Doctors Without Borders (MSF) trains its staff to be ready to provide medical assistance to vulnerable populations in all parts of the world, but harrowing experiences of violence and harassment often make them the ones needing protection, Sputnik has learned from an MSF security adviser
MOSCOW (Pakistan Point News / Sputnik - 29th January, 2020) Doctors Without Borders (MSF) trains its staff to be ready to provide medical assistance to vulnerable populations in all parts of the world, but harrowing experiences of violence and harassment often make them the ones needing protection, Sputnik has learned from an MSF security adviser.
Wouter Kok has been working with MSF for over 30 years in multiple countries in Africa and the Middle East. In an interview with Sputnik he explained which security aspects the teams working on the ground had to consider and what means of protection they possessed, and told his story of being kidnapped in Chad.
'YOU DON'T HAVE TO BEG FOR YOUR LIFE'
In 2014, two members of the MSF crew, himself included, were on their way home in a car in Chad when they were stopped by another vehicle. There were six men with guns inside, who took the MSF car and held Kok and his driver hostage.
"They have tied my hands, took my glasses, I have lost my shoes. It was a very serious situation. In my head I managed to get back to the training, telling myself 'you shouldn't panic,'" Kok said.
Since the MSF formally adheres to an unarmed protection policy, all the medical workers get is a five-day PPD course (Preparation for Primary Departure).
"If somebody is using violence against you, wants to intimidate you, what you can do with your body, with your attitude is to de-escalate violence. This has to do with control of your breathing, your composure, remaining quiet, not panicking. It's easy to say, but it helps, there are some very simple tricks, two or three tricks, but it helps," Kok said.
As he frantically thought about his family and all the chores they were supposed to be doing together upon his return, he said he made himself stop and think: "Wouter, forget about house, not important. You have to survive now, that is your assignment."
"Think about your breathing, tension in your muscles; try to make a rapport, a link with the guys keeping control of you, and make sure you are not seen as very afraid, you don't have to beg for your life. Try to make relations with these guys so that they continue seeing you as a human person, so that they develop a bit of respect for you. And you also have to respect them, you have to realize that for them it's also dangerous. If something goes wrong they will be killed," Kok continued.
Realizing that the situation was equally dangerous for both parties made him realize it was a non-zero sum game where all could get what they needed to get out alive.
"So in fact we have a shared objective, we have something in common: he wants to survive, I want to survive. If I work together with them then I have a better chance for survival. So that sort of techniques help you to get through this type of situations," Kok said.
Kok and his driver were eventually released and left in the middle of the woods after some six hours of driving the kidnappers were of Central African origin and needed a vehicle.
'EACH HAD A BULLET IN THEIR HEAD'
In 2004, four MSF staffers were found shot dead in a car in Afghanistan's northern Badghis province.
"It looked execution style in a sense that we found a car and there were four people in that car and each had a bullet in their head," Kok said.
Perplexed and unable to understand what made someone so angry that they decided to kill four innocent medical workers, the MSF expected an investigation to follow. It never happened, Kok said � the Afghan authorities only briefly held someone in custody.
"So it was all very fake, and we never really understood. That also made us realize that there are situations when it's a bit naive to ask for justice, complete 100 percent justice," he said.
That was when MSF decided to leave Afghanistan, and it was not until 2009 that they came back. In a similar vein, violence has often made humanitarian staff leave unsafe locations, which unfortunately mean also leaving behind people who were truly in need, Kok's stories revealed.
In 2013 in Somalia, two MSF members were kidnapped and held hostage for two years. Kok said that when they were released, the organization was unable to determine who was behind the abduction or what their motive was.
"We as MSF decided to leave Somalia, and that was also a signal to everybody in that area that this is unacceptable, if it goes like this we cannot work. It was very bad, we didn't like it at all because we had some 10 hospitals in total in the country and many people in Somalia were dependent on us for the healthcare we provided," Kok said.
It took MSF three years to return to Somalia.
NEVER KNOW WHERE VIOLENCE CAN COME FROM
When agreeing to a humanitarian mission abroad, one should not expect safety guarantees to come attached by default just because they are promised in international treaties, Kok's stories revealed.
"For instance, it is promised by governments that they will not attack hospitals; hospital should be an area of sanctuary, where people are safe. When an attack on a hospital does happen, then via the United Nations or addressing the governments directly, we would call on respect to the Geneva Convention [relative to the Protection of Civilian Persons in Time of War, 1949]. But of course politicians are an independent entity and we do not have the power to stop it," Kok said.
He also said that local populations sometimes constituted an unexpected threat.
Last February, an MSF-managed Ebola treatment center in the Democratic Republic of the Congo (DRC) was burnt down by local residents in the city of Katwa, killing several workers. According to Kok, this violence is rooted in people's distrust toward medical staff, which they believe is "a trick from the authorities to do harm to them."
When it comes to Ebola, the most dangerous period for contamination is when a person dies and the virus leaves the host in search for another. The body therefore becomes highly contagious and any contact with it could lead to dozens becoming infected. However, keeping locals away from the bodies of their loved ones contradicted their funeral rituals.
"The traditional way of burying is when the whole family comes, touches the body, washes the body, carries it together with all the friends and relatives and puts it into the grave. If you allow that to happen, one body is able to contaminate 10, 20, 30 more people. That is the way Ebola was spreading in the beginning so fast," Kok said.
Therefore, to curb the spread of Ebola the government had to send in soldiers to help medical personnel convince people to abandon the dangerous burial ritual. The locals understandably perceive the tandem of soldiers and doctors as a threat and react with violence, especially in countries like the DRC where "for almost 70 years people feel distress towards their own government," Kok said.
CULTIVATING PREPAREDNESS, NURTURING RESILIENCE
According to the security expert, when MSF is preparing a mission to a certain location, the first thing it tries to understand are the realities of that location, specially "what is the conflict, what's the situation, who's playing which role in this context, who's the government, what's the interest of the government, who's the opposition and what their interests are, what's this rebel group and why they exist, what's their cultural composition, what tribes exist, what religious groups exist."
Establishing contact with these local actors be it an official or moral authority is an important component of coming to a new place and explaining the medics' presence there. Kok also said that in their mission, MSF relies heavily on the local staff, as they are the main intermediary in talks between the government and the population for every 10 expatriate doctors, there are about 100 local medical professionals.
At a more micro level, the organization tries to figure out the safest settings for its everyday operations, such as which locations to avoid, what time of the day to travel, which means of transportation to choose, how many cars to use, whether to equip them with trackers, and so on.
In some countries MSF counts thousands of personnel being an important provider of healthcare in a situation of a failed state, civil war, epidemics, changes of government and other circumstances that make populations vulnerable.
"We are sometimes victims of political decisions. But we believe there is people-to-people solidarity, that we help each other when the politicians cause humanitarian problems," Kok said.
