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Doctors Without Borders

Humanitarian Quests, Impossible Dreams of Médecins Sans Frontières

Renée C. Fox

Publication Year: 2014

Médecins Sans Frontières / Doctors Without Borders (MSF) is a private international medical humanitarian organization that was created by a small group of French doctors and journalists in 1971. In 1988, MSF was awarded the Nobel Prize for Peace in recognition of the worldwide assistance it provides for people in distress who are victims of manmade and natural disasters and armed conflict. Committed to the principles of neutrality, impartiality, and independence, the men and women of MSF bear witness by speaking out about conditions of extreme need and suffering, acts of violence against individuals or groups, and threats or hindrances to medical care that they observe in the course of carrying out their work. Renée C. Fox is a sociologist known particularly for her pioneering work in medical sociology and for her ethnographic research and writing. Doctors Without Borders is based on the first-hand research she conducted about and within MSF since 1993. Its vivid, “thickly descriptive” data are derived from her participant observation, in-depth interviewing, and collection of primary and secondary documents in numerous MSF contexts. The book begins on the ground with the blogs of women and men of MSF in the field, recounting their experiences in moving detail. From there it chronicles MSF’s early history and development, paying special attention to its inner struggles, during the first decades of its existence, to clarify and implement its principles and to more fully realize its “without borders” transnational vision. Detailed case studies form the core of the book, describing MSF in postapartheid South Africa, dealing with that nation’s rampant epidemic of HIV/AIDS, and MSF in postsocialist Russia, responding to the thousands of homeless persons on the streets of Moscow and to the massive epidemic of tuberculosis in the penal colonies of Siberia. The book ends with an account of the fortieth anniversary meeting of MSF in Paris and with the author’s exit from the field. Doctor Without Borders tells a narrative enriched by photographs of MSF missions and by ironic, self-critical cartoons drawn by a member of the Communications Department of MSF France.

Published by: The Johns Hopkins University Press

Title Page, Copyright Page

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The Quests: An Introduction

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pp. 1-10

This introduction, and the book to which it is a prelude, encompass two interrelated quests. One is the continuous quest of Doctors Without Borders to provide international medical humanitarian assistance in ways that perpetuate and constantly revitalize its founding principles and ethos. The other is my...

PART I: Overture

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1. Voices from the Field

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pp. 13-40

Darfur is cursed. . . . It’s either very hot, or very windy, or very wet or very dry. What is very clear is that it’s a tough and exacting place. It sings an ancient song of sadness dusted with weather and socio-political storms alike. Few days left here for me. I get to return home to [W]oolworth’s foods, family and friends...

PART II: Growing Pains

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2. Origins, Schisms, Crises

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pp. 43-58

The roots of Médecins Sans Frontières /Doctors Without Borders extend back to the passionate debates of left-wing French intellectuals after World War II, and to the moral anguish and indignation of young physicians from that milieu serving with the International Red Cross during the Nigerian civil war...

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3. “Nobel or Rebel?”

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pp. 59-72

On October 15, 1999, the Norwegian Nobel Committee announced its decision to award the Nobel Peace Prize for 1999 to Médecins Sans Frontières /Doctors Without Borders “in recognition of the organization’s pioneering humanitarian work on several continents.” “Since its foundation in the early 1970s,”...

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4. MSF Greece Ostracized

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pp. 63-87

Oslo, 6 December 1999. The recent expulsion of Doctors Without Borders/ MSF Greece from the International Council of the organization because of their decision to provide humanitarian assistance towards the victims of both sides of the Kosovo crisis, did not leave the whole movement untouched [sic]. The forthcoming Nobel Peace Prize nomination to MSF is a great honor...

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5. The Return of MSF Greece

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pp. 88-98

MSF Greece was reintegrated through a prolonged, incremental process, which began at a meeting of the International Council in Barcelona on November 22–24, 2002, where two MSF members appointed to go on a “fact-finding mission” to Greece presented their report. The aim was “to assess whether we feel...

PART III: A Culture of Debate

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6. La Mancha

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pp. 101-118

In November 2004, MSF’s International Council and its “EXDIR” (general directors of its nineteen sections) launched what was called the La Mancha process. Its aim was to “better define . . . the basic raison d’être” of MSF, its “roles and limitations,” and “in what ways [it] should be governed.”1 This...

PART IV: In South Africa

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7. Struggling with HIV/AIDS

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pp. 121-132

In 2000–2001, MSF began to integrate the treatment of HIV/AIDS with anti-retroviral drugs into its programs and to engage in intensive witnessing and advocacy to promote access, at affordable prices, to these medications, which are essential for treating the disease. The decision to do this was not arrived...

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8. In Khayelitsha

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pp. 133-184

With its sparkling and churning two oceans, rocky coastline, terraced hills dotted with white stucco and pastel-colored houses and villas, ancient mountains, luxuriant foliage, massive arrays of blooming flowers, and radiant light, Cape Town must be one of the most beautiful places on the face of the earth. During the early...

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9. A “Non-Western Entity” Is Born

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pp. 185-198

MSF South Africa officially became a new MSF “association” on December 16, 2011, the first day of MSF’s first International General Assembly in Paris, France, and of the simultaneous fortieth anniversary celebration of the movement’s foundation.1 Discussions at MSF’s international “La Mancha” conference in 2004 had...

PART V: In Postsocialist Russia

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10. Reaching Out to the Homeless and Street Children of Moscow with Olga Shevchenko

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pp. 201-214

My interest in seeing MSF’s work in Russia firsthand had several personal sources. Both my maternal and paternal grandparents came to the United States from Russia in the early years of the twentieth century as part of the great wave of East European Jewish migration to the United States between 1880 and 1914. Determined that their...

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11. Confronting TB in Siberian Prisons with Olga Shevchenko

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pp. 215-248

During the nineteenth and early twentieth centuries, there were more deaths from tuberculosis (TB) in Western industrialized societies than from any other disease. It was not until 1882, when Robert Koch discovered Mycobacterium tuberculosis, the bacterium causing TB, that it was understood to be a disease...

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Coda. Remembering the Past and Envisioning the Future

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pp. 349-268

Doctors Without Borders / Médecins Sans Frontières celebrated its fortieth anniversary and held the first meeting of its newly created International General Assembly on December 16–18, 2011, in Saint-Denis, a commune in the suburbs of Paris, at a conference center called L’Usine (The Factory). Throughout the nineteenth and twentieth centuries, until the 1970s, Saint...

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pp. 269-274

At its inception, my sociological quest to know and understand Doctors Without Borders / Médecins Sans Frontières (MSF), out of which this book grew, was given intellectual and moral impetus by three inspiring individuals: Willy De Craemer, Jonathan Mann, and Ernest Drucker. Albeit in differing ways, each...


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pp. 275-308


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pp. 309-316

E-ISBN-13: 9781421413556
E-ISBN-10: 1421413558
Print-ISBN-13: 9781421413549
Print-ISBN-10: 142141354X

Page Count: 304
Illustrations: 11 halftones, 6 line drawings
Publication Year: 2014