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"MSF is what we make of it"

Peter Firmenich - Member of the Board of Directors of MSF Luxembourg
Peter Firmenich travelled to Conakry and Kindia, in Guinea, as a Board member for MSF Luxembourg. He shares his experience.

    What projects is MSF working on in Guinea?

    In Guinea, MSF is promoting better access to medical services and the development of innovative care models adapted to the health system, which had deteriorated after the Ebola epidemic in 2014-2016.

    In collaboration with the Ministry of Health, MSF is currently supporting 11,000 people living with HIV in Matam, an area of Conakry. The project offers services to detect, treat and monitor HIV, as well as wellness activities in six health centres around the capital city of Conakry. Since December 2016, MSF has been supporting a 31-bed clinic at Donka Hospital which cares for hospitalised patients.

    In 2017 MSF also launched a new initiative in Kouroussa, in north-east Guinea, where malaria is highly endemic and the leading cause of death.

    Can you tell us about the event you participated in while you were there ?

    To understand it, you need to hear the story from the beginning. Médecins Sans Frontières (MSF) is an international association that is strongly influenced by its members (current and former employees) through a culture of questioning and discussion. Members meet once a year at the general assembly to talk about the overall directions the organisation should take and to elect its board members, whose role is to meet the objectives defined by the association.

    The reason for my trip was to attend one of these general assemblies, known as a FAD (Field Associative Debate). The purpose of these debates, which are organised by our missions, is to give a voice to the people who are the working at the heart of the MSF projects.

    What is the impact of these FADs on the field ?

    FADs are exceptional opportunities to have discussions and share ideas. They give the mission's employees and members a chance to talk and participate in decision making, instigating the changes that will move projects forward. So the FADs are a real source of motivation and commitment at MSF. If a problem arises that is related to an international decision, then a motion or recommendation can be drafted and presented at the international level or the Luxembourg level.

    FADs are tangible proof that being a member affords the opportunity to play a role in deciding on the organisation's operations, identity and strategy. MSF is what we make of it.

    What was your role as a Board member?

    My role was to connect the people on the field with our association based in Luxembourg, to amplify the voice of the members of the Guinea mission. This connection is very important to sustaining our actions and services. The people I met in the field have in-depth knowledge about their project and their work. The MSF movement will evolve fairly and constructively only if we listen to them and promote their interests in the general assemblies.

    Which topics were addressed during the Guinea FAD?

    Three main subjects were chosen for discussion at the FAD in Guinea.

    The first topic was antibiotic resistance which is a real challenge not just in Guinea, but around the world! Controlling the rise in resistance is a pressing concern. As an international medical and humanitarian organisation, MSF must lead by example in this matter, but the stakes are very high and actions are required over the long term. The solutions mentioned during the Guinea event essentially involved the reasonable, cautious prescription of antibiotics, the elimination of counterfeit medicines, and prevention through stricter hygiene practices.

    The second topic was sexual violence in Guinea. As part of the HIV project in Matam, the MSF teams also provide care to victims of sexual violence who are referred to them by the Ministry of Health, which is the only authority invested with the power to legally declare cases of sexual assault. The ministry refers cases to Matam for the HIV aspect because the clinic has the appropriate skills and resources to handle them.

    This debate proves that FADs can have practical impacts.

    This means MSF is assisting with this issue, though it does not specifically promote the service in the community. During the discussion, the question was whether to expand the initiative by adding an awareness component for the neighbourhood. This debate proves that FADs can have practical impacts because, after the exchanges, it was decided that a potential project expansion would be discussed again and carried out by a team of volunteers.

    The final topic was the principle of inclusion in the MSF movement and in Guinea. The subject is both very broad and very sensitive. In Guinea, many expatriates from the Democratic Republic of Congo, Mali, Burundi, Norway and France work hand in hand with locals to serve the mission. The cultural differences can sometimes be a source of frustration, misunderstanding and even conflict. However, they form the foundation of our operations because they enable us to have intimate knowledge of different contexts and strengthen our independence. Mutual respect is essential to the ongoing development of MSF and therefore it is an important topics to address.

    What was the most memorable moment from the two days of exchanges?

    During a discussion, a person stood up and said that she was an Ebola survivor. It is true that Guinea was deeply affected by the devastating epidemic between 2014 and 2016 and one often forgets the traces left behind by such events. That person, who continues to work for MSF, really moved me: for some people commitment knows no bounds.

    Header photo: Discussion on antibiotic resistance at the FAD in Guinea, February 2018. © MSF