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Doctors Without Borders (MSF) as disaster relief organization

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Doctors Without Borders is also known as Médecins Sans Frontières (MSF).

Table of Contents

Where we looked

All of the below was examined in September 2010.

How much did the organization raise and how much did it spend?

Source Organization Dates: January 12, 2010- Amount donated Amount Spent
Chronicle of Philanthropy1 MSF-US January 25, 2010 $34 million N/A
Chronicle of Philanthropy2 MSF-US January 27, 2010 $36.5 million N/A
Chronicle of Philanthropy3 MSF-US February 3, 2010 $43.5 million N/A
MSF 3 month report4 MSF (International) April 20105 87 million euros 40 million euros (as of April 1) and 70 million euros predicted by the end of 2010.
Chronicle of Philanthropy6 MSF-US April 30, 2010 $61.1 million N/A
Chronicle of Philanthropy7 MSF (International) April 30, 2010 $124 million $50 million
MSF 6 month report8 MSF (International) May 31, 2010 Over 91 million euros 53 million euros (89 million euros predicted by end of 2010)
MSF 1 year report9 MSF (International) October 31, 2010 104 million euros 79 million euros

How specific is the organization about how it spent its funds?

In late December 2010, MSF published a report breaking down the funds allocated to categories such as reconstruction, rehabilitation, and ongoing operations of medical facilities (30%); medical materials and supplies (15%); transportation (19%); the remainder was primarily spent on national and international staff and administration costs.10 This updates MSF's previous report in June 2010.11

MSF also published a report detailing the outputs of its programs: the numbers of patients treated for various problems and supplies distributed.12

Number Category
2,844 Haitian staff
260 International staff
15 Operating theatres
1,121 Number of beds
358,758 Patients treated
16,578 Surgical operations
10,939 Patients treated: post operative care
7,110 Patients treated: violence-related trauma
38,534 Patients treated: other trauma
61,000 Patients treated: cholera (by December 12)
177,212 Patients treated: psycho social and mental health
15,105 Patients treated: deliveries
696 Patients treated: sexual violence
37,217 Relief kits distributed
45,940 Tents distributed
12 Number of fixed sites
3 Number of mobile clinics
516,000 Liters of water distributed per day as of October 31
823 Latrines built
277 Showers built

These figures are an update to those previously published as part of its 6-month update.13

Non-disaster relief activities

MSF works in nearly 60 countries.14 For each country in which it works, MSF provides:

  • Financial data: these reports show how MSF allocates funds, divided into the following general categories: international staff, national staff, operational running expenses, medical and nutrition, logistics and sanitation, training and local support, transport, freight and storage, consultants and field support, grants, and miscellaneous.15 (More specific information about fund allocation within these categories is not available except in a few isolated cases, from what we have seen.)
  • Activity Reports: descriptions of MSF's activities in each country. In the 2009 Activity Report, MSF includes a section on each country and a synopsis of the problems it is addressing in the country, as well as some details about its projects there. Its descriptions do not seem to be comprehensive, but they do generally give a number of details (treatments provided, numbers of patients in particular locations, plans to expand, etc) about its work in the country.16
    • For example, in its 2009 Activity Report, MSF describes its activities in Malawi as follows:17

      • "At the end of 2009, MSF was providing ART [antiretroviral therapy] to more than 15,000 patients at Chiradzulu, and another 15,000 at Thyolo."
      • "The capital, Lilongwe, was hit by a cholera outbreak at the end of 2008 and in early 2009...MSF provided supplies and medical staff and gave intensive training to health workers. Teams cared for more than 3,700 patients during the epidemic, and gave logistical support to improve water and sanitation services in nine health centres and one district hospital."
      • "On December 20, an earthquake of magnitude 6.2 hit the rural province of Karonga...MSF focused more on technical support, setting up a health centre in the camp for those who had been made homeless and providing sanitation and access to drinking water. The team also ensured that the earthquake victims had access to HIv care."
  • Field updates: MSF publishes field updates on its work in each country. These contain some details about its recent projects as well as accounts of the experiences of MSF workers/volunteers.18

The level of specificity concerning activities and expenses is not comprehensive (to the point of connecting expenses to specific verifiable outputs) but is noticeably more detailed than that of most other disaster relief charities we've reviewed.

Additional factors

Limited fundraising

MSF stated in its 6-month report that it was no longer accepting earmarked donations for Haiti, because it was not clear that there was more room for Haiti-specific funding.19

Frequent, detailed field updates

MSF posted frequent field updates on its website in addition to its 1-, 3-, and 6-month reports.

  • The field updates were posted almost daily in the two weeks after the disaster, and less frequently after that (every few days to twice per month). They contain

    • Assessments of where aid is needed.20
    • Reports on specific numbers of personnel and commodities being delivered. A few updates contain very thorough information about sites and services.21
    • Reports from doctors and nurses in the field.22
  • The field updates do appear to give a sense of some of MSF's plans and projects at a given time, though they generally do not contain a complete list of the activities. The longer reports (particularly the 6-month report) contain the most complete list of MSF's activities and how it allocates its funds. None of the field updates contains information on how funds are being allocated to specific activities.

Pre-reported staff on the ground around the world

In its annual financial report, MSF reports the number of staff (divided into international and national staff categories) that it has in each country.23 In the event of a natural disaster in a particular country, donors are able to verify the number of staff that MSF has had in the country in the previous year. Note that the presence an organization has on the ground (including local ties, etc) when a disaster strikes is often considered to be an advantage in its ability to help quickly and effectively.24

Sources

  • 1.

    "The Doctors Without Borders U.S. operations had raised $34-million for work in Haiti as of Friday morning. The organization has also received $11.9-million for its general Emergency Relief Fund." Chronicle of Philanthropy, “A Roundup of Haiti Fund Raising.”

  • 2.

    "The Doctors Without Borders U.S. operations had raised $36.5-million for work in Haiti as of Wednesday. As of Friday, January 22, the organization had also received $11.9-million for its general Emergency Relief Fund."
    Chronicle of Philanthropy, “A Roundup of Haiti Fund Raising as of January 29.”

  • 3.

    Chronicle of Philanthropy, “American Charities Raise $709-Million for Haiti Relief, Chronicle Tally Finds.”

  • 4.

    MSF, “Three Months After the Earthquake That Has Impacted on the Lives of Millions in Haiti.”

  • 5.

    The exact date is not reported – it is between April 1 and April 12.

  • 6.

    Chronicle of Philanthropy, “$1.1-Billion Donated for Haiti Relief: Updated Tally.”

  • 7.

    Chronicle of Philanthropy, “$1.1-Billion Donated for Haiti Relief: Updated Tally.”

  • 8.

    MSF, “Emergency Response After the Haiti Earthquake: Choices, Obstacles, Activities and Finance.”

  • 9.

    MSF, "Haiti: 1-Year Report."

  • 10.

    "Operating such emergency health programs requires a range of investments. Given the devastation in Port-au-Prince and beyond, including the near-total destruction of many health centers and hospitals, nearly 30 percent of MSF's expenditures as of October 31 were devoted to logistics, such as the rehabilitation or construction of medical facilities and the ongoing maintenance of health structures, which includes the provision of water and electricity. Without this investment, medical staff would not be able to operate and patients would not receive the scope and quality of treatment MSF offers. A further 15 percent of MSF's expenditures have been attributed to medical materials and supplies. Because large numbers of essential emergency workers and vast amounts of relief goods had to be brought into Haiti, transportation accounted for 19 percent of the total spending through October 31. The percentage was reduced from 25 percent of total expenditures for the emergency phase period of January 12 – April 30 because our coordinators made both the supply chain and human resources management more efficient." MSF, "1 Year report," Pg 3. See the full pie chart on Pg 3 for all costs.

  • 11.

    "Operating such emergency health programs requires a range of investments. Given the devastation in Port-au-Prince and beyond, including the near-total destruction of many health centers and hospitals, nearly 30 percent of MSF's expenditures as of May 31 were devoted to logistics, such as the rehabilitation or construction of medical facilities, and ongoing maintenance of health structures including water and electricity provision. Without this investment, medical staff would not be able to operate. A further 16 percent of MSF's expenditures have been attributed to medical materials and supplies. Because of the large number of essential emergency workers and vast amount of relief goods brought into Haiti, transportation accounted for 23 percent of the total spending to date. At one point, the MSF team totaled over 3,500 Haitian and international emergency personnel – many of them doctors and nurses, but also logisticians, administrators, drivers, and project coordinators. At the end of June, MSF still has more than 3,000 staff on the ground, well over 90 percent of them Haitians. The costs related to employing personnel accounted for 28 percent of the money spent.3" MSF, "Emergency Response After the Haiti Earthquake: Choices, Obstacles, Activities and Finance (6-Month Report)," Pg 26.

  • 12.

    MSF, "Haiti: 1 Year Report," Pg 4.

  • 13.

    MSF, "Emergency Response After the Haiti Earthquake: Choices, Obstacles, Activities and Finance (6-Month Report)," Pgs 23-4.

    Number Category
    2,807 Haitian staff
    209 International staff
    16 Operating theatres
    1,187 Number of beds
    173,757 Patients treated
    11,748 Surgical operations
    11,421 Patients treated: post operative care
    264 Patients treated: bullet wounds only
    2,147 Patients treated: other violence related trauma
    44,717 Patients treated: other trauma
    81,735 Patients treated: psycho social and mental health (total)
    20,652 Psychological consultation
    61,083 Psychological education
    3,752 Patients treated: maternal deliveries
    212 Patients treated: sexual violence
    35,350 Relief kits distributed
    26,971 Tents distributed
    19 Number of fixed sites
    3 Number of mobile clinics
    723 Litres of water distributed per day in cubic meters
    880 Latrines built
    415 Showers built
  • 14.

    MSF, “About Us.”

  • 15.

    MSF, "International Financial Report (2009)," Pgs 37-67.

  • 16.

    MSF, "Activity Report (2009)," Pgs 12-77.

  • 17.

    MSF, "Activity Report (2009)," Pg 23.

  • 18.

    See, for example, MSF, "Haiti" and MSF, "Angola."

  • 19.

    "Following the earthquake, MSF initially developed fundraising activities and the generosity of people around the world in response to the tragedy that befell Haiti has been overwhelming. While the MSF medical relief effort was immediately shaping up to be massive in volume, the total of funds donated to MSF by the public specifically for this emergency threatened to eclipse what MSF could foresee to spend. Striking the right balance so early on was complicated by the fact that it took weeks for the real scale of needs to become clear as well as to gauge what other organizations would bring in terms of practical emergency assistance.
    MSF takes the expectations of donors seriously and decided to discontinue active fundraising for the victims of the earthquake in the days following the disaster. While MSF continued to welcome donations, pro-active earmarked fundraising for Haiti was put on hold. Instead, MSF called upon donors to continue to support the organization for its current and future emergency work in general." MSF, “Emergency Response After the Haiti Earthquake: Choices, Obstacles, Activities and Finance,” Pg 25.

  • 20.

    MSF, "Haiti: MSF Teams Set up Clinics to Treat Injured After Facilities Are Damaged."

  • 21.

    A good example of a thorough field update is: MSF, “MSF Operational Update – Haiti Earthquake Response (Feb 19, 2010).”

  • 22.

    MSF, "Treating Crush Syndrome in Haiti With Lifesaving Dialysis."

    MSF, Haiti: Strong Aftershock Was "Frightening for Everyone."

  • 23.

    MSF, "International Financial Report (2009)," Pgs 37-67.

  • 24.

    E.g. "Do look for organizations with prior experience and expertise.
    There is a great deal of money after well publicized disasters. The ease of raising money makes it tempting to respond even if the organization does not have prior experience in that area. After the tsunami many organizations with no prior experience built boats or houses. I attended one handover ceremony where the boats actually sank during the ceremony because they weren't properly sealed. There is a steep learning curve when agencies move out of their normal work, this may lead to mistakes and wasted money. Make sure the organization has prior experience in their proposed projects." Schimmelpfennig 2010.

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