Martin Sloot is the General Director of Doctors Without Borders / Médecins Sans Frontiéres (MSF) India. In this conversation, he sheds light on the upcoming MSF Scientific Day South Asia, MSF’s medical humanitarian work and its main challenges.
Why did you join MSF?
I am from Holland, where MSF is quite reputed. It was always my dream to work for this organisation as I believe MSF is walking the talk by making a real difference in the lives of vulnerable people. In 2000, after working 6 years for an agency, I joined MSF.
What does MSF do?
MSF is an international, independent, medical humanitarian organisation that delivers medical aid in over 65 countries to people affected by disasters, conflicts as well as exclusion from healthcare. We provide impartial, neutral medical assistance to people who are most vulnerable and who need it most. Based on our evidence gathered through stringent research and what we observe on the field, MSF may: speak out publicly in an effort to bring a forgotten crisis into view; alert the public to abuses occurring beyond the headlines; criticise the inadequacies of the aid system; advocate for improvement of medical protocols; or call out policies that restrict access to medical care or essential medicines.
What are MSF’s guiding principles? What is the framework within which MSF operates?
Since we are a medical and a humanitarian organisation, our operative framework is a unique one. We work in the ambit of humanitarian law which is also linked with medical ethics. Medical ethics entail treating everybody irrespective of where they come from, which religion they belong to or what their political affiliations are. All that matters is they are human beings in need. This also highlights one of our principles – impartiality.
Neutrality is another principle. This means we don’t take sides; we are not political and go where the needs are greatest. In the ward of an MSF field hospital, you might find wounded civilians alongside injured soldiers from opposing sides. Hostilities, uniforms and weapons have to be left at the gate.
We are also independent, which means we make our own choices about where we work, how we work. We rarely take funds from governments or institutions for our work, but rely mainly on the generosity of individual members of the public. Over 90 per cent of our income comes from private donors giving small amounts.
This means that when there is an emergency, we don’t need to wait for official funds to be released or for the media to generate interest; we can act fast to save people’s lives based on need alone.
Our financial independence also means the aid we provide cannot be used to further any government’s political or military goals.
So given the framework you just described and the increasingly complex geopolitical nature of the world, how difficult is it for MSF to function in a conflict zone?
Our work in conflict zones is becoming increasingly difficult. This is because the acceptance of humanitarian principles – neutrality, impartially and independence – is being continuously challenged. For our teams that work in places like Yemen, Syria or Afghanistan, getting medical supplies into the country is extremely difficult; the fact that they are often based in areas being bombed almost every day doesn’t make things easier.
Over the last year our medical facilities have been repeatedly bombed – in Kunduz, Afghanistan, and subsequently in Yemen and Syria. This is a grave violation of international humanitarian law- which ironically, most countries in the world have agreed to. Bombing of hospitals means people who really need the medical aid we provide are more vulnerable than ever now. No longer do patients feel safe in a hospital; can you imagine?
Even war has rules, but we see them being flouted repeatedly. The respect for humanitarian law and humanitarian principles is eroding very quickly. These are the main challenges we face because it directly affects our access to those areas.
What has MSF’s response to the bombing of hospitals been?
We are publicly denouncing the bombings very strongly, globally. We have asked for an independent investigation into what happened in Kunduz and Yemen to be conducted by the International Humanitarian Fact Finding Commission (IHFFC). Established in the Additional Protocols of the Geneva Conventions, the IHFFC is the only permanent body set up specifically to investigate violations of international humanitarian law. So far, the commission has not been activated because governments involved have not consented to this investigation. MSF cannot rely only on the internal investigations by parties to the conflict and remains firm in its call for an independent and impartial investigation by the IHFFC.
MSF India organised its first Scientific Day in 2015. Do you plan to do something similar this year?
Yes, we are organising it again. MSF Scientific Day South Asia 2016 offers a platform for MSF and other institutions, including medical institutes in India and South Asia, to exchange and debate relevant medical research.
The South Asian perspective is invaluable. For instance, a comparative look at kala azar studies which are being done in India, Bangladesh and Pakistan can offer an in-depth analysis of the disease in the region. We believe that by sharing such research we can contribute to the improvement of medical protocols; identify gaps; and improve the quality and quantity of medical action.
What does MSF offer to someone willing to work with the organisation?
Working with MSF will not just be another assignment, but a journey you will share with people from diverse cultures who are committed to delivering urgent medical care. You will be part of a family of over 30,000 medical and non-medical professionals that saves lives every day and restores dignity to people in distress.
Whether you are a doctor or a logistician, you will encounter situations which will push you to be your professional best. While it may involve adjusting to unfamiliar food, pace of life and forms of entertainment, the experience of working with MSF will ultimately be a richly rewarding one – as thousands of people have found out over the years.
How can people reading this support MSF?
We want to be grounded in the Indian society. We are a grassroots organisation which needs broad support for the sake of independence, especially financial. As I mentioned previously, we seek private funding i.e. from people like you and I. This is the kind of support we are looking for, in addition to a stronger engagement with the medical community, media and other critical stakeholders including the government.