Issue 39 - Article 4

Civilian protection and humanitarian advocacy: strategies and (false?) dilemmas

July 14, 2007
Marc DuBois, MSF-Holland

Sad but true: advances in the collective discussion of civilian security and protection during violent conflict far outstrip any progress in actually ensuring that security or protection. In the humanitarian arena, there is a gulf between the promise of protection and its realisation – a gulf downplayed by humanitarians due to our own self-interest or self-delusion (See Marc DuBois ‘Protection: The New Humanitarian Fig-Leaf’, Dialogues, (4):2–5, September 2007, MSF UK). Nonetheless, we must accept our limited lot. Humanitarians do not carry arms. We cannot freeze the assets of a top-flight marauder. We must work towards the protection of our beneficiaries through less potent mechanisms, such as risk reduction via intelligent programme design, the provision of information, strategic presence – and by raising our voice (Humanitarian protection should not be confused with the provision of physical safety. It consists more in activities ‘aimed at obtaining full respect for the rights of individuals’. Strengthening Protection in War (Geneva: ICRC, 2001), p. 19).

As discussed during a recent series of HPG meetings at ODI, humanitarian actors practicing protection have increasingly taken on the mantle of advocates for the victims of crises (Transcripts of the meetings, held in April and May 2007, are available here). By raising public awareness of the extent or nature of a crisis, by holding organisations with a formal protection role accountable for their responsibilities or by confronting perpetrators with the consequences of their actions, humanitarian organisations have sought to reduce abuses against civilians under attack. Some appear unhappy at this apparent expansion of the humanitarian mandate, charging NGOs with political meddling, or taking steps to block access for agencies perceived as posing a threat. ICRC’s expulsion from the Ogaden region of Ethiopia in July 2007 is testament to the gravity of the issues at stake. Whether through diplomatic lobbying or public denunciation, advocacy can have negative consequences for beneficiaries, for staff and for the organisation’s capacity to deliver aid. In other words, there is a perceived tension between operationality and advocacy, with one pitted against the other.

Bearing witness in MSF

Médecins Sans Frontières (MSF) uses a number of more-or-less interchangeable terms to refer to its humanitarian advocacy: témoignage, witnessing (bearing witness), speaking out, campaigning and advocacy. Albeit even a core term like témoignage has never been defined, MSF derives a substantial part of its identity from its commitment to bear witness: its ‘rebellious humanitarianism’.

Bearing witness essentially refers to active engagement with local populations, through medical treatment and presence on the ground. The medical act may involve providing care to women and girls with sexually transmitted infections (STIs). But humanitarian action goes further: taking note of epidemic levels of STIs in a certain area; seeking to understand why the prevalence is so high, primarily by listening to the patients themselves (collapse of the local economy? survival sex? sexual violence?); and then calling attention to the problem. The key here is that MSF’s humanitarian advocacy flows directly from its experience in the field, through medical data and eyewitness accounts, rather than through the kind of investigation and analysis a think-tank or human rights group might conduct.


The nature of bearing witness itself thus forms the first and most significant protection for the organisation. Put simply, our advocacy originates in our ‘legitimate’ aid activities, meaning that advocacy is our business (contradicting the frequent charge that we are meddling in affairs which are none of our business). If we speak of government forces pillaging villages and burning food stocks, we do so because our medical responsibility includes asking caretakers in our feeding centres why their children are malnourished.

Conceiving of fieldwork as a filter for advocacy initiatives implies that we are obliged to report what is happening when faced with the consequences. It also implies that we confront political actors with their responsibility. However, we do not propose political solutions. This requires an analysis well beyond the ken of our medical interventions. It also implies that MSF does not speak out on behalf of a local population (and hence endangering that population), but speaks in its own voice about that population.

Basing a message on direct experience should improve the accuracy of the message. Yet humanitarian organisations operate in a world with little if any accountability for their public advocacy. On the contrary: donor publics reward organisations for the sexiness of their revelations, for their condemnation of the plight of the victims and for their denunciation of the bad guys. It is easy to compromise accuracy through our own ardour and at the behest of our communications departments. Content must hence clear only the low bar of being motivated by good intentions, with little internal or external attention to the literal or scientific validity of the message.

What we denigrate as ‘backlash’ can thus be construed as the first stirrings of accountability. In certain contexts, the authorities have challenged the veracity of our reporting, for example charging that we are being used by locals who feed us fabricated or exaggerated information. There is only one solution: NGOs must be able to defend their work. For MSF, direct experience means that we do not assert, for instance, that certain villages have been burned down unless we have seen the ashes for ourselves.

The same principle extends to the literal accuracy of what we report. There is a critical distinction between saying ‘500 women were raped’ and saying ‘500 women sought treatment for rape’ or ‘500 women reported to MSF that they had been raped’. Similar concerns also govern the extrapolation and interpretation of data. It is in practice quite difficult to moderate the outrage which drives us into taking a public position. Do declining consultation rates after the handover of an MSF clinic to the local government demonstrate the invidiousness of imposing a fee for services, as MSF would be eager to conclude? Or are other factors at play, such as declining confidence in the quality of services or deficiencies in book-keeping?

Beyond accuracy, public advocacy needs to respect local sensitivities. For example, one government became angry because the language of an MSF report lumped government forces and rebel militias together in one term, ‘warring parties’. Incredibly to us, the government barely reacted to the content itself, which consisted of a denunciation of abuses by government forces. This example highlights a key weakness in the expatriate-driven approach to témoignage.

Defensibility: strategy and methods

Most humanitarian organisations involved in advocacy understand the link between modes of action or tactics on the one hand, and impact (both positive and negative) on the other. Countless potential messages arise from any given situation, and the organisation must weigh possible approaches (from factual exposure to persuasion to denunciation/condemnation) and tactics (quiet diplomacy, passing on the information to other actors, semi-public advocacy, dissemination to a limited number of targets or full public diffusion). There can be no template, rather a case-by-case analysis balancing potential outcomes and consequences. There are, however, preparations to be made in advance of humanitarian advocacy which can greatly reduce the risk of a negative impact. These are outlined in Box 1.

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Each organisation has its own internal structure or protocol for making decisions about their advocacy. Typically, MSF examines a mix of factors:

  • Impact on the security of MSF teams and beneficiaries.
  • Impact on access and operational activities.
  • Expected positive impact on the situation of the beneficiaries.
  • Relation to MSF activities and identity.
  • Importance of medical activities and other aid.
  • Replacement possibilities (who can take over activities if MSF is denied access).

Scientific calculation is illusory: in the end, with experienced people around a table, decisions coalesce from what is necessarily a gut reaction to a situation. Some questions, however, remain unanswerable. How do we measure the value of advocacy to a population? If public denunciation of their plight helps restore some dignity to victims of violence, what value do we assign to this? What does it mean to people that our public report forms a historical record that breaks a silence or counters future denials? Do we understand the importance of victims having their suffering ‘validated’? Given the inability to quantify these results, our faith in the benefits of advocacy may falter in the face of What good will it do? cynicism.

From the process standpoint, discussion and development of advocacy take place at all levels, from projects to the desks managing the various geographic portfolios. The operational ‘line’ makes the final call, led by the Head of Mission and Operational Manager. Because humanitarian advocacy by one section of MSF may have consequences for others, other sections operating in the same country are notified, and their views taken into consideration. The draft report is then circulated internally.

The fallacy of opposition

The logic underpinning the opposition between humanitarian advocacy and humanitarian aid betrays an incomplete conceptualisation of the nature of humanitarian action itself. Except for theoretical purposes, the idea of protection cannot be separated from aid, as if delivering blankets were the sine qua non of the humanitarian actor and protection work were an optional activity, to be jettisoned at the first hint of trouble. Hence, the aid versus advocacy discussion is rooted in the incorrect perception that we can deliver technical assistance with our eyes, ears, mouths or hearts shut.

Burdening advocacy with the weight of this tension is manifestly unfair, a bias left over from the days when operations were equated with the delivery of assistance. In fact, this tension inheres in humanitarian action itself. Once protection work becomes an integral component of humanitarian action, the positing of one against the other loses its rigidity. It is impossible to deliver aid during crisis and conflict without incurring palpable risk. And yet we distinguish advocacy from aid when we think about risk. It would be odd to say, for instance, ‘If we treat malaria in that village we may get attacked’ in such a way as to suggest that treating malaria endangers security. Yet we accept the logic of warnings like ‘If we publish X we may get kicked out of the country’. Moreover, the readiness of organisations to conceive of advocacy as a threat to access belies the reverse causal relationship: it is often because of and through advocacy that we gain and maintain access (and it is the silent who are often more likely to disappear than those capable of speaking out with both force and credibility). Is there any doubt that considerable and high-level advocacy is responsible for the relative bureaucratic ease with which humanitarian NGOs can enter Darfur?

The notion of advocacy versus aid seems to conceive of advocacy as an all-or-nothing proposition, one governed by a binary yes/no decision. In MSF, we often get bogged down in discussions of whether or not to bear witness, instead of the more relevant question of how to bear witness given certain risks and opportunities. Of course there should be hand-wringing – these are difficult decisions, with serious potential consequences for the organisation, its staff and even beneficiaries. Yet for all the anguish we invest in examining the possible harm posed by speaking out, there is seemingly zero interest in similarly analysing the consequences of our silence.


Humanitarian action comprises more than the sterile delivery of assistance. Stemming from a direct engagement with people in crisis, humanitarian organisations must bring aid to meet needs, while at the same time protesting against the man-made causes of those needs. MSF views this témoignage as part of humanitarian action, part of its identity. To minimise any threat of backlash and improve the likelihood of positive results, advocacy initiatives are developed and implemented with regard to the three axes of defensibility (content, strategy and process/method).

The nature of MSF’s témoignage, whereby messages emerge from within the framework of the organisation’s medical activities, provides a first layer of protection against hostile reactions. The practices encompassed by the concept of defensibility provide another layer of protection: gaining acceptance for advocacy, preventing potential harm from negative responses, and counteracting direct backlash. In an arena without monitors and where there is little accountability, humanitarian agencies must struggle to formulate public messages with equal parts punch and fairness (accuracy).

The standard is high: we must be able to defend every word. In the end, though, it is perhaps not the hostile reaction of governments or warring parties that presents the greatest obstacle to humanitarian advocacy, but our own tendency to disconnect advocacy from the core of humanitarian action, and to focus solely upon its risks.


Marc DuBois works as a Humanitarian Affairs Advisor for MSF-Holland. He can be reached at: The views expressed in this article are the author’s own, and are not intended to speak for the entire MSF movement. Moreover, this article creates an impression of clarity, coherence and orderly implementation that idealises what is usually a far messier process.


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