Médecins Sans Frontières is 'institutionally racist', say 1,000 insiders

The medical NGO Médecins Sans Frontières is institutionally racist and reinforces colonialism and white supremacy in its humanitarian work, according to an internal statement signed by 1,000 current and former members of staff.

The statement accused MSF of failing to acknowledge the extent of racism perpetuated by its policies, hiring practices, workplace culture and “dehumanising” programmes, run by a “privileged white minority” workforce.

Addressed to senior management and colleagues, the letter calls for an independent investigation into racism within the organisation and for urgent root and branch reform to dismantle “decades of power and paternalism”.

Signatories include Javid Abdelmoneim, chair of the board of MSF UK, Agnes Musonda, president of the board in southern Africa, and Florian Westphal, managing director of MSF Germany.

Christos Christou, MSF’s international president, welcomed the statement as a “catalyst” to act faster on a series of changes already planned at the organisation.

The statement follows fierce internal debate about racism and the Black Lives Matter movement. Some staff were angry at a recent statement released by MSF Italy, suggesting it should not use the term “racism” and that “everyone, starting with MSF”, should talk about “all lives matter”.

MSF, one of the world’s largest humanitarian organisations, which was awarded the Nobel peace prize in 1999, provides emergency medical services to people in need in poorer countries and conflict zones.

Last year, it employed 65,000 staff, about 90% of whom were hired locally. However, most of its operations are run by European senior managers out of five operational centres in western Europe, with only one, which opened last year in Senegal, located in the global south.

Shaista Aziz, former MSF aid worker and the co-founder of NGO Safe Space, an intersectional feminist platform seeking accountability over #AidToo abuse, said: “This moment of reckoning is massively overdue.”

“The real work that has to be done is about dismantling the power structures that are inflicting harm and this is the work very few people really want to do.”

Change, Aziz said, “requires brave and bold leadership and it requires a lot of ‘do-gooding’ white people with power to get out of the way”.

Padma Priya, a former media manager for MSF in Delhi, who left in 2018, said the casual racism was “a reality for people like me every single day”.

“There was a constant feeling that they need the national staff to get on with things, but otherwise ‘we’ are better than ‘them’. It was exhausting.”

Personal testimonies by signatories of the letter suggested the extent of the problem. “Trying to support a national staff [member] to apply [for a job] as an international staff [member] is the most tedious, unjust and gut-wrenchingly frustrating process I have ever endured,” said one staffer.

There was an “almost suffocating” white saviour mentality, another said, while others complained of recruitment policies that “[pushed] staff with 10 or 20 years experience to be supervised by fresh graduates”.

Related: The aid sector must do more to tackle its white supremacy problem

Christou said: “I look at this as an opportunity that has come through a tragic event that triggered rage and discussion within our movement.

“Our priority is to shift the decision-making closer to where the needs are, and involving the patients and community in designing strategies of intervention. To shrink the decision-making power of Europe and redistribute it to the rest of the world.”

Many of the action points set out in the statement, which was sent on 29 June, had been agreed at a staff meeting a week before the letter went out, he said.

He acknowledged that a review of human resources policies in 2017 to tackle the “unfair and discriminatory” pay structure did not go far enough. “We are now reviewing this,” he said.

Over the past decade, the percentage of MSF’s international programme coordinators from the global south rose from 24% to 46%, he said.

“The senior top management positions were still people, unfortunately, from the global north,” he said. “This is another thing we are trying to overcome.”

He said a review of staff pay had already begun.

An attempt to address racism within the organisation three years ago failed when its international general assembly decided not to adopt a motion on “unpacking racism, prejudice, and privilege” drafted by MSF USA.

Avril Benoît, executive director of MSF US, said: “Much of the current focus was triggered by the brutality of a police officer with his knee on the neck of George Floyd. A lot of us who are white are appreciating that police violence is only the apex of a pyramid of oppression.

“When you first encounter this, you say ‘That’s not me, I’m a humanitarian, we’re all such good people.’ But if you look at a picture of those at the highest executive levels, there is your answer. The good people we may be and the policies we’ve brought in are not enough.”

Claudia Lodesani, MSF Italy’s president, apologised for hurt caused by the Italian board’s statement advising against use of the term “racism” on 28 June. “We have since written a new letter to clarify our intention and apologise for hurt caused to colleagues across the world, reaffirming that we fully support and stand with the BLM movement and that, like the whole of MSF, we condemn racism and all discrimination.”

In 2019, MSF received seven formal complaints of racial discrimination, of which less than five were confirmed following investigation. It recognised that complaints of abuse and behaviour issues, especially from locally hired staff, patients and their carers, were underreported by the organisation.