© Kjell Gunnar Beraas/MSF
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Security and protection

The main task of Doctors Without Borders/Médecins Sans Frontières (MSF) is to deliver emergency medical aid to people in need. To reach those who need us most, we often have to work in areas where there still are, or have just recently ended, various conflicts. In each region there are different risks, depending on the contexts, in which our humanitarian missions are conducted.

As MSF workers you will often find yourselves in unsure and unstable environments. Work in these regions automatically means a certain risk or even danger. Some of the specific risks are explained in more detail below.

Managing risk situations

All risks of course cannot be avoided, but we do everything to minimize them. Strict security protocols help us in that. Before the start of a new project as well as during its course we conduct detailed risk analysis.

With each field mission we set specific and detailed security rules and plans, specify strategies and introduce security measures and obligations. These protocols take into account the kind of danger that MSF workers face in the field and introduce compulsory procedures for cases of various security threats.

Security measures

All MSF workers must adhere to the established security measures. The best protection is appropriate behavior and approach. Work for our organization is based on voluntary decision and the applicant should take all this into account.

If you decide to work for MSF, you identify with our decision to work in environment full of various security risks. Therefore, if you do not adhere to the security measures, it may even lead to your expulsion from the mission.

Risks

To understand the various degrees of security measures, it is appropriate to divide our projects into projects with low, medium and high risk level.

Low risk level

On missions and projects with low risk level the security measures do not have to be so strict. Curfew is usually not necessary; workers can use public transport and even travel within the particular country for holidays.

Medium risk level

On many missions of Doctors Without Borders we encounter medium risk level. Depending on the specific situation, the following measures can be used:

  • Curfew (during certain hours)
  • Movement restriction
  • Culturally sensitive behaviour
  • Visible identification of organization workers

In situation with medium risk level workers are often required to report their location and in all situations carry appropriate communication devices (such as walkie-talkies or mobile phones).

In some cases restrictions may be introduced related to contact with local workers and inhabitants, choice of clothing or consumption of alcohol in public spaces, that being if such activities could threaten the workers and others.

During work for Doctors Without Borders you will automatically be perceived as a representative of the organization and your words and acts do not only affect your own security, but also the rest of the team. It is often not possible to rest from this responsibility on a mission.

High risk level

On missions with high risk level movement of our workers can be considerably restricted and everyone without any exception has to follow very strict security measures and regulations.

In some situations it is necessary to temporarily stop working and travel to a safer location. In most cases it is possible to return and continue working as soon as the situation calms down. And finally in extreme cases security situation can deteriorate so much that it is no longer possible to leave the area, even though you would wish to do so. In such situations it is better to stay where you are rather than to choose evacuation at any cost.

Hierarchy of responsibility

Field workers have to follow valid security rules and measures for the duration of the mission. In security questions clear hierarchy of responsibility is set.

The Project Coordinator is responsible for security of the team at the project level. The Head of the Mission is responsible for security of the whole mission of Doctors Without Borders in the particular country. Overall responsibility is in the hands of the Operation Centre.

Doctors or also nurses sometimes share responsibility for health of other field workers with the Medical Coordinator, who is based in the capital city of the particular country. Members of the team must in all situations follow their instructions.

Personal responsibility

Considering the nature of security measures that Doctors Without Borders introduce and follow, each member of the team has certain amount of responsibility and shares it with other members of the organization. Apart from this shared responsibility, each worker has to be able to assess potential negative impact of their words or acts both on their own situation as well as on that of the others. This assessment is an inherent part of the fieldwork.

If you are unhappy with the security situation in the specific location, you can leave the project (or mission) as soon as the Project Coordinator or the Head of the Mission concludes that it safe enough.

The organization will try to inform you about all necessary measures already prior to your departure. However, the final responsibility is yours. Doctors Without Borders never transfer responsibility for the security of their workers to other organizations.

Specific types of risks

During the work on a project of Doctors Without Borders it is possible to encounter risks of all types. These risks may include:

Illnesses and natural disasters

Risks of this type are relatively frequent during the work for Doctors Without Borders. Long-term stress is also considered an illness.

Risks of illnesses (among the most serious threats are malaria, TBC, HIV, meningitis or hepatitis) can be reduced by various means. Vaccination, antimalarials, or condoms are among the most effective ones.

Road accidents

The most frequent cause of injuries or death of the field workers is road accidents. The risk increases particularly in countries where standard road rules are not really obeyed and drivers rather follow specific and elsewhere unknown habits. Especially in conflict situations the traffic is extremely chaotic and dangerous.

Doctors Without Borders usually use services of local drivers, because field workers of the organization are not insured against road accidents on the missions.

Minor crimes

Less serious criminal acts, primarily pickpocketing, happen all around the world, especially in crowds or at public places. In an unknown environment one easily loses the sense of direction, of which the thieves can easily take advantage.

Foreign workers are also exposed to risk of fraud or robbery (including armed robberies and car hijack).

Violence

Violent acts are also among the frequent risks. Women can also become the target of sexual violence and should be particularly careful. In extreme conditions armed groups can conduct plundering, kidnapping or violent attacks on Doctors Without Borders and other non-governmental organizations.

Workers can find themselves under fire or can be seriously threatened on health or life by unexploded munitions, landmines, artillery fire or air bombarding.

We try to protect the safety of our workers with all our efforts; in spite of that there are no guarantees. It is necessary to know the risks in advance, reduce them to the maximum possible extent and make sure that everyone knows whom they can affect.