McMaster Friends of MSF

In the chaos of conflict, access to unbiased and impartial medical care becomes a beacon of hope for countless civilians. Medical neutrality, a principle embedded in humanitarian efforts, ensures that healthcare transcends political and military conflicts, protecting both lives and human dignity.^1,2

In war-torn areas, healthcare professionals often operate under intense pressure to favour certain groups.^1,2 However, by adhering to medical neutrality, organizations like Médecins Sans Frontières (MSF) provide care based solely on medical need, rather than political or military considerations. 

MSF’s principles clearly emphasize neutrality and impartiality. As stated in their guiding principles:

MSF offers assistance to people based on need and irrespective of race, religion, gender or political affiliation. We give priority to those in the most serious and immediate danger. Our decisions are not based on political, economic or religious interests. MSF does not take sides or intervene according to the demands of governments or warring parties.³

This approach not only saves lives but also helps to mitigate mistrust and hostility in already volatile environments.^1,2 The centrality of this principle is highlighted by critiques of the humanitarian movement itself. David Rieff, a leading critic, argues that the growing alliance between the humanitarian sector and the human rights community, as well as its increasing ties to Western governments, has compromised the core values of humanitarianism.⁴ He believes that this relationship has distorted the priorities of aid and eroded its independence. Rieff decisively declares, “Humanitarianism is neutral or it is nothing”.⁴

Supporting medical neutrality also has far-reaching implications for global health. It reinforces the ethical foundation of healthcare, ensuring that medical professionals can practice without fear of retribution or coercion. Moreover, it saves lives by ensuring that healthcare systems remain functional during conflicts. For instance:

• Neutral healthcare provision reduces mortality and disease transmission in war zones.²
• It facilitates the continuous provision of essential services, such as maternal and child healthcare.²
• It fosters resilience in communities by providing a sense of stability amid chaos.²

MSF has provided life-saving medical care in hospitals under constant threat of airstrikes and treated all injured civilians, regardless of their affiliations. By prioritizing medical needs over political biases, MSF has treated thousands of individuals, creating an environment of trust and humanity even in the most turbulent conditions.⁵

The Geneva Conventions and their Additional Protocols form the foundation of international laws that protect medical neutrality. These treaties prohibit attacks on healthcare workers, facilities, and patients, emphasizing the strict protection of medical missions in conflicts.² However, enforcement of these treaties remains a vast challenge. In Sudan, for example, repeated attacks on healthcare facilities in El Fasher, as well as ongoing blockades of medical supply trucks, are contributing to a rising death toll in the city.⁶ MSF has called on all parties to respect healthcare facilities and civilians, and to facilitate the urgent delivery of aid to the area. Such political conflicts interfere with MSF’s mission to deliver impartial care, showing how the enforcement of legal treaties often fails to protect healthcare in practice, as power struggles on the ground disrupt access to necessary medical services.⁶

Despite weak enforcement mechanisms, these laws are crucial. They provide a moral and legal basis for humanitarian organizations to advocate for the protection of medical care. MSF’s persistent documentation of violations highlights the importance of holding parties accountable, ensuring that medical neutrality remains a universally recognized standard.¹

MSF exemplifies medical neutrality through its commitment to impartial care. Operating in over 70 countries, MSF prioritizes medical need above all else, often risking the safety of its staff to deliver care in conflict zones.¹ During the Ebola outbreak in West Africa, MSF’s neutrality enabled it to gain the trust of communities that were initially resistant to international aid. This trust was pivotal in controlling the epidemic and saving lives.⁷ The importance of this principle is evident in MSF’s work in Palestine, and particularly in Gaza, where impartial healthcare provision has helped alleviate suffering amidst the ongoing conflict.³

By maintaining transparency and engaging with all parties in a conflict, MSF ensures its operations are perceived as neutral. This approach not only protects healthcare workers but also enhances their ability to reach vulnerable populations, irrespective of their circumstances.¹

Overall, medical neutrality is more than a principle; it is a moral responsibility that transcends borders and conflicts. By ensuring impartial care, reinforcing international laws, and building trust in medical institutions, medical neutrality upholds the dignity and resilience of humanity. As MSF’s work demonstrates, unwavering commitment to this principle can turn the tide for countless lives, even in the darkest times. Medical neutrality is not just a principle; it is a vital lifeline for those caught in the crossfire of conflict.

References

1. Terry F. The Principle of Neutrality : Is it Relevant to MSF. Médecins Sans Frontières (MSF) International. December 2000. https://www.msf.fr/sites/default/files/2000-12-01-Terry.pdf. 
2. Introduction to Medical Neutrality. Physicians for Human Rights. https://phr.org/wp-content/uploads/2019/11/Introduction-to-Medical-Neutrality-Fact-Sheet-2013.pdf. 
3. MSF Charter and Principles. Médecins Sans Frontières (MSF) International. https://www.msf-azg.be/en/msf-charter-and-principles.
4. Shatz A. Mission impossible – Humanitarianism is Neutral or it is Nothing. Médecins Sans Frontières (MSF) International. October 20, 2002. https://www.msf.org/mission-impossible-humanitarianism-neutral-or-it-nothing. 
5. Gaza-Israel War. Médecins Sans Frontières (MSF) International. December 27, 2024. https://www.msf.org/gaza-israel-war. 
6. Attacks on Hospitals and Aid Blockade in Sudan Jeopardises Lives. Médecins Sans Frontières (MSF) International. August 1, 2024. https://www.msf.org/sudan-msf-outraged-and-alarmed-over-repeated-attacks-hospitals-el-fasher-and-blockade-urgently. 
7. Ebola is About Human Beings and Trust. Médecins Sans Frontières (MSF) International. October 12, 2018. https://www.msf.org/ebola-about-human-beings-and-trust.

Edited by Katana Hussein