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Fighting against all illnesses - even injustice.

Médecins du Monde (Doctors of the World) is an international medical organization founded in 1980 by Bernard Kouchner and a group of doctors who had been part of Médecins Sans Frontières. MdM broke away from the larger organization on acrimonious terms in the late 1970s due to a disagreement about helping Vietnamese boat people. While MSF went on to win the Nobel Peace Prize in 1999, MdM is relatively unknown, despite its good work all over the world.

Prehistory of Médecins du Monde

Kouchner was born in 1939 in Avignon to a Jewish father and a Protestant mother. When the Nazis came, his family fled Paris, only to return when they could find nowhere to live. His grandparents were sent to Auschwitz and gassed. Although he is obviously unable to remember these early years, they left an indelible mark on him. At age fourteen he joined the French Communist Party, a thing that was not unusual to do at a time when the Party had huge support in France. He participated as a teenager in street battles against right-wingers and anarchists when Soviet troops rolled into Hungary in 1956. He was, for a while, Communist through and through.

But by the time Kouchner came to found MSF in 1971, his views had changed hugely. Having been involved in the student movement in Paris in 1968, and having visited Cuba, Kouchner's views began to change. At a time when his friends in the student movement were starting to form terrorist groups in Europe, or going to Latin America to engage in the revolutionary struggle there, Kouchner had different ideas. By now a doctor, he set about applying the spirit of 1968 to his own field.

Kouchner spent the last two years of the 1960s in Biafra in Nigeria with the Red Cross. In Kouchner's estimation, there was a genocide going on in Biafra, co-ordinated by the Nigeran government: a situation not too different to our own problem in Darfur today. He and his team provided medical help, and then returned to Paris. When he got back, he was highly frustrated by Red Cross policy that its agents never pass judgement on a situation they had been in. They were not supposed to ascribe blame, or describe what they had seen: they were supposed to do nothing.

This angered Kouchner, and so he rushed to press with what he had seen in Biafra. Then, he rushed to form his own small organization that would do exactly the opposite. He conceived a humanitarian organization that would be composed of people with the spirit of 1968 - willing to risk death in dangerous places to help others, but through providing medical aid and not through revolutionary struggle. The organization would not be afraid to speak out against atrocities, expose the criminals behind them, and bring the pressure of the international community to bear on the perpetrators. He considered such activity much more worthwhile than trying to help Marxist guerrilla movements, who in his opinion ended up causing more destruction than anything. MSF was born.

MdM is born

The first few missions of MSF were apolitical, taking the form of disaster relief efforts. It went to the aid of victims of an earthquake in Nicaragua and a hurricane in Honduras. In 1975, they went to the Thai border to help refugees who were fleeing the genocidal Khmer Rouge regime in Cambodia. Few in the West believed the atrocity stories coming from within Cambodia. The left didn't want to admit their precious "agrarian reformers" were capable of such things, and the right didn't want to think about the moral implications of not intervening. However, MSF were there, with the horror before their eyes and humanitarian packs on their backs. They remained there four years later when the Khmero-Vietnamese war drove yet more refugees over the border.

Yet in that same year, MSF was torn apart. In 1979, the Vietnamese Communists had embarked on a new program of repression, as well as starting a war with the Khmer Rouge.1 Refugees duly poured in poorly-constructed boats into the South China Sea. Kouchner, founder of MSF, wanted to set off in a French boat, the Isle of Light, and pick up some of the refugees so they could be taken to a safe country. Simple enough, and one would have thought, uncontroversial enough. But this was not so.

It must be remember that this was only a few years after the Vietnam War had ended, and most on the left (and MSF was made up of those on the left) saw the Vietnamese regime as something great. It was a new vanguard of socialism in the world, a finger in the eye to the American imperialists. To help those who were enemies of this regime was no humanitarianism at all, they said. It was short-sighted. The only real humanitarianism was to support the enemies of Western imperialism, and declare solidarity with the Communist movements of Asia.

This was all compounded by Kouchner's legendary capacity for self-promotion, which led to numerous clashes within the organization. Many people saw the boat expedition as an attempt by him to boost his popularity, a motive hardly likely to gain him much sympathy. And so, Kouchner went off and did it anyway, without MSF. And then, a year later, about one fifth of MSF broke off and formed Médecins du Monde.

Médecins du Monde was based on the idea that the humanitarian organization had a right to "intervene" (note the quasi-military language) anywhere. They formally announced this doctrine in 1987 as "le droit d'ingérence". The organization proclaimed its goal was to "make health a human right". And human rights, unlike civil rights, know no borders: hence Médecins du Monde claims the right (Kouchner calls it a "duty") to intervene anywhere people are suffering, regardless of the existence of a sovereign nation state or the ideology of that state.

Since the creation

I'd like to add a note on the Vietnamese boat people, and what subsequently happened to Bernard Kouchner. Kouchner went on to occupy places in the French government, and went on to be the U.N. administrator in Kosovo. Interestingly, this former Communist went on to support the U.S. war against Iraq in 2003.

The Isle of Light managed to help some Vietnamese refugees, which was all well and good. But then, President Carter decided to send the Sixth Fleet of the U.S. Navy to perform the same task. Naturally, this Fleet was able to get substantially more done than one boat. To Kouchner, it became obvious that enlisting power in the support of humanitarian intervention was the only way of really getting things done. Hence, he was the natural choice for U.N. administrator in Kosovo. While there, he went around saying things like "The fascists must be beaten" - an odd thing to say in the former Yugoslavia, you might think. But really not so odd at all, if you consider the similarities between the Nazis and Milesovic's regime. Similarities that also extended to the Iraqi Ba'ath. Here was a man who represented liberal anti-totalitarianism, and hence his support for the war on Iraq. He soon, however, became disillusioned with the United States' poor handling of the post-war situation.

Kouchner ceased to be director of MdM in 1982, but the organization went on. In 2003, it had a global budget of 436 million Euros and delegations in twelve countries. Its primary mission to provide healthcare wherever it is needed, but also to vigorously report situations where healthcare is denied along with other basic human rights. It continues to respond to all crises, be they disasters or man-made.

Kouchner and Médecins du Monde have much to teach us. In a world of increasing dogmatism, their outlook on the world allows them to do the maximum amount of good, even more so than the apolitical Red Cross. For the Red Cross can never tackle the root causes of problems, despite the huge amount of good humanitarian work it does. While it can be argued that MdM's strategy of condemnation makes it likely to be ejected from nations, it is vital that organizations exist which continue to denounce and publicize human rights abuses on the globe.

Secondly, we can learn something from Kouchner himself. Kouchner realized that the extreme left is just as inclined toward totalitarianism as the extreme right, and soon abandoned his romance with Che Guevara and Third World revolutionaries. The organizations he went on to create oppose state power brutally wielded in all its forms, without excusing a country because of its ideology. This seems to me the standpoint that everyone in Western nations, the liberals, the conservatives, and the government - oh, especially the governments - should go on to adopt. This will lead to true progress. Idealistic, yes, but maybe, 37 years after 1968, we need a touch more idealism in our societies.

1. A war, however, that we can hardly be sorry was fought. Interestingly, as well as hoping to stop the pesky meddling of the Khmer Rouge in Vietnam, the Vietnamese also hoped they would get credit from the West for overthrowing the vicious regime. The Americans, demonstrating the way common sense and humanity can take a back seat when local conditions are not sufficiently understood (and possibly demonstrating a touch of hatred at their former enemy), continued to support the Khmer Rouge for years afterwards.


The interpretation of Kouchner and the political outlook of MdM is explicated in Paul Berman, Power and the Idealists: Or, the Passion of Joschka Fischer and Its Aftermath (Brooklyn, N.Y.: 2005).

On Cambodia, see Samantha Power, "A Problem From Hell": America and the Age of Genocide (Perenniel, 2002)

"LIFESAVER HERO: BERNARD KOUCHNER", http://myhero.com/myhero/hero.asp?hero=kouchner_fredericksburg_04

Médecins du Monde UK, http://www.medecinsdumonde.org.uk/

Läkare i Världen (MdM Sweden), http://www.lakareivarlden.org/sidor/om_liv_en.htm

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