Canadian doctor Joanne Liu held the position from 2013 to 2019 through tumultuous times for the organization Médecins Sans Frontières (MSF), including the West Africa Ebola epidemic, a wave of attacks on health facilities in conflict zones, and what became known – in Europe at least – as a migration “crisis”.
MSF is not a single organization: Several large NGOs operate under a loose umbrella structure. As international president, based in Geneva, Liu was elected by a general assembly representing MSF’s branches around the world. The president does not have executive control across the whole MSF family but acts as an external representative and “deal-broker”.
Liu talked with The New Humanitarian by phone from London a few days after her successor, MSF fieldworker and surgeon Christos Christou, took over. Highlights from the interview follow:
TNH: In an internal report in June you gave a diagnosis of some of the illnesses you think MSF faces. ‘Humanitarian diva’ was number one. Tell me about that.
Joanne Liu: I really do think that we have all passed this era where an international organization will come into a country and say, ‘it is my way, otherwise, it’s no way’. That [era] is over. … At the end of the day, we are a guest wherever we are.
TNH: MSF used to be an ‘enfant terrible’, but now it’s middle-aged – how is the organization?
Liu: We started from a few people who were volunteering – you were initially having to pay for your ticket to go to the field. … [Now] it’s massive. When you start to manage an organization of that size, then you have to put in place some systems and some structure. … We need to make sure that the core social mission of MSF, which is bringing assistance to people in crisis, remains the priority focus [is] not being overtaken by the survival of the institution and headquarters. So that is tricky. It is difficult right now to find the right balance because we basically have outgrown all of our systems and processes.
TNH: You’ve talked about ‘selective humanitarianism’. What can MSF do and what can’t it do?
Liu: We are tolerated when it fits the agenda, we are obstructed when it doesn’t. I know that we are not fixing the root cause of what’s going on in Libya, but if we were not in the Libya [detention] centers, and if we weren’t able to tell what is going on and then share the stories of people we care for, it would be off the radar: nobody would talk about it. It’s to humanize crisis. … We have to tell the story of a mother and father and a child who were looking for a better future. And I think we have a key role. We never realized the blessing of our financial Independence as much as today, because people come to us and tell us, ‘if MSF doesn’t say it, nobody’s going to say it’.
TNH: When MSF is at the top table, briefing the Security Council or invited to international summits, do you feel uncomfortable about being part of the establishment?
Liu: Every time that we’ve been at those, it’s been an internal debate. If you go there and [don’t] challenge the establishment in a strong way, then you should not go there.
TNH: Looking back: highlights and lowlights?
Liu: The 20th century was, after World War II, somehow the humanitarian century. The 21st century for me is a century of fear. Everything today is seen through the lens of security. … We get our hospitals looted over and over again, in South Sudan, or in Central African Republic, massively. What is striking about Kunduz* is the fact that it was a repeated attack: five airstrikes over a little bit more than an hour. We somehow still believed in immunity in the hospital, and then our staff believed that it was a safe place. We told them it was a safe place.
TNH: Will you miss your job?
Liu: I will certainly miss it. It’s been it’s been an immense, immense privilege… because we faced some of our biggest challenges over the last few decades. It’s such a privilege to be at the center of those crises and, having the confidence of the movement, to go and speak on their behalf and try to basically move lines on things and try to advance.
*On 3 October 2015, a United States Air Force AC-130U gunship attacked the Kunduz Trauma Centre operated by Médecins Sans Frontières (MSF) in the city of Kunduz, in northern Afghanistan. It has been reported that at least 42 people were killed and over 30 were injured.