Written submission to the International Development Committee on the philosophy and culture of aid: racism in the aid sector
9 May 2021
1.1. Thank you for the opportunity to submit evidence to the first sub-inquiry, Exploring Racism in the Aid Sector under The Philosophy and Culture of Aid umbrella inquiry. I am an aid professional who has worked for almost a decade in the aid sector. I have been employed with Médecins Sans Frontières (MSF) and engaged in antiracism activism with a group called Decolonise MSF, which will be further described in this submission.
1.2. Upon seeing the UK International Development Committee's call for evidence, many Decolonise MSF members wanted to submit responses, but felt unable to do so. They expressed fear because they have already faced retaliation, bullying and harassment when raising concerns about racism in their daily work. Some have experienced abuse simply for being part of Decolonise MSF.
1.3. I share their fears: drafting this submission could be career-ending, so I would like to be anonymous. Though Decolonise MSF members could suffer adverse consequences for this submission, several of us weighed them against the costs of remaining silent. We also weighed not naming our employer directly against the possibility that MSF would choose not to engage in this inquiry formally (as appears to be the case with the previous Committee inquiry on sexual exploitation and abuse).
1.4 MSF does not take funding from the UK government, but it does receive private donations from the British public and employs British staff. Moreover, globally MSF positions itself with moral credibility; its debates on humanitarian values, stances, and activities have historically reverberated across the wider sector. Engagement of MSF is critical on topics such as the wider culture of aid and how we can prevent abuse and exploitation.
1.5. This submission is framed in response to the Committee's question: How can aid actors be actively antiracist? I provide an example of grassroots antiracism activism in a large INGO by staff who feel these concerns are overdue to be addressed. I explain how the Decolonise MSF group formed, the actions taken by its members, recent challenges, and recommendations for the Committee. I provide this information to the best of my knowledge, and if there are mistakes, I will submit amendments to the Committee.
2. The start of Decolonise MSF: How WhatsApp enabled an open letter and 74 pages of testimonies for change
2.1. In early 2020, a few staff informally started a WhatsApp group called ‘Decolonise MSF’. The group was created to exchange ideas on how to acknowledge and reform racist and neocolonial tendencies within MSF. Though calls for change in MSF are dated decades ago—including the 2006 La Mancha agreement—discriminatory treatment of people of colour, particularly those designated 'national' staff, continues. There remains a differentiation between national and international staff in policy and practice, formalised by parallel human resource management systems with different pay scales, investments in capacity-building, and realised leadership and decision-making power depending on where someone resides. Over time, the WhatsApp group membership grew; friends added themselves and referred others to join.
2.2. Shortly after the killing of George Floyd in the US and momentum around the Black Lives Matter movement, some WhatsApp members wrote and started signing a letter on Google Docs, called an Open Letter to Senior Management and Colleagues in MSF: Beyond Words to Anti-Racist Action (hereafter referred to as the Open Letter).
2.3. The Open Letter states emphatically, "Not only is racism perpetuated within MSF, but it is racism and white supremacy that shape the culture and mindset that still defines our organisation: the white European' expert' and the 'distant other in need'. With few exceptions, MSF's humanitarianism still suppresses indigenous voices, overlooks indigenous knowledge, denies individual and community agency, and makes a mockery of the radical notion of solidarity."
2.4. The letter makes ten explicit demands for Senior Management to dismantle racist and oppressive systems in MSF, calling for:
(1) Public acknowledgement of institutional racism in MSF, and of racism, white supremacy and intersecting forms of discrimination (notably gender) in humanitarian action more broadly;
(2) A commitment to, and a clear roadmap for, the radical re-imagination of our approach to humanitarian action that centres affected individuals and communities and seeks to redress decades of power and paternalism;
(3) Elaboration of MSF's stance on racism, white supremacy, and intersecting forms of discrimination, and the impact this has on patients and staff;
(4) An independent, external assessment of racism in MSF, and the impact this has on patients, staff and the integrity of our social mission;
(5) Internal auditing of all hiring processes (including recruitment channels) at all levels of the organisation, with identification and exploration of barriers hindering the recruitment and retention of a diverse workforce. This must be accompanied by interventions to dismantle barriers, and promote inclusion, retention and progression;
(6) Establishment of a clear plan of action to ensure sustained diversity and genuine representation at all levels in MSF, with a particular focus on MSF governance boards and leadership positions;
(7) Rapid and sustained implementation of antiracism training at all levels of the organisation;
(8) A review of policies and practices across all departments, and a clear implementation plan to ensure antiracist praxis, particularly as relates to operational decision-making, management, recruitment, fundraising and communications;
(9) Assessment of existing donor relationships and donor policies, and whether they reinforce racism;
(10) Commission of an independent, external review to explore the history of colonialism, expressions of neo-colonialism, and manifestations of white supremacy in all aspects of MSF's work.
2.5. Written first in English, the Open Letter was subsequently translated into Arabic, Bengali, French, Portuguese, Spanish, and Urdu by those signing to be accessible to more colleagues. By July 2020, numerous media outlets published articles on the Open Letter (some selected sources are in Annex 1).
2.6. The Open Letter allowed those signing to also provide further comments and testimony. A total of 74 pages of testimonies were added, exemplifying the multiple ways racism and neo-colonialism permeate MSF in practice, policies, and operations on individual and structural levels.
2.7 As of 9 May 2021, the Open letter has 1147 signatures and 205 personal reflections from current and former MSF staff.
3. Response to the Open Letter
3.1. MSF's Executive Committee issued a public statement, dated on 24 July 2020, to MSF staff on racism and discrimination. This statement did not explicitly acknowledge the Open Letter, its demands, or testimonies. Instead, it stated, "We welcome the current debate on racism as an opportunity to accelerate change within our organisation. Pain and suffering have been expressed in recent weeks across the movement, these words reflect the reality of so many of our staff, and patients."
3.2. This statement did not convey the broader spectrum of views in MSF that had arisen about the Open Letter. Subsequent examples aim to be illustrative, rather than exhaustive, of the different leadership responses.
3.3. The MSF Operational Centre in Amsterdam issued its own letter, clearly citing the letter and committing to some of the demands specified by signatories.
3.4. Others in the MSF movement saw the Open Letter as representing American sentiment, rather than concerns expressed and witnessed by MSF staff worldwide. MSF France's Executive Director indicated in an internal board post that Black Lives Matters is at the "edges of our social mission." While noting there are "real discrimination problems", he argued "all problems are not of the same nature, and are not to be treated in an undifferentiated manner by MSF, and certainly not through 'feel good' institutional communications where MSF would pose as an activist in a fight in which we take no risks, in which we confront no opponent. We choose to not address all the problems of the world, as real as they are. It's not a matter of morality or strategy, but rather a matter of labour economics: with limited resources, where do we chose to act? Participating in resolving the historical social and racial tensions shattering the American society is not at the heart of our commitment" (included in Annex 2 as not publicly available).
3.5. On 28 June 2020, the MSF Board in Italy published an internal post titled "We shouldn't use the word 'racism'" (included in Annex 3 as not publicly available). It argued: "We would like everyone, starting from MSF, to talk about 'All lives matter', all lives count, because discrimination exists against blacks, whites, yellows, women, men, gays, old, young, etc. And we see it these days in many countries, where the movement started in the United States with 'Black lives matter' has spread to many other societies and is supported by the most diverse people." MSF Italy later retracted this statement.
3.6. After the MSF's Executive Committee statement, the submission author knows of no statement referencing the Open Letter or its testimonies. Although there have been new official institutional initiatives addressing racism, the submission author knows of no invitations or attempts of senior leadership to meet with the signatories or writers of the Open Letter and its testimonies since its drafting. If there have been efforts, the author finds it telling to be unaware, as many others in the MSF movement likely are as well.
4. After the Open Letter: Decolonise MSF grows
4.1. After publication of the Open Letter, many more joined the Decolonise MSF WhatsApp group until reaching total capacity (256 members). Slack and Telegram accounts and email groups were created for further engagement.
4.2. Please note: these channels were not official channels created by MSF. Current and former staff joined for a variety of reasons. Many, frustrated with leadership and lack of prospects for change, wanted to galvanise support from the public and media connections. Others were optimistic for internal change, but cautious about using external mechanisms that could compromise MSF's reputation. Yet others were wary of risks from this type of unofficial group altogether and wanted to surveil.
4.3. Despite mixed motivations, in the following months, it became apparent that many were committed to being part of a leaderless grassroots movement dedicated to increasing awareness of racism and neo-colonialism and changing MSF. Some members began to organise strategy workshops, trade reading suggestions and create internal resource guides. A few authored media pieces on their own experiences. Some published wider recommendations on the decolonisation of public health and aid. Collectively, numerous members shared experiences of racism as they happened and sought emotional support from one another.
5. Decolonise MSF in 2021
5.1. Grassroots groups often ebb and flow in their activity over time, and Decolonise MSF was no different. Individual members' involvement in Decolonise MSF fluctuated depending on personal and professional commitments. Some more initially engaged with the group took a step back, allowing others to move to the forefront.
5.2. In early 2021, however, several members involved at earlier stages disclosed that they were facing new harassment, bullying, contract non-renewals, and being blocked from deployments to the field. Were these individual coincidences? Was this targeted retaliation for involvement in Decolonise MSF? Were these isolated incidents linked to broader systemic issues, such as poor management and discomfort with those perceived as 'troublemakers' for desiring change?
5.3. Uncertain but deeply concerned, members created an informal survey on bullying and retaliation of Decolonise MSF members and MSF as a movement to learn more. A relatively dormant Facebook group was also re-engaged by enabling anonymous posting. With this feature, many new members began to join the Facebook group, sharing anger, concerns, stories, and questions. In this group, Decolonise MSF affirmed it existed as a leaderless movement that cannot represent all people of colour in MSF. Instead, it aimed to be a space where current and former host-country staff and allies among international and HQ staff could exert collective democratic power to change the structures, policies, and practices of MSF.
5.4. Spaces like the Facebook group enabled Decolonise MSF to further leverage collective knowledge to visibilise racism in the everyday at the organisation. As an example, a member opened a poll to collect responses that have been used in MSF to stop and derail conversations related to antiracism. Phrases shared included:
• "Maybe MSF is not the organisation for you."
• "MSF has problems, but it is better than other humanitarian organisations."
• "We already know these problems in MSF. We just want to focus on solutions now."
• "You are damaging your cause by being angry."
• "I don't think X is racism."
• "We can't trust national staff to…."
• "MSF has more important things to focus on."
5.5. As of 9 May 2021, the Decolonise MSF Facebook group has 1023 members, including staff who have resigned or were let go by the organisation, current employees, managers, and board members. Motivations to be part of the group still vary, but it speaks volumes that a significant number of people would voluntarily join such a space in the first place.
6. Recommendation 1: Using stories to move away from values linked to White Supremacy Culture in organisations
6.1. For a Committee investigating the culture of aid, it is likely evident that stopping racism and neocolonialism requires illuminating the cultural values and practices that have allowed such paradigms to persist. One way Decolonise MSF has done this is by bearing witness via personal stories of what racism looks like for us and how it manifests on a daily basis. By combining digital technology and collective storytelling, Decolonise MSF members have been able to encourage a broader movement at MSF and contribute to a sector-wide conversation.
6.2. To foster a safe space for such stories and ideas to be shared, many of us in Decolonise MSF have reflect on what values are needed to avoid replicating the power dynamics we observed at work. One helpful resource is White Supremacy Culture in Organisations by the Centre for Community Organisations in Canada, which describes how organisations may unconsciously use standards that make it difficult to open the door to cultural norms that promote genuine inclusivity.
6.3. The resource details the following problematic values:
• Perfectionism, including worship of the written word, "one right way," and "either/or" thinking;
• The Concentration of Power, including power hoarding, paternalism, and defensiveness;
• Right to Comfort, including fear of open conflict;
• Individualism, including the myth of meritocracy and the assumption "I am the only one";
• Progress is Bigger/More, including objectivity, quantity over quality, and sense of urgency.
6.4. Many of these problematic values are prevalent in the aid world and perpetuated by donors in the Global North. One example is the powerful narrative the UK's 'Value for Money' had for all aid actors, including MSF, about measurement, quantity, and economy of resources. For future change, the Committee must reflect on how to reframe expectations for aid organisations so they can better enable values that empower those affected by racism to be heard.
7. Recommendation 2: Stop bullying. Promote psychological safety, mutual responsibility and accountability.
7.1. In the last inquiry on sexual exploitation and abuse, the Committee wrote on the importance of reporting and whistleblowing protection. These are also important for addressing racism. But whistleblowing protections generally do not extend to those who face negative consequences while trying to encourage antiracism during their daily work. Instead, many are at risk of bullying, such as described by a former MSF staff: "They're going to go after you. They will re-frame you as a troublemaker. They will say you were bad at your job. They will imply you didn't get on with people. They will deny your experience. And they will end by deeming you a liar. They are protecting a system of privilege. My suggestion is this: Control the narrative about yourself." Decolonise MSF members and those fighting for antiracism are tired of controlling their narrative just to do their job.
7.2. The Committee must acknowledge how this type of bullying culture enables many abuses, including racism, and blocks reform. It must advocate for organisational cultures that uphold accountability, mutual responsibility, and psychological safety to encourage addressing problems related to racism when they arise. Too often, antiracism recommendations focus on actions for Diversity & Inclusion or Accountability to Affected Populations teams. But ultimately, everyone in the aid system must own and act on dignity, belonging, justice and accountability—including so-called "beneficiaries", community authorities, donor and recipient governments, aid staff, and organisations. Change in the sector will not come without commitment to share power and responsibility.
8. Recommendation 3: Support allyship and accountability of the aid sector through independent press and labour unions
8.1 Certain actions by Decolonise MSF could not have succeeded without media attention. Unfortunately, few agencies are dedicated to investigating the aid sector. The New Humanitarian is one agency with full-time staff looking into these issues, but it is still under-resourced. The Committee should consider how it can support the vital role an independent press has in bringing to light ongoing injustice, verifying claims, and encouraging reform for the aid sector.
8.2. An integral part of the discussion on racism in the aid sector is connected to labour structures. Labour unions may be a practical way to ensure that all staff are heard and respected in the sector. The Committee should explore the potential of international labour unions to protect employee rights, particularly in organisations with a multinational workforce operating in countries with different and potentially unequal regulations.
Annex 1: Selected Media Coverage of Open Letter
Aizenman, N. (2020). 'Doctors Without Borders Responds To Charges Of 'Racism' From Its Staff', National Public Radio, 15 July. Available at: https://www.npr.org/sections/goatsandsoda/2020/07/15/864544382/doctors-without-borders-responds-to-charges-of-racism-from-its-staff [Accessed 9 May 2021]
McVeigh, K (2020). ‘Médecins Sans Frontières is 'institutionally racist', say 1,000 insiders’, The Guardian, 10 July. Available from: https://www.theguardian.com/global-development/2020/jul/10/medecins-sans-frontieres-institutionally-racist-medical-charity-colonialism-white-supremacy-msf [Accessed 9 May 2021]
NA (2020) 'MSF accused by staff of upholding white supremacy and colonialism', The Middle East Eye, 10 July. Available from: https://www.middleeasteye.net/news/medecins-sans-frontieres-accused-white-supremacy-colonialism [Accessed 9 May 2021]
Parker, B. (2020) ‘Médecins Sans Frontières needs ‘radical change’ on racism: MSF president’, The New Humanitarian, 24 June. Available from: https://www.thenewhumanitarian.org/news/2020/06/24/MSF-racism-black-lives-matter-debate [Accessed 9 May 2021]
Samuel, H. (2020) ‘Médecins Sans Frontières ‘institutionally racist’ say 1,000 insiders’, The Telegraph, 10 July. Available from: https://www.telegraph.co.uk/news/2020/07/10/medecins-sans-frontieres-institutionally-racist-say-1000-insiders [Accessed 9 May 2021]
Annex 2: Internal Post by Executive Director of MSF France on 17 June 2020
Reflexion on the #BLM
Published on: June 17th, 2020
Posted by Thierry Allafort-Duverger, Executive Director of MSF France
A debate has been opened at Dircom level on the position taken by the president of MSF USA about "Black lives matter". As expressed by Africa, her contribution is a mix of personal and institutional positioning. From my point of view, it is something that a president or a GD or any other member of the association can decide to do in such circumstances, a very contextual opportunity "here and now". I support this initiative. We are on what Rony Brauman calls (as he wrote during the debate around whether or not to support Julian Assange) the edges of our social mission; we need to explore regularly those edges so to occupy our territory fully. Avril, GD of MSF USA, explained that her position in this context was beyond that edge which she nevertheless thought MSF should cross. This nuance explains why it is not obvious to take a position on the question.
The terms of the debate between the directors of communication are, as I understand it, around the institutional use that the movement should make of this position. In this perspective, I don't think the points made by Africa should be transformed into an MSF institutional position or repackaged in a movement campaign. It is a respectable and edgy position, a cause to which as a citizen I am particularly sensitive, and it must be considered as such. It is not about giving up on complexity, it is not about denying that, within MSF there are real discrimination problems and that you have sometimes to take advantage of such windows of opportunity.
Those moments can also be an opportunity to critically look at how we do ourselves replicate discrimination. In that vein, we started to address the issue of glass ceilings through a policy aiming at promoting our national staff during the early 2000's which led to major progress, while leaving much to be done, still. In 2018, scandals around inappropriate sexual behaviours revealed some of our own vulnerabilities and triggered another round of MSF introspection, but it remained very much focused on the problems of abuse of power within our staff and we have done very little so far for our patients.
But all problems are not of the same nature, and are not to be treated in an undifferentiated manner by MSF, and certainly not through "feel good" institutional communications where MSF would pose as an activist in a fight in which we take no risks, in which we confront no opponent.
We chose to not address all the problems of the world, as real as they are. It's not a matter of morality or strategy, but rather a matter of labor economics: with limited resources, where do we chose to act? Participating in resolving the historical social and racial tensions shattering the American society is not at the heart of our commitment.
As legitimate and just this struggle is, I would find it inappropriate that we mobilize the entire MSF forces on it, particularly in this period of time where our energy must be turned towards the future of our teams and patients in Afghanistan or more generally towards the constraints to overcome to ensure the deployment of our aid in most of our field missions.
In this text, Thierry brings a part of his reflexion on the #BLM within our MSF Sphere. His commitment to a modern vision of humanitarian help is not new. Indeed, in 2015, while being the president of ALIMA, he interestingly described it that way: "…A Humanitarian help more International, less Western and more Local, gathering energies from all horizons, associations as well as individuals…make NGOs stronger…Together, we must pursue this humanitarian ideal so that we can treat those who need it most every day and innovate to advance humanitarian medicine."
Annex 3: Internal Post by MSF Board in Italy from 28 June 2020
MSF Board in Italy: We shouldn't use the word "racism"
Published on: June 28th, 2020
Posted by Board of Directors of MSF Italy
this message has been written by MSF Italy board: given the actual debate within MSF, we wish to bring our contribution on the topic of discrimination in MSF.
We need to highlight some premises:
In the last days, the exchange of emails within the MSF Movement, they are mentioned insufficient or too slow actions: on this we agree but, at the same time, we understand the difficulty of changing an organization complex as it has become MSF. Recently new structures and new models have been created outside Europe: WACA, East Africa Association, Camino, LatAm. Many of the partner sections have incorporated part of the medical services such as Bramu, Samu, Australia. Maybe all this is not enough, but 10 years ago these changes were not even imaginable, and now they are reality. Surely there is still a lot to do and the most important thing is to do it together. And we agree with Julia Barsch, President of MSF Brazil, that it is time to continue to act in a concrete way, and all ideas are welcome, from a constructive and proactive point of view.
Unfortunately, in many countries, including Italy, discriminatory attitudes are increasing: we believe that MSF can play an important role in the debate within society and try to change the narrative and give a point of view of an association that has offices in which more than 80 different nationalities work.
On behalf of MSF Italy we concretely propose:
Thank you very much
MSF Italy board
 Available at: http://associativehistory.msf.org/la-mancha-agreement [Accessed 9 May 2021]
 Available at: http://msf.me/beyondwords [Accessed 9 May 2021]
 Available at: http://msf.me/reflections [Accessed 9 May 2021]
 MSF's Executive Committee comprises General Directors of the five MSF Operational Centres (Amsterdam, Barcelona, Brussels, Geneva, Paris), plus two members elected from amongst the General Directors of the MSF Partner Sections, and the International Medical Secretary at MSF International.
 Available at: https://www.msf.org/msf-management-statement-racism-and-discrimination [Accessed 9 May 2021]
 Available at: https://msf.org.uk/letter-msf-operational-centre-amsterdam-management-team-concerning-institutional-racism [Accessed 9 May 2021]
 Centre for Community Organisations (2020) ‘White Supremacy Culture in Organisations’. Available at: https://docs.google.com/viewerng/viewer?url=https://coco-net.org/wp-content/uploads/2019/11/Coco-WhiteSupCulture-ENG4.pdf&hl=en_US [Accessed 9 May 2021]
 Majumdar, A. (2020) ‘Bearing witness inside MSF’, The New Humanitarian, 18 August. Available at https://www.thenewhumanitarian.org/opinion/first-person/2020/08/18/MSF-Amsterdam-aid-institutional-racism [Accessed 9 May 2021]