© Natacha Buhler/MSF
18 Jun 19 18 Jun 19

Harassment and abuse

Médecins Sans Frontières (MSF) promotes a working environment free of harassment and abuse. Our leadership has unequivocally committed to fight abuse and to reinforce mechanisms and procedures to prevent and address it. All staff are expected to abide by the MSF movement's Behavioural Commitments and our guiding principles as stipulated in our Charter.

In early 2018, MSF published a statement on the actions we had taken to combat abuse and harassment, the challenges we faced, and the number of cases recorded in 2017.  One year on, we have put together the following short update on progress so far, including figures from 2018, which we hope will help maintain a constructive focus on this important issue.

One of the most significant challenges we identified previously was that of underreporting – and the need to do more to ensure that our staff and patients are aware of, and trust, our reporting mechanisms.  While the 2018 figures show an increase in the reporting of incidents of unacceptable behaviour compared to 2017, we still believe this picture to be a significant underestimate – this is likely due to a combination of challenges around both under-reporting and data gathering.

Our statement last year set out a number of ongoing measures to improve the detection and prevention of unacceptable behaviour.  These included training, workshops, field visits, and the production and distribution of leaflets and audio-visual materials.  2018 saw continued activity in all these areas, as well as the allocation of increased staffing to MSF’s responsible behaviour teams; the development of new tools for improving awareness, prevention and detection of unacceptable behaviour; and the improvement of data-gathering and sharing across the MSF movement.  It is worth acknowledging that an increased public focus on this issue will very likely have contributed to increased awareness and reporting.

In 2018, MSF had over  43,000 staff working in the field (the following figures relate to complaints from the field and do not include the additional 4000 staff working in MSF HQs). 2018 saw a significant increase in the number of complaints from the field recorded about all types of behaviour, a total of 356, up from 182 in 2017.  We hope that these figures are an indication that an increased focus on the issue has encouraged more people to come forward.

Of those complaints, after investigation 134 were confirmed as either situations of abuse or of inappropriate behaviour (83 in 2017). This includes 78 cases qualified as abuse of all forms, compared to 61 in 2017 (this category includes sexual abuse, harassment and exploitation; abuse of power; psychological harassment; discrimination; and physical violence). 52 members of staff were dismissed for all forms of abuse (58 in 2017).

Of the total 78 cases of all forms of abuse in 2018, 59 were confirmed after internal investigation as cases of sexual abuse, harassment or exploitation, up from 32 in 2017. 36 staff were dismissed as a result of those cases, up from 20 in 2017.

There were also 56 confirmed cases of inappropriate behaviour, up from 22 in 2017 (inappropriate behaviour includes: mismanagement of people; inappropriate relationships; inappropriate behaviour not in line with societal standard or affecting team cohesion; the use of substances).

It is worth stressing again that this is still not the complete picture that we would like to have – while we have improved data-gathering since last year, we still have more work to do to address both this issue and the challenge of under-reporting.  We continue to urge staff, patients or anyone else who comes into contact with MSF to report any incidents of unacceptable behaviour which they come across. 

Note on changes to the figures

Due to improved data collection and compilation, MSF has updated its figures for 2017. As a result, the total number of complaints for 2017 is found to have been higher than previously estimated: 182 as opposed to 146; the number of confirmed cases has also risen slightly.  The above comparisons use the updated 2017 figures; but for the purposes of comparison, the original figures remain available in last year’s statement.  Please note that some cases  in 2018 are still being investigated and  have not yet been qualified, so the figures may change slightly.