Doctors Without Borders:
An Exclusive Interview with Dr. Nicolas de Torrente
By Joan Baum, Ph.D.
The year 2009 marks ten years since Doctors Without Borders (DWB) / Médecins Sans Frontières (MSF) won the Nobel Prize for Peace “in recognition of the organization’s pioneering humanitarian work on several continents.” The good news is that this remarkable, independent, international NG0—founded in 1971 by doctors and journalists and now staffed also by nurses, logistics experts, administrators, epidemiologists, laboratory technicians, mental health workers -- is bringing even more quality medical care to people caught in crises, “regardless of race, religion or political affiliation,” and notwithstanding danger. The bad news, of course, is that man-made and natural disasters have escalated dramatically in the last decade due to continuing wars, new armed conflicts, natural disasters and recurring epidemics.
No one knows about the dilemmas and challenges facing DWB more than Executive Director Dr. Nicolas de Torrente, who, though stepping down this year, will continue to address related issues in his position as adjunct Associate Professor at Columbia University’s School of International and Public Affairs (SIPA). Until mid-year he will be on special assignment for DWB, researching global health activities and large donors, such as the Gates Foundation.
The Swiss-born Dr. de Torrente was graduated from the University of Geneva, has a Master’s degree from the Fletcher School of Law and Diplomacy in Boston, and a Ph.D. in International Relations from the London School of Economics. His area of expertise is “the relation between humanitarian action and political and military strategies,” which is as much to say, upholding the organization’s principles of medical ethics and impartiality and not falling into or being perceived to fall into any country’s political, military or religious agenda.
DWB is a privately funded, independent, apolitical organization, but it gets involved in areas of the world that are clearly rife with sectarianism. Dr. de Torrente appreciates the fine line. Before becoming Executive Director, he served as an administrator, then head of mission, in Tanzania and Rwanda, eventually assuming the role of emergency coordinator in Somalia, Liberia, the Democratic Republic of Congo, Macedonia and Afghanistan, and also serving shortly thereafter as advisor in Sierra Leone, Liberia and Guinea. He was fulfilling a youthful goal to try to reduce and prevent poverty. Before coming to DWB he worked on practical problems involving Somalian refugees in Kenya -- storing materials, meeting payrolls. His eight years at DWB have only confirmed his practical idealism.
Under his leadership, DWB has suffered no diminution of support. Even in trying times, Dr. de Torrente points out, people give. This past December, a month when the agency typically receives 30% of its annual funding, donations came in at $50 million. During his tenure he was able to increase the budget five times and double the staff. Over one half million people in The United States now give anywhere from $25 to million to DWB. But Dr. de Torrente also points to qualitative changes as well as quantitative ones, especially in New York, where there has been a growth in medical administration and area program teams.
Because the mission statement of DWB / MSF indicates that the organization “reserves the right to speak out to bring attention to neglected crises, to challenge inadequacies or abuse of the aid system, and to advocate for improved medical treatments and protocols,” the question arises: how can one remain neutral and not bear witness to policies and procedures that, for example, make victims of innocent children? Indeed, among all the important jobs facing DWB, addressing and preventing childhood malnutrition is central Dr. de Torrente says. Infant mortality overwhelmingly occurs in poor rural areas. At any time 20 million children suffer from malnutrition and only 7% receive “ready-to-use food” – highly successful paste supplements that were featured on “60 Minutes” a few months ago.
Of course, there are other problems facing the world community, the result of genocide, forced exile, massacre. The names of afflicted areas are iconic: Ethiopia, Sudan, Croatia, Darfur, Congo, Chad, Somalia. What can DWB really do? In the case of the paste product, train local inhabitants how to make and distribute it, Dr. de Torrente says. And how to avoid being perceived as political? Ah there’s the rub, though Gaza might be a timely example. Just days after the situation exploded, DWB moved in to do what it could in areas not cut off by the fighting. That meant concentrating humanitarian activities in Shifa Hospital in Gaza City. Prioritize, act: there are no borders in the human heart.#
