Are you a dunantist or a wilsonian?

“MSF does not accept funding from institutions or parties who are directly involved in conflicts where MSF is involved”

At our breakfast conversation with MSF (Doctors Without Borders) we learned about two approaches to humanitarian aid which can influence how we support different organisations. The oldest approach is called Dunantist, after businessman and Red Cross founder Henry Dunant. After witnessing the heavy casualties at the Battle of Solferino in 1859, he created the Red Cross in 1863 to assist those in need on the battlefield, regardless of which side they were on. The principle of a Dunantist organisation is that they position themselves outside the realm of influence of state interests. In opposition is the Wilsonian approach – the application of President Woodrow Wilson’s principles. His intention was to project humanitarian values and further US influence using humanitarian aid. Organisations following this approach are heavily dependent on public funding and tend to follow governments diplomacy. MSF sees itself as a Dunantist organisation. It does not accept funding from institutions or parties who are directly involved in conflicts where MSF is involved. They also refuse donations from pharmaceutical companies.
Because they are being largely funded by individuals, MSF “can meet the needs we find, rather than the needs defined by a donor” says Stephen Legg, Head of Giving. “Most of the employees at MSF are people who have worked in the field and been exposed to patients”. MSF’s 13 founders were all doctors. As an association, staff are involved in decision making on the field as much as at headquarters. Stephen Legg recounts when in early 2015 they debated whether MSF was best placed to launch search-and-rescue operations in the Mediterranean Sea and was the best use of their resource.

“MSF focus is to address medical needs where there are no other options. Sometimes this isn’t cheap, but it means reaching those most in need.”

“MSF has responded to the needs of refugees for decades and in late 2014/early 2015 our teams in countries like Greece and Italy were seeing a massive increase in refugee patients who had just arrived in Europe with gunshot wounds, engine oil fuel burns or organ failure. We also heard countless reports of people who had already died from dehydration or asphyxiation during the journey and it was this direct testimony (what our colleagues were seeing and hearing first-hand) which aligned us as a movement. Seeing things with our own eyes remains a guiding principle for MSF in our decision making. In that first year, MSF teams provided nearly 100,000 medical consultations to people on its search and rescue vessels in the Mediterranean Sea, and in reception and transit points throughout the continent”. Data and project analysis are an important part of deciding which field operations to carry out, without cost-effectiveness being the main focus. He explains: “Following the Nepal earthquake in 2015 we focused our work on reaching those most in need in remote villages. The majority of NGOs where responding in the major towns and cities and areas which were easier to reach. In the remote rural areas thousands of people are totally cut off because the earthquake had destroyed the mountain roads. We focus on addressing medical needs where there are no other options. Sometimes this isn’t cheap, but it does mean that we are reaching those most in need.”

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Why we support MSF:
1. It is mostly funded by the generosity of private individuals (90% according to MSF)
2. It specialises in humanitarian medical response and has high experience in this area
3. Its outcome is direct: saving lives through prevention and treatment