This book is the result of the meeting between humanitarian field actors and legal practitioners from the Law Faculty at Paris 8 University. Physicians, journalists, lawyers, politicians and soldiers met at this university, which has the reputation of being very “avant-garde”, in order to debate the concept of access to victims, here and abroad. Their original goal was to contribute to the development of key points begun by French and international medical NGOs. These new rights, recognised over the course of several years, enabled the transition from the right to intervene to the right of access to victims (1988), ultimately resulting in the United Nations’ Responsibility to Protect (2005). Nevertheless, this international humanitarian law must continue to evolve in order to become more efficient. NGOs are largely responsible for this evolution.
Translated from the French by Juliet Powys
Universal health coverage by 2030 for every human being, from the West to the Global South? Achieving this sustainable development goal, which is as ambitious as it is necessary, will require exceptional political will, but also solid and convincing data on how to accomplish it, especially in terms of the most effective global health interventions. Proper evaluation of these interventions is therefore a key challenge. It will not be enough to simply measure their efficiency: we need to understand why they work (or don’t), how, and in what conditions. This collective publication, which brings together contributions from 39 authors from different countries and disciplines, aims to present a clear, accessible, French-language compendium of approaches and advanced evaluation methods for interventions (qualitative, quantitative, and mixed), in order to study the evaluability, durability, processes, fidelity, efficiency, fairness and effectiveness of complex interventions. Each method is presented in a chapter by means of a real-life case study in order to facilitate the transmission of this precious knowledge.
The book is available to read at the following address: https://scienceetbiencommun.pressbooks.pub/evalsantemondiale
Translated from the French by Juliet Powys
Unsung Heroes is a joint endeavour undertaken by Denis Rouvre and Médecins du Monde. This photography project “arose from the desire shared with Médecins du Monde to bear witness to the violence in the world as experienced by women” as the photographer said. “For eight months in nine countries worldwide, over one hundred women put their trust in me and accepted my presence behind the microphone, behind the lens. Despite the language barrier, cultural codes, and personal trials, these women have told their story. They have broken the silence with courage and sincerity. With tears, too, a harrowing emotion. All of them posed openly and mindfully, prepared and supported by the NGO. You are not the same after these kinds of encounters. The direct and tangible reality far exceeded the idea in my head. It was a real shock, from the very first portraits in Bulgaria. Meeting women from the Roma community doomed to marry and have children when they are teenagers in the filthy surroundings of a ghetto. Violence and extreme poverty. Moral violence, experienced by displaced Syrian and Palestinian women. Sexual violence carried out on women in the Congo and Colombia. Domestic violence, gang rapes, brutality. Not excluding our European capitals, where women who are abused, exploited, and facing precarity come up against rejection and hate. For thirty years, I have photographed many women who are putting on a front. They are looking for a controlled, smooth image from me that goes without a hitch. Here, with the unsung heroes I met, shadows are coming into the light. Bruises and cracks on the surface of the skin, in the hollows of the eyes. The voices, words, and authentic tone of the personal experience of violence are being expressed. Recounting the specific suffering experienced by women. As well as the strength of being a woman. The ability to pick yourself up and keep on fighting.”
This project brings together some 60 portraits and testimonies of women, an excerpt of which we are presenting here. The project is also available in a book, “Unsung Heroes, Breaking the silence”, published by Editions Textuel in November 2019. It was also presented as an itinerant exhibition first in Paris and then in Bordeaux. Unsung Heroes will be exhibited in Belgium during the Mechelen Exposition at the Kazerne Dossin, from March 5th to May 17th 2020.
Someone came to me to tell me that my son Ahmad had been injured. I thought it was nothing serious, because Ahmad had quite often been injured in the past. Once he had a serious injury on the knee, another time, on the head, once he got a rubber bullet in the leg… So, this time, I did not believe it was serious. There was a wedding at the village on that day. Ahmad was going, he had washed up and got dressed up. The party was starting at 10:00 AM. But people told me that he only got to the checkpoint and that’s where he was injured.
We all decided to go see the checkpoint. We waited for up to three hours for the Israelis to come, open the checkpoint and let us pass. Then, we went to the hospital, and we saw him coming out of the operating room. He was there for one week afterwards. He was unrecognizable because of the swelling in his face. He was exhausted. Unrecognizable. I knew he would not make it. After one week, on Thursday, I was worried, so I went to the hospital. Doctors told me I could not go in. I told them: “No! I want to see him!”. They responded: “If you go and see him, promise you’ll leave afterwards?”
I promised. I got into the room. I saw that they had unplugged the machines. They had closed his eyes with adhesive tape. Because of the light? They told me yes, it was so. They did not tell me he was dead. I got out and sat on top of the stairs, without feeling anything unusual. A few seconds later, my nephew, who works as a nurse in this hospital came to see me. He was crying. He told me: “Oh my auntie, God gives life and takes it back. Ahmad left us”. Then, I collapsed. I cried and screamed so much that the hospital shook.
It has been three years since I set foot in a party, even for the weddings of my loved ones. My niece got married, and even then, I did not have the heart to go there. I cannot see newlyweds anymore; I just can’t do it. It is too much of a loss. Losing your mother, your father or brother, it’s all right, but your son…
Attacks by settlers and the Israeli army, expropriation, destruction of crops and forced displacement are having
a serious impact on the lives and health of the Palestinian people.
I was at home. It was market day. I told my husband I was going to get some detergent. He told me to be quick. I stopped by my mom who sells vegetables at the bazaar and I helped her for a bit. A disabled person showed up, so I helped her too, before going to get a snack with my little sister. Then, we headed home. On the road, someone attacked me from behind and threw acid on my head. My little sister got some on her cheeks too. I got stabbed, got kicked in the head and elsewhere. I collapsed and lost consciousness.
Since then, fear never leaves me, only dreams allow me to escape. I am always scared. What haunts me is that my kids’future is ruined. Before, I was not afraid of anything, I was coming and going, I was talking easily to everyone. If I had been more educated, maybe I would have understood, and it would not have happened.
It is necessary to inform young girls. They must be frightened; they need to be wary of boys. Married women too. We think that once married, everything will be fine, that we will be respected, but we are never safe. But it is complicated, women at the village don’t understand much. We would need a place in the village where we could explain all that. We would also need a home where we would take care of the women who have been harmed forever and explain to people that physical beauty is not everything, that inner beauty is equally important.
Basanti, 29 years old, Nepalese.
Basanti has been acid burnt by her husband’s friend who
harassed her and whom she kept refusing the advances.
I realized I was different at the age of 14 years old. I knew it, but I did not have anybody to talk to, until I started to get on well with a girl from school. We became friends. I did not know how to tell her what I was feeling. One day, while my mom was out, we saw a scene in a romantic movie on TV where two girls were kissing each other. We kissed too.
In Cameroon, there is a law forbidding people from the same sex to have a relationship. Our relationship was our secret, we did not talk about it in public, we never held hands in public. People thought we were best friends. We kept the secret until my eighteenth birthday.
We were coming back from the university. My mother was away. We went to a restaurant and after that, we decided to go to my house. We thought we were safe there. Suddenly, we heard loud knocks on the door. It was the police. I don’t know who told them. Maybe the neighbours. We got followed, a policewoman had been observing us for a few days.
The police arrested us. While we were being dragged to the closest police station, really near to our house, the neighbours got out and threw rocks at us, cursing at us. “We knew it, witches, do not come back, they must be cured”. They were saying they would strip us in public. There was no one we could tell what was happening. We got put into different cells.
We were tortured. Me, at least. I do not know what she was subjected to. I never saw her again. They did everything they could so that we would not see each other again. It was worse for me, because I think her parents and brother were a little empathetic to her situation. They could defend her and take care of her. There was no one to come get me. I stayed there for one month. It was terrible.
They tortured me, they forced me to do things that I had never done before. I don’t know how to say it. I don’t want to talk about it. I was still a virgin at the time, I had never been out with a man. I stayed there and the men would enter one at a time. They would tell me: “I am going to give you a lesson. I think you will like it because you have never had an experience with a man. When you will leave this cell, you will not want to be with a woman ever again.”
Dorine, 26 years old, Cameroonian.
At the university, I was being hit on by boys. I was trying to be normal, to hide, to dress like the other girls… I tried to go out with boys or to respond to their advances, but I could not do it. I was afraid of people, of the police. There were rumours that I was gay. There was this boy whose advances I had been refusing for a long time. We were in the same class. He raped me. He had heard the rumours and called that a “sexual correction”.
He threatened to tell on me, to call the police…Finally, I told on him. But when I explained to my father that I had been raped because I was gay, he did not take me seriously. For him, it was better to have been raped than being gay. Upon my uncle’s advices, he took me to see some sort of a healer. I was scared. This healer got me completely undressed. He took leaves that he had soaked and hit me while talking in a language I did not understand. It was supposed to “correct” me.
My coming out, the rape, the imprisonment, that was the worst time of my life. I was scared, I did not know what to do. Three or four months later, I found out I was pregnant. I wanted to get an abortion. It is weird to say that because today, I love my son. But they did not let me do it. They thought that maybe it would cure me. My father tried to get in touch with his family. Not to tell on him or to tell his family what he had done to me, but to talk, to tell them he got me pregnant and ask them if he would marry me…
We cannot live in hiding all of our life. When you are gay, you get humiliated, people talk behind your back, you are afraid of going out when people know. Where I come from, homosexuality is punishable by imprisonment. We see it like that, like something evil, some kind of possession.
Right now, in Kenya, we are trying to abrogate the article from the Penal Code that criminalizes homosexuality. I am not part of the group that is working on this abrogation, but I am in touch with two of them from London. They have been fighting this for years and years.
Diana, 28 years old, Kenyan.
Dorine and Diana have both fled their home
countries where homosexuality is criminalised.
It was June. It was 8 PM. It was dark outside. We were at home. Some Raia Mtomboki arrived and entered. They grabbed my husband, they stabbed him in the neck and killed him. Then, they grabbed me and told me that they were going to kill me too, in front of my three kids: two boys and one girl. But they took me and raped me in the forest. Many died, they burnt down many houses, and little kids, adults and old people were killed, but me, they raped me.
I am at eight months… eight months ago they did that to me. When I think about it, I get overwhelmed by sadness. This child, I am going to look after him, like I take care of the other ones, and I am going to raise him well, because I am alive, thanks to God. I cannot discriminate against him, or treat him differently than the others, he is himself a child. But later, when he is going to ask me who his father is, when he will be the age of reason? How am I going to answer him?
I cannot go back to my husband’s village. Over there, they will first say that I am a Raia Mtomboki woman. Then, they will say I cannot carry a child if I don’t know about his family. I don’t think about getting remarried, or about being with a man, or being in a relationship. I only think about taking care of my children. That’s all I can think about.
Élysée has been taken in and cared for by the hospital
of Panzi where Dr Mukwege repairs women.
I come from an honourable family. I wanted to have a decent life. A woman who is biologically born a woman doesn’t give that much importance to her identity as a woman, but it’s very important to me. Because I suffered a lot to become a woman.
I had to beg on the streets, I took drugs, I became a sex worker, then a dancer in a bar, that kind of thing. I saved the money to have an operation. I got informed. I saw doctors, an endocrinologist, a psychologist. I took medical certificates and went to see the plastic surgeon. To have a perfect body.
After my operation, I resumed my studies, I obtained my social work diploma and I began to look for work in the private sector. During the interviews, they always asked me questions about my gender, they asked to see me naked. I would answer, “My work will be perfect, my body has nothing to do with it, my mind is there for you.” But they always wanted to see my body, to know whether I had a penis or a vagina. It was very embarrassing, I felt ill at ease.
I understood that education was the most powerful weapon to change my world. From that day on, I began to work on behalf of trans people, because lots of young trans people have the same experience as me. I don’t want anyone to experience what I went through. I now work for the Humsafar Trust. It’s the oldest LGBTI organization in Asia-Pacific. I support lots of new-generation trans women. I conducted an awareness-raising program in the private, school and public sectors. They began to understand.
In India, our identity was recognized by a court ruling in 2014.
My friends said to me, “You can’t have children.” I replied that lots of women on earth can’t have children. I’m a real woman, like you, because I respect my body in its femininity, I respect it in its entirety. I’m a woman without an uterus, but that’s OK. Perhaps I’ll be reborn like that, in a woman’s body. My dream was to become a doctor, but I’ve not fulfilled it. That’s why I want to do a PhD. Because after my PhD, they can call me Dr Shreya Reddy.
Shreya, 30 years old, India.
Shreya works for the oldest LGBTI rights organization
in the Asia-Pacific region.
Fighting for women’s right to decide for themselves
Médecins du Mondeacts and campaigns for the right of women to freely control/decide their bodies and to make free and informed decisions about their sexuality, health and life. Whether in the Democratic Republic of Congo, Haiti, Madagascar, Côte d’Ivoire, Uganda, Palestine or Bulgaria, Médecins du Monde works with communities, civil society actors and public institutions to improve the availability and quality of healthcare services, particularly in sexual and reproductive health.
The association supports people in knowing their rights, strengthens their capacity to act and challenges decision-makers to confront their shortcomings and responsibilities. Médecins du Monde is particularly in favour of access to healthcare for safe abortion and is fighting to repeal the laws that provide for punitive measures against women and girls or healthcare workers in the event of pregnancy termination.
Testimonies edited by Thomas Flamerion
– Editorial Manager, Médecins du Monde France
Translated from the French by Médecins du Monde
Fabrice Weissman • Centre de réflexion sur l’action et les savoirs humanitaires (CRASH/MSF)
Our issue on climate change has clearly fuelled the debate within the Médecins Sans Frontières movement. Following an article co-written by members of the Swiss and Canadian sections, Fabrice Weissman presents a critical analysis of the arguments put forward by his colleagues. An analysis that could be useful to the entire movement, and to the humanitarian community as a whole. Read the article
Valéry Ridde • Centre Population et Développement, IRD, France
Solange Dabiré • AGIR, Burkina Faso
Christian Dagenais • Université de Montréal, Canada
The authors stress the importance of taking research findings into account for NGO interventions, and identify the technical and political challenges this presents. They put forward several approaches favorable to taking research into account, while explaining that knowledge and initiatives are still lacking in this area. This article provides a brief outline of the current state of affairs and puts forward the idea of an issue of Humanitarian Alternatives with a focus on knowledge transfer by NGOs, to be published in 2021. Read the article
Amador Gomez, Pascal Revault, Pawankumar Patil • Action contre la Faim
Many NGOs have already responded to the requirement of linking action and research. For instance, since 2016, Action Against Hunger has been holding a conference to take stock of these mutual insights and advances in malnutrition. Here, the three authors summarise the latest event held last November. Read the article
Karine Meaux et Haryanti Sunarta • Fondation de France
Chaerul Umam • Bina Desa
Patrick Verbruggen • Triangle Génération Humanitaire
At a time when local actors’ capacities are progressively gaining recognition in the field of international aid(1)The Grand Bargain’s second commitment, established in the wake of the World Humanitarian Summit in Istanbul in 2016, pledged “More support and funding tools for local and national responders”. Coordination Sud, Localisation de l’aide. Plus de proximité permet-il d’assurer une meilleure autonomie des projets ?, novembre 2019., what lessons has the Fondation de France drawn from its twenty years of experience in giving priority to these local actors ? In this article, we provide a comparative analysis of two recent experiences, from Nepal and Indonesia, in order to better understand current trends and meet the challenges that they represent.
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|1.||￪||The Grand Bargain’s second commitment, established in the wake of the World Humanitarian Summit in Istanbul in 2016, pledged “More support and funding tools for local and national responders”. Coordination Sud, Localisation de l’aide. Plus de proximité permet-il d’assurer une meilleure autonomie des projets ?, novembre 2019.|
Étienne Baudon • Action contre la Faim
It seemed fitting to us to give voice to a young employee of an NGO when we developed the theme of “generational changes”. It is an effective way to get to know and better understand how members of the younger generation have come to characterise humanitarian aid, and to identify the points they share and do not share with their elders – and to reflect on what the all generations can create together. Read the article
Éric Gazeau • Directeur général de Résonances Humanitaires
Founded in 2002 to assist former international aid workers with their social and professional reintegration, Résonances Humanitaires has become a valuable observatory over the years. In this article, its co-founder, Eric Gazeau, shares his vision and analysis of the changing profiles of successive generations of humanitarian personnel and the evolution in their humanitarian commitments. Read the article