Medical Care under Fire: Understanding violence against MSF

Working in situations of conflict and being exposed to violence is nothing new for MSF. Since MSF launched the Medical Care Under Fire (MCUF) project in 2013, staff have been held for long periods of time, physically attacked, threatened, killed or otherwise harassed. MSF facilities have also been robbed and ransacked—in some cases, destroyed—and equipment, including vehicles, have been stolen or vandalized.

Most of these incidents have both direct and indirect consequences on MSF’s operational capacities and choices, and, most importantly, on the ability to access and treat patients. Although difficult to quantify, the consequences for patients are dramatic and disturbing as well. Some are too frightened to even attempt to seek care whilst others are unable to reach hospitals when they try to do so. In the most extreme cases, patients have been assaulted or, in certain instances, killed in their hospital beds. When medical humanitarian organizations are forced to suspend or withdraw their projects, people lose access to medical care.

These dynamics are what the MCUF project was designed to document in order to improve MSF’s understanding of violent incidents and their consequences. While the field research for this project is still ongoing, MSF would like to share the preliminary findings of its Medical Care Under Fire (MCUF) project at a time when other individuals and organizations—the International Committee for the Red Cross, the World Health Organization and the Safeguarding Health in Conflict Coalition, in particular—are undertaking similar efforts.