A Q&A With the Head of Doctors Without Borders

As other organizations were still trying to get into Haiti last week, Doctors Without Borders was already there, with more than 800 doctors, nurses, and other medical professionals on the ground—though getting supplies and more people in proved a critical problem. Just before taking off for the island, the group's president, Christophe Fournier, spoke to NEWSWEEK's Stefan Theil. Excerpts:

Why did you have so much trouble getting aid into Haiti?
Our planes were getting rerouted to the Dominican Republic while VIPs were allowed to land. So we were not able to supply emergency equipment in time and lost five of our patients, not to mention the delays in setting up new clinics.

Are bottlenecks and mistakes inevitable in a tragedy like this, or is there a fundamental problem with the way the U.S. is handling things?
Barack Obama wrote a very impressive article in your magazine where he said that the U.S. will lead the world in helping Haiti. Without wanting to question America's commitment, the problem is that if you unilaterally take the lead, you also become responsible for coordinating the operation. In one hospital, we had a medical team treating patients that was kicked out by the military.

Is the U.S. directing too much of its effort at security?
Yes. It's needless. We've been in Haiti for 19 years. We don't need armed escorts.

Haiti isn't the only place where you've complained about the military role in organizing humanitarian relief.
It's much more of a problem in places like Afghanistan, where the military strategy has made the work of aid groups more difficult and dangerous. Again, I don't want to question the commitment of NATO forces. But when humanitarian aid becomes part of the counter-insurgency strategy, two things happen. One, aid goes where it fits strategic objectives, not where it's most needed. Kabul has quadrupled in population since 2001 and medical care is terrible, but it's considered stable and thus not prioritized for aid, which instead targets the insurgency areas. Two, when the West explicitly connects the military effort with aid, then those installations become targets. So we've gone in and set up an unprotected, neutral clinic instead.

Former U.S. secretary of state Colin Powell called aid organizations "force multipliers" that help America win wars.
The problem of aid organizations getting identified with a military campaign goes farther back than that. It's the legacy of center-left politicians like Bernard Kouchner [cofounder of Doctors Without Borders and now the French foreign minister], who first promoted the idea of humanitarian intervention. In Somalia, Kurdistan, and Kosovo in the 1990s, aid became associated with a political and military agenda.

What about the role of the NGOs themselves?
There has been a multiplication of NGOs since the end of the Cold War. Many of them have a political agenda associated with the West, like exporting democracy or promoting peace. What we do is different. Our purpose is very, very limited—to help people survive the depredations of disasters and war. We don't pick sides; we don't say who's good or bad. That's the principle of neutrality. It's not because we don't recognize the brutality of what's going on, but because it's the only way we can actually get the aid to where it's needed.

Where is aid needed most in 2010?
Congo is by far the biggest and longest-lasting humanitarian crisis. In some areas we're the only aid organization on the ground. We have been deliberately used as bait by government forces to attack civilians lining up for vaccinations. But don't forget Sudan, Somalia, Pakistan, and Sri Lanka. And Haiti is going to need help for a very long time.