When a deathly ill woman arrived at a clinic in Harare, Zimbabwe, staff were just as concerned for an accompanying infant as they were for the mother.
The woman required immediate medical attention and was dealt with accordingly, recalled Zakaria Mwatia, a project coordinator for Médecins Sans Frontières (also known as Doctors Without Borders). But it was clear that the child was also in need of assistance.
“The mother had no relatives to take care of the baby,” explained Mwatia. He then mentioned that a Zimbabwean nurse working for MSF ensured that the infant was looked after.
Day and night, at work and at home, Roslyn Bamu kept the malnourished infant by her side.
“Roslyn went home with the baby every evening,” recounted Mwatia. “She ensured proper feeding and medical care. And when the mother recovered and was discharged seven days later, she found that her baby was well cared for.”
Temporary adoptions are obviously not an item included in Bamu’s MSF job description. However, her story is just one example of the efforts performed by MSF national staff on a regular basis.
“I think it is fairly reasonable to assume that in 1971, when MSF started, it was European doctors trekking out to some of the least accessible parts of the world,” said Paul Foreman, head of MSF Amsterdam’s operations in Zimbabwe. “Today, you’ll find that there are about 2,000 international recruits or expats working alongside more than about 25,000 national staff.
“[Expatriates] are outnumbered 10 to one by nationally-hired employees,” Foreman added during an interview at his office in Harare.
Yet media reports often portray MSF as groups of Americans and Europeans dropped into disaster-struck countries and tasked with saving the day.
One notable exception, when journalists did devote attention to national staff, was in 1994, during the genocide in Rwanda. Most international employees were evacuated from the country before the worst of the violence. But MSF’s Rwandan workers had to stay, and nearly 100 were killed.
According to MSF’s International Activity Report 2010, the NGO maintained 87 projects in “areas of armed conflict” and a further 125 in regions undergoing “internal instability” in that year.
Regarding the levels of danger, Foreman dismissed the idea that nationals face greater risks than expats. “It’s all about context,” he argued.
“If you look at Badghis in Afghanistan in 2004, five [MSF] people were killed, but it was three international staff of three different nationalities and two Afghans,” he explained. “So the risk in that situation seemed to be just as huge for the Afghan staff and the international staff.”
He called specific attention to the case of Pakistan, where the CIA recently conducted a vaccination program as part of its hunt for Osama bin Laden.
“How do you carry out your normal life as a westerner when everybody knows that there are covert operations being carried out by Western governments that are killing Pakistanis?” Foreman asked. “So the old concept of the passport being the protector, I think, is a little bit of a colonial perspective.”
Dangers aside, teams of international and national staff benefit all involved. Expats have access to national colleagues’ knowledge of local affairs, Foreman said, and staff hired in-country gain experience and skills that they can take to other parts of the world and back to their’ home communities.
Touring MSF’s operations in and around Harare, it was all but impossible to miss examples of such employees.
Mwatia is from Kenya, starting there with MSF as a nurse, and now working as a project coordinator for Zimbabwe. Etalem is Ethiopian, first working with MSF in Addis Ababa, and now serving as a logistics-supply staffer for Zimbabwe. And Magutsa, who began with MSF in Zimbabwe six years ago, recently returned to Harare from a mission in Somaliland, and will soon depart for a posting in Pakistan.
MSF’s primary objective is to save lives, Foreman emphasized. “But after a crisis is over and after the international element pulls out, you leave a significant additional capacity,” he noted. “So with national staff, there is an element of sustainability.”aid > doctors without borders > harare > health > Médecins Sans Frontières > msf > zimbabwe