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"MSF: Past, Present, and Future"
(Hanyang University, Seoul, Oct. 10, 1996)
Ladies and gentlemen,
  The concept of peace has changed globally during the present decade, and Humanitarian Organizations such as Medecins Sans Frontieres have been more than ever involved in questioning their role in contributing to the challenge of Peace. This is the reason why I feel very honoured to be here with you for receiving the Seoul Peace Prize of the Seoul Peace Prize Cultural Foundation.
  To begin with I'd like to say a few words about the organization you are honoring today, the principles that have guided it since its beginning and how it has developed.
  I'll continue with a short background of humanitarian relief work as we conceive it in the West, aware of the gaps that a talk like this might reveal when it is delivered in this part of the world.
  Finally since it is a matter of a peace prize, I'll give you my modest understanding of the contribution that humanitarian action make to world peace.
  1) Introducing MSF
  MSF was born in France in the early 1970s, in the aftermath of the May '68 events, which in my country and generally in the West was a deep-running social movement. The idea of offering help to endangered human beings in compliance only to the injunction of universal moral values gave birth to what has come to be known as the "without borders" movement. This human undertaking, which has been built in the name of a duty to act, has, with help from the media, contributed to a deep-running change in public awareness of the tragedies that continue to challenge our very humanity.
  Medecins Sans Frontieres is celebrating its twenty-fifth birthday this year. Although started in France, the organization is in the process of reaching its "no border" goal by working towards becoming an international organization, for we are now represented in some twenty countries.
  A charter, principles for action and above all, independence
  From the small group of doctors and journalists who decided to start MSF to the thousands of relief workers from every nation who today speak for this organization's "success", twenty-five years of eventful existence, deeply anchored in the ideas of the times, have contributed to the emergence of an organization shaped more by a confrontation of ideas than any guiding principle and by the many different fields it has worked in.
  The Medecins Sans Frontieres charter defines its principles of action, its operational rules and its field of action, but the identity of the organization is more an empirical result of organizational choices intended to adapt MSF to constantly evolving requirements.
  - Under the heading of our principles for action, it is humanism, the medical ethics that require our providing help to victims without expecting any payment in return and the impartiality of the act of providing care - which means no discrimination of any kind - that sum up the essence of the principles to which the organization's independence gives its full force.
  - Created as a non-profit, non-governmental organization(NGO), MSF has been duty-bound to develop independence in its initiatives and operations.
  James Rosenau, a well known academic, engaged in the study of the "New World Disorder", said convincingly that these new actors are "Sovereignty- Free", suggesting by this wording that they cannot be suspected of defending national interests or of obeying to whatever "Reason of State" in disguise of humanitarian action.
  In declaring our independence from governmental and inter-governmental institutions, MSF both defines its field of action and its doctrine : humanitarian activity cannot be accomplished without use of a strong and willful freedom of action. Because the greatest suffering inflicted on mankind was more often than not the result of human activity, MSF, while continuously struggling to provide aid, wanted to raise awareness and inform the public of the tragedies that were occurring and even go so far as to confront those responsible.
  But the development of real financial independence could only be built with a good deal of realism.
  At the beginning of the Eighties the organization launched its first donation campaigns through the press and direct-mailing. For fifteen years now MSF has developed its self-financing capacities by contacting hundreds of thousands of private donors in France, Europe and, more recently, on other continents.
  MSF's present budget is somewhere near the 250-million-dollar mark, half of which comes from private donations. The remainder is made up of project financing from institutions like the European Union or some of the United Nations agencies like the High Commissioner for Refugees and contributions from governments. MSF's aim is to be able to undertake a relief mission at any time, whether it is to help earthquake victims, a sudden flood of persons displaced by an armed conflict, an epidemic or whatever...
  But financial independence on its own would mean very little if it was not to ensure the independence of ideas, aims, the means used and the mission's validity in humanitarian terms. So as not to lose that from view, sometimes, when humanitarian aid is diverted from its primary target and when the aid programme is turned against the victims, we have to be able to step back. Independence is also the ability to cast healthy doubt and the possibility of saying 'No'.
  Operating rules and a field of action as a mandate
  Medecins Sans Frontieres is an organization active on the medical and humanitarian levels but does not possess a "mandate" and in contrast to the so-called International Organizations does not benefit by inter-governmental agreements. MSF operates on its own initiatives and a certain number of "rules" define the organization.
  - Associativeness, means that control is held by an elected panel of directors, one-third of which is voted upon each year at the Annual Meeting. All persons joining the organization, especially relief workers leaving on missions, become members of the organization. Each member is therefore able to participate in the organization's decision-making, great and small, and question its aims and conduct.
  - But above all it is the "voluntaries" that characterizes MSF's activity. "Voluntary service" implies an individual commitment, not to serve the organization but to serve the purpose of helping others. The volunteer is therefore in opposition to the professional in the sense that he or she is not so much a means of the organization (an employee) as an end of the action itself, i.e. promoting the presence of volunteers among peoples at risk. Of course these volunteers must be in full possession of their professional skills, be they doctors, technicians or managers. In this sense they are professionals, but their humanitarian qualities are not acquired in advance and forever after. This quality implies an ability to adapt and exchange incessantly under the pressure of new situations and the evolving nature of their own ambitions. It is within this delicate balancing act, in this "availability" that humanitarian action is carried out. A third of our volunteers in the field are "first-timers". The other two-thirds are more experience and handle supervision and co-ordination.
  - The international nature - or to be more exact, the national nature - of Medecins Sans Frontieres is also a part of the agency's identity, even if 25 years have not been enough to attain this goal completely. From its earliest days MSF has recruited volunteers from outside of France. Then sections were created in Europe and more recently all over the world. There are by now about twenty entities in Europe, the United States, Japan and Hong Kong... and someday perhaps in Korea, which contribute to the MSF movement. MSF's activities are embodied by the presence of more than a thousand relief workers of all nationalities in more than fifty countries in the world.
  - MSF is a medical organization. The development of a technical capacity, both logistical and medical, has been a deciding factor to ensure that our activities be effective. Of course, in humanitarian activity matters the desire to act is always preponderant, but it is not enough. Action that wouldn't show relevance and usefulness would be nothing more than a vain exercise in good intentions with very little benefit to the victims.
  A few medical ethical rules guided these decisions, "primum non nocere", first of all, do no harm; which is not all that easy in human distress situations; it calls for a serious analysis of the problems and a capacity to respond to them sufficiently. Then comes the well-known "obligation of means", which, if it doesn't dispense with obtaining results, too, at least requires that everything be done to do with all that science and technology can offer nowadays. In this way MSF over the years has developed numerous working relationships with many different players in the field of international health as well as in the realm of science.
  2) A short resume of the Humanitarian action background
  That's about MSF, but to understand what humanitarian action now represents we have to start in the past and trace its beginnings and its recent changes.
  Humanitarian aid was not invented with the "French doctors", far from it.
  In Europe certain researchers trace the birth of humanitarian action back to the philosophy of the Enlightenment (V rifier) in the middle of the eighteenth century. In the place of traditional charity, which had been working since antiquity, another form of compassion arose, inspired by "the philosophical rejection of a natural order in which mankind had to suffer blights". Thus did Europeans of the eighteenth century discover other human beings at the four corners of the earth and decided to consider them as their equals in every regard. The notions of progress and physical and social well-being took on a universal dimension, and the disasters that struck the neediest had to be fought as injustices.
  The "brotherhood of man" gave birth to the notion of a humanity encompassing all mankind, and any harm to one became harm to all.
  Yet modern humanitarian action was still to be invented. It was in 1859 that a Swiss gentleman, Henri Dunant, appalled by the desolation and terrible suffering of some 40,000 dying and wounded on the Solferino battlefield, came up with the idea of a neutral but standing body of volunteers specialized in helping the wounded of war and the populations affected by armed conflicts.
  Thanks to his stubborn character and his diplomatic skills, Dunant convinced the main sovereigns of the time to recognize the principles that today found the International Humanitarian Law contained in the famous Geneva Conventions(1864). This was the beginning of the Red Cross.
  The Second World War saw the development of a quantity of charitable organizations, in the United States, especially. The first NGO's were more often than not religious ones or closely linked to governments. Their favorite field of action was post-war Europe in reconstruction.
  Then the Cold War made "developing" the young Southern nations a stake fought over by the two super powers. In such an atmosphere, decolonization opened a new era of conflicts, secessions and liberation movements. The ideological value of the victims shunted the impartiality of aid into the background. The main humanitarian organizations took side for the "progressive" camp and deserted the emergency relief field for developmental aid. This was the "Third World" movement.
  It was on this terrain between politics and morality that the "without borders" movement was born in the waning days of the tragic war in Biafra where a million people died in the Ibo stronghold "All victims must be helped". There are no good or bad victims. Humanitarian aid could no longer be content with feeding and caring for populations in need; it only had any real meaning if it was prepared to "defend" these populations. By testifying if necessary as to their fate in order to mobilize public opinion and possibly by denouncing infractions of the international conventions. This was a turning point in humanitarian action and it went well beyond the framework of our single organization.
  In the seventies and eighties, this new turn coincided with the rise in audio-visual communication techniques. Television brought the world and its tragedies into each home. And the "French doctors" very quickly gained a great deal of notoriety.
  In only a few years this movement induced the birth of dozens of organizations whose efforts are being jointly rewarded today.
  Then, humanitarian action seemed to have overflowed the framework of private initiative to become a major element in international relations. Under our very noses it turned into a new form of diplomacy.
  But as its use spread, the meaning of the word 'humanitarian' grew hazy to the point of, in some instances, losing all meaning and being reduced in a technique of communication.
  "Armed humanitarian operations" saw the light, in some cases as in Somalia to hide great power politics behind a strutting parade of solidarity, and in others (as in Rwanda during the genocide months) to disguise their weakness or political complacency as a firm determination of relief intentions.
  Meanwhile, with the end of the twentieth century, large-scale massacres and whole populations held hostage by their governments or their leaders continue to engender massive displacements, despoliation and famine.
  At the present moment, with the demise of the socialist bloc, the ideological confrontation that hallmarked this entire century has spent itself, and although economic liberalism seems to have carried the day as the unique model of development, the globalization of trade and the pre-eminence of "economy-first theories" are leaving millions of human beings stranded by the wayside, living in poverty, insecurity and injustice.
  3) Humanitarian action and the search for peace
  It is not the least of paradoxes that at the very moment of globalization we observe the violence wrought by sectarian and even xenophobic identity-related tension.
  Development has broken down in many parts of the world. In others it is done at a cost of even more insupportable fractures.
  The world without borders is still nothing more than a fond hope, yet it is mobilizing more and more people as we can see on topics like peace and the environment.
  Humanitarian action most certainly has not set its goals on transforming societies or on resolving the conflicts it is caught up in. Its goal is both more down to earth, more distant and more disinterested. Humanitarian aid aims to help populations get through a crisis period by asserting universal principles, i. e. the preservation of human life by respecting dignity and restoring to victims the ability to hold on their future without discrimination and peacefully.
  With the end of the Cold War armed conflicts are increasing with the civilian populations more than ever being the pawns and primary victims of war. Present armed conflicts cannot be seen as merely "unimportant wars in far-off places". Their repercussions can be felt in the values we defend and in our daily lives by the impact they have on our societies.
  In contrast to the pacifist movement of the seventies, humanitarian action remains a fight that highlights the dignity and humanity of the victims. As such, it can be a tool of resistance, disorder and rebellion. Indeed war is not just an absence of peace when it implies populations who aspire to the respect of their rights, to equity, to social progress and to an end of oppression. Yet, again, a new form of threat to peace has taken appalling dimensions in the recent days. I refer to the threat which is generated by the collapse of the protection that the States used to provide to their own populations.
  Although humanitarian workers can sometimes be proud of contributing to peace, they must be careful not to feed wars. Many modern conflicts are financed by trafficking, racketeering and plundering the civilian populations, including relief assistance. As is the case in today's Liberia, humanitarian organizations sometimes represent a major if not unique source of external resources. Therefore if we are not careful, humanitarian aid could become a factor in perpetuating conflicts. In such situations humanitarian organizations are accountable for ensuring that the aid destined to civilian populations is not used by the combatants to serve their own ends.
  These contradictions between the relief assistance and war are now well known and deserve the full lucidity of the players, who must not try to suppress them (this would be tantamount to suppressing the aid) as much as to limiting their effects as much as possible.
  Private humanitarian action may not be as such a major element in resolving armed conflicts, but the dimensions taken in the past few years by what has become a social movement allow us to ask the question of what its role is in the quest for peace and in preventing conflicts.
  - By their presence in the field, humanitarian relief workers can make their contribution by restoring a minimum of dignity and justice which are the precondition for any subsequent scaffolding that might lead to reconciliation and peace.
  - Through the observation, testimony and information that they make on the suffering endured by populations, the humanitarian organizations contribute to raising public awareness and mobilizing the international community.
  - Because humanitarian action is not automatically applied and is at best tolerated, it can also indirectly contribute to opening up bridges between the warring parties through the contacts it generates. Raising awareness of human suffering and the implementation of contacts where they have been broken off aims at opening a "humanitarian space", a space for dialogue and investigation, a space of freedom and inventiveness. Herein perhaps lies our greatest contribution to peace.
  4) As a conclusion
  The success of humanitarian action is probably in good part due to the ingenuity and dynamism of these tens or so organizations that make up today's "humanitarian battalions". Yet, for developing a more humane world, a safer world that is fairer and enables progress to reach out all of mankind, an international political commitment must continue to demand centre stage.
  In this respect, what I would like to emphasize here refers to what I might call The Korean Paradox. This country is deep in the difficulties of its national reunification. Yet this crucial national challenge does not prevent you from removing yourselves from this foremost priority in order to support actively and generously the cause of peace in quite different contexts: those contexts characterized by the urgent need to support the restoration of human dignity in difficult situations which are becoming more and more commonplace in many parts of our world.
  You cannot help wondering if tomorrow you will still be at peace with your neighbour, but this constant concern affords you enough time to be concerned for peace throughout the world. In fact, we of Medecins Sans Frontieres are not the only ones deserving of the award that we receiving here. We must share it on equal terms, with all who are putting the same expectations into practice.
  I would like also to mention another striking issue. There are two global challenges predominant in the world today: the long term challenge of the economically developing peoples who still know what hunger and profound moral misery are, and the more urgent one of calling for the alleviation of the distress of populations at risk of almost immediate death generated particularly by the new ethnic strives.
  Now, together with other new East Asian industrialized countries, Korea has overcome the first challenge of development. Nevertheless, this brilliant success is not enough in your eyes. You want to commit yourselves to meeting the challenge of humanitarian action.
  And in this sense, with the award of the Seoul Peace Prize by one of the world's last remaining countries still divided, I see a wonderful message of hope, and on behalf of Medecins Sans Frontieres I would like to express our most heartfelt gratitude.
  We are all part of a profoundly changing world; it is rich in promise but where people and whole populations still live in deprivation, isolation and injustice. I am thinking of the street children in the world's great cities, growing up alone with poverty and violence, of the millions of refugees running away from war and destruction, to the silent victims of repression and to the many suffering from epidemics that rip through the world's poorer countries, especially those in Africa. To them all, I dedicate this prize.
  Thank you.