Promoting a work environment free of harassment, exploitation and abuse

Médecins Sans Frontières (MSF) promotes a working environment free of harassment and abuse. Our leadership has unequivocally committed to reinforce mechanisms and procedures to prevent and address abuse and harassment. All staff are expected to abide by the MSF movement's Behavioural Commitments and our guiding principles as stipulated in our Charter. 

 

The integrity of our organisation is upheld by the good conduct of each individual staff member, in any location, with full respect for the communities we serve. For us, this means not tolerating any behaviour from our staff that exploits the vulnerability of others, or of employees taking advantage of their position for personal gain.

 

 

Procedures, including grievance mechanisms, are in place to encourage prevention, detection, reporting, and management of all types of misbehaviour, harassment and abuse. Through these mechanisms, all staff members are encouraged to report inappropriate behaviour or abuse either through their management line or through specific reporting channels outside any hierarchical lines, using dedicated email addresses. Victims or witnesses in the communities where MSF works are likewise encouraged to report misconduct to us so that allegations can be properly addressed. 

Broad awareness activities are carried out to inform all staff of the mechanisms available to them to report abuse. This information is shared through specific communications, including in printed staff manuals, and is conveyed in briefings, field visits and trainings. Moreover, e-briefings and learning modules related to behaviour and management of abuse are regularly updated and improved. 

There is a range of ongoing work in this area that has been taking place across the MSF movement in recent years. Examples include: 

• Creating new positions and/or increasing staff support to provide training, field visits and investigation on these issues. 
• Undertaking workshops and other forms of consultation with staff to assess the problem and the steps needed to address it. 
• Revising, promoting and strengthening guidance provided to staff on how to report harassment, abuse or exploitation. 
• Reinforcing awareness at the patient and community level where we have operations. 
• Improving data-gathering and sharing across the MSF movement. 

 

 

MSF aims to ensure that these situations are addressed with the utmost confidentiality, to create an environment where people feel they can safely file complaints, without fearing for their safety, their job, or their confidentiality. 

 

Our first priority when misbehaviour is reported is the safety and health of the potential victims. Immediate attention is given to provide support, which can include psychological and medical care, and securing legal assistance.

 

MSF always respects the victim’s decision to bring – or not – a matter to justice. In the event of sexual abuse against minors, MSF’s policy is to report the case to judiciary authorities depending on the child’s best interests and availability of such procedures.

 

In 2023, over 69,000 individuals worked for the MSF movement worldwide. During that year, we saw a total of 823 complaints about abuse or inappropriate behaviour made across the MSF movement. Of these, 714 were related to our medical and humanitarian projects, and 109 related to our international headquarter offices. Of those complaints, after investigation, 300 were confirmed to be cases of abuse or inappropriate behaviour, with some complaints still being investigated at the end of 2023. The paragraphs below break down data from project and headquarters cases separately, as they are not necessarily comparable in terms of legal and reporting processes.

The overall number of complaints received related to our medical and humanitarian projects increased by 18 per cent in 2023 (714 complaints), compared to 2022 (606 complaints). Complaints received in our international headquarter offices in 2023 (109 complaints) increased by 22 per cent compared to 2022 (89 complaints). MSF remains concerned about under-reporting of abuse and inappropriate behaviour given the breadth of our activities and the reach of our operational footprint – especially from patients, their caregivers, and from community members in the areas where we work.

Complaints received related to our medical and humanitarian projects in 2023:

• Around 89 per cent of MSF staff (69,100 people in total) in 2023 were working in MSF’s projects. A total of 714 complaints were made about the behaviour of staff in these projects, up from 606 in 2022.   
• Of those complaints, after investigation, 264 were confirmed to be cases of abuse or of inappropriate behaviour (204 in 2022), with some cases still being investigated at the end of the year.
• This includes 187 cases which were confirmed as abuse, compared to 121 confirmed cases of abuse in 2022 (this includes different forms of abuse: sexual exploitation, abuse and harassment [SEAH]; abuse of power; harassment and bullying; discrimination; exploitation; aggression; abuse of the case management process – including retaliation, false reporting, interference in a case, and breach of confidentiality). 
• A total of 85 staff members were dismissed for different types of abuse in 2023 (52 dismissals in 2022). Depending on the severity of the case, other types of sanctions were also issued, including but not limited to suspension, demotion, formal written warning, or mandatory training.
• Of the 187 confirmed cases of abuse, 85 were cases of SEAH, compared to 67 in 2022. Forty-five (45) staff were dismissed based on the findings of investigations related to those SEAH cases in 2023 (35 in 2022), noting that behaviour like sexual harassment covers a range of behaviour.
• The other confirmed cases of abuse included cases of harassment or bullying (31 confirmed cases); abuse of power (30 confirmed cases); aggression (23 confirmed cases); exploitation (13 confirmed cases); discrimination (9 confirmed cases); and abuse of the case management process (4 confirmed cases). 
• There were also 77 cases of inappropriate behaviour found (83 in 2022). Inappropriate behaviour means behaviour which does not amount to the forms of abuse outlined above, but which are not in line with MSF’s behavioural standards. This includes, but is not limited to, mismanagement of people; inappropriate relationships; inappropriate behaviour not in line with societal standards or affecting team cohesion; inappropriate communication; and substance (mis)use.

We have continued to see some increases in the number of complaints submitted by previously under-represented groups, like locally hired staff, though there is still much room for improvement, especially with patients and community members. 

The total number of complaints submitted by patients and their caregivers was 33 in 2023, and 36 from community members (which may also include patients and others in the community whom MSF staff encounter) for a total of 69 (67 in 2022).  There were also 24 complaints submitted by “other” external parties – a category which includes suppliers, media, other organisations, partners, ex-MSF staff, non-MSF contracted staff.

It remains concerning that the number of complaints from patients, their caregivers, and community members has remained so low. Increased efforts are needed to reach out to patients and community members by making them aware of their rights and MSF expected standards of behaviour, and to ensure there are accessible, appropriate complaints mechanisms available to them to hold MSF accountable for any abuse or inappropriate behaviour. 

The total number of complaints submitted by locally hired staff increased from 232 in 2022 to 328 in 2023. Efforts to encourage and support these staff to report need to be continued, as locally hired staff account for around 78 per cent of the global workforce, but are responsible for only 58 per cent of complaints made by MSF staff. 

In reviewing all complaints from both MSF staff and individuals outside of the organisation, there have been a relatively low number of complaints made about discrimination – despite ongoing movement-wide efforts to address it. A total of 45 complaints relating to discrimination were received in 2023, up slightly on the total of 40 in 2022. This suggests that continued and sustained efforts are needed on diversity and inclusion, to ensure people affected by acts of discrimination in any form, report it.

Complaints from our offices worldwide

Since 2020, MSF has also compiled complaints from our offices around the world, in addition to the data gathered from our medical projects. Eleven per cent of the total MSF workforce is based in these international offices.

While efforts have been made to standardise reporting, this data relates to many different legal and human resource processes, and so may not yet be fully harmonised.
 

• From all of the  headquarter offices, 109 complaints were received in 2023 (up from 89 in 2022).
• Of these, 36 cases were confirmed to be abuse or inappropriate behaviour (with 11 complaints still under investigation at the end of the year, noting that some complaints made were not about abuse). 
• There were 34 cases related to abuse and 21 to inappropriate behaviour.[1] This compares to 38 confirmed cases of abuse and 30 of inappropriate behaviour in 2022. 
• Overall, 13 staff members were sanctioned (ranging from coaching to verbal or written warnings) and 15 staff members were dismissed for abuse in 2023.  

[1] Note: one “case” can be qualified as several offences, so totals may not match.

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Achieving and maintaining a work environment free from abuse and harassment is an ongoing endeavour, for which we are all responsible. We also commit ourselves to do no harm to people with whom we work and to be accountable to them.

We continue to urge staff, patients, or anyone else who comes into contact with MSF, to report any incidents of abuse or inappropriate behaviour.