Articles

This article is an addition to Issue 25 of Humanitarian Alternatives "Food crisis: what role for humanitarian actors?", published in March 2024.

Challenging the idea that humanitarian actors can act free from politics by virtue of their principles, this chapter argues that the politicization of humanitarian aid is in fact the primary condition for its deployment. Humanitarian actors can only act if they maintain a balance between their own interests and those of people in positions of power. This raises a crucial ethical question: At what point do humanitarian organisations consider that deals reached with political powers cross the blurred but very real line beyond which humanitarian assistance does more harm than good?

This article was published in the London Review of books website on September 8, 2023. The former evokes the dire conditions in which roughly 1 000 000 Rohingyas live in Cox’s Bazar, the largest refugee camp in the world. In this coastal district in south-east Bangladesh, the humanitarian deployment is impressive, but commitment by donors is waning. Between March and June, monthly food allocations fell from $12 to $8 per person. The difficulties of accessing care, the social control to which they are subjected and the lack of prospects are many reasons explaining the perils faced by the Rohingya population.

This interview by Didier Billion and Marc Verzeroli was originally published in the Revue internationale et stratégique. To examine the concept of de-westernization, Rony Brauman describes the current state of international relations, marked by fluid alliances and new power relationships. He states and details his reservations about whether universal values truly exist and how the international criminal justice system functions.

In Groupe URD's new issue of "Humanitaires en mouvement" (n°25), Michaël Neuman describes rescue operations in the Mediterranean and the strategies put in place by MSF to adapt to the constraints imposed by governments.

The central question raised in this discussion relates to two profoundly intermeshed issues for humanitarian practitioners and organisations: the use of history for humanitarian organisations, and the need for them to preserve and maintain archives

Michaël Neuman describes his visit to Goma’s IDP camps, where he spent two weeks. He shares his dismay at the low level of assistance provided by the aid sector, especially when we recall that the Sphere standards, born precisely out of the failure of the humanitarian response in this same region of Goma in the mid-1990s, were conceived and championed by all of us.

This article was published on March 27th, 2023 in the journal Alternatives Humanitaires, in an edition focused on mental health.

Based on a reflection regarding how patient rights have changed, in France in particular, Fabrice Weissman discusses humanitarian medicine’s shortcomings in that regard and proposes several avenues for improvement at MSF.  This text was originally posted on MSF’s associative website, The Souk.

This article was published on December 26th, 2022 on the Souk, the MSF associative website.
Accusing the mothers of malnourished children of being lawless fraudsters is a well-worn trope in malnutrition treatment programmes worldwide – and one that has resurfaced recently in Nigeria, stirred up by health workers and the media. These types of accusations obscure a series of tricky truths on the control of resources, the quality of malnutrition treatment programmes, and on the extreme precariousness in which many families live. We see all of this in northwest Nigeria’s Katsina state, where we are currently conducting the largest malnutrition programme in the history of Médecins Sans Frontières/Doctors Without Borders (MSF).

“Death is an extremely grave non-emergency; its only treatment is mourning”. That is how doctor Miguel Martinez Almoyna introduces his concept of emergency. The retired 92-year-old anaesthesiologist played an active role in creating France’s SMUR, and later SAMU, emergency medical systems. Still quite active overseas (in Brazil and Mexico), where he has exported the French pre-hospital model, he explains his approach to régulation médicale, whose purpose is to guide patients to the medical services their condition requires while offering a range of responses corresponding to different degrees of severity and urgency.

This article was published on December 22nd, 2021, in the Journal of Humanitarian Affairs (Issue 3, Volume 3).
Despite a concerted international effort in recent decades that has yielded significant progress in the fight against HIV/AIDS, the disease continues to kill large numbers of people, especially in certain regions like rural Ndhiwa district in Homa Bay County, Kenya. Although there is still no definitive cure or vaccine, UNAIDS has set an ambitious goal of ending the epidemic by 2030, specifically via its 90-90-90 (treatment cascade) strategy – namely that 90 per cent of those with HIV will know their status; 90 per cent of those who know their status will be on antiretroviral therapy and 90 per cent of those on antiretroviral therapy will have an undetectable viral load. These bold assumptions were put to the test in a five-year pilot project launched in June 2014 by Médecins Sans Frontières (MSF) and Kenya’s Ministry of Health in Ndhiwa district, where an initial NHIPS 1 study by Epicentre (MSF’s epidemiology centre) in 2012 revealed some of the world’s highest HIV incidence and prevalence, and a poor “treatment cascade”. Six years later a new Epicentre study, NHIPS 2, showed that the 90-90-90 target had been more than met. What explains this ‘success’? And given the still-high incidence, is it truly a success? What follows is an interview on the political, scientific, and operational challenges of the Ndhiwa project with MSF Deputy Director of Operations Pierre Mendiharat and physician Léon Salumu, Head of MSF France Kenya programs, conducted by Elba Rahmouni.