Witnesses 50 years of humanity

1971

Creation of Médecins Sans Frontières

"22 December 1971 will thus come to mean the mobilization and determination to topple the barriers and break down all the borders that separate those who seek to save lives and provide care from the victims."
— Tonus, 3 January 1972
Nigeria, 1971
Nigeria, 1971 — © Abbas / Magnum Photos

The emergency aid organization Médecins Sans Frontières/Doctors Without Borders (MSF) was founded by a group of French doctors and journalists to provide relief and assistance to people in distress, without discrimination. Its creation was announced in the 22 December issue of the medical journal Tonus. Medical action is the heart of its mission; bearing witness is inseparable from that. Why? Two years earlier, in 1969, a group of doctors had gone to Biafra, a territory seeking to secede from Nigeria, and later decided to break the “culture of silence” imposed by the International Committee of the Red Cross, the organization they were working with. 

1976

Thailand: in the refugee camps

"We are here to demand protection for these civilians, these unarmed people."
— Claude Malhuret, President of MSF, during the March for Survival of Cambodia, 1980
Cambodia, 1975
Cambodia, 1975 — © Hiroji Kubota / Magnum Photos

To assist Cambodians and Vietnamese fleeing oppressive regimes in their countries, MSF set up its first large-scale medical program for refugees surviving in these huge camps. In February 1980, MSF, working with the media and other NGOs, organized the “March for Survival” calling for international aid to be distributed in Cambodia. While the operational objectives may not have been achieved, the action gave tangible expression to MSF’s right to speak out. 

Read the thematic “Flee to survive”
1976

Lebanon: MSF’s first operations in a conflict zone

"No photos! I tried to have a conversation. Then, several minutes later, I heard the safety release click again. The bullet was loaded in the chamber. One false move—and boom."
— Raymond Depardon, Magnum photographer, 1979
Lebanon, 1978
Lebanon, 1978 — © Raymond Depardon / Magnum Photos

Long-standing tensions among Lebanese communities and power struggles led to outbreaks of violence, particularly in the capital, Beirut. When MSF arrived in Beirut, bombs were dropping, and the city was burning. Working initially in the besieged Nabaa-Bourj Hammoud district, a Shiite enclave, the organisation, in order to comply with its own principles of neutrality and impartiality, then worked in the predominantly Christian town of Zahlé, and later, starting in 1978, in the town of Deir el-Qamar.

Read the thematic “Conflict zones and violent realities”
1980

Afghanistan: clandestine medical aid deep in the mountains

"There was nowhere else to go for treatment. Our centres were oases in the midst of deserts of indifference."
— Juliette Fournot, MSF head of mission in Afghanistan, 1982-1989
Afghanistan, 1978
Afghanistan, 1978 — © Raymond Depardon / Magnum Photos

Immediately after Soviet troops invaded Afghanistan in December 1979, MSF teams rotated through the country to treat, operate on, and vaccinate Afghan people. Departing from Pakistan with supplies and drugs carried on horseback, they entered the country in secret, travelling hundreds of kilometres and setting up small hospitals deep in the mountains. Although lacking official authorisation, MSF decided to provide assistance where the needs existed. Over 10 years, more than 550 MSF doctors and nurses would rotate through the country’s high plateaus. 

Read the thematic “Conflict zones and violent realities”
1984

Ethiopia: facing a humanitarian disaster, choosing to speak out

"If nothing changes, I don’t know what we’re doing here. Without food, medical treatment is meaningless."
— Brigitte Vasset, MSF medical coordinator in Ethiopia, 1984
Sudan, 1985
Sudan, 1985 — © Stuart Franklin / Magnum Photos

With famine ravaging the northern part of Ethiopia, people were crammed into improvised camps. MSF sent food, medicine, and supplies and worked in therapeutic feeding centres. After witnessing aid being diverted to the south, where people were transferred by force, the staff decided to speak out. The Ethiopian government expelled MSF in October after the organisation denounced the manipulation of humanitarian aid. However, MSF continued to work with Ethiopian refugees in neighbouring Sudan.

1991

Somalia: humanitarian aid under duress

"If humanitarian aid must now come under the systematic control of the military or of governments […], that will be very troubling. I don’t want to lose my humanitarian soul."
— Patrick Vial, MSF head of mission in Somalia, 1993
Somalia, 1992
Somalia, 1992 — © Chris Steele-Perkins / Magnum Photos

As international aid agencies were leaving Mogadishu because of insecurity, MSF teams arrived in January. MSF opened nutritional centres across the country to treat the thousands of children suffering from malnutrition as a result of the months-long famine. After being victimised by kidnappings and repeated security incidents, and being forced to travel with armed escorts, MSF decided to leave the country in April 1993. The necessary humanitarian space could not be ensured, and the organisation could not act in accordance with its principles of neutrality and impartiality. 

1994

Rwanda: powerless in the face of genocide

"We were saying, ‘They’re killing these people.’ The only decent position was to break completely with humanitarian neutrality and call for military intervention against the perpetrators of the genocide."
— Jean-Hervé Bradol, MSF project coordinator in Rwanda, 1994
Rwanda, 1994
Rwanda, 1994 — © Gilles Peress / Magnum Photos

The assassination of Rwanda's president provided a pretext for unleashing a campaign to exterminate the Tutsis and the government’s Hutu opponents. Between April and July 1994, between 500,000 and one million people were killed against a backdrop of general indifference by the international community. MSF watched, powerless, as its Rwandan staff members and many patients were massacred. For the first time, MSF issued a warning and testified before the United Nations, hoping to trigger quick action on the part of the States. The escalating violence led to a massive exodus of refugees; MSF provided medical and nutritional assistance to them in Zaire and Tanzania.

Read the thematic “Flee to survive”
1995

Srebrenica: abandonment and shame

"We were witnesses, we knew what was going to happen. We did nothing. […] Picking up my camera at least meant facing that responsibility: I don’t want to look away."
— Gilles Peress, Magnum photographer in Srebrenica, 1996
Bosnia, 1996
Bosnia, 1996 — © Gilles Peress / Magnum Photos

For three years, Serbian leaders laid siege to the Bosnian enclave of Srebrenica. Food convoys and humanitarian aid employees were blocked from entering. When Serbian troops captured the town in July 1995, MSF—the only organisation still there—was forced to evacuate, leaving behind some of its Bosnian staff and patients. Srebrenica’s abandonment by UN peacekeepers ended in the killing of more than 7,000 people and the forced expulsion of another 40,000. MSF called for an inquiry into the UN troops’ failure to act to prevent the tragedy. 

1995

HIV: the fight for access to treatment

"Why do we want to introduce antiretrovirals? Because our doctors are treating opportunistic diseases, because these patients keep coming back, coming back, coming back—and because we’ll end up sending them all to the cemetery."
— Maryline Mulemba, MSF head of mission in Malawi, 2001
Uganda, 1995
Uganda, 1995 — © Paolo Pellegrin / Magnum Photos

MSF teams working across a variety of projects were seeing many of their patients die, victims of a new virus: HIV. Because of the prohibitive cost of treatment, the areas of the world most affected lacked access to antiretroviral drugs (ARV), which represented a treatment revolution. MSF became involved in the intense political and social mobilization in South Africa in 1995. The movement’s slogan was “Lives before profits.” The powerful collective campaign went global and eventually led to the production of generic treatments and dramatically lower prices. In 2000, MSF’s first patients received ARVs in Thailand. 

1999

Kosovo: the “humanitarian war” alibi

"If you wanted to know what was going on in Kosovo, given that there was no one left to provide information, you had to listen to the people who were leaving. As we listened to them, we became convinced that a crime was being committed."
— Thierry Durand, MSF operations director, 1999
Albania, 1999
Albania, 1999 — © Cristina Garcia Rodero/ Magnum Photos

As the Milosevic regime continued to operate in the former Yugoslavia, Serb forces were conducting a campaign of terror and violence, forcibly deporting ethnic Albanians from Kosovo. MSF offered medical care to these persecuted people on site. In March 1999, when Kosovo came under fire from NATO, which justified its intervention as a “humanitarian war,” MSF withdrew from the province. The teams continued to work in the refugee camps in Albania, North Macedonia (formerly Former Yugoslav Republic of Macedonia), and Montenegro, insisting that the civilians remaining in Kosovo must be protected

Read the thematic “Flee to survive”
1999

The Nobel prize awarded to dissenting humanitarians

"We are not sure that words can always save lives, but we know that silence can certainly kill."
— James Orbinski, president of the MSF International Council, Nobel Peace Prize speech, 1999
Chechnya, 1996
Chechnya, 1996 — © Thomas Dworzak/ Magnum Photos

MSF was awarded the Nobel Peace Prize, accepted by International Council President James Orbinski. In his speech, he denounced the abuses and indiscriminate bombing of the Chechen village of Grozny by Russian forces, which the teams were witnessing. By taking this position, he reaffirmed the right to dissent and denounce, and helped define MSF's reputation for speaking out boldly. 

2003

Darfur: the emergency facing displaced people and refugees

"At one point, everyone was aware of these atrocities. Thanks to the press, people could no longer say that I was lying when I would tell people in Khartoum about what was happening in Darfur."
— Jamal Abdalmula, MSF referring physician in Sudan, 2020
Sudan, 2004
Sudan, 2004 — © Paolo Pellegrin / Magnum Photos

In Darfur, a land rich in natural resources, the conflict between Sudanese government forces and rebel groups had become a civil war. The Janjaweed militia, backed by the government, were attacking and looting villages. Thousands of people died and more than one million fled. MSF responded immediately by providing medical and nutritional treatment to displaced people in the Darfur region and to refugees in Chad, where teams were already present. The organisation sent more than 2,000 staff. Restrictions and repeated attacks led MSF to suspend most of its activities in Darfur in 2006.

Read the thematic “Conflict zones and violent realities”
2005

Niger: famine and a nutritional revolution

"Sometimes I would cry when I saw all these little children who would show up in a terrible state, just skin and bones. … My experience as a paediatrician hadn’t prepared me to confront the deaths of so many of them."
— July Menschink, MSF doctor in Niger, 2005
Niger, 2005
Niger, 2005 — © Stuart Franklin / Magnum Photos

Niger was hit by a particularly severe food crisis, which resulted in unprecedented rates of malnutrition. In response, the teams used Plumpy’Nut, a ready-to-use therapeutic food made of oil, milk, sugar, vitamins, minerals, and peanuts, on a large scale for the first time. It proved to be revolutionary. Recovery rates were spectacular, and this treatment became a national protocol in August. 

2010

Haiti: a huge emergency of extreme dimensions

"I didn’t leave the hospital for the first five days. Gradually, Haiti will no longer appear on the front page of our newspapers every day, but the needs of this community, of the people who’ve lost everything, won’t be met for months and, perhaps, years."
— Paul McMaster, MSF surgeon in Haiti, 2010
Haiti, 2010
Haiti, 2010 — © Paolo Pellegrin / Magnum Photos

Already struggling with poverty and a weak health care system, Haiti was struck by a magnitude 7.0 earthquake on 12 January. MSF, which had been working on the island for several years, began treating the wounded within the first hours following the disaster. Teams began rebuilding medical facilities and restoring access to water. In the following months, the emergency response shifted to combatting the cholera epidemic raging throughout the country. With more than 350,000 people receiving treatment in 10 months, the response in Haiti became the largest operation in MSF’s history.

2011

Syria: MSF’s underground hospitals

"The first thing that struck me was the number of civilians who’d been killed. They weren’t just collateral damage—they’d been targeted by Syrian army snipers."
— Jérôme Sessini, Magnum photographer in Syria, 2012
Syria, 2012
Syria, 2012 — © Jérôme Sessini / Magnum Photos

Against the backdrop of the growing Arab Spring movement, Syria experienced  unprecedented mass protests in March. The regime of President Bashar al-Assad used violence to put down demonstrations across the country. Doctors who tried to care for the wounded were also subject to reprisals. Networks of medical professionals organised secretly, but they often lacked supplies and equipment. MSF operated without official authorisation and provided essential medicines to local health providers before opening three hospitals in northern Syria. 

Read the thematic “Conflict zones and violent realities”
2014

Ebola: MSF on the front lines

"I cannot stand aside and watch my people die. But I, along with my colleagues here, cannot fight Ebola alone. …If the international community does not stand up, we will be wiped out."
—  Jackson Naimah, MSF medical assistant in Liberia, 2014

In March, an Ebola outbreak was declared in West Africa. MSF responded quickly in Guinea, Liberia, and Sierra Leone, setting up treatment centres specifically to combat the virus. The lack of a vaccine and available treatments resulted in very high mortality rates. Facing the deadliest Ebola outbreak in history, MSF criticized the inaction of the international community. When the outbreak ended in January 2016, more than 11,000 people had died. 

2015

Saving lives in the Mediterranean

"It is impossible to see people as numbers—or even as migrants or refugees—after experiencing a rescue. They are wholehearted and three-dimensional human beings. There is no ‘others’ – there is only ‘us."
— Lindis Hurum, MSF project coordinator on the Bourbon Argos, 2015
Mediterranean, 2015
Mediterranean, 2015 — © Paolo Pellegrin / Magnum Photos

After the Balkan migration route closed, the Mediterranean Sea became one of the last ways for asylum seekers to reach Europe. Lacking a commitment by European nations to save lives at sea, and facing a steadily growing number of deaths, MSF decided in April to launch a search and rescue and medical assistance operation in the Mediterranean. Over six years, seven boats staffed by MSF teams in partnership with other organizations have rescued and assisted more than 81,000 people. 

2017

Mosul: on the front line

"The noise of the explosions was deafening. The constant gunfire created a reign of terror. We wanted to be close to the front line so that we could stabilize the wounded and increase their chance of survival."
— Trish Newport, MSF project coordinator in Mosul, 2017
Iraq, 2017
Iraq, 2017 — © Lorenzo Meloni / Magnum Photos

The Islamic State armed group had occupied Mosul for nearly three years when the Iraqi Army and US-led coalition forces launched an offensive to retake the city in October 2016. As residents tried to flee to the camps set up for displaced people, MSF teams opened a hospital and medical posts close to the front line. MSF was the only organisation working in the western part of the city. Under constant fire, teams treated war-wounded people and patients with life-threatening emergencies. 

Read the thematic “Conflict zones and violent realities”
2017

Rohingya refugees in Bangladesh: the struggle to survive

"The camp is a time bomb ticking towards a full-blown health crisis. And in the mud and despair, it is hard to fathom that the people there are the lucky ones—the ones who escaped."
—  Joanne Liu, president of MSF International, 2017
Bangladesh, 2017
Bangladesh, 2017 — © Moises Saman / Magnum Photos

In August, attacks by militants on government forces in Myanmar’s Rakhine State sparked a wave of reprisals against the Rohingya community at large. The violence drove more than 660,000 people to flee to Bangladesh. MSF teams began providing assistance in the huge, overpopulated camps. After gathering statements and conducting a series of surveys with survivors, MSF published a report documenting the horrific scale of the violence. The report found that at least 6,700 Rohingya had died as a result of violence within the first month of the military’s “clearance operations.” They had been targeted for attack.

Read the thematic “Flee to survive”
2020

COVID-19 pandemic: adapting and acting in solidarity

"At times of global crisis, solidarity is not a given. But if we don’t mobilize together, this pandemic will take more than lives—it will cause us to lose our humanity."
— Monica Rull, MSF medical director, 2020
Greece, 2020
Greece, 2020 — © Enri Canaj / Magnum Photos

On 11 March, WHO declared the COVID-19 outbreak to be a global pandemic. Confirmed cases multiplied around the world. Ordinary life in many places came to a halt. MSF reorganized activities across its international projects and expanded operations to support overwhelmed health systems. The teams gave priority to supporting the most vulnerable communities while still ensuring continuity of care for our patients and protecting health care workers.

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