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MSF UK’s commitment to addressing institutional racism

MSF UK’s commitments to addressing institutional racism

MSF bio lab at MSF’s Aden hospital Caption
29 June 2020 | Jump to 2021 updates below

In MSF UK’s new Strategic Direction for 2020 – 2023 we set down a vision to be an organisation and part of a movement that values its staff and ensures that all those who work with and for us feel this value in their working lives and are treated with equity and respect.

Today Médecins Sans Frontières / Doctors Without Borders (MSF) is a global movement that works in 70 countries, with a 45,000 strong workforce.  We staff our country programmes with management structures where key field coordination positions are largely filled by international staff hired on short-term contracts.

International staff supervise local staff, despite the latter frequently having greater experience of the project. Staff hired locally are rarely given positions of responsibility over colleagues hired internationally and as a result, locally-hired staff perceive obstacles to career development. 

There are clear structural differences between the way these two groups of staff are treated in terms of rewards including professional rewards like career progression and learning and development, exposure to risk and their ability to be heard within MSF.

In our Strategic Direction we have termed these issues as that of workforce injustice and equity. Today we need to go further and acknowledge them as institutional racism.

Actions across MSF internationally

MSF UK is just one part of the global MSF movement – and action on this issue is of course needed across all our offices and projects.

MSF has five ‘Operational Centres’, and a new Operational Directorate opening in Senegal and Ivory Coast, which make decisions on how and when we intervene around the world. As part of the Operational Centre based in Amsterdam, MSF UK is supporting commitments to address racism in MSF at an international level.

Aquarius Search and Rescue - July 2016

Read Dr Javid Abdelmoneim's reflections

The Management Team of the Amsterdam Operational Centre (OCA), of which I am a member, recently sent an update to our staff to acknowledge that institutional racism and discrimination is present within MSF in many forms, and to set out steps to tackle this problem.

We recognised that, while MSF brings huge positive impact for people in need, it is also rooted in European post‐colonial traditions, and this manifests in many aspects of our organisation. We committed to accelerating the ongoing redistribution of power and decision‐making more evenly across the world; ensuring our medical humanitarian assistance is free from any racist or discriminative barriers; and working on addressing all aspects of structural racism as they manifest in MSF.

In the interests of transparency and accountability, we have made that letter available on our website. As an internal document, some of its language may not be accessible for those not familiar with MSF, so I have highlighted some of the key commitments here:

  • Commit resources to addressing all policies and procedures that entrench institutional racism and discrimination and create barriers to equitable staff career progression, with an immediate focus on recruitment policies and processes at all levels and in all locations.
     
  • Lead on and remain accountable for the progress of a plan of action to ensure diversity and representation at all levels in MSF‐OCA, with a particular focus on leadership positions, and informed by data and indicators that will be in place by mid-2021.
     
  • Incorporate anti‐racism and anti‐discrimination training into our learning and development as an urgent priority by the end of 2020.
     
  • Provide the means for self‐education within the organisation to ensure we all understand open and hidden discriminatory practices, the system of privilege and power imbalance, to be able to participate in the dialogues that will bring change.
     
  • Enable a process of safe spaces, dialogue and support mechanisms across MSF OCA
     
  • Assess our internal and public communications and imagery to ensure avoidance of the projection of white saviour complex and white privilege, attitude and culture. We commit to communication in which the staff who are closest to the provision of medical care represent the organisation and their work.

We also pledged to publish our actions and performance indicators, and hold ourselves publicly accountable against these towards our staff and associations, the people we assist, their communities and our supporters.

Actions to be taken by MSF UK

Closer to home our Strategic Direction commits us to creating a healthy working environment in MSF UK built on community, inclusivity, diversity and a proactive idea of acceptance. A diverse staff team at all levels strengthens us and makes us more innovative and effective.

MSF UK has already put considerable effort and resources to the process of breaking down structural barriers that prevent staff from across the world from making progress within the organisation. Our Leadership Education Academic Partnership (LEAP) programme and Global Health and Humanitarian Medicine (GHHM) course enable access to world-recognised higher education, and our Scientific Days conferences are key knowledge-sharing events.   

We will continue to champion and resource these courses and conferences, prioritising access for staff across the world. 

Over and above our investments in and commitment to the LEAP, GHHM and Scientific Days, the MSF UK Management Team have already committed to the following actions:

  • A diversity and inclusion action plan by the end of 2020 covering all areas including recruitment policies and internal language, fully implemented by the end of 2022
     
  • An audit of HR policies to check for statements that undermine workforce inclusion, fairness and diversity; and if required will have updated its policies or developed new ones to address this by the end of 2020
     
  • An increased proportion of locally hired MSF staff members enrolled as students in the LEAP programme and the GHHM course will be 10 percent higher than the 2020 baseline

You can read more of those plans in our Strategic Direction for 2020 – 2023. From June 2020 we will be reviewing and consulting on them to ensure they are good enough, go far enough and actually happen.

In addition, we will be creating safe spaces, dialogue and support mechanism for staff across MSF UK – field, offices and associative membership.  We will be supporting the process of educating ourselves, signposting to relevant literature and resources, and identifying anti-racism training, with senior managers having undertaken this training by the end of 2020. Once we have reviewed our plans, we will publish any updates to our commitments and be accountable towards them in the public domain.

In addition, the MSF UK Board of Trustees has issued a statement supported by some more personal reflections from the Chair, Dr Javid Abdelmoneim.

MSF exists because of the principle of humanity, the belief that all humankind shall be treated humanely and equally.  Institutional racism has no place in MSF and MSF UK fully commits to be part of making the change both across our wider movement and closer to home.  

Vickie Hawkins
Executive Director, MSF UK

Updates

September 2021

We last updated our progress in February 2021. Now, it is time to do so again. Our work, to confront these issues in a forthright and honest way, and to find sustainable solutions in the areas where MSF UK must improve, is ongoing.

Commitment: A diversity and inclusion action plan by the end of 2020 covering all areas, including recruitment policies and internal language, that is fully implemented by the end of 2022.

Progress: MSF UK’s development of the action plan has slowed significantly since the commitment was first made as a result of the demands of responding to the global pandemic. However, an equity, diversity, inclusion (EDI) audit was conducted to explore current DEI practices and wider organisational culture at MSF UK. The audit focused on the voices of marginalised staff and let their experiences shape our learning priorities.

The consultant’s final report is now with the MSF UK Board of Trustees and Management Team for their review. This is an important milestone on our journey towards meeting this commitment.

The next stage of this work will be to use the results of the audit to further develop and focus MSF UK’s established EDI vision and objectives. We will build a concrete, measurable action plan that clarifies and expands the scope of action currently being undertaken by the organisation.

Following this, the key results from the report, vision and action plan will be shared and discussed with MSF UK staff, ahead of being published on this website.

Commitment: An audit of human resources (HR) policies to check for statements that undermine workforce inclusion, fairness and diversity. If required, MSF UK will update its policies or develop new ones to address any issues identified in the audit by the end of 2020.

Progress: The consultants who conducted the audit also included as part of this process an audit of our HR policies in December 2020. Alongside this, MSF UK completed an internal audit of the same policies in February 2021.

Following both sets of recommendations and related analysis, revised HR policies will be rolled out as each is ready, starting in the last quarter of 2021.

Throughout 2021, MSF UK’s HR department have been working to improve EDI data collection. In July, MSF UK office staff were given the opportunity to provide data relevant to this area, such as ethnic origin and sexual orientation.

While the initial focus was on office staff, the second phase of data gathering will cover our medical humanitarian project staff. The data will be used to create a baseline picture of our organisation against which future improvements can be measured.

Commitment: The proportion of locally hired MSF staff members enrolled as students in the LEAP programme and the GHHM course will be 10 percent higher than the 2020 baseline.

Progress: The 2020 baseline for locally hired staff participation in the LEAP programme and GHHM course are as follows:

2020: 40 percent of staff enrolled in the LEAP programme were recruited locally

2021: 51 percent of staff enrolled in the LEAP programme were recruited locally

2020/21: 39 percent of staff enrolled in the GHHM course were recruited locally

We have also gathered data on the proportion of students from low- and middle-income countries (LMICs), which is as follows:

2019: 68 percent of students enrolled in LEAP came from LMICs

2020: 80 percent of students enrolled in LEAP came from LMICs

2019/20: 64 percent of GHHM students were based in LMICs

2020/21: 74 percent of GHHM students were based in LMICs

Commitment: We will be creating ‘safe spaces’; dialogue and support mechanisms for staff across MSF UK, including project and office staff, and members of the MSF UK Association 

Progress: Office staff, MSF UK Association members and UK-contract project staff were surveyed about their opinions on anti-racism initiatives and institutional racism within MSF, with results considered by the Management Team.

The results of these surveys were analysed by the MSF UK anti-racism project team and a report was presented to Board of Trustees in February 2021.

At the end of 2020, MSF UK office staff attended a series of ‘brave spaces’ sessions, facilitated by an anti-racism consultant, where discomfort and honesty were encouraged as a means of learning, challenging and developing personal responses to anti-racism. 

The outcomes and conclusions of the brave spaces sessions were incorporated into the above-mentioned EDI audit. The sessions also launched various grassroots staff initiatives, including an anti-racism reading circle.

Following this, the consultant produced a report, which included seven recommendations for MSF UK. The report and its recommendations can be found here.

MSF UK accepted these recommendations and has already delivered on numbers 3 and 5. Number 7 will form part of our EDI action plan work, while the remainder represent committed goals for MSF UK.

MSF UK continued to hold discussion events around the issues of racism in 2021. In June, the topic was feature at our flagship associative event, the Annual General Meeting, under the title, ‘You can’t choose that for me’.

The talk focused on the unique vulnerabilities that locally hired staff face in places where MSF projects are 'exposed to risk' while providing medical humanitarian assistance, and our duty of care towards them.

Commitment: We will support the process of educating ourselves, signposting to relevant literature and resources, and identifying anti-racism training, with senior managers having undertaken this training by the end of 2020.

Progress: As of February 2021, 89 percent of MSF UK line managers at all levels have undertaken ‘brave space’ capacity building training sessions with our anti-racism consultant. All members of the MSF UK Management Team have completed this training.

MSF UK has created a page of resources on anti-racism on MSF UK’s intranet, including books, articles and audiovisual material, to allow us to educate ourselves on these issues. Staff have been encouraged to undertake this activity as part of their working day, rather than on top of it, with the support of their line managers. The MSF UK Management Team has committed to making space and time for staff to read this material and discuss it in team meetings.

The Management Team has also begun a reading club, where its members share articles and books on topics around anti-racism and dedicate time to discussing them.

Other areas:

MSF UK is continuing its work to ensure that our public communications fully represent the diversity of our global workforce, and to ensure that our public communications push back against traditional humanitarian stereotypes of the ‘white saviour’. 

We are working across the MSF movement to further diversify the staff who speak on our behalf. In recent years, MSF UK identified a challenge regarding the communications materials produced to inform our supporters and the wider public about our work.

An over-reliance on the stories of returning UK-contracted staff to explain our work left the majority of our global workforce under-represented in our communications. To address this, we have developed ways to ensure that colleagues hired and based in the countries where we work have more opportunities to represent MSF, whether via remote link-ups to panel events or through written and audiovisual communications.

In the past six months for which figures are available, we have seen a significant improvement in representation, with 50 percent of the communications products produced entirely within the UK now featuring locally hired colleagues. We are building on this work and will monitor and analyse its results.

To further embed this in MSF UK’s working culture, we have revised our brand guidelines to emphasise how we should present ourselves and those we assist, both in terms of language and imagery. MSF has also produced a language guide to help staff write in ways that focus on inclusion, diversity and the empowerment of all our staff.

February 2021

When we published the above statement on MSF UK’s commitments to addressing institutional racism, we stated that we would “publish any updates to our commitments and be accountable towards them in the public domain.”

We believe that eight months on from making these commitments, it is important to provide an interim update on progress so far.

We intend to publish a more substantive update by the end of June this year (2021). [NOTE: we now expect to publish this update by early September 2021 and would like to apologise for the delay]

Commitment: A diversity and inclusion action plan by the end of 2020 covering all areas including recruitment policies and internal language, fully implemented by the end of 2022

Progress: This is underway, although we have not met our original aim of having the plan completed by the end of 2020 due to the ongoing challenges and workload posed by COVID-19.

Consultants to support the creation of the plan were instructed in December 2020. We now hope to have the plan completed by mid-2021. We will continue to provide regular, publicly available updates on progress.

Commitment: An audit of Human Resources (HR) policies to check for statements that undermine workforce inclusion, fairness and diversity; and if required will have updated its policies or developed new ones to address this by the end of 2020

Progress: We have completed the audit, and an overview of where MSF UK meets best practice standards and where there is room for improvement has been submitted to the Management Team. 

The recommendations will be implemented as part of a bigger piece of work that takes into account the outcome of the diversity and inclusion action plan.  

Commitment: An increased proportion of locally hired MSF staff members enrolled as students in the LEAP programme and the GHHM course will be 10 percent higher than the 2020 baseline

Progress: The latest available figures are as follows:

Locally hired MSF staff:

  • 2019: 31 percent of staff who enrolled in LEAP in 2019 were recruited locally
  • 2020: 40 percent of staff who enrolled in LEAP in 2020 were recruited locally

Note: we are still compiling figures on locally-hired staff enrolled in the GHHM.

We have also gathered data on the proportion of students from Low and Middle-Income Countries (LMICs), which is as follows:

  • 2019: 68.1 percent of students who enrolled in LEAP in 2019 came from LMICs
  • 2020: 78.7 percent of students who enrolled in in LEAP 2019 came from LMICs
     
  • 2019/20: 64 percent of GHHM students were based in LMICs
  • 2020/21: 68 percent of GHHM students were based in LMICs

Commitment: We will be creating safe spaces, dialogue and support mechanism for staff across MSF UK – field, offices and associative membership. 

Progress: Within the office, we undertook discussions via ‘brave spaces,’ facilitated by an anti-racism consultant, where discomfort and honesty are encouraged as a means of learning. 

We surveyed office-based staff about their needs and opinions in this area, with results being analysed and considered by the Management Team.

We also surveyed all MSF UK/IE Association members and all international staff who had worked on assignment for MSF on a UK/Irish contract in the last five years, regarding their opinions on institutional racism within MSF and what they would like to see done in this area.

The results of this survey were collated and analysed by the MSF UK/IE Anti-Racism project team, and a report was presented to Trustees at the Board Meeting in February 2021.

We held three events in 2020 for association members and staff:

  • First, an educational webinar, ensuring participants began subsequent discussions from a place of similar understanding.
  • Second, a space in which participants proposed steps towards making MSF UK/IE an anti-racist organisation. The ideas proposed at this meeting were collated and presented to relevant teams within MSF UK for input into their annual plans.
  • Third, a discussion of members’ motions relating to addressing structural imbalances of power at the international level of MSF. These discussions informed how our representatives voted at our International General Assembly, the highest governing body of MSF. 

We will continue to hold discussion events on the issues of racism in 2021, and the topic will feature at our flagship associative event, the AGM, in June.

Commitment: We will be supporting the process of educating ourselves, signposting to relevant literature and resources, and identifying anti-racism training, with senior managers having undertaken this training by the end of 2020. 

Progress: We have created a page of resources on anti-racism on MSF UK’s internal website – including books, articles and audio-visual material – to allow us to educate ourselves on these issues.

Staff have been encouraged to undertake this activity as part of their working day, rather than on top of it, with the support of their line managers. 

The MSF UK management team has further committed to making space and time for staff to read this material and discuss it in team meetings.

The MSF UK management team has undertaken ‘brave space’ and capacity-building sessions with our anti-racism consultant. In addition, 89 percent of MSF UK line managers at all levels have undertaken capacity-building sessions.

Other areas:

In addition to the progress set out above, MSF UK is also continuing its work to ensure that our public image fully represents the diversity of our global workforce; and to ensure that our public communications and fundraising materials avoid problems such as the use of ‘white saviour’ imagery. 

To this end, we are working with our partners elsewhere in the MSF movement to further diversify the staff who speak on our behalf and we have updated our brand guidelines to further emphasise relevant points on how we should present ourselves and those we assist, both in terms of language and imagery.  

NOTE

MSF UK is part of an international movement of legal entities, commonly referred to as MSF, which are bound by a shared name and identity, and shared commitment to the MSF Charter and principles.

The statements in this article relate to both the international movement’s global field projects and to the MSF UK office.

Further reading