On 12 January 2010, a high-magnitude earthquake caused numerous buildings in the city of Port au Prince in Haiti to collapse. Tens of thousands of people were killed or injured by falling blocks of concrete. The aftershocks from the earthquake, the predictions made by some seismologists and public rumours prompted fears of a repeat of the disaster. Houses, schools, churches, hospitals and business premises – all the places that had housed the capital’s residents and their main activities – had become lethal traps and a permanent threat. 

First Published December 1, 1999 - Nonprofit and Voluntary Sector Quarterly (NVSQ) - Volume 28 Issue 1.

This article begins with a look at the role played by Médecins Sans Frontières (MSF) since its inception in 1971, and then looks at the challenges facing MSF today. It focuses on the confusion of humanitarian and political roles and on the goals MSF has laid out for itself to address this confusion. Humanitarian aid has become the favored response of governments to political crises, and governments have increasingly turned to NGOs to carry out their policies. In turn, NGOs have become increasingly dependent on governments for financial support. These changes have politicized aid delivery and made it difficult for NGOs to maintain their independence. In addition, as the number of NGOs increases and their activities become more specialized, there are pressures toward institutionalization and bureaucratization. To respond to these challenges, MSF has identified several goals, including maintaining organizational independence and flexibility and avoiding bureaucratization.