Editing Médecins Sans Frontières (section)

==Ethical concerns and criticism==
{{See also|Sexual exploitation and abuse in humanitarian response|Structural racism|Development porn}}
Questions about the ethical treatment of MSF staff, clients and communities by MSF as a result of some of its policies and practices have arisen, with issues being canvassed by employees, others in the development sector, and the media.<ref name="new human"/>

MSF has maintained separate employment conditions and pay for its "national staff" (those employed locally for field missions) and its "international staff" (those deployed from regional or national units to field missions in other countries). The international staff tend to hold the senior posts on a mission, with the national staff most often reporting to the senior staff who have come from elsewhere. There are ongoing complaints from national staff that they are treated less favourably, employed on more dangerous tasks, paid considerably less, and are without access to benefits of housing, health care, and other advantages afforded incoming expatriate staff. MSF stated in 2020 that this policy would be reviewed with the intent to eliminate differential treatment. These practices, amongst other concerns, were the catalyst for a 2020 statement by 1,000 of its current and former employees outlining their concerns regarding the organisation's perceived structural racism. Included in the collective staff statement was testimony of personal experiences of racism within MSF, both in the form of adverse treatment in the workplace, and what is perceived as a white supremacist and colonial mindset expressed in the formation and implementation of programmes.<ref name="new human">{{Cite web |date=2020-06-24 |title=Feelings running high at 'Eurocentric' MSF |url=https://www.thenewhumanitarian.org/news/2020/06/24/MSF-racism-black-lives-matter-debate |access-date=2022-12-11 |website=The New Humanitarian}}</ref><ref>{{Cite news |last1= Campbell |first1=Sean |last2=Kardas-Nelson |first2=Mara |title=Doctors Without Borders saves lives every day. Some insiders say it is also a racist workplace where nonwhite workers get worse pay, less security, and inferior medical care |url=https://www.businessinsider.com/doctors-without-borders-faces-with-allegations-of-racism-and-segregation-2021-9 |access-date=2022-12-12 |work=[[Business Insider]]|archive-date=5 December 2022 |archive-url=https://web.archive.org/web/20221205172623/https://www.businessinsider.com/doctors-without-borders-faces-with-allegations-of-racism-and-segregation-2021-9 }}</ref><ref>{{Cite news|last=McVeigh |first=Karen |date=2020-07-10 |title=Médecins Sans Frontières is 'institutionally racist', say 1,000 insiders |url=https://www.theguardian.com/global-development/2020/jul/10/medecins-sans-frontieres-institutionally-racist-medical-charity-colonialism-white-supremacy-msf |access-date=2022-12-11 |work=[[The Guardian]]}}</ref>

While MSF hires ninety percent of its staff for missions "in-country", the organisation continues to have a preponderance of Europeans in its higher management. Despite the percentage of its international programme coordinators originating from the [[Global South]] rising from 24 percent to 46 percent over the decade 2012−2022, the international president Christos Christou acknowledged that the highest echelons of MSF were still dominated by those from the Global North. With its headquarters and five operational units located in western Europe, MSF's policies and operations were characterised in the 2020 MSF-staff statement as "Eurocentric".<ref name="new human"/>

In 2018, there were revelations of [[sexual misconduct]] by MSF employees, including sexual harassment and abuse of patients, local community members or other MSF staff. Nineteen people were fired as a result of MSF's investigations of complaints. The complaints ranged from sexual harassment by MSF colleagues; exploitation of local (and possibly underage or solely "[[survival sex]]") sex workers by field staff, against MSF policy; and disparaging attitudes and remarks from staff regarding the supposed sexual availability of patients or community members, or an expressed intent to barter medical treatment for sex. Nearly all the resulting dismissals related to inter-staff sexual misconduct.<ref>{{Cite journal |last=Arie |first=Sophie |date=2018-06-25 |title=Médecins Sans Frontières is focus of new sex scandal in charity sector |url=https://www.bmj.com/content/361/bmj.k2788 |journal=The BMJ|volume=361 |pages=k2788 |doi=10.1136/bmj.k2788 |issn=0959-8138 |pmid=29941460|s2cid=49407281 }}</ref><ref>{{Cite news |title=MSF dealt with 24 cases of sex abuse in 2017 |date=14 February 2018 |url=https://www.dw.com/en/medecins-sans-frontieres-fired-19-people-for-sexual-abuse-in-2017/a-42592652 |access-date=2022-12-11 |work=DW News|publisher=Deutsche Welle}}</ref><ref>{{Cite news |date=2018-02-14 |title=Doctors Without Borders fired 19 people for sexual abuse last year|work=[[Reuters]]|url=https://www.reuters.com/article/us-britain-oxfam-msf-idUSKCN1FY2QC |access-date=2022-12-11}}</ref><ref>{{Cite news|first=Anna |last=Adams |date=2018-06-20 |title=Medecins Sans Frontieres staff 'used local prostitutes'|publisher=[[BBC News]] |url=https://www.bbc.com/news/world-africa-44523086 |access-date=2022-12-11}}</ref><ref>{{Cite web |title=MSF apologises after BBC reports 'widespread' sexual misconduct issues |url=https://www.civilsociety.co.uk/news/msf-apologises-after-bbc-reports-widespread-sexual-misconduct-issues.html |access-date=2022-12-11 |website=civilsociety.co.uk}}</ref>

Another controversy involved images taken without informed consent of vulnerable patients, some of whom were minors without adult guardians. Some images were criticised as exploitative and objectifying. They included a photograph of a mother mourning the death of her baby, with the boy's body visible; child rape survivors and sexual and domestic abuse survivors, with details of their experiences included. Intended to increase awareness of dire conditions prevailing in places where MSF works and the need for their programmes, the images were used on MSF and community websites and in print publications. Licensing of the images were available for sale to image databases. The ethics of exposing devastated or victimised individuals, sometimes with partially identifying information was questioned. Following the criticism, MSF decided to cease use of the images. The removal of the images was in turn also criticised.<ref>{{Cite news|last=Batty |first=David |date=2022-05-26 |title=Médecins Sans Frontières apologises for using images of child rape survivor |url=https://www.theguardian.com/global-development/2022/may/26/medecins-sans-frontieres-apologises-for-using-images-of-child-survivor |access-date=2022-12-11 |work=[[The Guardian]]}}</ref>

MSF's funding model has come under scrutiny after [[BlackRock]] donated $500,000 towards its COVID-19 crisis fund, leading to calls of hypocrisy from staff and other humanitarian organisations.<ref name="BlackRock's COVID-19 Response">{{Cite web |title=BlackRock's COVID-19 Response |url=https://www.blackrock.com/corporate/about-us/social-impact/our-commitment-to-people-and-communities |access-date=2022-12-11 |website=BlackRock}}</ref><ref>{{Cite web |title=Mission impossible: humanitarianism is neutral or it is nothing |url=https://www.msf.org/mission-impossible-humanitarianism-neutral-or-it-nothing |access-date=2022-12-11 |website=Médecins Sans Frontières (MSF) International}}</ref><ref name="middleeasteye.net">{{Cite web|last=Ullah |first=Areeb |title='Gut punch': MSF staff wounded by decision to accept Blackrock donation |date=17 September 2020 |url=https://www.middleeasteye.net/news/msf-staff-blackrock-donation-hedge-fund-arms |access-date=2022-12-11 |website=Middle East Eye}}</ref><!-- page 89: Total programme expenses listed as 669.1 million Euros, converted to US dollars gives 755 million -->