More Than Needles and Bandages
Fourteenth European Students' Conference
A Meeting of the Minds
More Than Needles
I was hesitant at first to join the Médecins Sans Frontières
(Doctors Without Borders) volunteer group here at McGill. I thought
that I would be committing myself to an organisation whose humanitarian
actions were solely medical-related and never crossed over to
topics of injustice and human rights violations, which as many
people do not realise,is just as crucial, if not more, than needles
and bandages. It is an honourable thing to save lives, but it
is a crime to do it with indifference. With aspirations of becoming
a doctor myself, I was not ready to promote healing with a mouth
Luckily, I soon found out that in addition to providing medical
assistance, MSF's main missions are to raise awareness by speaking
out, either in private or in public, as witnesses of the plights
suffered by populations around the world. As the world's most
important independent medical relief organisation, MSF provides
assistance in more than 85 countries, in the wake of armed conflicts,
civil war, epidemics, chronic refugees’ situations, natural
disasters and famines, while launching awareness campaigns and
publicly denouncing acts that violate humanitarian laws. In fact,
it is one of the first non-governmental organisations (NGOs)
to have combined medicine with activism. Another important feature
is its complete independence from all political, religious and
A little more about MSF
Winner of the Nobel Peace Prize in 1999, MSF assists those who
have fallen victim to natural or man-made disasters. Its offices
are located in 18 countries around the world and its staff is
composed almost entirely of volunteers who often work in the
most dangerous and remote areas of the world. In a medical crisis
situation, within hours, the teams are ready to set off and devote
six to twelve months of their lives on a mission. In the field,
the teams arrive with equipment specifically designed by the
group of logistics to fit the geography and climate of the country,
allowing the teams to get right to work (1).
The field teams provide first aid medical assistance, perform
surgical operations, restructure health clinics and hospitals,
run nutrition and hygiene programs, train local medical personnel
and offer mental health care. They also establish long-term programs
aimed at treating infectious diseases such as tuberculosis, malaria
and AIDS, while directly helping excluded and marginalized groups
such as children and ethnic minorities.
MSF also mounts exhibitions, releases publications, and launches
campaigns with the aim of raising awareness. An important part
of MSF's work consists in addressing any violations of human
dignity and humanitarian law encountered by team members on the
field, and violations perpetrated or sustained by political actors,
by either confronting the responsible actors or putting pressure
on them through public denouncement and the mobilization of the
Impartiality and the Media
Most NGOs are not credited with impartiality and neutrality.
MSF is one of the few private, non-profit, non-partisan and impartial
organisations left. From the beginning of its foundation by a
small group of French doctors in 1971, it has continued to distance
itself from any political or religious affiliations in order
to maintain the neutrality needed to ensure assistance without
discrimination on the grounds of race, sex, religious convictions,
social stature or political views. Further independence is maintained
by primarily turning to public or private donations, and to a
limited extent (less than 20%) to international institutions
such as the UN, for funding.
Humanitarian aid should be impartial and neutral, and have as
sole aim to prevent or relieve suffering according to the victims'
needs and interests. However, for the past decade, these principles
have slowly declined in the humanitarian world. As the government,
the media and the military have become more and more involved,
many NGOs have been bought in by those who supply the funds or
threatened into submission by authorities (2). "Governments
and donors [have] tried to influence belligerents by withholding
funding for humanitarian aid, and by providing assistance to
particular groups" (3). This type of bias defiles the word "humanitarian",
a word that embodies self-devotion to others, a pure form of
compassion and altruism, whose very essence is contradicted by
any reference to ulterior motives or personal agendas.
An organisation's degree of independence also influences the
level of discrimination behind the selection of information it
wishes to publicize and the extent to which the organisation
will speak out against acts of violence and abuse. Previous biased
humanitarian actions in Bosnia, Chechnya, Somalia, Afghanistan
and in much of the Arab world, have fuelled feelings of anger
among the victims, for whom it has become increasingly difficult
to identify friend from foe in conflict situations (4).
The impact of the media on the humanitarian world is very significant.
It often dictates the areas in the world that obtain the most
help and the level of funding and attention received for a project.
Unfortunately, only a small percentage of the populations that
find themselves in a situation of danger actually gain the attention
of the media and those who are left in the dark receive little
sympathy from the outside world.
The media also profoundly influences the organisations themselves. "[S]ome
agencies have tried to harmonize both public and private storytelling… There
are risks of this outspokenness…that agencies themselves
become more enamoured of the politics of moral gesture than of
reaching…victims themselves" (5). However, funds are
needed to provide assistance, and lobbying for the emotional
support of spectators in search of tear-jerking real life drama
is where the money's at. Thus awareness campaigns are turned
into advertising campaigns, and the bulk of efforts and money
is spent in the media rather than in the line of action.
"The agency most determined to get the highest media profile
obtains the most funds from donors…[In] doing so, it prioritises
the requirements of fund-raising…follows the TV cameras…engages
in picturesque and emotive programmes [and] abandons scruples
about when to go in and when to leave…. Agencies that are
more thoughtful…fail to obtain the same level of public
attention, and suffer for it." (6)
If the sufferings of a population stem from the manipulations
of political, military or economic forces, medical assistance
alone is not a sufficient humanitarian action. There is no doubt
that saving even just one life is an incredible and admirable
deed, but a broader remedy must be employed when entire populations
are subjected to the consequences of corrupt forces. To provide
a long-term sustainable resolution, the problem must be attacked
at its source.
If we succeed only in mending the war wounds of a mother and
a father, for example, but action is never taken against the
movement that is the cause of this war, then later on the children
of these parents will in their turn find their own wounds in
war, and so will the next generation, and the one after. Do we
simply wait and watch in silence for the children to face war
and then run to their rescue? It is as absurd as having a leaky
pipe with an enormous gap that steadily causes the pipe to crack
along its length, and a team of plumbers constantly mending the
cracks without giving heed to the gap. Of course the cracks will
be repaired, but if the gap is never fixed, the cracks will continue
to spread, the pipe will always leak and the problem will never
be completely solved. The gap must be filled. We cannot content
ourselves with mending the cracks.
Many organisations keep silent because they believe that they
have no responsibility or no capacity to influence the oppressive
forces. They regard themselves as accountable only for the maintenance
of their relief operations, or are afraid that speaking out may
jeopardize their freedom to operate in the country. This kind
of passive complicity is the easier path, involving fewer risks
for the organisation. However, other organisations, acknowledging
the power they possess to testify, negotiate and make public
statements, hold themselves responsible for speaking out as witnesses
of injustice (7).
"[MSF] refuses to accept that silence is a precondition
for its operational freedom" (7). MSF teams, known for their "rebellious
humanitarianism", were expelled on a few occasions for speaking
out: in 1985, after denouncing the Ethiopian government for its
diversion of humanitarian aid and the forced migration of its
people, a team was forced out of the country; in 1995, the France
team was expelled from Rwanda for denouncing the abominable conditions
of the prisons and the treatment of the prisoners (8). In these
cases, it might appear that speaking out did more harm than good,
since the expelled teams were no longer able to provide assistance,
but in fact MSF, having 5 operational centres, can take a stand
and speak out via one centre, which alone suffers the consequences,
while the other centres safely carry on with their work in the
Speaking out demands more than passion and conviction. To be
heard and believed, one requires facts. To ensure credibility
with governments, other international relief organisations and
the public audience when issuing statements, MSF takes a scientific
approach. The field teams document casualties, conduct intensive
surveys and analyse sample groups to gather scientific evidences
to support their cases when giving testimony of human rights
violations. The studies conducted by MSF in Rwanda, Congo, Sierra
Leone and Kosovo, among others, were well reputed and gained
much public attention (9).
In the face of horrors, inaction is unacceptable. Being active
is hard and risky for the organisations, but remaining passive
is costly and dangerous for the victims. After all, is not the
right to freedom and respect just as crucial as the right to
essential medicines and physical assistance? Upon receiving the
Nobel Peace Prize in 1999, MSF put it this way: "Silence
has long been confused with neutrality and has been presented
as a necessary condition for humanitarian action. From the beginning,
MSF was created in opposition to this assumption. We don't know
whether words save lives, but we know for sure that silence kills" (10).
The Other Side of Medicine
The issues dealt with not only pertain to MSF as a humanitarian
organisation, but also touch on an important and often neglected
aspect of medicine in general. Political figures are most influential,
but spend most of their time in the public spotlight and little
time in direct contact with the actual subjects of their lavish
speeches; activist groups are most devoted, and actively promote
their cause, but often lack credibility and professional experience.
The medical personnel is by far the best placed people to raise
the issues of justice, dignity and human rights, not only because
of their well-respected social status but also because of their
direct contact with victims. The importance of activism in medicine
is perhaps not so obvious in Canada, where the majority of population
not only has access to medical care but is also protected under
strict laws. But it becomes very obvious when working in countries
where there is little protection of human rights and little or
no medical assistance available, and where health emergencies
are often the result of violence, oppression and injustice.
I have often heard medicine being referred to as a "noble" profession.
There is nothing noble to be found in the medical field if treating
a patient is viewed as merely operating on a machine. If practicing
medicine does not go beyond fulfilling the job requirements and
earning a good salary, it is no more noble than any other profession.
There is a tendency to immediately classify a career in medicine
as an admirable one because of the prospect of saving many lives.
There is a distinction to be made however, between those who
do it with apathy, out of duty or as a routine, and those who
truly care for the relief of human suffering, who believe in
the high ideals of medical ethics, who are in quest of knowledge
and understanding without prejudice, who sacrifice and labour
and endure to help others, who are outraged by the sight of any
form of abuse of another human being and who take action against
it. Therein lies true nobility.
Faculty of Science
1. MSF Canada. The Work of MSF: Past, Present, and Future. Medicins Sans Frontières
/ Doctors Without Borders, Canada. www.msf.ca/about.
2. Parry MS. Phyrric Victories and the Collapse of Humanitarian Principles.
The Journal of Humanitarian Assistance. www.jha.ac/articles/a094.htm.
3. Macrae J, Stevenson F. Legislating for Humanitarian Aid. Humanitarian Practice
Network Report. 2002; 21: 33-35.
4. Center for Economic & Social Rights. Violations of the Right to Food
by all Parties to the Conflict in Afghanistan. www.cesr.org/Emergency%20Response/righttofoodrapportuer.doc.
5. Ignatieff M. The Stories We Tell: Television and Humanitarian Aid. In: Moore,
ed. Hard Choices: Moral Dilemmas in Humanitarian Intervention. Lanham, Maryland:
Rowman & Littlefield. 1998: 291.
6. De Waal A. The End of the Cold War: A New Humanitarian Dispensation, In:
Currey, ed. Famine Crimes: Politics and the Disaster Relief Industry in Africa.
Bloomington, Indiana: Indiana University Press; 1997: 65.
7. Bouchet-Saulnier F. Between Humanitarian Law and Principles: The Principles
and Practices of "Rebellious Humanitarianism." Medicins Sans Frontières
/ Doctors Without Borders, Canada. www.msf.org/content/page.cfm?articleid=6589C8A5-DC2C-11D4-B2010060084A6370.
8. MSF France, Chronologie de 1971 à aujourd'hui. www.paris.msf.org/msf/web.nsf/html/459PGX?OpenDocument.
9. Marschner A. A Scientific Approach to "Témoignage." Medicins
Sans Frontières / Doctors Without Borders, Canada. www.msf.org/content/page.cfm?articleid=0F722DE2-BF6A-11D4-852200902789187E.
10. Melicharova M. Special Agents. Peace Matters. 2002; 38: 23.
Given, that the MJM and the European Students' Conference (ESC)
share the common goal of encouraging the pursuit and communication
of medical research among students, we thought your readers might
be interested in learning more about our Conference.
As our name implies, the Conference enjoys a European flavor
but we wish to actively encourage Northern American students
to also attend, facilitating closer ties and a greater flux of
ideas between the two continents.
The 14th European Students' Conference will be held from the
4th - 9th of November 2003, at Charité, the medical school
of the Humboldt University in Berlin. It offers medical students
and young doctors from more than 40 countries a great opportunity
to present the findings of their research. Uniquely, professors
and specialists will evaluate them. Prizes and scholarships totalling
more than 10 000 Euro will be awarded to the best oral and poster
The fields of neuroscience, pharmacology and infectious diseases
are our main focal points at the 14th ESC and we welcome everybody
working or researching in this field. Besides that, different
workshops concerning topics in medical education, fundraising
for medical projects, working in Europe or alternative medicine
will be offered. In addition there will be a forum for interactive
discussions between highly regarded scientists and students.
Combined with the conference sessions there will be initial skill
adoption training courses as chances to get in touch with the
practical side of medicine. We will also have an exhibition -
the "job contact market", where subject related companies
can present themselves or recruit young scientists directly.
One of the main goals of the 14th ESC is anchored in our leitmotif,
which expresses our interdisciplinary thinking: For open minded
young scientists willing to look beyond.
Our wide variety of cultural and social programme points implies
the aim to show Berlin as a European capital with its specific
flair and a doorway between east and west. Historical oriented
sightseeing tours as well as dinner parties and sport activities
will be part of the programme to bring people together.
The 14th ESC has recently extended the agreement with the IFMSA
(International Federation of Medical Students' Associations,
ifmsa.org) during the March meeting in Estonia. The IFMSA´s
Standing Committee on Research Exchange (SCoRE) recommends that
the participants of its research exchange attend at the 14th
European Students Conference and present their work. If you have
done research and are going to attend an exchange programme,
why not apply to the 14th ESC?
We enthusiastically welcome students and young doctors from
the biomedical sector worldwide to become active as well as passive
applicants. The application details and further information are
noted down in writing on our website.
The Organizing Committee
N. Züfle, N. Ledenig, W. Blaum, A. Schuster, A.Gómez-Carrillo,
A. Kötter, F. Ufer, S. Herrmann
A Meeting of the Minds
On February 26, 2003, the Experimental Medicine Graduate Students'
Society (EMGSS) proudly hosted the 3rd Annual McGill Biomedical
Graduate Conference (AMBGC) at McGill University. The AMBGC is
the biggest student-run biomedical symposium at McGill and it
was created to strengthen relations among graduate students and
to promote awareness of the research being performed throughout
the university. The AMBGC gives graduate students the opportunity
to hone their presentation skills and to get feedback on their
research from a diverse audience. Although only in its third
year, the AMBGC has already gained the reputation as being one
of the leading biomedical research conferences in the Montreal
region. In fact, the 1st AMBGC was selected as the winner of
the Forces Avenir Award (Health Category), Québec's most
prestigious student award designed to recognize and honor university
This year's AMBGC attracted over 250 people and a record high
of 102 abstracts were submitted by graduate students from 14
biomedical departments, representing 15 different research institutes.
Top-ranked presentations, as selected by a panel of McGill professors,
were awarded with cash prizes of up to $1000. The conference
was financially supported by 16 sponsors, whose donations totaled
over $17,000. This year's keynote lecture was given by Dr. Lawrence
Rosenberg of McGill. Dr. Rosenberg's lecture focused on the discovery
of INGAP, a naturally-derived peptide which stimulates the regeneration
of pancreatic islet cells and is being touted as a potential
cure for diabetes. Unfortunately, due to a personal emergency,
Dr. Rosenberg's co-speaker, Dr. Aaron I. Vinik of Eastern Virginia
Medical School, could not attend.
Overall, the 2003 AMBGC provided an outstanding forum for biomedical
graduate students to share some of the exciting research currently
being performed at McGill. The EMGSS would like to thank all
of the sponsors, graduate students and judges who participated
in this event. For more information and for pictures from the
3rd AMBGC, please visit the conference website (1).
Randy Levitt and Sabrina Perri
Experimental Medicine Graduate Students'
1. EMGSS. 3rd Annual McGill Biomedical Graduate Conference. http://www.medcor.mcgill.ca/EXPMED/AMBGC