MSF Identity
What does it mean to ‘be MSF’? This chapter looks at how the MSF identity draws on assumptions about who is neutral, expert and competent. It shows how this risks reinforcing power hierarchies in countries where MSF operates, as well as in the movement’s associative structure.
Key Findings
MSF identity assumes certain ideas about who is neutral, competent and an expert – this justifies continued inequity between different categories of staff.
Ideas about MSF’s identity, and the inequalities that go with it, are drummed in from the moment someone joins, through the different training offered to internationally mobile and locally recruited staff.
Informal power dynamics based around perceptions of MSF identity have been formalised over time and interact with formal structural hierarchies.
These dynamics are mirrored at a movement level, with ideas about who is ‘really MSF’ built into its hierarchies and associative structure. This drives who can and can’t contribute to shaping the organisation’s identity and agenda.
Chapter Overview
Assumptions about who is ‘neutral’ or an ‘expert’ still influence who is seen to be legitimate and a trusted leader of MSF operations. This has led to institutional barriers to locally recruited employees holding responsibility, and there’s still distrust about their ability to embody MSF’s principles.
Proximity to the field is a positive for internationally mobile staff, but a negative for locally recruited staff. ‘Field’ experience brings influence to internationally mobile staff, but for locally recruited staff, being seen as close to the working environment often excludes them from being able to fully lay claim to being part of MSF.
Assumptions about aid workers from the Global South, such as the risks of partisanship, nepotism and corruption, keep unequal power structures going – yet some locally recruited staff are also worried about corruption or “power abuses” if their colleagues were put in senior decision-making roles. Employees commented on the need to ensure blanket judgements don’t replace case-by-case considerations.
“The information that is sold to you, is sold in a way that even though it’s against you, you still support that information because you don’t see the bigger picture. You just believe so much that it’s true unless you really see the other side […] we were all convinced that following the MSF neutrality principle, that as a local you cannot be in a decision-making position […] automatically you just saw all the international employees, this holy person, this pure person, that comes and is purely neutral, follows MSF’s principles.”
There’s a widespread perception that “expats are experts”. This assumption is embedded in the way that MSF operates, with the assumed need to bring someone in from elsewhere suggesting that existing ‘capacity’ is inevitably lacking.
Some medical staff describe a working culture where foreign managers are assumed to hold superior expertise, even when dealing with areas for which they have limited previous experience. Even with high turnover of foreign managers, local medical staff found that their own expertise was too often dismissed.
Interviewees had the impression that locally recruited staff in coordination positions were not given the same level of responsibility as internationally mobile staff. What’s more, when security conditions deteriorate, it’s often locally recruited staff who are left behind to continue working.
Different training for new staff members, depending on their contract type, means a distinction is drawn from the start between ‘international volunteers’ and ‘locally hired employees’. International training presents ‘the field’ as a distant, inherently risky place, overlooking the fact that the majority of MSF staff are working in their own country. This contributes to different understandings of who can assume an MSF identity and on what terms.
Induction training and guidance documents favour internationally mobile staff, presenting them as better suited to holding positions of responsibility. Right from the beginning, this makes it feel ‘normal’ that there’s a hierarchy in which internationally recruited staff are decision-makers managing teams of locally recruited staff.
Despite attempts at reform, hierarchies also remain entrenched in the associative structure of MSF – the membership-based associations, their meetings, and their representative forums. This influences who can contribute to shaping the organisation’s identity and agenda. MSF staff and former staff who participate in the associations theoretically have the power to direct its formal leadership, but in practice, it is much harder for some staff to participate than others, reflecting wider inequity.
Institutional support is concentrated in the Operational Centre and section offices, rather than in countries of operation. The problem has been recognised in efforts to promote engagement, including through supporting role of Associative Life in the Field focal points, known as ‘ALFies’ – but these roles are unpaid and add to existing workloads.
The way associations are structured reproduces the dominance of power-holders within MSF. Unequal access has led to what some consider to be two tiers of association members, which reflect different opportunities for participation, as well as who is more likely to be part of governance. Board members are required not to be employed by MSF, which complicates the idea of building engagement among ALFies and other locally recruited staff for involvement in board or council structures.
International governance is also unrepresentative. Newer associations have been created on a regional basis, representing countries in the Global South, while older ones representing a single country (nearly all in the Global North) have not been required to merge or regionalise. Each association holds equal votes in the International General Assembly, resulting in more governance weight given to a minority of MSF staff.
Delve deeper
Image credit:
9. iAko M. Randrianarivelo/Mira Photo
10. Newsha Tavakolian/Magnum Photos
11. MSF