Doctors Without Borders: Humanitarian Quests, Impossible Dreams of Médecins Sans Frontières

This study of Medecins Sans Frontieres / Doctors Without Borders (MSF) casts new light on the organization's founding principles, distinctive culture, and inner struggles to realize more fully its "without borders" transnational vision. Pioneering medical sociologist Renee C. Fox spent nearly twenty years conducting extensive ethnographic research within MSF, a private international medical humanitarian organization that was created in 1971 and awarded the Nobel Prize for Peace in 1999. With unprecedented access, Fox attended MSF meetings and observed doctors and other workers in the field. She interviewed MSF members and participants and analyzed the content of such documents as communications between MSF staff members within the offices of its various headquarters, communications between headquarters and the field, and transcripts of internal group discussions and meetings. Fox weaves these threads of information into a rich tapestry of the MSF experience that reveals the dual perspectives of an insider and an observer. The book begins with moving, detailed accounts from the blogs of women and men working for MSF in the field. From there, Fox chronicles the organization's early history and development, paying special attention to its struggles during the first decades of its existence to clarify and implement its principles. The core of the book is centered on her observations in the field of MSF's efforts to combat a rampant epidemic of HIV/AIDS in postapartheid South Africa and the organization's response to two challenges in postsocialist Russia: an enormous surge in homelessness on the streets of Moscow and a massive epidemic of tuberculosis in the penal colonies of Siberia. Fox's accounts of these crises exemplify MSF's struggles to provide for thousands of people in need when both the populations and the aid workers are in danger. Enriched by vivid photographs of MSF operations and by ironic, self-critical cartoons drawn by a member of the Communications Department of MSF France, Doctors Without Borders highlights the bold mission of the renowned international humanitarian organization even as it demonstrates the intrinsic dilemmas of humanitarian action.

Table of Contents:
The Quests Part I 1. Voices from the Field Part II 2. Origins, Schisms, and Crises 3. "Nobel or Rebel?" 4. MSF Greece Ostracized 5. The Return of MSF Greece Part III 6. La Mancha Part IV 7. Struggling with HIV/ AIDS 8. In Khayelitsha 9. A "Non-Western Entity" Is Born Part V 10. Reaching Out to the Homeless and Street Children of Moscow with Olga Shevchenko 11. Confronting TB in Siberian Prisons with Olga Shevchenko Coda Acknowledgments Notes Index

About the Author :
Renee C. Fox is the Annenberg Professor Emerita of the Social Sciences at the University of Pennsylvania. She is the author of Experiment Perilous: Physicians and Patients Facing the Unknown, In the Belgian Chateau: The Spirit and Culture of a European Society in an Age of Change, and In the Field: A Sociologist's Journey and the coauthor of The Courage to Fail: A Social View of Organ Transplants and Dialysis and Observing Bioethics

Review :
Carefully researched and delightfully written, Doctors Without Borders establishes a new bar for those who would cover Medecins Sans Frontieres in the future. This book will take its due place as one of the most comprehensive works on MSF. Science A commendably reflective work of sociology that, more importantly, tells a remarkable history of care. Publishers Weekly Generally interested readers will find Fox's thoughtful and thought-provoking overview ambitious and well worth the effort, while anyone focused on health care and medicine will be deeply fascinated. Booklist A treasured and monumental depiction of MSF's courageous and persistent commitment to millions of people in distress. South African Medical Journal A remarkable story of healing, conflict, and the journey of an organization once dismissed as a bunch of 'medical commandos' [and now] one of the most important health care humanitarian organizations in the world. Hospitals and Health Networks Doctors Without Borders: Humanitarian Quests, Impossible Dreams of Medecins Sans Frontieres provides detailed insights on the Doctors Without Borders medical ideals and culture... The result is a blend of organizational history and development and observations of the group's struggles to combat third world nation diseases, making for an outstanding social and health history. Midwest Book Review The author tells an exquisite story of the organization's origins and challenges... This book, honoring those who provide such important humanitarian assistance, will enrich a wide audience. Choice The author provides a well written ethnographic account of the often conflictual internal dynamics of inclusion and exclusion among various factions within MSF. This book is original in its scope, taking seriously the opinions and personal history of past and current MSF members, from the more prominent and infamous leaders to veterans of humanitarian aid and newcomers alike. -- Sadia Habib The Sociological Imagination Sociologist Renee C. Fox has written an eloquent, sensitive, and complex ethnographic profile based on extensive fieldwork. Fox conducted numerous interviews, site visits, and attended a number of major meetings and conferences; she ended her fieldwork at a landmark event, the first meeting of a newly created International General Assembly which also marked MSF's 40th anniversary. She describes her role as an "insider-outsider" combining access to internal information, public documents, and a staff blog. These multiple methods allowed her to become a sensitive yet detached and objective observer of the social relationships and culture of MSF. -- Susan M. Chambre Nonprofit and Voluntary Sector Quarterly The first extensive social scientific description in English of MSF, its origins and action in the field, and its cultural identity...Reaching beyond the history of the organization-the schisms and tensions that it has undergone-the book aims to explore how these tensions are related to the field of operations and to what happens in the field. -- Johanna Simeant European Journal of Sociology How has MSF come to occupy this role as canary in the coalmine, as the embodiment of humanitarian ideals and as a provocative moral force for medical ethics and human rights around the world? This question is answered in Renee Fox's rich sociological and historical text... A must-read for anyone considering a medical mission abroad or studying humanitarian assistance. -- Lauren Carruth Global Public Health Sociologist Renee C. Fox has written an eloquent, sensitive, and complex ethnographic profile based on extensive fieldwork. Fox conducted numerous interviews and site visits, and attended a number of major meetings and conferences; she ended her fieldwork at a landmark event, the first meeting of a newly created International General Assembly which also marked MSF's 40th anniversary. She describes her role as an "insider-outsider" combining access to internal information, public documents, and a staff blog. These multiple methods allowed her to become a sensitive yet detached and objective observer of the social relationships and culture of MSF. -- Susan M. Chambre Nonprofit and Voluntary Sector Quarterly Over half a million people contribute $10 or $20 to MSF each month... Doctors Without Borders will enlighten them about how hard yet rewarding this work is. Springer: Sociology