They are surgeons, internists, nurses and medics, but they share a specialty: disaster. In Bangladesh, a French medical team delivers emergency medical supplies to victims of that country’s killer cyclones. In Romania, Medecins du Monde (Doctors of the World) struggles to contain the rapid spread of AIDS. In Myanmar, Assistance Medicale Internationale (International Medical Assistance) works covertly among the forgotten Karen and Mon tribes. In Sri Lanka, two relief workers from Medecins sans Frontieres (Doctors Without Borders) were wounded recently when a government helicopter strafed their Toyota. But hundreds of physicians await a similar mission. “Once you’ve done this kind of work,” says Dr. Luc Dubois, a top Belgian specialist who recently returned from treating Kurdish refugees in Iraq, “you can’t wait to get back to it.”
It has been 20 years since a handful of idealistic young physicians created what became known as the “French doctors” movement, but the volunteers have lost none of their zeal. Medecins sans Frontieres and the two smaller groups it inspired still move fast and thrive on improvisation. Unlike the International Red Cross, they “bear witness” by protesting loudly and often against human-rights abuses they encounter. They work undercover in tyrannical nations. They break the law-and sometimes the rules of ordinary medicine. “If we have had an impact, says MSF president Rony Brauman, “it may be partly a result of our national character: the instinct and the ability to get around convention, to make it up as we go along.”
There is no denying the movement’s impact. This year more than 3,000 French, Belgian and Dutch doctors and paramedics will serve in more than 61 countries under the three groups. The movement has attracted such enormous support from the French public-more than a million donors a year contribute roughly $60 million-that the groups now struggle to keep up with their own success. Ten years ago MSF operated out of a cramped office suite with one part-time secretary. The organization now is housed in a handsome four story building in Paris where employees manage a budget of $42 million. MSF and MDM both run sophisticated fund-raising campaigns, and “logistics” has become a major division of what was once a shoestring enterprise.
Responding to emergencies anywhere in the world remains the top priority. The groups still rely mainly on doctors and nurses between 25 and 40 years old who take a month or a year off from their careers to work for the cause. But rapid growth has brought some subtle changes. The doctors are not nearly so leftish as they were in 1971, when the movement was founded in the wake of a decade of student protests. Though its leaders cherish their independence from the French government, they now work closely with the European Community and the United Nations High Commissioner for Refugees. In El Salvador, Malawi and two dozen other countries, the “French doctors” are at work on long-term public-health projects that smack of the “development” approach they once spurned as ineffective.
Over the past five years the movement has also taken root in the Benelux countries. The Belgian branch of MSF is playing the lead role in Kurdistan. So far efforts to export the formula to English-speaking countries have met with little success. Among the main difficulties, according to leaders of the French movement, is the very high price of personal and malpractice insurance in the United States. But within the last year, Medecins du Monde has opened an American branch headed by Dr. Jonathan Mann of Harvard, former director of the World Health Organization’s anti-AIDS campaign. And MSF now has a small office in New York. During the first month of the Kurdish catastrophe, MSF received $156,000 in donations from individual Americans. More than a thousand U.S. doctors offered their services in Kurdistan and eight are preparing to go.
Critics accuse the disaster doctors of playing to the media and of occasionally being too quick to denounce human-rights violations in far-off places. But the naysayers are a tiny minority. For millions of the world’s sick and oppressed, these “French doctors” represent hope in an otherwise callous world. To the Hippocratic oath, which commits doctors to heal the body, they have added a new undertaking-what they call “the duty to intervene” wherever human misery prevails or human rights are trodden down. Growing support for their movement shows that the people and governments of the West are adopting that duty as RET-RAPHO their own.
