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To address protection, however, is to address the question of our responsibility and role when confronted with violence, in the context of healthcare. Has this question been settled once and for all within MSF? In order to provide elements for a reply, the study looks at the practices and discourse, both past and present, employed by MSF (headquarters, field teams, individuals) when faced with situations of violence affecting either the population in general, or the people we assist. It analyses our discourse on responsibility - discourse which has inevitably evolved with the changes in our work environment, particularly states' international actions. The study also tries to identify the constancies within our practices. Three case studies are presented in the appendices.

Judith Soussan

This survey investigates patients’ coping mechanisms and their dependence on medical institutions both from the patients’ standpoint and from that of MSF’s project teams.

Marc Le Pape and Suzanne Bradol

A series of failures was the starting point for this analysis. Several outbreaks of hepatitis E, transmitted via the water supply, occurred in refugee and IDP sites in the Sahel (Sudan in 2004, and Chad in 2007) and in central Africa (Central African Republic in 2002, and Uganda in 2007). MSF was responsible for all or part of the water supply, as well as medical care. These outbreaks are a reminder that significant infectious risks persists even after we implement our usual procedures.

Jean-Hervé Bradol, Francisco Diaz, Jérôme Léglise, Marc Le Pape