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Attacks on medical missions: overview of a polymorphous reality: the case of Médecins Sans Frontières*

Published online by Cambridge University Press:  11 June 2014

Caroline Abu Sa‘Da ,
Françoise Duroch  and
Bertrand Taithe
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Abstract

The aim of this article is to carry out a preliminary analysis of issues relating to the types of violence that are directed against humanitarian medical missions. Starting from the observation that violence can cause some degree of disruption for a medical organisation such as Médecins Sans Frontières, despite its wide experience which has brought it much wisdom and generated numerous and sporadic responses to such events, the article offers a more subtle analysis of terms and of situations of violence so as to contribute to the establishment of a research project and, in a second phase, to an awareness-raising campaign focusing on these complex phenomena.

Keywords

violenceattacksmedical carecriminalitywarmedicine
Type
Research Article
Information
International Review of the Red Cross , Volume 95 , Issue 890: Violence against health care Part II: The way forward , June 2013 , pp. 309 - 330
Copyright
Copyright © icrc 2014 

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Footnotes

*

The authors wish to thank Dr Maude Montani for all her help, Michaël Neuman for his references and commentaries, Fabrice Weissman for his suggestions, Eleanor Davey and John Borton for certain of the references in the framework of the academic cooperation between the Humanitarian Policy Group (HPG) and the Humanitarian and Conflict Response Institute (HCRI), and Jérôme Oberreit for his attentive rereading of the text.

References

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66 For example, see: Médecins Sans Frontières, ‘Afghanistan – L'humanitaire “assassiné”’, 5 July 2004, available at: http://www.msf.fr/actualite/articles/afghanistan-humanitaire-assassine (last visited 13 June 2013).

67 A patient executed in a Honduran Red Cross ambulance: ‘Acribillan a un hombre dentro de ambulancia en Honduras’, in La Prensa, 20 March 2013, available at: http://www.laprensa.hn/csp/mediapool/sites/LaPrensa/Sucesos/Policiales/story.csp?cid=365888&sid=951&fid=98 (last visited 29 August 2013).

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69 For example in Ciudad Juarez and Tamaulipas State: ‘Médicos huyen por violencia’, in El Universal, 5 October 2010, available at: http://www.eluniversal.com.mx/primera/35648.html (last visited 13 June 2013).

70 Private communication, MSF adviser, Mexico, 2013.

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75 ‘Médecins Sans Frontières expresses its serious concern for the security of its surgical centre in Aden, following the irruption into the hospital of a group of armed men during the night of 18 to 19 June. These men tried to carry away a patient who was receiving treatment in the emergency room’ [ICRC translation]. See Médecins Sans Frontières, ‘Yémen: MSF appelle au respect de la neutralité des hôpitaux’, 21 June 2012, available at: http://www.msf.fr/actualite/articles/yemen-msf-appelle-au-respect-neutralite-hopitaux (last visited 13 June 2013).

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83 A field in which MSF teams have often shown great sensitivity, which has sometimes influenced international opinion. Archives MSF France, Comité Solidarité étranger (Afghanistan, 1985–1987).

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85 Médecins Sans Frontières, ‘MSF Calls for End to Bahrain Military Crackdown on Patients’, 7 April 2011, available at: http://www.doctorswithoutborders.org/press/release.cfm?id=5170&cat=press-release (last visited 13 June 2013).

86 ‘MSF is gravely concerned for the safety of our staff and patients following a serious incident occurring in an MSF medical facility in Dinsor (Bay region, Somalia) on December 27. After taking control of Dinsor, representatives of military forces entered the MSF medical facility, pressured the Somali medical staff employed by MSF, and confiscated all inpatient confidential medical files’, in Médecins Sans Frontières, ‘After a Week of Intense Fighting in Somalia, MSF Extremely Concerned about the Security of Medical Staff and Safety of Patients’, 28 December 2006, available at: http://www.doctorswithoutborders.org/press/release.cfm?id=1916&cat=press-release (last visited 13 June 2013).

87 For example in Somalia, where two MSF colleagues were killed in Mogadishu in December 2011.

88 The National Report on the increase in reports of acts of violence in the hospital setting records a similar trend and notes that a policy encouraging reporting of such incidents may result in their increase, while tolerance with regard to violent episodes depends largely on the persons who fall victim to them. ‘The establishments do not all report the events that occur in the same manner, for a subjective analysis of the event partly remains, and the threshold of tolerance to agression is very different from one set of personnel to another, from one structure to another, from one establishment to another’. [ICRC translation] See French Ministry of Work, Employment and Health, above note 10, p. 6.

89 ‘It should be remembered finally that the problem of violence within health facilities requires prudence and prior definitions because violence is protean and subjective. Everyone who encounters this notion gives his or her own definition, a fact that must imperatively be taken into account before any attempt at analysis is made, so as to define a common language from which everyone can draw the elements of communication and information that he or she is seeking.’ [ICRC translation] See French Ministry of Work, Employment and Health, above note 10, p. 4.

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96 Discussion with Laurent Ligozat, Deputy Director of Operations, MSF Switzerland, Geneva, 13 May 2013.

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