The tumult of 2016 has severely challenged humanitarian groups, which are trying to protect and care for an ever-growing number of refugees while the world’s richest nations turn inward.
Medecins Sans Frontieres (MSF), also known as Doctors Without Borders, has been particularly outspoken about the challenges of the past year.
The medical aid group pulled out of a major humanitarian summit in May, saying it had sidelined the real problems, including violations of refugees’ rights and international humanitarian law, “on a daily basis.” Then the group said it would stop accepting funds from the European Union and its members, out of opposition to their “damaging deterrence policies” in the wake of the March E.U.-Turkey deal.
Meanwhile, the international president of MSF, Dr. Joanne Liu, has appeared before the U.N. Security Council several times this year to demand accountability for the increasing targeting of medical workers in war, including in Syria and Yemen.
Refugees Deeply spoke to Liu, a Canadian doctor who has headed MSF since 2013, about how the organization has confronted the dilemmas of the past year and the road ahead.
Refugees Deeply: You first started out with MSF working with Malian refugees in Mauritania in 1996. How has MSF’s role in responding to refugee crises evolved in the two decades since?
Joanne Liu: Since the origins of MSF, we’ve been facing people on the move. Initially, it was much more refugees, people crossing borders. Now, a lot of conflicts are within borders, and we have more internally displaced people (IDPs). Everybody who was working in these environments, not only MSF, faced the question of how we address those needs and who is responsible for what.
Another factor is the increasing number of people crossing the Mediterranean Sea. We decided to get involved because of the dire needs of people taking this deadly journey across the sea. We advocate for “safe passage” and we put our actions where our mouth is by starting search-and-rescue operations. It was difficult and challenging and completely unchartered waters for MSF. Like other battles we have faced – when we first began providing treatment for HIV, for instance – we did not have competence initially, but we’ve built that competence over time.
Refugees Deeply: This past year has seen public debate over refugees become even more polarized, while nations increasingly resort to closed borders, offshoring of refugees and aid deals to deter migration. Has MSF had to change or adapt its work with refugees in response to these developments?
Liu: To a certain extent, but we are limited by the policy. We are a medical humanitarian organization, so we bring assistance wherever we can. We see the limits of our actions. MSF cannot be the catalyst to open a border. That is why we have been vocal in the public arena that states have a responsibility with respect to refugees, which today is being flouted.
That’s the reason we took the stance of stopping to take funds from the E.U. For us, the E.U.-Turkey deal was completely against our humanitarian principles and it would have been completely hypocritical for us to continue to take E.U. funding.
Refugees Deeply: In April, MSF-run boats resumed search-and-rescue operations in the Central Mediterranean Sea, a mission first begun a year earlier. Do you see a risk that the private rescue missions in the Mediterranean will allow Europe to be complacent about its responsibilities?
Liu: Yes, we do see a risk. But as humanitarians, as doctors, we cannot look on from the shore as people drown in an increasingly militarized Med. In December 2016, our presence is especially important given the lack of dedicated search-and-rescue resources at sea. Until there are safe and legal routes for people to flee Libya we will stay at sea. And onboard the Aquarius, which we run in partnership with SOS MEDITERRANEE, we will be the only NGO present throughout the deadly winter months.
Refugees Deeply: In May, MSF pulled out of the World Humanitarian Summit warning that it had become a ‘fig leaf of good intentions.’ Have your warnings been borne out in the seven months since?
Liu: It would be very presumptuous to think that. We thought it was a huge missed opportunity. For me, it was sad that everyone was focusing on MSF pulling out – the scoop was not MSF pulling out, but that a gathering of 6,000 people was not addressing our shared humanitarian challenges. When you bring the world together for a common purpose and you’re not addressing the key challenges we are facing – it is as if you’re a physician and you’re giving a medical conference, and you decide to have the core discussion on gardening.
Refugees Deeply: To go back to MSF’s decision in June not to take funds from the E.U. or its member states, has this impacted MSF’s funding and how long do you plan to keep this measure in place?
Liu: Of course it has an impact. In 2015, our funding from E.U. institutions was 19 million euros [$19.7 million] and funding from E.U. member states was 37 million euros [$38.4 million]. One of the things we are discussing now is what our criteria would be to take E.U. funding again. For us, it would be if we see some real change in policy toward refugees and migrants, but the outlook is pretty grim. For now, we haven’t seen anything that is a change in policy. Even more, the E.U.-Turkey deal set a dangerous precedent and has created a trend and ripple effect with other states.
Refugees Deeply: Many people have despaired of 2016, as Western nations turn inward and wars continue in Syria, Yemen and South Sudan. Do you see any signs of hope from the past year?
Liu: Signs of hope? I don’t know how I can answer that. Aleppo is being crushed by war without limits. South Sudan is facing one of the worst peaks of violence they’ve had over the past year. Jordan closed its border with Syria, halting the medical evacuation of war-wounded Syrians from southern Syria, so we were forced to close our clinic at the Zaatari refugee camp in Jordan [earlier this month]. So am I hopeful? I wish I could be, but it’s quite a challenging exercise at this stage.
I think the world – not only NGOs – needs to fight back for our common humanity. We have been building a collective construct in terms of where we see our common humanity, and now we’re flouting the Geneva Conventions in terms of attacks on the medical missions, we’re failing the Refugee Convention of 1951 and we are letting countries pull out of the International Criminal Court. We need to seriously ask, what kind of world do we want for tomorrow? What is the alternative, without allowing full impunity and falling into chaos and war?
We are losing the essence of our humanity. I don’t understand how we got there, and how we are letting it happen without much more of a fight. The outcome of recent elections in different countries is showing us that people are falling back on themselves, instead of trying to tackle very, very big challenges collectively. Those big challenges include the refugee and migrant crisis, but also medical challenges such as antimicrobial resistance as well as climate change. Honestly, if we don’t put ourselves collectively [back] together we probably will not manage. I am actually running out of words about how we’ve lost part of our common humanity. I don’t know if we’re ever going to be able to bring it back together.
This interview was conducted by phone and email and has been edited for length and clarity.