanitarian aid, a dangerous combination that jeopardizes the lives of relief workers.  Insurgents will be more apt to kill humanitarian workers if they appear to be an arm of the U.S. military.  Also, food drops in Iraq and Afghanistan, for instance, can have the opposite effect than what the military intend.  Civilians sometimes cross into dangerous areas to pick up the food; at other times they mistake bombs for food packages.  Besides, warlords usually seize this aid and sell it for a profit.  One thinks of the warlords who seized humanitarian aid in Somalia, thus turning a UN relief effort into a U.S. military intervention and bloody battle in Mogadishu.  This “co-optation of humanitarian action,” as Bortolotti calls it, has pros and cons, for aid that U.S. and NATO forces are able to bring to suffering and impoverished people is considerable.  In the long-term, though, the dangers might outweigh the benefits.  The ability of a relief organization to maneuver with and make an impact upon murderous regimes hinges on their reputation for impartiality and independence.

I admire MSF’s stance on the Iraq War.  Though individuals might have had objections to the invasion, the organization as a whole remained true to its principle of neutrality.  After some organizations opposed the Iraq War by claiming that the loss of life would be catastrophic, MSF, though no defender of U.S. interests, countered “by asking how these NGOs knew that a US invasion would be worse than Saddam Hussein’s dictatorship.” Humanitarian NGOs should not be in the business of either war or peace; rather, they ought to focus solely on assistance, medical or otherwise.

It hasn’t been my intention to review Bartolotti’s Hope in Hell: Inside the World of Doctors Without Borders; instead, I wanted to ruminate on the challenges and pitfalls of humanitarian aid, especially given the upcoming course I’ll be teaching.  Notwithstanding my critical remarks on at least certain aspects of French history, those gaunt-faced wine-drinking Franks, all things considered, have made the world a better place, and MSF is one example thereof.  If you’re looking for a good cause for charity and you’re more interested in humanitarian work abroad than in our own country like me, consider Médecins Sans Frontières.  “Its doctors and nurses accept the limits of the aid they deliver, and they constantly question their own work,” writes Bartolotti at the end of his book.  “Yet they do not dither in a crisis.”  What more could one ask of such an organization?