From Vienna to the world – “Doctors Without Borders” has been around for 30 years

Since its foundation 30 years ago, the organization “Doctors Without Borders Austria” has developed into an important humanitarian aid organization. What began in 1994 with the Viennese doctor Clemens Vlasich and eleven donors is now an institute that operates worldwide. “Private donations are still the only source of funding for our aid operations in Austria,” says Managing Director Laura Leyser.

One of the first missions of the Austrian team was during the war in former Yugoslavia in Srebrenica. The organization was also able to help the survivors of the tsunami in Indonesia in 2004. “It would be nice if our organization no longer needed it one day. But unfortunately we are still far from that. Our work is more necessary today than ever because of the many conflicts and crises, but also because of the climate crisis,” says Leyser. “Doctors Without Borders” is also present in the current war in Ukraine.

Only after evaluation will the location of the deployment be determined
The decision on where to conduct operations is based on a careful assessment of the needs in the crisis area. A specialized reconnaissance team assesses whether and how the organization can help and, if necessary, launches an operation within 48 to 72 hours. However, limited financial resources also mean that difficult decisions have to be made about which crises to prioritize.

“We are seeing that more and more people are barely visible in humanitarian crises and that there is therefore no awareness and too little support for them. We are active in more than 70 countries. In this respect, it is the crises that are forgotten and not reported in the media that are the biggest gaps, both financially and in terms of aid,” explains the general director. In war zones such as Gaza or Sudan, there is a shortage of surgeons, among other things. But the operations are also becoming increasingly complex and expensive, especially in conflict zones or where Doctors Without Borders is virtually the only remaining aid organization in some places – such as in Sudan.

The local population is included
An important part of the work on location is the involvement of the local population. “Of the more than 69,000 employees in 2023, almost 80 percent were local employees who were recruited in 70 different countries. Training and retraining local specialists is an integral part of the aid in our programs. “In addition, we have our own ‘Doctors Without Borders’ academy to train health workers,” says General Director Laura Leyser.

A key goal for the coming years is to halve our ecological footprint by 2030. We will also continue to work on innovations to make aid more effective on the ground. However, the overall goal remains unchanged: providing emergency medical aid where needed and raising awareness of humanitarian crises.

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“We help where people are in need” is the motto of “Doctors Without Borders Austria”. On the occasion of the 30th anniversary, logistician and board member Georg Geyer provides in-depth insights into the challenges and successes of working in crisis areas around the world.

Can you tell us about a particularly formative experience during one of your assignments?
Yes, of course there are some. There are beautiful moments that are a bit rarer, but also less beautiful moments that are unfortunately also memorable. So from my side as a technician at Doctors Without Borders I would definitely say that the beautiful situations are like the ones in South Sudan. There was a local conflict there. People fled two villages away and we had a clinic there where we knew there was not enough drinking water. Then we built a water purification plant for 6,000 people within 48 hours. These are moments when you are very satisfied when you can drink the first glass of water that you ‘produced’ yourself and everyone is happy. These are the beautiful moments. The less beautiful ones are certainly when there are problems. In 2015 I was in Sierra Leone twice because of Ebola and when you find out that a close colleague tested positive, those are of course moments that stay with you, but they are not so pleasant.

What are the biggest challenges you face in your assignments?
On the one hand, these are the problems that you encounter in every job. When it comes to HR, I don’t think it’s pleasant for anyone to fire someone, for example. These are things that everyone knows in normal life in Austria. On top of that, it’s the context, the environment, that is always a challenge. The safety issue is of course very big, but also the cultural differences. If we are honest with ourselves, we have a lot of corruption in the less developed countries. So these are all issues that you have to deal with on a daily basis.

What measures are being taken to ensure the safety of emergency workers?
Security is a very important issue for us. It is actually the most important issue, even above medical necessity. So when we say: “We cannot do this for security reasons”, the doctors have to accept that. Security management is omnipresent. Security concerns everyone, everyone is on board. The security concept that dominates most security operations is ‘security through acceptance’. Because of the neutrality and independence of “Doctors Without Borders”, we have the possibility to more or less demand the acceptance of the host community. So it is also the case that when we talk to people on our missions and say to them: “We would like to do this, we would like to help here, there are these and these problems”, we can only implement this if we remain neutral and independence is guaranteed. This acceptance by the population means that you are well embedded, but you have to constantly monitor your environment and be constantly alerted. There are many projects where we have a briefing every day at 8:00 with the whole team, where security issues are also discussed.

What successes and progress have you observed during your missions?
At its core, Doctors Without Borders is an emergency aid organisation and if we are honest with ourselves, we are often not able to implement medium-term or sustainable change. For us, the goal is paramount: this patient is treated, the job is done, the next patient. Of course, there are developments, so we try to get the local population on board, because that is the biggest source of support. But unfortunately, I have often experienced that we close a project and three months later we are back in the same area and sometimes it is as if we were never there. We have to be realistic about that. We are very good at delivering patient care quickly and well on the spot, but sustainable or medium-term development is not really our primary goal.

What motivates you personally to do this often dangerous and challenging work?
I just find the work incredibly exciting. I loved travelling and was always interested in other cultures. That is one part and the other is the organisation. “Doctors Without Borders” is very pleasant as an employer because this existing independence is also put into practice internally. Independence is not only expressed externally, but is also present internally. Every voice counts, ultimately the decision is made by one person who is also responsible, but it is a very nice employer. And as I said: if you like to travel abroad and travel under different circumstances, then it is a very exciting and sometimes very rewarding task.

How do you deal with the psychological and physical stress of your job?
We keep a close eye on that. For us as an organization it is clear that it is sometimes very stressful. There are assignments where you have to work 14 to 16 hours a day. It is also clear that you cannot do this for much longer than two months. But we make sure that our employees take regular vacations and get enough rest. Everyone knows that stress reactions, sleep disorders and much more have serious consequences. But we try to train people to observe these things and to always keep an eye on themselves and their colleagues.

What can still be improved to increase the effectiveness and efficiency of humanitarian operations?
It depends a lot on where you are in the operation, but in principle more resources, both human and financial, always help. When it comes to efficiency, you also have to look at each case individually.

And how do these cases differ?
First of all, there are big problems with logistics, administration or government. It is always complicated to get a visa in difficult countries. Believe it or not, there are situations where we have people ready, but we cannot start working because we cannot get a visa. That would be one case, but there are also very different cases. In South Sudan, for example, the weather and the soil are a big problem all year round. You cannot really move, except by plane or helicopter.

What role does public relations play in raising awareness of humanitarian crises among the population?
This is also a task that we take on. Especially in Austria, where we fortunately have no activities, we try to convey our field observations and make the population aware of them. This happens less in the projects and more in Europe or the donor countries.

Then we arrived at my last question. What is the best way to support Doctors Without Borders besides donations?
The donations are of course important. We are the largest privately funded aid organization in the world. This is also the quality that gives us our independence and is therefore an important point. If you are interested, you can also submit an application and see if you want to go on a mission yourself. And you can support us in the sense of observing by following us on social media and see which topics appeal to you.