The Limits of Médecins Sans Frontières

One of MSF’s closed offices in Kabul

I swung by one of the offices of Médecins Sans Frontières in Kabul yesterday. The humanitarian organization is justly famous for its lifesaving work in conflict zones. In 1999, it won a Nobel Peace Prize for its labors. And for almost 25 years—through the Soviet occupation, the civil war, and Taliban rule—MSF doctors and staff provided assistance to the suffering Afghan people.

But now the offices are empty. The signs had been pulled down. Nothing was left in the compound but a few MSF stickers and two rusted bed frames in the front yard. These doctors might not have borders, but they do have limits. On July 28, MSF announced that it was withdrawing from Afghanistan. In the United States, the news was spun as an indicator of deteriorating security in the country. From Kabul, the story looks more complicated.

There is no doubt that security in Afghanistan has worsened in the last several months. The numbers tell the story: Thirty-three aid workers were killed in the first six months of 2004 compared with 14 in all of 2003. Recently, I spent an hour in the office of an organization that provides security advice to relief groups. On one wall was a giant map of the country. Huge swaths of territory were crossed out with red marker: no-go zones. Most of the eastern edge of the country was in red, as were chunks of the south.

MSF logo at the abandoned compound

But is security in Afghanistan really as bad as when the Soviets were waging a bloody campaign against rebels or when mujahideen forces were kidnapping and bombarding each other in Kabul? Is the situation here worse than it is in the many other conflict zones in which the organization operates? In announcing their withdrawal, MSF representatives pointed to the traumatic executions of five employees in northwest Afghanistan on June 2 and the failure of the Afghan government to find the killers. But when I caught up with John Sifton of Human Rights Watch, he told me that “MSF has faced security situations in other places, including Chechnya, that are far worse.” In the wake of the June killings, few organizations want to criticize the MSF decision, but several veteran Afghanistan hands found the move very surprising. Other aid agencies have also suffered grievous losses, but they have adjusted operations and stood their ground.

And that leads to what may be the more important reason for MSF’s departure: the perception that humanitarian aid is being politicized in Afghanistan. MSF stated that “the violence directed against humanitarian aid workers has come in a context in which the U.S.-backed coalition has consistently sought to use humanitarian aid to build support for its military and political ambitions.” For months, aid workers here have complained that the military is encroaching onto their territory and blurring the line between military and humanitarian action.

Particularly nettlesome are the Provincial Reconstruction Teams that the United States, Britain, and NATO have established. These teams blend security and reconstruction work in a way that is troubling to humanitarian purists. But it’s not just the PRTs; it’s also the SUVs: Some coalition soldiers have taken to driving around the country in white Toyota Land Cruisers, aid agencies’ vehicle of choice. It’s a practice I never witnessed in the Balkans, and the humanitarian community’s discomfort is understandable.

And then there were the leaflets. Apparently, U.S. forces dropped flyers in the southern town of Spin Boldak suggesting that humanitarian aid might not continue unless the population helped turn over opposition forces.

All this is anathema to groups like MSF and the International Committee of the Red Cross, which emphasize (some might say fetishize) strict neutrality. In the parlance of the aid community, governments that use humanitarianism to further political goals erode the “humanitarian space” available to aid organizations. In their view, mixing aid and politics not only endangers aid workers, it taints humanitarianism. Military forces should focus on security and leave the aid work to the professionals. So, even if Afghanistan in 2004 is not as dangerous as Afghanistan of 1993 or Chechnya today, the noxious mix of aid and politics means it’s time to pack up and head elsewhere.

There’s nothing new about this humanitarian soul searching, and Dr. Hugo Slim of the Centre for Humanitarian Dialogue has little patience for the view that today’s mix of aid and politics presents some new threat to humanitarian action. In a controversial essay published by the centre earlier this year, he wrote that “many of the risks faced today are no greater than they were and humanitarianism is certainly no sicker.” For Dr. Slim, trying to cordon off humanitarianism from politics is a fool’s errand. “To complain about rejection, politicization and cooption and to suggest that they somehow need to be eradicated before any pure humanitarian action can take place is bizarre.”

Nor is it clear that the blurring of lines is what really puts aid workers in danger. The idea that extremist forces here would curtail attacks on aid workers if only the military maintained a bright line between its activities and those of the aid community strikes some people here as far-fetched. Like it or not, aid workers import values along with antibiotics. And those values—including gender equality and religious tolerance—are a problem for groups like the Taliban. Paul Barker of the aid organization CARE told me, “It’s very difficult to be fully neutral—a lot of what we do is inherently political.” As important, the Taliban remnants are outgunned and out of power. Lashing out at aid groups—even ones the Taliban tolerated when they ran the government—is one of the few ways they have left to rage against their fate.

Whatever its merits, the MSF decision has been a shock to those working on Afghanistan policy. NATO governments have had to answer tough questions about their commitment to security in the country. The Afghan government has tried to convince MSF to stay and may become more aggressive in curtailing renegade warlords and commanders. Taken together with other pressure, the withdrawal might actually push those with power to get serious about security. All of which is to say that MSF’s withdrawal could be seen as very good politics indeed.