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OFF THE CUFF

OFF THE CUFF is a participative blog run by the Crash. Its purpose is to expose the diversity of experiences and opinions that exist among humanitarian aid practitioners.

On-line comments as well as direct contributions are more than welcome (please send to crash@paris.msf.org).

Views expressed on this blog are those of their authors and do not necessarily relfect the official positions of Médecins Sans Frontières


Debate : The limits of humanitarianism in Gaza

Debate : The limits of humanitarianism in Gaza

A few days after the start of the operation 'Protective edge', Jonathan Whittall, Head of Humanitarian Analysis at Médecins Sans Frontières/Doctors Without Borders (MSF) posted an opinion in which he questions MSF's role in Gaza. Michaël Neuman, Director of research at MSF - Crash responds. ...

Whittall, Jonathan; Neuman, Michael14 July 2014

The Poverty of Humanitarian Critique?

The Poverty of Humanitarian Critique?

While MSF has just recently launched a report, 'Where is everyone? ', aiming at exposing the limitations and deficiencies of the international aid response to crises, Bertrand Taithe, from the HCRI and a member of the scientific committee of the Crash asks whether the approach taken and the que ...

Taithe, Bertrand08 July 2014

Violence against Kosovar Albanians NATO’s intervention 1998-1999

Violence against Kosovar Albanians NATO’s intervention 1998-1999

The ‘ Violence against Kosovar Albanians NATO's intervention 1998-1999 ' case study describes the constraints and dilemmas facing Médecins Sans Frontières teams that witnessed a process of terror and expulsion which they described as the ‘deportation' of Kosovar Albanians by Serb forces. It also de ...

Binet, Laurence23 June 2014

MSF and the aid system: choosing not to choose

MSF and the aid system: choosing not to choose

We often hear it said within MSF that the aid system - that is to say all the institutional actors involved in international humanitarian aid - is unable to provide effective relief, or that the aid system's ability to provide aid is in decline. In a paper published on the Crash website , Rony Bra ...

Brauman, Rony; Neuman, Michael16 June 2014

Managing the risks to medical personnel working in MSF projects in Yemen

Managing the risks to medical personnel working in MSF projects in Yemen

Michaël Neuman has just published a paper, in Humanitarian Exchange Magazine (issue 61, May 2014 ) focusing on the exposure to risk for medical personnel working in MSF projects in Yemen. This article is the result of a research conducted in Yemen in 2013. A more longer version of this research was ...

Neuman, Michael05 June 2014

Central African Republic: Questions around a forced exodus

Central African Republic: Questions around a forced exodus

For a few months now, the world's response to the organized expulsion of the Muslim community out of the Central African Republic (CAR) can best be described as strikingly mute. The expulsions, which are in particular taking place in Bangui, the capital city, and the Western regions, are set agains ...

Neuman, Michael; Chedorge, Delphine05 May 2014

The Great Lakes of Africa Crises 1994-1997

The Great Lakes of Africa Crises 1994-1997

The Great Lakes of Africa Crises 1994-1997 MSF Speaking out cases studies are out. The first case study: Genocide of Rwandan Tutsis 1994 depicts the MSF reaction when confronted with systematic extermination of Rwandan Tutsis between April and July 1994. The case studies draw from internal field re ...

Binet, Laurence04 April 2014

Collecting data on sexual violence: what do we need to know? The case of MSF in the Democratic Republic of Congo

Collecting data on sexual violence: what do we need to know? The case of MSF in the Democratic Republic of Congo

Claire Magone has just published a paper, in Humanitarian Exchange Magazine (issue 60, February 2014 ) focusing on gender-based violence (GBV) in humanitarian crises. In an article called "Collecting data on sexual violence: what do we need to know? The case of MSF in the Democratic Republic of C ...

Magone, Claire20 February 2014

“No patients, no problems:” Exposure to risk of medical personnel working in MSF projects in Yemen’s governorate of Amran

“No patients, no problems:” Exposure to risk of medical personnel working in MSF projects in Yemen’s governorate of Amran

Michaël Neuman has just published a paper, "No patients, no problems:" Exposure to risk of medical personnel working in MSF projects in Yemen's governorate of Amran, in the Journal of Humanitarian Affairs . The result of an investigation launched in March 2013, this paper aims to provide a better ...

Neuman, Michael19 February 2014

The polio eradication campaign: time to shift the goal

The polio eradication campaign: time to shift the goal

Claire Magone, director of study at MSF-Crash and Dr. Emmanuel Baron, executive director of Epicentre, have just published in the 'International Health' review an article debating the polio eradication campaign. The article 'The polio eradication campaign: time to shift the goal' is available in th ...

Magone, Claire; Baron, Emmanuel03 February 2014

The Last Mile. Can we afford to keep believing in the eradication of polio?

The Last Mile.  Can we afford to keep believing in the eradication of polio?

The original version of this paper (in French) was published in La vie des Idées . In the 1980s, a global commitment was made to eradicate polio in the wake of the eradication of smallpox. As far as the world health community was concerned, this successful experience (the world's last reported ...

Magone, Claire13 January 2014

The security debate: restricting one’s individual freedom?

The security debate: restricting one’s individual freedom?

John Tucker is an epidemiologist. Between June and December 2013, he was on a field assignment in Kenya, where he lived, for MSF. He was in Nairobi when the attack on the Westgate mall happened in Nairobi on September 21st, 2013. In his end of mission report, he exposes his opinion of some aspects ...

Tucker, John20 December 2013

The « Salvadoran Refugee Camps in Honduras 1988 » case study

The « Salvadoran Refugee Camps in Honduras 1988 » case study

The « Salvadoran Refugee Camps in Honduras 1988 » case study describes the dilemmas regarding a stance that ... was not supposed to be public. ...

Binet, Laurence19 December 2013

Paralysis: How political deadlock is failing to stop polio in Syria

Paralysis: How political deadlock is failing to stop polio in Syria

This piece is authored by Hernan del Valle, Head of Humanitarian Affairs, at MSF, Operational Center Amsterdam. The chances of a person to receive life-saving health care inside Syria today are defined by the side of the front-line in which they happen to be. This is not just a matter of luck. It ...

del Valle, Hernan11 December 2013

Polio in Syria: an opportunity to save lives?

Polio in Syria: an opportunity to save lives?

Deployment of chemical weapons in Syria has proven to be such a horrific event it has mobilized the muscle and diplomacy of the most powerful international actors. What will it take to unleash this same determination to come to the aid of the youngest Syrians? ...

Shepherd, Suzanne22 November 2013

Disabilities and Medicine. A survey of the Amman surgical reconstruction project 2012

Disabilities and Medicine. A survey of the Amman surgical reconstruction project 2012

Our survey bears something of a resemblance to a study carried out by Vanja Kovacic in Homa Bay, Kenya, in which she investigated patients' disease coping mechanisms and their "dependence on medical institutions" (V. Kovacic and J. Amondi, "Social navigation and HIV/AIDS", in "AIDS: a new pandemi ...

Le Pape, Marc; Bradol, Suzanne21 November 2013

Book launch : International Organization and Global Governance

Book launch : International Organization and Global Governance

Fabrice Weissman, coordinator and director of Studies at Crash has published 'Crisis and humanitarian containment' in International organization and global governance , 'the most comprehensive textbook available for all interested in international organization and global governance'. ...

Weissman, Fabrice04 November 2013

MSF launches website revealing insights to its decisions to speak out on crises

MSF launches website revealing insights to its decisions to speak out on crises

Médecins Sans Frontières (MSF) is today launching an educational website, speakingout.msf.org, that provides unprecedented insight into its decisions during key humanitarian crises of the past 40 years. ...

Binet, Laurence03 October 2013

The plague and cholera

The plague and cholera

Three years after it occurred, Haiti's cholera epidemic is still in the news. I have already discussed how the disease was introduced by Nepalese peacekeepers serving in the United Nations Stabilisation Mission in Haiti (MINUSTAH). An epidemiologist sent to the country by the French ambassador r ...

Brauman, Rony10 September 2013

Scaling up aid in Syria: the role of diaspora networks

Scaling up aid in Syria: the role of diaspora networks

Syria is certainly the most deadly conflict in the world today and the most underserved in terms of international humanitarian assistance. Exposed to violence and lack of essential services, millions of Syrians, living under the authority of opposition groups, have almost no access to international ...

Weissman, Fabrice06 September 2013

Médecins Sans Frontières and the ICRC: matters of principle

Médecins Sans Frontières and the ICRC: matters of principle

How do Médecins Sans Frontières (MSF) and the International Committee of the Red Cross (ICRC) differ, and how are they alike? The question came from the Editor-in-chief of this Review, but it is regularly discussed at MSF, which might just as well have queried a member of the ICRC on the same subje ...

Brauman, Rony15 July 2013

David Miliband's new role will only hinder our aid work

David Miliband's new role will only hinder our aid work

The appointment of David Miliband as president and CEO by a major relief agency is another nail in the coffin to claims of humanitarian independence. As a native European who has spent decades negotiating with warring parties around the world, I know all too well the dangers of being perceived as a ...

Hofman, Michiel03 April 2013

Syria: Breaking the De Facto Humanitarian Embargo against Rebel-Held Areas

Syria: Breaking the De Facto Humanitarian Embargo against Rebel-Held Areas

While European Union members are debating the lifting of arms embargo on Syria, populations living in opposition held territories continue to be severed from desperately needed humanitarian aid. Yet, there is a controversy among aid agencies on the best ways to scale up relief activities in Syria.. ...

Weissman, Fabrice ; Rodrigue, Marie-Noëlle03 April 2013

Three questions to Fabrice Weissman on current humanitarian challenges

Three questions to Fabrice Weissman on current humanitarian challenges

Tensai, United States What are your tangible suggestions for improving negotiations with Syrian government for cross border access, and why do you believe that greater pressure from OCHA and ICRC would yield results?­ With regard to the question of access, the main challenge faced by aid organ ...

Weissman, Fabrice03 April 2013

Perspectives on the future of humanitarian action

Perspectives on the future of humanitarian action

On the occasion of the 150th anniversary of the ICRC (1863-2013) and in light of the recently launched issue of the Review on "The future of humanitarian action", the Harvard Program on Humanitarian Policy and Conflict Research (HPCR) and the International Review of the Red Cross are pleased to co- ...

Weissman, Fabrice03 April 2013

My Enemy's Doctor Is My Enemy

My Enemy's Doctor Is My Enemy

What do the Syrian National Coalition, a foreign jihadi group, a Gulf State and the Iranian and American governments all have in common? All are providing varying degrees of 'humanitarian' aid to the side they support in the Syrian conflict, but none are able to curtail the immense suffering alone ...

Whittall, Jonathan07 March 2013

Vaccination against poliomyelitis: violence and resistance

Vaccination against poliomyelitis: violence and resistance

On January 8th, nine Nigerians, all working on the poliomyelitis vaccination campaign, were murdered in Kano, in the north of the country. A few weeks before, several Pakistani (nine in December, seven in January), again members of poliomyelitis vaccination teams, were also killed. These barbari ...

magone; Magone, Claire01 March 2013

"Remote management in Somalia"

"Remote management in Somalia"

Discussions on the merits of remote control management of humanitarian projects have been particularly intense over the last few years. MSF is not an exception and we are pleased to share this contribution published in Humanitarian Exchange Magazine (January 2013, No. 56) by Joe Belliveau, the ope ...

Joe Belliveau23 January 2013

Syria: "Health facilities have become part of the war zone"

Syria: "Health facilities have become part of the war zone"

In June, Médecins Sans Frontières/Doctors Without Borders (MSF) opened a hospital in the Idlib region in northern Syria, an area under rebel control. Located behind the front lines, the hospital has 15 beds and a staff of approximately 50, including 10 international MSF workers. Designed to perform ...

Weissman, Fabrice09 January 2013

Gaza: Alive, but slimmer

Gaza: Alive, but slimmer

Last October, the Israeli Minister of Defence resolved under judicial order to declassify documents dating from January 2008. These archives contain the implementation details of the embargo imposed on Gaza in 2007, following Hamas' rise to power. They specify that only essential items and humanita ...

Neuman, Michael06 December 2012

MSF and economy-generated environmental disasters

MSF and economy-generated environmental disasters

The humanitarian vocation has been defined as bringing "a measure of humanity, always insufficient, into situations that should not exist" (Rieff, 2002 p. 19). This definition raises three important considerations. The first is humanity. As MSF aid workers, the measure of humanity that we provide i ...

Pringle, John07 November 2012

Jean-Hervé Bradol: "In Syria, delivering aid is expensive, low-impact and highly frustrating".

Jean-Hervé Bradol: "In Syria, delivering aid is expensive, low-impact and highly frustrating".

LA CROIX: What are the humanitarian needs of people living near Alep? Jean-Hervé Bradol: The priority remains treating the uninterrupted flow of the wounded. To date, Syrian medical staff have been providing their care through a network of private hospitals. These semi-clandestine centres treat ...

Bradol, Jean-Hervé29 October 2012

PHAP Hosts Discussion on the Challenges and Compromises of Humanitarian Access

PHAP Hosts Discussion on the Challenges and Compromises of Humanitarian Access

On 19th of September, PHAP hosted a discussion on the compromises and negotiations the humanitarian aid community must contend with during crisis situations with Michael Neuman and Antonio Donini... ...

Neuman, Michael03 October 2012

Massacre of 17 Action Contre la Faim employees in Sri Lanka: demand justice or reveal the truth?

Massacre of 17 Action Contre la Faim employees in Sri Lanka:  demand justice or reveal the truth?

On 4th August 2006, 17 Sri Lankans working for Action Contre la Faim (Action against Hunger/ACF) and all wearing the NGO's tee-shirt were executed inside their own compound, the same day Sri Lankan government forces reclaimed control of the town of Muttur which had fallen into rebel hands on August ...

Magone, Claire06 August 2012

Refusing to accept the death toll from drug-resistant TB

Refusing to accept the death toll from drug-resistant TB

Epidemiological studies estimate that nearly nine million people were suffering from active tuberculosis (TB) in 2010, causing upwards of one and a half million deaths. More than 90% of these deaths took place in low- or middle-income countries, thus reinforcing an old idea that TB and poverty are ...

Bradol, Jean-Hervé ; Varaine, Francis27 April 2012

Humanitarian exoticism

Humanitarian exoticism

This article is about humanitarian exoticism and culturalist convictions: those to which members of NGOs currently adhere. They become apparent when NGO workers, motivated by empathy or the desire to explain certain types of behaviour, attempt to find cultural traits that are characteristic of the ...

Le Pape, Marc11 April 2012

Torturing in peace with medical help

Torturing in peace with medical help

Two operational situations have recently caused Médecins Sans Frontières to confront the question of torture and the instrumentalisation of medicine by those who practise it. The organisation suspended its activities in Libya at the detention centres in Misrata in January, having concluded that its ...

Neuman, Michael22 March 2012

Negotiating Humanitarian Access: How Far to Compromise to Deliver Aid

Negotiating Humanitarian Access: How Far to Compromise to Deliver Aid

On January 26, the Brookings-LSE Project on Internal Displacement and Doctors Without Borders/Médecins Sans Frontières (MSF) hosted a discussion on the compromises and negotiations the humanitarian aid community must contend with during crisis situations. Michael Neuman, research director with the ...

Neuman, Michael30 January 2012

Follow-up to "Wartime rapes: men, too"

Follow-up to "Wartime rapes: men, too"

In "Wartime rapes: men, too", I discussed an article, "The rape of men", by Will Storr published in The Observer on 17 July 2011 (http://www.guardian.co.uk/society/2011/jul/17/the-rape-of-men). The newspaper summarises the article as follows: "In this harrowing report, Will Storr travels to Uganda ...

Le Pape, Marc25 January 2012

The origin of cholera in Haiti: the culprit has been found!

The origin of cholera in Haiti: the culprit has been found!

Two scientific studies published last year confirmed the origin of the cholera epidemic that struck Haiti in October 2010. It was indeed caused by massive amounts of the bacterium Vibrio cholerae in the Artibonite river delta, originating from the sewage in the Minustah soldiers' camp. Before being ...

Magone, Claire25 January 2012

Horn of Africa: the weaknesses of a controversial operation

Horn of Africa: the weaknesses of a controversial operation

In a report titled "A Dangerous Delay", Oxfam and Save the Children rebuke everyone - governments, humanitarian organisations, the United Nations - who participated in the humanitarian response to the food crisis that struck the Horn of Africa in recent months. The subtitle says it all, highlightin ...

Neuman, Michael20 January 2012

Wartime rapes: men, too

Wartime rapes: men, too

Since the beginning of the 2000s, a number of English-language researchers have regularly asked the following question: why do international aid organisations (United Nations agencies and NGOs) pay so little attention to rapes of men and boys committed during armed conflicts?... ...

Le Pape, Marc15 December 2011

Humanitarian Negotiations revealed: the MSF experience

Humanitarian Negotiations revealed: the MSF experience

From international NGOs to UN agencies, from donors to observers of humanitarianism, opinion is unanimous: in a context of the alleged ‘clash of civilisations', our ‘humanitarian space' is shrinking. Put another way, the freedom of action and of speech of humanitarians is being eroded due to the ra ...

Magone, Claire; Neuman, Michael; Weissman, Fabrice15 December 2011

If you have to starve to death, better to do it in a war-torn country

If you have to starve to death, better to do it in a war-torn country

For the past several months, news about food shortages and famines affecting large segments of the East African population have been fueling donation appeals from major public and private aid organizations. Low rainfall and - in Somalia's case - recent stirrings in the 20-year-old civil war explain ...

Bradol, Jean-Hervé22 September 2011

Somalia and the International Status Quo in Refugee Management: When is the right time to say the big F word?

Somalia and the International Status Quo in Refugee Management:  When is the right time to say the big F word?

Reporting on her meeting in January 2010 with M. Ahmedou Ould-Abdallah, the then UN special representative for Somalia - Ambassador Susan Rice noted in a leaked diplomatic cable posted by Wikileaks: "(Ould-Abdallah), noted the high number of foreign fighters who have joined the armed opposition, in ...

Chkam, Hakim22 September 2011

When the United Nations cry wolf

When the United Nations cry wolf

The United Nations announces a famine and that 12.4 million people are threatened by drought in the Horn of Africa. Radio and television repeatedly broadcast an appeal for donations to UNICEF, brandishing disturbing figures. Oxfam accuses the French government of being tight-fisted.  Rony Brauman q ...

Brauman, Rony17 August 2011

Haïti : on aid and reconstruction

Haïti : on aid and reconstruction

One year after the earthquake in Port-au-Prince, a number of observers and actors are questioning the international aid : reconstruction is at a standstill, homeless people are still facing the same situation and the deadly cholera epidemic reminds us that international aid has not helped to improv ...

Brauman, Rony; Weissman, Fabrice14 January 2011

Inequality seriously damages health

Inequality seriously damages health

The main objective of the United Nations Development Millennium Goals ¬- a consensus if ever there was one - is to end poverty. Wiping out illiteracy, ensuring access to safe drinking water and education, and reducing maternal and child mortality are seemingly unarguable aims. And indeed, one can a ...

Brauman, Rony06 October 2010

15 years later : a UN report confirms the massacre of Rwandan refugees in eastern Congo denounced at the time by Médecins Sans Frontières

15 years later : a UN report confirms the massacre of Rwandan refugees in eastern Congo denounced at the time by Médecins Sans Frontières

For several weeks now the international press has been announcing the report to be published on 1st October by the Office of the United Nations High Commissioner for Human Rights (OHCHR) describing the human rights violations in DRC between 1993 and 2003... ...

Binet, Laurence01 October 2010

UN accuses, and congratulates, Rwanda…

UN accuses, and congratulates, Rwanda…

The United Nations has again raised the question of the implication of the Rwandan Patriotic Front (RPF) - in power in Rwanda since July 1994 - in crimes committed between 1993 and 2003 in the Democratic Republic of Congo. A draft UN High Commissioner for Human Rights (HCHR) report circulating on t ...

Bradol, Jean-Hervé28 September 2010

UN women : because I'm worth it

UN women : because I'm worth it

UN Women was created in July 2010, after intense negotiations between United Nations member states and women's rights organizations. This new structure will take over the mandates of the four UN organizations heretofore devoted to gender issues . It was created in response to the observation that d ...

Magone, Claire17 September 2010

Feeding malnourished children: not so simple!

Feeding malnourished children: not so simple!

Using Niger as an example, this text seeks to explore the dilemmas involved in medical responses to child malnutrition when such malnutrition is endemic (strong, permanent presence) and gives rise to seasonal peaks (epidemics) each year. It is this form of malnutrition that continues to have a majo ...

Bradol, Jean-Hervé31 August 2010

Has liberal universalism run its course?

Has liberal universalism run its course?

The debate over humanitarian intervention is keeping the northeastern US's left wing intelligentsia in a continual stir, torn between its opposition to imperialism and its devotion to human rights. Progressive interventionists aren't at all pleased with the regular reminders by their opponents that ...

Neuman, Michael30 July 2010

R2P and the use of violence for humanitarian ends

R2P and the use of violence for humanitarian ends

Should military forces be dispatched to a foreign country to save its population from massacre, famine, epidemics, or oppression? Debated in the 1990s as the "right or duty to intervene", the application of military might to rescue populations in danger is today debated as the "responsibility to pr ...

Weissman, Fabrice 17 June 2010

Gaza Flotilla : humanitarian or political ?

Gaza Flotilla : humanitarian or political ?

Was the flotilla boarded by the Israeli army on a "humanitarian" or "political" mission? Is there a "humanitarian crisis" in Gaza or not? The answers to the questions everyone has been asking over the last few days say nothing about the situation itself but do tell us something about the already we ...

Brauman, Rony09 June 2010

NATO and the NGOs: honeymoon over

NATO and the NGOs: honeymoon over

On March 3, NATO Secretary-General Anders Fogh Rasmussen sent a direct appeal to the humanitarian community. Acknowledging the limits of military force - "hard power" - in the stabilization and reconstruction effort in Afghanistan, he wants to create a closer partnership with the NGOs, whom he sees ...

Weissman, Fabrice04 May 2010

International Emergency Aid put to the Test in Haiti

International Emergency Aid put to the Test in Haiti

Emotions generated by the brutal and murderous character of a natural disaster are not calmed by the feeling that the victims bear a certain responsibility for the origins of the drama—whether because they are engaged in conflict (war), or poor sanitary or economic practices (epidemics, famines). C ...

Bradol, Jean-Hervé31 March 2010

Debate : the end of humanitarianism without borders ?

Debate : the end of humanitarianism without borders ?

The article written by my friend Christian Troubé, "The end of humanitarianism without borders?", published by Grotius.fr (June 2009 edition), and based on a description of humanitarianism of ‘yesteryear', strikes a cord with many of today's humanitarian figures. But acknowledged historical facts ( ...

Brauman, Rony20 March 2010

Haiti Earthquake: What Priorities?

Haiti Earthquake: What Priorities?

The earthquake that devastated Port-au-Prince and neighboring areas has led to a worldwide surge of solidarity which we must fully appreciate because no country could face such a disaster on this scale alone... ...

Brauman, Rony28 January 2010

The return of the titans

The return of the titans

The public arena is once again the stage for discourse and undertakings of Titanic proportions. Some endeavour to adjust our planet's thermostat while others devote themselves to wiping out the scourge of disease... ...

Bradol, Jean-Hervé20 December 2009

Humanitarian NGOs and the big stick policy

Humanitarian NGOs  and the big stick policy

In January 2009, eight regional and national NGOs got together to create the "International Coalition for the Responsibility to Protect*." The photo on their website's homepage sets the tone: strapping lads in fatigues, surrounding a group of children against a background of tropical vegetation  - ...

Brauman, Rony14 December 2009

Missing : malnourished children in Ethiopia

Missing : malnourished children in Ethiopia

In 2008, Southern Ethiopia was the epicentre of a vast nutritional intervention: more than 100,000 malnourished children received assistance from a mix of actors including both international actors and local health facilities. Given the structural factors affecting levels of malnutrition in this pa ...

Jézéquel, Jean-Hervé29 July 2009

Long live the (humanitarian) crisis!

Long live the (humanitarian) crisis!

According to Wikipedia, "a humanitarian crisis is an event or series of events which carry with them a critical threat to the health, safety or wellbeing of a collectivity, usually over a wide area... ...

Brauman, Rony22 June 2009

Prophylactic holiday in Mexico?

Prophylactic holiday in Mexico?

Influenza A H1N1 is turning into a pandemic. What will the number of cases be, what groups will be the most affected, how virulent will the virus be, and how long will it last?... ...

Bradol, Jean-Hervé15 June 2009

Kit Culture

Kit Culture

Analyzing the same event from different perspectives is a favourite trick of historians to spice up their narratives. It also works pretty well to describe humanitarian interventions... ...

Jézéquel, Jean-Hervé25 May 2009
 
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