Humanitarian Myths and Hubris A Critical Self-Portrait from Médecins Sans Frontières

Introduction: Humanitarianism in Retreat?

Duncan McLean

PART I – ELEMENTS OF CHANGE AND CONTINUITY

1 ‘Good’ and ‘Bad’ Victims? A Matter of Choice

Thierry Allafort-Duverger, Marie-Hortense Koudika, and Françoise Duroch 

Zoom-in: Healthcare without Borders: Navigating Securitisation and Exclusion of Migrants

Reem Mussa

2 The Evolution of How MSF Treats People

Karsten Emmanuel Noko and Marc DuBois

3 Hostility to Aid Actors: Normalising Transgression? 

Stephen Cornish, Alejandro Pozo, and Duncan McLean

Zoom-in: Security Management with Locally Hired Staff: A Collaboration with Gaps? 

Mahamat Seid Arabi 

PART II – NAVIGATING EXPECTATIONS

4 From Technique to Technicity: Evolving Aims in MSF’s Medical Practice 

Jacob Burns and Natalie Roberts

5 Global Health Security in Humanitarian Medicine: What Is the Greater Good?  

Melissa McRae

Zoom-in: The IFRC’s Community-driven Approach in DRC’s Ebola Outbreak 

Ombretta Baggio

6 Caught in the Crossfire? International NGOs and Contemporary Forms of Protest and Resistance

Maelle L’Homme

Zoom-in: Protecting Humanitarian Action in an Age of Disinformation 

Sandrine Tiller

7 Speaking Out With, Not For: Rethinking Humanitarian Narratives

Sophie Désoulières and Juliette Garms

PART III – CHALLENGING ADAPTATIONS

8 Liberal vs. Critical: Diverging Paths in Humanitarian Aid and Global Health 

Patricia Nayna Schwerdtle

Zoom-in: Reflecting on Diversity, Equity, and Inclusion in MSF

Meg Adhiambo Otieno 

9 Absorbed into the War Machine: What Is Independence When Everything Is Connected?

Martin Searle and Beatrice Lau 

10 Without Borders, Within Boundaries: Learning How to Deliver Aid in Light of the Climate Emergency

Bruno Jochum, Dikolela Kalubi, and Béatrice Godefroy

Epilogue: Negotiating Spaces, Defending Convictions

Françoise Duroch

Biography

Duncan McLean is currently a Senior Researcher with MSF’s Research Unit on Humanitarian Stakes and Practices (UREPH), based in Geneva. Holding a PhD in history, he has published widely on the humanitarian sector, regularly lectures at universities throughout Europe, and is on the editorial board of the Journal of Humanitarian Affairs.

Françoise Duroch began working in the humanitarian field in the early 1990s with Handicap International, then with MSF. She has spent 15 years researching gender-based violence and holds a PhD in social sciences. She is a lecturer at several universities and currently coordinates the MSF Switzerland research unit in Geneva.

Amy Mavor holds master’s degrees in languages from the University of Edinburgh and translation from Université Rennes 2, and has worked since 2018 as Publishing and Editing Officer at MSF Switzerland’s research unit.

"This book offers a reflective, self-critical examination of MSF as one of the world’s most iconic humanitarian organisations, which can’t be more timely as the aid sector faces acute crises and must radically evolve to remain fit for purpose."

Gilles Carbonnier, Professor of Development Economics, The Geneva Graduate Institute

"MSF’s ability to engage in uncompromising introspection remains fascinating! A collective book that provides an insight into the organisation’s ability to confront its own practices. These are relevant questions for the entire humanitarian sector as it navigates the challenges ahead."

Jean-Baptiste Richardier, President of the Board of Directors, Humanitarian Alternatives and Co-Founder of Handicap International / Humanity & Inclusion

"Humanitarian Myths and Hubris is a critical guide for the entire MSF movement at a moment when our principles, positioning, and practices are under growing strain. It is both a mirror and a map – inviting us to renew our mission with clarity, humility, and solidarity."

Wacuka Maina, The LEAF Charity

"This volume offers an insightful perspective on humanitarian action through a medical NGO’s lens, critically exploring contemporary challenges. Reflecting a sustained commitment to the continued reappraisal of humanitarian aid, it is an essential read for anyone working, studying, teaching, or simply interested in the field."

Alexandre Hermet, Faculty Member, Sciences Po Toulouse