50 years of MSF: “Independence saves our patients”

Director General Di Carlo: “Always the same principles, in some countries being perceived as neutral is a matter of life or death”

Fifty years of humanity. Fifty years of Doctors Without Borders. Of new challenges that add up to old challenges. Of new emergencies or those that have been there for “always” but they are forgotten crises. MSF was officially born on December 22, 1971, a small group of doctors and journalists. Today it is an international and intercultural medical-humanitarian organization with 65,000 workers in 88 countries. The “principles” have remained the same, the “modes of action” have changed, there has been a “growth” with respect to the type of interventions and “effectiveness”. But “we have remained the same, in spirit we have remained the same – says Stefano Di Carlo, general manager of MSF in Italy since May, who was eight years old when the organization was born – The one who has always given the propulsion to ours activities were humanitarian principles, being humanitarian, being a medical-humanitarian organization “. A “concept” that “seems to him very confused in public communication” because “the concept of being humanitarian workers, a humanitarian organization is closely linked to the principles of humanity, impartiality, independence and neutrality”.

The “thank you, but we cannot accept, happy if the funds will support other projects” of MSF to the members of the 5 Star Movement who have chosen the organization among those organizations to which the repayments of the spokespersons have recently arrived. “We are not a political actor – says Di Carlo – We are an organization that first of all cares about patients and we must do it impartially”. Evaluate “according to needs and urgency”.

Di Carlo, ‘crises can be prevented with a different policy, it is up to governments, devastating impact in Afghanistan’

“We have been attacked in the past for activities that we have also done in Italy, such as rescues at sea, considering ourselves and considering ourselves a political and criminal organization. This for us was a mystification of what the essence of our action means” , he remarked, underlining that for the organization it is “fundamental” to be able to “dialogue with political actors on issues that are dear to our patients”. A “total interest in dialogue with any actor”. It is different “to accept funding from political actors – he says – because this would seriously question our independence from humanitarian action”. In some countries where MSF works, “being perceived as independent and neutral means being able to reach the patient or it means never being able to reach him and – he summarizes – it is therefore a matter of life or death”.

The migrants? Ilaria Rasulo, a 43-year-old from Verona who worked in refugee camps with MSF, does not hesitate to reply, recalling that “we should go back over the years and remind everyone that we Italians were the first to emigrate after the Second World War” . He speaks of “people who are forced to leave”, of “the last chance to maintain human dignity” and of a phenomenon that “will not stop if wars are not stopped”.

Denounce crises and violence, bring care, save lives. MSF, in 1999 Nobel Peace Prize, is this. And today, says Di Carlo, “we cannot afford to forget or not see or not be indignant about things that are before our eyes and that are tragic”. “Crises can be prevented with a different policy and – he says – this is what is expected of today’s governments”. My thoughts turn to Afghanistan, where since mid-August the Taliban are again masters and where “they are no longer able to pay for health services”, where “the humanitarian crisis is taking on incredible dimensions” and “largely due to the blockades funding, the freezing of liquidity “with a” devastating impact on a country that has lived on aid for 20 years “, on the” lives of Afghans, the same people on the other side of the world we say we want to help “.

Rasulo, ‘in northeastern Syria it’s like stepping into a World War II postcard’

Not just Afghanistan. Many contexts worry MSF. Di Carlo, a Roman biologist, speaks of Haiti, land of his first mission in 2008 and in 2010 also of Rasulo, of the “earthquake during the crisis in Afghanistan”, last summer, of a “country that is entering more and more chaos” , of “gangs in Port-au-Prince are taking control of more and more parts of the city”, of how “we are much more difficult to work today than we were ten years ago.” And it also speaks of the Democratic Republic of the Congo, of the Central African Republic. Rasulo tells of northeastern Syria and Ethiopia. In the northeast of the Arab country, where the 2011 protests degenerated into a bloody repression and then into a conflict, it was his last mission. He spent the first eight months of this year there as deputy head of mission and, he tells Adnkronos, “the situation is still very serious”. Like “stepping into a World War II postcard” with “eight million internally displaced people” in a “vacationing country”.

The conflicts. But also pandemic and climate change among the challenges. The pandemic has had a “huge” impact on his organization’s work, initially more on a logistical level, and today it is “very strong” in the countries where Doctors Without Borders works, countries where it often adds to ongoing humanitarian crises. It is not only the difference in the prevention capacity, it is that “for many countries, access to vaccines is a luxury or a dream”, sums up Di Carlo. In northeastern Syria “vaccinations do not arrive, the classic ones we do as children – says Rasulo – And you find yourself having diseases that may not exist”. The Covid vaccine? “It’s to put your hands in your hair,” he replies.

the alarm for climate change, ‘water and malnutrition everywhere’

And then climate change, a global challenge, which – Di Carlo warns – “will progressively have very, very serious and worrying effects on our patients today”. “We see a lot of evidence that things are changing due to climate change,” he says. An example? “We see in countries the emergence of pathologies that did not exist before – he explains – Malaria or dengue fever in areas where they did not previously exist”. And a “resurgence of food crises, clearly linked to the regularity of the rains in some countries”.

And the water. In northeastern Syria, Rasulo says, it is “the first thing you need” and “it is one of the factors” that you say you “notice wherever you go in recent years”. “Water and malnutrition”. Two years ago he was in Gambella, Ethiopia, near the border with South Sudan, “in charge of two refugee camps” with “more than 180,000 people”. He tells of those two fields “for 15 days without water”, of his battle for water. “I left after ten months happy because something started to move – she says – Every 20 days we had five or six days without water”.

This was his second time in Ethiopia. The first, in 2013, in Wardher, “a three-day trip from Addis Ababa” with everything that entails for supplies. “The only hospital in the area – he remembers – Maternity is always full, with very difficult cases”. Here she assisted “nine deliveries, of which seven were dead children”. Rasulo tells of a “very strong” mission because “someone died every day”, even “a three-year-old boy bitten in the head by a snake, who died after 48 hours” for which they “tried to do everything”.

Faced with climate change, MSF’s goal is “to reduce 50% of emissions from our operations by 2030”, or – explains Di Carlo – “to enhance the tools” for activities while trying to “reduce the impact environmental”.

50 years after its birth, the organization relies on a logistic system that allows it to “be on an emergency in any place in the world, operational in 48-72 hours”, underlines Di Carlo. Even with “the ability to manage air operations” and to build hospitals from scratch. Months have passed since MSF’s intervention in Lodi and Codogno, “where – he remembers – there was also a need for our experience in epidemics”, and today MSF in Rome “supports the ASL for a vaccination project for groups of migrants” and in Italy more generally he works on “victims of violence and torture in Palermo and in Rome on maternal and child health”. Work abroad continues on Covid. In 50 years, Di Carlo observes, “we have become more international, more borderless”. “Helping the people in need, the most vulnerable – concludes Rasulo – pays all the sacrifices”.