As an organisation with a strong history and an iconic image, Médecins Sans Frontièreshas thought about the integration of new generations coming on board. Taking a practical, trial-and-error approach, dogmatic conscious that young people need to find their place, MSF has implemented various processes to encourage their integration and evolve without renouncing its principles of action.
The structuring of Médecins sans Frontières (MSF)“In the 1970s, the decline of political utopias combined with the growth of television opened up a new field for this form of commitment for the public good, which is humanitarian action”: Rony … Continue reading was prompted by a series of major emergencies that resulted in various categories of personnel. However, the sociological aspect of MSF’s staffing still remains a complex topicThomas Hofnung, « MSF, la firme humanitaire », Libération, 27 février 2012, https://www.liberation.fr/planete/2012/02/27/msf-la-firme-humanitaire_798851. In fact, it was during exceptional periods of intervention in Afghanistan (1980s), the Great Lakes (1994-1997), Bosnia and Kosovo (early and late 1990s), Niger (2005), Haiti (2010) that social groups appeared within MSF at a time coinciding with hiring spikes and major operational changes that would impact the organisation in the long term. The current issue goes beyond simply having different generational groups working together. The fundamental challenge today lies in maintaining a form of cohesion within an organisation whose staff come from a range of social and cultural backgrounds.
The impacts of MSF’s development
MSF’s history has been driven by two major trends, its internationalisation and its growthThe growth in the number of full-time equivalents (FTE) between 2005 and 2018 was 82% for the overall staff. MSF IO, International HR Indicators 2018, 2019 (unpublished)., which both took off in the mid-1980s, continued in the 1990s, and developed further into the 2000s. In 1995Initial in-house figures available, MSF Switzerland, internal document., expatriates on its staff represented 18 nationalities, mainly from Western Europe. From 20052005 was marked by an acute crisis of malnutrition in Niger, which led MSF Switzerland to significantly expand its recruitment., the organisation’s increased internationalisation brought in 98 nationalities in 2011 and 165 in 2019, 60% of whom were of non-European origin. The proportion of those with a medical background, concurrently, has fallen, from 65% in 1995 to just 43% in 2019MSF Switzerland internal statistics, 1996-2019 (unpublished)..
Staffing has, therefore, opened up in terms of both professional profiling and location of hiring. Over the past 15 years, the number of MSF employment offices has risen due to the investment made in developing the organisation in different regions of the world, and more recently, due to the associative initiatives set up by operational MSF field staff that are emerging in Africa, Latin America, and South Asia. In 2005, MSF was composed of 19 sections, all located in Europe and North America, with the exception of Japan and Australia. In 2019, there were 36 offices, 16 of which were located outside of Europe and North America. All have recruitment activities.
The professionalisation of the organisation has also resulted in structural changes. Recruitment has been extended to areas of activity that require highly qualified personnel, particularly in technical, administrative, and medical domains, but the “old guard” feels that this has regrettably weakened the organisation’s community spirit“Professionalisation is a way of being, which favours the individual over the collective group . For the ‘old guard’ professionalisation is characterised by increasingly distant behaviour with … Continue reading. While the main aim of professionalising MSF was to better equip the organisation, and indeed this has helped develop expertise and improve practices, it has also raised new questions on personnel’s status, specialisations, and social functionAnne Le Naëlou, « Pour comprendre la professionnalisation dans les ONG : quelques apports d’une sociologie des professions », Revue Tiers Monde, n° 180, 2004, p. 773-798, … Continue reading. Newly created academic courses have contributed to attracting young professionals, who come with diverse motivations, but are nonetheless united in their commitment to major social challenges, such as protecting the environment and combating abusive behaviour. However, these changes were not without their difficulties, especially in terms of integrating people from increasingly diverse backgrounds. The organisation has faced demands for access to a wider field of professional opportunities, especially from local staff, who are first in line to carry out operational relief. As such, the implementation and recent expansion of MSF’s induction policiesInduction is defined at MSF as the process of onboarding and orienting new hires in order to help them integrate into the organisation and settle into their new roles and work environment. express the organisation’s desire to unite its personnel around a set of core values that are not only tied to its historical origins, but also to issues that reflect the diversity of its human resources.
From diversity to inclusion
With a 67,000-strong staffMSF International Human Resources Indicators 2018, June 2019, p.11., 80% of whom are employed in their home country, MSF, presently undergoing a phase of tremendous growth, is hiring on every continentDespite the diversity that is perceived, international staff still mainly come from Europe and North America (58% in 2018). Staff from Africa represent 19% of international staff, while 12% are … Continue reading. In 2007, the year following the “La Mancha Agreement”La Mancha Agreement, 25 June 2006, Athens, http://associativehistory.msf.org/la-mancha-agreement, the organisation took deliberate steps to introduce policies granting locally hired professionals the right to hold positions as coordinators and the status of expatriate personnel“MSF has changed its image. To understand this, one just has to look at the teams composing its missions. More and more local employees, without whom no intervention would be viable, are joining … Continue reading. However, despite the undeniable diversity within the organisation, many are saying that this diversity is not suitably reflected in the upper echelons of leadership, that a glass ceiling prevents certain categories of personnel from accessing management positions, and that training opportunities seem unbalanced and depend on the affiliation and status of the professional in question. This inequity appears to be reinforced by the correlation between different levels of education, responsibility, and access to studies. In this regard, MSF mirrors the social dynamics being currently played out in EuropeAdults in training, over 5% for those less qualified, 18% for executives. Véronique Leclercq, « L’engagement en formation de base de publics adultes de faible niveau de scolarisation », … Continue reading. A factor strongly linked to the social indicators of the countries in which MSF leads interventions, for example access to education, female workers represent less than one-third of national staff in the fieldIn 2016, 31.8% of national MSF staff were women (30.5% in 2015), while they represented 50% of international personnel. MSF International Human Resources Indicators 2016, p. 12.. If these imbalances seem to be generally mitigated among international staff, especially in terms of the proportion of women holding the most senior positions at MSF’s various headquarters, a closer analysis tends to reveal that access to positions of responsibility remains predominantly skewed, especially in fieldworkMSF International Human Resources Indicators 2018, p. 20.. Despite recent initiatives to promote diversity in terms of gender and in field management positions, MSF remains tightly bound by social constraints. In addition, people have raised doubts on the sincerity of the inclusive approach taken, since such an approach may actually be driven by practical and operational reasons, rather than by humanist considerations, such as the desire to be a responsible employer. The broader questions of inclusionInclusion can be defined as a process of improving the working conditions of individuals considered disadvantaged (based on age, gender, etc.) through opportunities, initiatives, resources, or legal … Continue reading and understanding the visible and invisible barriers within the organisation have set the groundwork for preliminary proposals, motions, and considerationsOn this subject, see the discussions on the integration of people with disabilities. https://disabilityinclusion.msf.org that must be taken and explored further.
Induction, mentoring, and “buddying”: paths to transmission and unity
The notion of volunteeringSee MSF Switzerland website (in French or German), « Nos valeurs », https://www.msf.ch/a-propos/valeurs recently sparked debate in MSF associationsInternational General Assembly, June 2019, and Françoise Duroch, “Volunteers understand the risks and dangers of the missions they carry out”, TAG (internal journal of MSF operational center … Continue reading in how it might create a distinction between staff members with the status of volunteer“What is commonly called ‘professionalisation of humanitarian aid’ does not refer to a professional status. ‘Professional’ is the opposite of ‘amateur’, and not ‘volunteer’”: … Continue reading and those with the status of salaried employees of the organisation. This observation is closely linked to certain communication campaigns, as pointed out by Pascal Dauvin and Johanna Siméant: “The idealised image of a white doctor treating a black child has something to do with the general public’s perception of ‘humanitarianism’: to wit a voluntary, non-governmental commitment from professionals, notably medical personnel, in direct contact with populations in sufferingPascal Dauvin, Johanna Siméant et C.A.H.I.E.R, Le Travail humanitaire, Presses de Sciences Po, 2002, p. 15, … Continue reading.” On the other hand, in areas exposed to the greatest risk of kidnapping or abduction, the practice of profiling, i.e. a selection process based on non-professional criteria, has changed the composition of teams
assigned to missions“The ICRC uses a discreet new expression in this respect: it speaks of the ‘affectability’ of such and such a nationality”: Pierre Micheletti, « Les humanitaires français à l’épreuve … Continue reading. A further point, MSF’s European heritage as an organisation originally founded in France and having fostered solidarity between the Northern and Southern hemispheres, now seems to be tested by the multitude of pathways of a new generation of humanitarian workers coming from MSF’s countries of intervention.
“From the very inception of MSF the transmission of knowledge and expertise was considered important to ensure that humanitarian practices and the quality of aid.”
The growing professionalisation of the humanitarian sector and the recent development of Learning and Development (L&D) policiesL&D is the HR unit which experienced the strongest growth between 2016 and 2018, going from 62 FTE and €11.5M of expenditure to 117 FTE and €14M. MSF structural analysis 2017-2018, p.17. are notably symbolic of the desire to unite staff from increasingly diverse origins and backgrounds around a common cultural heritage. These transformations have also prompted “a significant increase in training and learning activitiesPaul Knox-Clarke, “Learning and humanitarian organisations: A ‘Golden Age’ of learning?”, Humanitarian Aid on the Move, n° 15, 2015, p.23-26, … Continue reading”. While from the very inception of MSF the transmission of knowledge and expertise was considered important to ensure that humanitarian practices and the quality of aid would be sustained, elements related to its historical background, analysis of its practices, and political positions have been more complex to disseminate and pass on. Indeed, MSF is an organisation with a strong identity in which a full understanding of its inner workings is essential to successfully complete professional pathways. The “buddy system” – a traditional system for transmitting knowledge – has generally been conducted informally, a product of circumstance and the capability of one colleague to pass on the skills falling short in the other. As Paul Knox-Clarke points out: “Much humanitarian knowledge is social by nature. It is not necessarily written down, but exists tacitly within groups and is exchanged through relationshipsIbid..” Coaching and training sessions is gradually taking over as the process for transmitting a common frame of reference to people from more and more diverse social and cultural backgrounds. Furthermore, after more than a decade of investments exclusively earmarked for formal development systems, perhaps the rediscovery of informal learning activitiesNon-formal learning occurs in a more or less structured framework and involves an intentional effort to master an activity or a skill. International standard classification of education: ISCED 2011, … Continue reading (through individual support programmes, such as mentoringMentoring involves matching an experienced or qualified person with a person who wishes to progress in an area or improve a skill or skills. https://www.capmentorat.org/quest-ce-que-le-mentorat ), and growing investment in communities of practice will eventually improve the way in which knowledge is transmitted, but also elements related to MSF’s identity such as its history, its CharterSee MSF Switzerland website (in French or German), https://www.msf.ch/a-propos/valeurs#charte, and its values and principles.
However, despite the progress made in terms of methods of transmission and participatory aspects, it is the issue of presenting an identity in which everyone might recognise themselves that best illustrates the debate around different generations working together, as well as the organisation’s capacity to listen to and integrate the younger generation’s preoccupations with what they see as society’s challenges. Added to this are the occupational labels assigned to different professions – doctors, nurses, logisticians, administrators – that mark out different social groups with diverse interests interacting with occasional tensions.
On the other hand, it is regrettable that teaching materials on subjects like the cultural and social identity of the organisation are seldom called into question. In fact, far too little effort has been undertaken to fully understand how concepts with occasionally blurred boundaries have evolved. It is customary to say that such and such an action or person “is or isn’t very MSF”. But opinions diverge on the meaning behind such an assertion. Unfortunately, as a consequence, teaching syllabuses simply pass on the principles of the Charter and the organisation’s history from one training session to another in a standardised, generally imperious fashion.
This method of passing on MSF’s history is especially interesting to examine. The channels of communication and the media might have changed, but the approach hasn’t much, given that the usual narrative consists of just a single version of the organisation’s origin story. An account that is more self-constructed mythology“A myth is a communication system that provides a message. From this we see that a myth is not an object, a concept, or an idea but a more general form or mode of signification”: Roland Barthes, … Continue reading that only accepts critical analysis begrudgingly.
This narrative may have partly originated as a protective response to the challenges prompted by the organisation’s growth, both in size and complexity. To these challenges can be added new ones stemming from the humanitarian world, i.e. the arrival of a host of new players and a mounting distrust from population groups and national governments towards NGOs. From this point of view, MSF’s account is an intangible unifying element. While being massively more multi-faceted, both in terms of geographical origins and the social makeup of its personnel, managers included, the organisation seems unwilling to radically challenge its fundamental mantras, that is, its principles and its Charter, whenever new recruits are onboarded.
For a “legacy” to be transmitted and sustained, it must be capable of changing with the times and open to new ideas so that each generation can adopt an organisational identity that is willingly accepted and not enforced, which will hopefully promote a sense of belonging to the organisation. Ultimately, a critical analysis of MSF’s history and its actions falls on veteran generations who not only bring their experience into the discussions, but also publish books and articles that question humanitarian principles and aid in generalSee for example: Claire Magone, Michaël Neuman and Fabrice Weissman (eds.), Humanitarian Negotiations Revealed. The MSF Experience,Hurst Publishers, 2011..
In an attempt to transform this situation, SanouSanou means “welcome” in Hausa, the language of Nigeria and Niger. The main learning objective is to build up the capacity of the organisation’s staff to become MSF’s ambassadors both … Continue reading was set up. This learning programme does not teach but rather opens up for discussion the organisation’s history and basic principles so that they can be better handed down. Instead of listing the principles behind a given concept of the organisation for the sole benefit of international staff, learners, regardless of their status, are assembled around a common set of values whose boundaries are continuously redefined and adapted.
The challenges revolving around the transmission of a collective identity are intimately linked to the development of common outcomes, which for MSF means the performance of its social mission as an organisation undergoing extremely rapid growth and subject to an onslaught of technocratic and bureaucratic procedures. “There is collective identity because members have identified with something they have in common. What cements a collective identity is both the common representation that its members have of its objectives or the reasons for having created a group, and the mutual recognition of everyone in this representationJulien Freund, « Petit essai de phénoménologie sociologique sur l’identité collective », inJ. Beauchard (dir.) Identités collectives et travail social, Privat, 1979, p. 65-91..”
“MSF must strive to demonstrate its capacity to change and adapt, while respecting the diversity of its personnel.”
Therefore, one of the major issues facing the organisation today revolves around not only its ability to integrate new generations, but more so its capacity to take on the challenges that its members have pointed out so that contemporary social issues are not ignored in the organisation’s operations. “There is no collective identity without an awareness of particularismsIbid., p. 74.”, wrote Julien Freund. Far from becoming dogmatic, MSF must strive to demonstrate its capacity to change and adapt, while respecting the diversity of its personnel. This will assure that all those involved in delivering its social mission will remain united, and that groups or individuals will not feel left by the wayside in an increasingly complex governance system.
The authors thank Françoise Duroch and the members of UREPH (Research Unit on Humanitarian Stakes and Practices, MSF Switzerland) for their support and valuable advice.
Translated from the French by Alan Johnson
ISBN of the article (HTML) : 978-2-37704-632-4