Doctors Without Borders

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Doctors Without Borders
legal form society
founding December 21, 1971
founder twelve doctors and journalists
Seat Geneva SwitzerlandSwitzerlandSwitzerland 
main emphasis emergency medical aid
method Education, action, help
Action space worldwide
Chair Christos Christou
(international president)
Managing directors Christos Christou
sales volume 1.44 billion euros (as of 2015)
Employees > 35,000 (worldwide, as of 2016)
MSF headquarters in Geneva
Doctors Without Borders introductory video

Doctors Without Borders (French: Médecins Sans Frontières , listen ? / I ) is the largest independent organization for medical emergency aid founded on December 21, 1971. Audio file / audio sample

The private aid organization provides emergency medical aid in crisis and war zones. For this she was awarded the Nobel Peace Prize in 1999 . For 2015 she was awarded the Lasker ~ Bloomberg Public Service Award .

All sections at international level, including the German section, use the French name Médecins Sans Frontières , its abbreviation MSF and the translation in their respective language. In English, for example, Doctors Without Borders .


Structure and staff

The association has sections in 19 states. An international office in Geneva has coordinating functions and supports cooperation in the network. Every year around 3,000 doctors, psychologists, nurses, midwives and logisticians are recruited for the organization's projects.


On June 17, 2016, the organization announced in a press release that the association would no longer apply for funds to the institutions of the European Union and its member states with immediate effect in protest against the European migration and asylum policy, which in its opinion serves the purpose of isolation and deterrence will.

According to the company's own information, worldwide revenues in 2017 amounted to 1.532 billion euros and expenditures for emergency aid projects amounted to 1.335 billion euros worldwide. 96 percent of the income came from private donations and contributions from more than 6.3 million donors worldwide.

The organization bears the Zewo seal of approval, which distinguishes non-profit organizations for the conscientious handling of donations.


The organization runs medical aid projects in more than 70 countries and in some cases also trains employees in the country. The aid projects are different and range from emergency medical aid to the provision of drinking water and latrines to medical education for the population. However, as in the case of Chechnya and Kosovo , the organization also draws attention to human rights violations and violations of international humanitarian law.


Memorial stone on Märkischer Platz in Berlin-Mitte

The humanitarian work for the victims of hardship and violence was particularly honored in 1999 with the award of the Nobel Peace Prize.

"The Norwegian Nobel Committee decided to award the 1999 Nobel Peace Prize to Doctors Without Borders in recognition of the pioneering humanitarian work of this organization on several continents."

- Norwegian Nobel Committee


The association seeks to act independently, impartially and as neutrally as possible. In the opinion of the organization, this is the only way to provide effective humanitarian aid in crisis regions. The organization has only approved military intervention once since it was founded, namely in 1994 in the case of the genocide in Rwanda .

The organization also sees “witnessing” (“being a witness”) in the context of medical emergency aid as an important task. Witnessing means drawing attention to peoples in need. It reports on what employees see on site. Possible actions are: discussions with those responsible, lobbying or public awareness campaigns, in the worst case even withdrawal from an area of ​​operation. In the opinion of MSF , it may be necessary to weigh up between witnessing and neutrality in practical humanitarian work, which makes it necessary to give up neutrality in individual cases. This concept of neutrality distinguishes MSF from the strictly practiced neutrality of the International Committee of the Red Cross (ICRC), from whose operational experience MSF emerged.



The MSF based in Brussels, was established in 1980.

German section

Doctors Without Borders , founded in 1993 as a registered association , is the German section. Since 2003 there has also been a Doctors Without Borders Foundation .

Together with the sections from Great Britain and the Netherlands, the German section forms the Operational Center Amsterdam . This is one of five centers that plan and carry out operations relatively independently.

The organization has been the bearer of the DZI donation seal since 1998 . In 2010, an average of 104 people were employed in the German offices. 289 employees were sent to project countries. The section had a budget of € 78,486,000. General practitioner Dr. Amy Neumann-Volmer .

Doctors Without Borders V. has been the institutional sponsor of the German think tank for humanitarian aid, Center for Humanitarian Action, alongside other NGOs .

Austrian section

In Austria, the association Doctors Without Borders - Médecins Sans Frontières Austrian Section , based in Vienna, has been the Austrian section since 1994. Reinhard Dörflinger, who is also a member of the Vienna Medical Association , acted as President from 2006 to 2015 . From 2008 to 2011 he was Deputy President of the international organization Doctors Without Borders. In 2015, Margaretha Maleh succeeded him as President.

The association also bears the Austrian seal of approval for donations with the number 5103. Since 2009, donations from private individuals have also been tax-deductible. The donation volume in 2010 was around 17.4 million euros.

Swiss section

Médecins Sans Frontières / Doctors Without Borders Switzerland was founded in July 1981 as an association within the meaning of Art. 60ff. Civil Code founded. The registered office is in Geneva ; an office is operated in Zurich .

More than a hundred employees, together with many volunteers, ensure the operation of the operation center. In 2010 the association carried out 59 projects in 26 countries and employed 158 people (full-time positions) in Switzerland.

According to Art. 9, first paragraph, letter f) of the Law on the Taxation of Legal Entities, MSF Switzerland is exempt from profit and capital tax and enjoys tax exemption on gifts between living and death (excluding registration fees for real estate transactions). The cantonal tax exemption was extended at the beginning of 2011 for a period of 5 years. The exemption from direct federal tax in accordance with Article 16 (3) of the resolution on direct federal tax (BdBSt) is valid for an unlimited period. It was granted by a decision of March 25, 1991.

The current board consists of nine members elected for the entire duration of a mandate. The elected members are currently:

  • Thomas Nierle, President
  • Anne Perrocheau, Vice President
  • Philippe Sudre, secretary
  • Patrick Reybet-Degat, Treasurer
  • Slim slama
  • Liza Cragg,
  • Gillian Slinger
  • Frauke Jochims
  • Claude Mahoudeau

Spanish section

The Spanish section is the Médicos Sin Fronteras España .



During the Biafra War (1967-1970), the Nigerian military imposed a blockade on the formerly independent Biafra region in the south-east of the country. At the time, France was the only country that supported the people of Biafra. Britain , the United States and the Soviet Union had sided with the Nigerian government. The situation of the population within the blockade was unknown to the rest of the world. A number of French doctors, including Bernard Kouchner , volunteered with the French Red Cross organization to work in hospitals and food centers in besieged Biafra. However, the Red Cross required its volunteers to sign a declaration stating neutrality under all circumstances. Kouchner and a few other French doctors saw it as an obligation of confidentiality, but signed the declaration nonetheless.

Once in the country, the volunteers, including health care workers and hospital workers, were exposed to attacks by the Nigerian army. They witnessed civilians being murdered or starving to death. Kouchner was also an eyewitness to these events. He saw a great many children die as a result of the famine. After his return to France, he criticized the Nigerian government, but also the Red Cross , by describing their behavior as complicity . He called for responsibility for the situation on an international level. Kouchner and other doctors were convinced that an aid organization was needed that was willing to prioritize the welfare of the victims over political and religious interests.


Bernard Kouchner, founding member and first chairman of Doctors Without Borders

The Groupe d'Intervention Médicale et Chirurgicale en Urgence (German "Group for medical and surgical intervention in emergencies") was formed in 1970 by French doctors who had worked in Biafra to provide assistance and to prioritize victims' rights over neutrality emphasize.

The editor of the medical journal TONUS, Raymond Borel , had founded an organization called Secours Médical Français (German "French medical disaster relief") in response to the bhola hurricane in Bangladesh in 1970 , in which around 500,000 people died . Borel was looking for doctors to help the victims of natural disasters. On December 20, 1971, Borel, Kouchner and their colleagues united the two groups to form Médecins Sans Frontières .

The first deployment of the new organization was in Managua , the capital of Nicaragua . There an earthquake on December 23, 1972 destroyed most of the city and claimed more than 10,000 lives. It took MSF three days more than the Red Cross to begin its operation. On September 18 and 19, 1974, Hurricane Fifi caused severe damage in Honduras, killing several thousand. Doctors Without Borders set up the first long-term disaster relief effort.

After South Vietnam fell to North Vietnam , millions of Cambodians emigrated to Thailand between 1975 and 1979 to escape the Khmer Rouge . In response, MSF established a refugee camp for the first time in Thailand . When Vietnam withdrew from Cambodia in 1989, the aid organization started long-term disaster relief efforts to help the survivors of the " killing fields " and to rebuild the country's health care system. Although operations in Thailand were aimed at helping war victims, the operation in Southeast Asia is viewed as MSF's first war effort. Thailand was considered a war zone as MSF faced enemy fire in 1976. During the civil war from 1976 to 1984, MSF provided surgical assistance in hospitals in Lebanon.

Change in leadership and split

In 1977, Claude Malhuret was elected as the new chairman. In the period that followed, the discussion about the future of the organization began. Malhuret and his supporters rejected or downplayed the concept of témoignage . They felt that the organization should avoid criticizing the governments of the countries in which they operated, while Kouchner believed that documenting the misery that prevails in a country was the best way to solve a problem . The question of testimony, i.e. the publication of crimes in crisis regions by aid organizations, split the MSF.

After the events in South Vietnam in 1979, in the course of which people also fled on ships (so-called " boat people "), Kouchner was one of the signatories of an appeal published by French intellectuals in the left-liberal newspaper Le Monde . They supported the “A Boat for Vietnam” project with the aim of providing medical help to the refugees. Most of the members did not support the project. Nevertheless, Kouchner chartered a boat called L'Île de Lumière (German "The Island of Light"), traveled to the South China Sea with other doctors, journalists and photographers and helped thousands of patients medically. Although the mission was a success, Médecins Sans Frontières hardly gave Kouchner any further support - whereupon he and around 15 other doctors founded a new organization called Médecins du Monde (“Doctors of the World”) in March 1980 . Kouchner's new aid organization is very similar to MSF , and often both organizations conduct field missions in the same countries.

In 1982 Malhuret and Rony Brauman managed to improve the organization's financial position by introducing welfare stamps to the post office. This made it easier to raise funds. Brauman became the new chairman that same year. In the 1980s, operational sections of the organization emerged in other countries: the second section was founded in Belgium in 1980, the Swiss section, based in Geneva , was formed in 1981. Further sections followed in 1984 in the Netherlands and 1986 in Spain . In the same year, the first supporting section was founded in Luxembourg . Malhuret and Brauman also made numerous organizational changes after Kouchner's departure. After the Soviet army invaded Afghanistan in December 1979 , field operations were immediately carried out to provide medical aid to the mujahid fighters.

In February 1980 the organization publicly denounced the Khmer Rouge .

During the famine in Ethiopia in 1984–1985 , the organization ran local nutrition programs, but was expelled in 1985 after denouncing the misappropriation of international aid and the forced relocations carried out by the Mengistu regime. Due to pressure from the international public and the threat of a freeze on funds by the most important donor countries, the regime relented. After San Salvador , the capital of El Salvador , was struck by an earthquake on October 10, 1986, the organization provided the local population with equipment to produce clean drinking water. In 1993 she received the Nansen Medal from the United Nations High Commissioner for Refugees (UNHCR) .

Early 1990s

Most of the other supporting sections arose in the early 1990s: Greece and the USA followed in 1990, Canada in 1991, Japan in 1992, Great Britain , Italy , the German branch Doctors Without Borders e. V. 1993 and Australia as well as the Austrian branch, which is based in Vienna, followed in 1994. MSF groups were also formed in Denmark , Sweden , Norway and Hong Kong , and one in the United Arab Emirates was added later.


The organization is currently active in 79 countries.

In 1990 an MSF logistician was murdered in Afghanistan . Then the organization broke the same year made the activities in the country until 1992. MSF in Liberia in order civilians and refugees in the Liberian civil war to help. The ongoing fighting during the 1990s and the second Liberian civil war resulted in members providing active support for food supplies and the establishment of a health system, as well as running vaccination campaigns . They also spoke out against attacks on hospitals and food stations, particularly in the capital, Monrovia .

Further aid missions were carried out to provide disaster relief for Kurdish refugees who had to flee before the Anfal operation in Iraq. Evidence of the atrocities there was also collected in 1991 . In 1993 the organization ceased operations in Iraqi Kurdistan after the murder of a Handicap International employee.

The organization began its work in Srebrenica ( Bosnia and Herzegovina ) in 1993, a year after the war in Bosnia began, as part of a UN convoy. The city was surrounded by the Vojska Republike Srpske , which contained around 60,000 Bosniaks , and thus became an enclave that was guarded by a UN protection force (UNPROFOR). Doctors Without Borders was the only organization providing medical care to the trapped civilians.


The civil war in Somalia began in 1991 and with it widespread famine and disease, to which MSF responded with relief operations from 1992 onwards. In 1993 there was strong condemnation of the United Nations' practices in Somalia because of violations of humanitarian principles; however, volunteers continued to provide health and food supplies. But even after the withdrawal of the UN mission UNOSOM II in 1995, the violence in Somalia continued unchecked, and MSF was one of the few organizations that helped civilians who fell victim to fighting by running clinics and hospitals . After 22 years, the organization announced its withdrawal from the civil war country in August 2013 after its employees had repeatedly been the target of attacks and kidnappings.


In 1979 the organization carried out operations in southern Sudan to help civilians who were near starvation or who were suffering from other consequences of the civil war there . Volunteers from the organization reported on multiple occasions of torture , mass executions, cannibalism and severe famine.

In 1989, when a Pilots Without Borders plane was shot down with a rocket, two employees and other victims were killed. The organization then left South Sudan until 1992. However, over the past 25 years it has continued to provide disaster relief to Sudan, although some volunteers have been arrested and there have been repeated massacres, including by civilians.


In 1994, delegates from MSF in Rwanda had to join the delegation of the International Committee of the Red Cross there to protect them from the threat posed by Hutu extremists in the context of the incipient genocide . The employees of Doctors Without Borders wore it the emblem of the Red Cross and agreed to act in accordance with the rules of the Red Cross, as this was the only effective protection against a possible assassination in the context of local conditions. MSF's approach to addressing violations of human rights and international humanitarian law and thereby making humanitarian aid more effective had reached its limits during this mission.

Both organizations managed to keep all major hospitals in Kigali, Rwanda, operational during the worst of the genocide. Together with 37 other humanitarian organizations, MSF was expelled from Rwanda a year later, even though many MSF and Red Cross volunteers worked together under the Red Cross rules of engagement, which state that neutrality should be a top priority. However, MSF had previously criticized the bloodbath by Rwandan troops in the Kibeho displaced person camp . These events led to a debate within the organization about the contradiction between being responsible for humanitarian aid on the one hand and being an eyewitness on the other.

In response to the operation in Rwanda, the organization's position on neutrality approached that of the Red Cross. This was a remarkable development given the occasion and the circumstances that led to the creation of MSF.

The Red Cross lost 56 staff and MSF lost nearly a hundred of their respective local workforces in Rwanda, whereupon the French section decided to get their team out of the country. The local workforce was forced to stay in the country. However, she announced the murders and demanded that the French armed forces intervene to stop the genocide. She also announced the slogan “You cannot prevent genocide with doctors alone” in the media.

Not even a month later, the controversial Opération Turquoise followed . This intervention resulted either directly or indirectly from the migrations of Rwandan refugees to Zaire and Tanzania , also known as the "refugee crisis in the Great Lakes region", which later resulted in cholera epidemics, starvation and other forms of mass death.

Kazakhstan / Uzbekistan, Nigeria, Afghanistan and Sierra Leone

In the late 1990s, the organization carried out missions in the Aral Sea area . Many people there suffered from tuberculosis , cholera , AIDS , anemia , drug-related diseases and malnutrition.

During a meningitis epidemic that killed 25,000 in 1996, MSF vaccinated a total of three million Nigerians. In 2009, eight million people are said to have been protected from the disease , which is endemic in the Sahel region , in their largest vaccination program to date .

In 1997 she denounced the Taliban's refusal to introduce health care for women.

A significant field operation in the late 1990s was in Sierra Leone , where civil war raged from 1991 to 2002 . In 1998 volunteers began helping with surgery in Freetown due to the growing number of amputations and to collect statistics on civilians (men, women, children) claiming to represent the ECOWAS Monitoring Group . In Sierra Leone, marauding groups from the RUF rebels traveled between villages systematically chopping off residents' limbs, raping women, gunning down families, destroying homes and forcing survivors to leave the region. Long-term projects that followed after the end of the civil war included the treatment of phantom pain after violent amputations.


Although the organization had worked in the Kosovo region since 1993, the beginning of the Kosovo war caused a flow of refugees in the five-digit range, as well as a decline in decent living conditions. MSF provided shelter, water and health care for the victims of the NATO bombing. During the mission in Kosovo, differences of opinion arose between MSF headquarters and the Greek section of the organization. The reason for this was an aid operation by the Greek section with the support of the Greek government, which also looked after Serbian refugees. The Greek section had given the Serbian government guarantees for this mission, which the umbrella organization did not want to support, as they ran counter to the principles of the organization. On June 12, 1999, the Greek section was therefore excluded from the organization. It was not until 2005 that the Greek association was re-accepted into the organization.


An MSF agent examines a malnourished child in Ethiopia
MSF staff working against Ebola

The organization has been active in Africa for decades. Sometimes it was the sole guarantor of health care, food and water supplies. She has constantly tried to raise awareness of the situation there through media coverage in order to ultimately increase international support. Nevertheless, long-term field work is still necessary. In many projects, MSF also treats people with HIV / AIDS, as many infected people still do not have access to life-prolonging antiretroviral drugs. Médecins Sans Frontières is also fighting to ensure that inexpensive generics of these drugs are made available.

The aid organization has also been active in the African Congo region since 1985. Both the First and Second Congo Wars led to increased violence and instability in the region there. MSF had to withdraw the teams from Bunia, the capital of the Ituri province, because of the escalating violence there. However, it continues to work in other areas to provide food to tens of thousands of displaced civilians and to provide medical care to survivors of mass rape and widespread fighting. The treatments and possible vaccinations against diseases such as cholera, measles , polio, Marburg fever , sleeping sickness, AIDS and the plague are also important in preventing epidemics or at least containing them.

The organization has been operating in Uganda since 1980 , providing disaster relief to civilians during the guerrilla war that raged during Milton Obote's second term . But the formation of the Lord's Resistance Army was the beginning of a long campaign of violence that ravaged northern Uganda and southern Sudan. Civilians were subjected to mass executions, rape, torture and child abduction. The kidnapped children were later to serve either as sex slaves or as child soldiers . While 1.5 million people were evicted from their homes, MSF ran camp assistance programs that provided clean water, food and sanitation to victims of internal evictions .

Asia and America

In 2001 two employees were kidnapped. One of them was released unharmed after being kidnapped in Colombia for six months , and another worker in Chechnya was released a month later. In 2002, MSF employee Arjan Erkel was kidnapped in Dagestan and released in May 2004 after 20 months.


The organization was active in Afghanistan from 1980. Médecins Sans Frontières supports the Ministry of Health in the Ahmad Shah Baba Hospital in eastern Kabul, in the Dasht-e-Barchi women's clinic in western Kabul and in the Boost Hospital in Lashkar Gah in Helmand Province. Doctors Without Borders operates its own mother and child clinic in Khost in the east of the country. Médecins Sans Frontières uses only private funds for its work in Afghanistan and does not accept any government funds.

On June 2, 2004, five employees (one Belgian, one Norwegian, one Dutch and two Afghans) were killed in an attack by the Taliban in Afghanistan . MSF sees one of the reasons for this attack in the previously criticized instrumentalization and abuse of humanitarian aid for political purposes by the coalition forces under US leadership. For example, Afghans were sent leaflets asking them to provide information about the Taliban and Al-Qaeda in order to continue receiving humanitarian aid. Because of this incident and the continued abuse by the coalition troops, the organization stopped working in Afghanistan on July 28, 2004 after 24 years of activity.

In August 2011, our own clinic with 55 beds was opened in Kunduz , which had more than 90 beds by 2015. Around 400 Afghan and ten international employees worked there. Patients from all the surrounding provinces came to the clinic. After the Taliban retook the city of Kunduz, which was considered liberated, at the beginning of October 2015, the Afghan army tried to liberate the city. These battles were supported by US air strikes. On October 3, 2015, 22 people were killed and more than 30 were injured, some seriously , in several targeted air strikes by the US armed forces on the Kunduz Clinic . MSF called the incident a "serious breach of international law" and called for an independent investigation. MSF spokeswoman Christiane Winje announced that there are twelve MSF employees and ten patients, including three children. A later investigation into the incident by the New York Times in May 2016 revealed a deep distrust by the Afghan Army (ANA) in Kunduz of the facility's staff, which it suspected of supporting the Taliban. The staff had forbidden fighters with weapons from entering the hospital, but left them with their radios, the emissions of which were later detected by Afghan special forces with sensors in the building, which suggested that the Taliban would lead their units out of the hospital in the battle for the city . Finally, when an air strike was requested on a building near the hospital, there were discrepancies due to the coordinates and the crew of the attacking aircraft demanded a description of the building to be attacked from the ground troops in order to determine the target. ANA units then described the hospital, which was bombarded with gun and machine gun fire from an AC-130 at 2:30 in the morning. Doctors Without Borders put the number of victims at 42 dead and dozen wounded.

Mediterranean Sea

Since the refugee crisis in Europe from 2015 onwards , MSF has been active in various roles. MSF chief Joanne Liu condemned the refugee agreement between the EU and Turkey in an open letter in May 2016, calling on Europe to welcome all who needed help. In addition to medical support from Syria to Greece, the organization is also involved in rescue operations in the course of immigration to the EU via the Mediterranean . In 2015, MSF operated the Bourbon Argos (May 9) and Dignity 1 (June 13), two of its own search and rescue vessels on the Mediterranean Sea, and had medical specialists on board the motor yacht Phoenix (May 2) of the Migrant Offshore Aid Station ( MOAS). In the spring of 2017 there was a scandal when the border protection organization Frontex accused the aid organizations involved in the rescue operations off the Libyan coast of taking in people ever closer to the coast and of identifying the migrants who were taken in and collecting information about escape routes not to cooperate with the authorities. In this way the business would be supported by smugglers. An MSF statement said it was conducting " pro-active " rescue operations and that it was not the group's job to work with the authorities on smuggling. At the beginning of August 2017, the ship Prudence was banned from docking in a Sicilian port because MSF had not signed a code of conduct for private sea rescuers drawn up by the Italian government. MSF was temporarily involved in the operation of the Ocean Viking of the aid organization SOS Méditerranée . MSF has been operating the Geo Barents for sea rescue in the Mediterranean since May 2021 . (See also: Debate about ports of destination and criticism of NGOs .)

Further missions

In 1999, MSF spoke about the lack of humanitarian aid in Kosovo and Chechnya after conducting field operations to help civilians suffering from their respective political situations. In both regions, large numbers of people were forced to leave their homes, resulting in unhealthy conditions and the violence of the war in Kosovo and the Second Chechnya .

Another country where civilians were directly affected by the war was Colombia , where the organization began its first programs in 1985. With fighting raging almost all the time between government forces, guerrilla groups such as the FARC and paramilitary groups such as the Autodefensas Unidas de Colombia , millions of civilians were displaced from their homes and physical violence and kidnappings were widespread. Médecins Sans Frontières provided active advice to people affected by acts of violence. It also built health care facilities for large groups of displaced people. Mobile clinics were used to support isolated groups.

The organization has been active in Haiti since 1991. But since former President Jean-Bertrand Aristide was overthrown, there has been an increase in violent attacks and rape by armed groups. MSF provided medical and psychological help in the existing hospitals; there was only one free practice in the capital, Port-au-Prince. She also looked after the victims of Hurricane Jeanne and cared for patients suffering from AIDS or malaria. After the devastating earthquake in January 2010, Doctors Without Borders treated tens of thousands of injured people in what was then the most extensive mission in history. When cholera broke out in the devastated country a few months later, the organization cared for the majority of the sick in specially built cholera treatment centers.

In 2005, the organization sharply criticized the United Nations : the famine in Niger was made public too late. To date, hundreds of thousands have been affected by the drought.

Structure and content of field operations

Before a field operation is carried out in a country, a team from MSF visits the area in advance to determine the circumstances of the humanitarian emergency, the level of security there and the type of assistance needed. Medical assistance is the primary target of most missions, although some missions are primarily aimed at purifying water and providing food .

Field work team

A relief operation usually consists of a small number of coordinators who are assigned to lead each component of a field operation and a mission leader. He is usually the most experienced of all members and it is his or her job to negotiate with the media, country governments or other humanitarian organizations.

Medical care volunteers include doctors, nurses, and numerous other professionals. In most cases, the team is made up of local and international employees.

Although these health care volunteers almost always get the most media attention when the world hears about MSF field operations, there are a number of non-medical volunteers who keep the field operation up and running. The logisticians are often the most important members of a team. You are responsible for everything from the medical equipment required in the field, from the selection of security technology and vehicles to the supply of food and electricity. They can work as engineers or foremen , but they usually help set up treatment centers or oversee local workforces. Other groups outside of the medical workforce include water and sanitation professionals (mostly experienced water engineers) and financial or administrative professionals who are deployed in field operations.

Medical health care and preventive care

Vaccination campaigns are an important part of MSF's medical care efforts . Vaccinations can help prevent diseases such as diphtheria , measles, meningitis , tetanus , pertussis , yellow fever , polio, and cholera, which are rare in affluent countries .

Some of these diseases, such as cholera and measles, spread rapidly in high population densities, such as in refugee camps. Hundreds or even thousands of people housed there have to be vaccinated within a very short time.

Another part of the medical care provided during the missions is the treatment of people with HIV / AIDS. For many countries in Africa, whose inhabitants make up the majority of those infected with HIV worldwide, MSF is often the only point of contact for the treatment of HIV / AIDS.

In most countries, MSF also supports local hospitals by, for example, improving hygiene, providing additional equipment and medicines, and training local hospital staff. If the local workforce is overwhelmed by the number of patients, MSF is able to build new specialist clinics for the treatment of endemic diseases or for surgical interventions on war victims. Although these clinics are opened with foreign employees, Médecins Sans Frontières endeavors to increasingly place the operation of these clinics in the hands of local employees through appropriate instruction and further training measures.

In some countries, such as Nicaragua , the organization provides public education to raise awareness about health care and the spread of sexually transmitted diseases .

Child in the Biafra war suffering from kwashiorkor , a disease resulting from malnutrition


When the organization conducts an operation, there are often situations in which, at least in part, or even very severely, there is malnutrition as a result of war, drought or government bad administration. Deliberate starvation is also sometimes used as a weapon during war. In addition to the supply of food, the organization brings the situation to the attention of the people and insists on the intervention of foreign governments. Contagious diseases and diarrhea , both of which cause weight loss and the weakening of the human body, especially in children, must be treated with medication and adequate diet to prevent further infection and weight loss. A combination of the above scenarios, i.e. when a civil war rages in times of drought and contagious diseases break out, can lead to famine.

In situations where there is no real famine but a lack of nutritious food, protein malnutrition and lack of energy are common among young children.

  • Marasmus , a form of calorie deficiency, is the most common form of malnutrition during childhood and is characterized by a considerable and often disastrous weakening of the immune system.
  • Kwashiorkor , a form of energy and protein starvation, is a much more dangerous form of malnutrition. It is most common in young children and can have dire effects on physical development.

Both types of malnutrition can make potential infections fatal.

There are two methods of treating marasmus and kwashiorkor: inpatient treatment in the therapeutic nutrition center or treatment in the family home, known as home care . The latter is an innovation in the treatment of severe malnutrition, which has decisive advantages for the patients and their families compared to the usual nutrition centers. In the therapeutic nutrition center, malnutrition is treated with the gradual introduction of special milk-based diets (F75, F100) and standard medication, which leads to the desired weight gain. The treatment is divided into two phases:

  • The first phase serves the medical stabilization of the patient and the recovery of the appetite and usually lasts one to two days. During this time, milk meals (F75) are served every three hours.
  • In the second phase of two to four weeks, the rapid weight gain to normal weight is achieved through the use of a second therapeutic milk (F100). The mother or another family member is always present to care for the entire treatment.

By developing nutritionally enriched ready-to-eat therapeutic foods that can be consumed immediately, the treatment of severe malnutrition can also be carried out at home in most patients. After admission to the program, the weight gain is assessed in an outpatient medical check-up every week and a ration of peanut paste packed in an edible bag format is handed out for the next week. In the event of medical complications, an inpatient stay in the nutrition center is carried out to stabilize the patient with the aim of being discharged into home care as soon as possible. The treatment in home care usually lasts about six to eight weeks and thus longer than in the therapeutic nutrition center. However, it can be easily integrated into the family's everyday work and does not destroy the family structures.

The so-called MUAC test is often used to quickly determine the nutritional status of a large group of people .

Water and hygiene

Clean water is usually achieved by cleaning, remodeling and expanding existing wells . In such situations, water is often cleaned by storage for sedimentation and subsequent filtration and treatment with chlorine . The actual process, however, depends on the respective circumstances and available resources.

The organization also educates the local medical workforce on effective sterilization procedures , the establishment of sewage treatment plants , and proper waste management. The population is also informed about physical hygiene and how to deal with waste and water. Proper sewage purification and water hygiene have proven to be the most effective ways to prevent certain infectious diseases.


Countries in which MSF has missions

In order to provide the world public and government officials with precise information on the status of a humanitarian emergency, data is collected for documentation purposes during each field operation. The malnourished child rate is used to determine the magnitude of the undernourished in the population and thus to determine whether feeding centers are needed. Different types of death rates are used to document the severity of a humanitarian emergency; One common way to measure the death rate in the population is to have a workforce keep an eye on the number of burials in cemeteries. By collecting data on the incidence of illnesses in hospitals, the organization can track and locate the increased incidents of epidemics, as well as stockpiles of vaccines and other medicines. The so-called meningitis belt was located in sub-Saharan Africa, as this is where most meningitis cases worldwide occur during the meningitis season from December to June. Shifts in this belt and the arrival of the corresponding season can be predicted using all the data collected over many years.

In addition to statistics on epidemics, the organization conducts popular surveys to determine the rate of violence in different regions. By assessing the extent of potential massacres and determining the rate of kidnappings, rape and killings, one has an empirical basis for psychosocial programs to lower the suicide rate and to increase the feeling of security in the population. Large flows of migrants, excessive civilian deaths and massacres can be quantified through surveys. The organization can use the results e.g. It can be used, for example, to put pressure on governments to provide aid.

Dangers to which employees are exposed

Attacks on employees, kidnappings and arrests

In addition to injuries and death, which occasionally result from bullets, mines and epidemic diseases, MSF helpers are sometimes attacked or kidnapped for political reasons. Since humanitarian aid organizations work in some countries during a civil war, they often run the risk of being seen as “helpers to the enemy” if an aid mission is initiated exclusively for victims of one side of the conflict. The “ war on terror ” has also brought about the attitude in some countries that are being occupied by the USA that non-governmental organizations such as Doctors Without Borders are allied with the “ coalition of the willing ” or even work for them. Since the US began to label its war operations as "humanitarian operations", some independent aid agencies have been forced to defend their positions or even withdraw their personnel.

The security situation in some cities in Afghanistan and Iraq has steadily deteriorated since the US invasion of these countries. As a result, Doctors Without Borders realized that it was too dangerous for them to provide assistance in these countries. The organization was forced to abandon its missions in Afghanistan on July 28, 2004, after five of its employees (the Afghans Fasil Ahmad and Besmillah, the Belgian Helene de Beir, the Norwegian Egil) at Khair Khana in Badghis province on June 2 Tynæs and the Dutchman Willem Kwint) were ambushed by strangers.

Arrests and kidnappings of employees are possible in politically unstable regions. In some cases, MSF missions have been expelled entirely from the country. Arjan Erkel, the leader of the operation in Dagestan in the North Caucasus , was kidnapped and held hostage at an unknown location by unknown kidnappers from August 12, 2002 to April 11, 2004.

Paul Foreman, head of the section in the Netherlands, was arrested in Sudan in May 2005. He had refused to hand over documents to be used to produce a report on rape by pro-government militias of the Janjawid during the Darfur conflict . Foreman cited the privacy of the women concerned. MSF believed that the Sudanese government had arrested him for displeasing the bad publicity from the report.

Attacks on hospitals and transports

In crisis and war regions, the employees of the aid organization are at risk from attacks on hospitals and medical transports. This is evidenced by the following incidents from 2015:

On October 3, 2015, the U.S. Air Force bombed Doctors Without Borders hospital in Kunduz , killing at least 19 people, including seven patients. Three of the dead were still children. The UN sharply condemned the attack, claiming that it might constitute a war crime. The combatants knew the exact location of the hospital.

In August 2015, air strikes were carried out on nine hospitals in north-western Syria, including three supported by the organization, over four days, killing 11 civilians and injuring 31 people, according to the organization. Between late September 2015 and late October 2015, air strikes on 12 hospitals in northern Syria, including six MSF-supported facilities, killed at least 35 Syrian patients and medical staff and injured 72 people. On April 27, 2016, an MSF-supported clinic in Aleppo was hit by several air strikes, killing 11 members of the medical staff.

The organization's facilities were also attacked in Yemen . On the evening of October 26, 2015, her clinic in Sa'da in northern Yemen was hit by several air strikes while a number of staff and patients were in the building. The UN condemned this incident as well. Western media assume that these attacks were carried out by the Arab military coalition. Reports of further incidents followed in the months that followed: There were two dead and eight injured in an air strike on one of their mobile clinics in Taiz on December 2, 2015, six dead and at least seven injured in an attack on Shiara Hospital on January 10 2016, which was supported by the organization, and seven dead and numerous injured in a series of air strikes in Sa'ada Governorate on January 21, 2016 in which an organization ambulance was hit. After four attacks on MSF-backed facilities, the aid organization withdrew its staff from six hospitals in the north of the country in August 2016, citing “arbitrary bombing” and “unreliable assurances” by the Saudi-led military alliance as the reason.

The organization reported that in 2015 a total of 106 air and artillery attacks were carried out on 75 clinics operated or supported by the organization.

Campaign for access to essential medicines

The campaign for access to essential medicines (Campaign for access to essential Medicines) was passed in 1999 in the ways of access to vital medicine to improve in developing countries. At that time, 15 million people died annually from treatable infectious diseases (today 17 million die from them every year.) Indispensable drugs are those drugs that are needed to meet the most urgent needs of the population for medical care. However, many diseases that are common in developing countries are almost extinct in affluent countries; This is why the pharmaceutical companies often consider the production of these drugs to be unprofitable and accordingly increase the prices, no longer develop the drugs or in some cases completely stop the production of these drugs. For other diseases such as For example, HIV / AIDS, which is also important in industrialized countries, there are often effective drugs that are often unaffordable for people in developing countries due to international patent law . The organization Médecins Sans Frontières has often lacked effective and affordable medicines during its field operations, so this campaign was launched to put pressure on governments and pharmaceutical companies to finance an adequate supply of essential medicines to the population.

Sexual exploitation by employees

In the wake of the sex scandal involving the development organization Oxfam in 2018 , it became known that there were also cases of sexual assault at Doctors Without Borders. According to the organization, the data was not only collected and published under the pressure of the Oxfam revelations, but was already collected in January 2018.

In 2017 alone, 24 cases were reported by employees. However, Doctors Without Borders admitted that the number of unreported cases is likely to be higher because those affected did not report attacks out of concern about negative consequences. 19 accused were released.


With the initial issue date January 2, 2021 the German Post AG on the occasion of the 50th anniversary of the institution was a special stamp in the denomination out of 270 euro cents. The design comes from the graphic designers Daniela Haufe and Detlef Fiedler from Berlin.


  • Elliott Leyton, Greg Locke: Touched By Fire: Doctors Without Borders in a Third World Crisis. McClelland & Stewart, Toronto 1998, ISBN 0-7710-5305-3 .
  • Dan Bortolotti: Hope in Hell: Inside the World of Doctors Without Borders. Firefly Books Ltd, Richmond Hill 2006, ISBN 1-55407-142-9 .
  • David Morley: Healing Our World: Inside Doctors Without Borders. Fitzhenry & Whiteside Limited, Calgary 2006, ISBN 1-55041-565-4 .
  • Petra Meyer (Ed.): Pain Limits: On the way with Doctors Without Borders. Gütersloher Verlagshaus, Gütersloh 2008, ISBN 3-579-06979-9 .
  • Kimberly S. Greenberg: Humanitarianism in the Post-Colonial Era: The History of Médecins Sans Frontières. In: The Concord Review. Vol: 13: 2 (2002), The Concord Review Inc., Sudbury MA, pp. 57-92.
  • Fox, RC: Doctors Without Borders: Humanitarian Quests, Impossible Dreams of Médecins Sans Frontières . Baltimore. Johns Hopkins University Press, 2014, ISBN 978-1-4214-1354-9 .


  • With open cards. Doctors Without Borders: From Action to Talk. Documentary, France, 2011, 12 min., Director: Frédéric Lernoud, moderation: Jean-Christophe Victor, production: arte France, film information at

Web links

Commons : Doctors Without Borders  - collection of images, videos and audio files

Individual evidence

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  24. Our work. In: , as of 12/2011
  25. Nicolas Kulish: "Doctors Without Borders to Pull Out of Somalia" NYT of August 14, 2013, viewed on August 14, 2013
  26. Dominic Johnson: Epidemic Without Attention. In: taz , May 4, 2009.
  27. Hellenic Link - Midwest (PDF file; 117 kB)
  28. Serbian daily newspaper: Kažnjeni zbog Srba (Punished because of the Serbs). ( Memento from June 11, 2009 in the Internet Archive ) In: Glas javnosti , October 21, 1999
  29. Question in the European Parliament regarding the exclusion of the Greek section from MSF , December 17, 1999
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  32. Matthieu Aikins, “Doctors With Enemies: Did Afghan Forces Target the MSF Hospital?” New York Times, May 17, 2016
  33. Joanne Liu: "Europe, don't turn your back on Asylum: #TakePeopleIn" MSF of May 13, 2016
  34. MSF intensifies operations in the Mediterranean , MSF Switzerland from June 15, 2015
  35. Patrick Wintour: "NGO rescues off Libya encourage traffickers, says EU borders chief" The Guardian of February 27, 2017
  36. Italy prohibits MSF ship landing in Sicily | NZZ . In: Neue Zürcher Zeitung . August 6, 2017, ISSN  0376-6829 ( [accessed December 24, 2018]).
  37. 19 dead in US attack on clinic in Afghanistan. In: Retrieved October 4, 2015 .
  38. ^ US air raid on clinic in Kunduz. The death toll rises to 16. In: October 3, 2015, accessed on October 4, 2015 : "... the exact location of the clinic with GPS coordinates communicated to all parties to the conflict, including Kabul and Washington ..."
  39. Civil war: Dozens dead in air strikes on hospitals in Syria. Spiegel online, October 29, 2015, accessed on November 3, 2015 .
  40. Syria: Airstrikes on nine hospitals in Idlib province, 11 civilians killed and 31 wounded. MSF, August 14, 2015, accessed November 3, 2015 .
  41. Syria: Massive displacement in Northern Syria as violence escalates and intensifies. MSF, October 29, 2015, accessed November 3, 2015 .
  42. ^ Anne Barnard: "Divided Aleppo Plunges Back Into War as Hospital Is Destroyed" NYT April 28, 2016
  43. UN Secretary General condemns air strike on clinic in Yemen. Die Welt, October 28, 2015, accessed November 2, 2015 .
  44. Yemen: Repeated attacks on health facilities - Doctors Without Borders calls for independent investigation. Press portal, January 25, 2016, accessed on January 25, 2016 .
  45. ^ Air strikes on hospitals in Yemen. Doctors Without Borders is withdrawing staff. In: taz. August 19, 2016. Retrieved August 28, 2016 .
  46. Kim Son Hoang: US attack on hospital in Kunduz: The trauma among the helpers., May 19, 2016, accessed on May 19, 2016 .
  47. Annual report 2015: Doctors Without Borders warns of the humanitarian consequences of the Austrian asylum policy. Doctors Without Borders, May 18, 2016, accessed May 19, 2016 .
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  49. Hermann Lueer: Why do 100,000 people starve to death every day ?: Arguments against the market economy. MV-Verlag, 2007, ISBN 3-86582-517-6 , p. 17.
  50. Pharmaceutical companies and "Third World". ( Memento from January 18, 2012 in the Internet Archive ) In:
  51. Hannelore Crolly: NGO sex scandals: Oxfam is followed by Doctors Without Borders and IRC . In: THE WORLD . February 16, 2018 ( [accessed February 27, 2018]).
  52. ↑ The scandal spreads . In: . ( [accessed on February 27, 2018]).