Médecins du Monde is a medical humanitarian NGO that, for more than 20 years, has relied on volunteer health professionals. President Dr Claude Moncorgé told Amy Cook in Paris about his organisation’s commitment to achieving the goals of providing care and protecting the health rights of those excluded from society's safety net.

AN: When was Médecins du Monde set up, and why?

CM: Médecins du Monde was founded in 1980, following the actions of a group of doctors that went to help the Vietnamese boat people adrift in the South China Sea after the fall of Saigon.

AN: What was the organisation’s initial goal?

CM: It’s difficult to look at this in isolation from the general humanitarian movement in France, a movement born in the 1970s with the creation of Médecins Sans Frontières, and a group of doctors who pulled out of Médecins Sans Frontières to create Médecins du Monde. Both organisations were part of this general movement of going out to help people. As doctors, the goal was to provide medical help, but at the same time to expose the facts, and to bear witness to situations where people were suffering. This separated them from the general movement and the International Red Cross, whose work, though also medical, was founded on the principles of neutrality and impartiality.

AN: Could you give an example of a problem you feel should be highlighted, and what your organisation is doing?

CM: Today, the one debate in the European Union is directed towards reaching a unified policy towards asylum seekers throughout Europe, and promptly. Discussions focus on the need to give asylum to people whose life is threatened elsewhere because of opinion, or religious beliefs. But this is very restrictive -- 90 percent of these people will be refused. Few countries still exist where people are oppressed for the colour of their eyes or skin. But the important thing is that the 90 percent of people who come knocking at the European Union’s door are here because they are dying of hunger, because they have no medical treatment, because their living conditions are impossible -- for reasons of poverty, not politics.

If this issue is not addressed, millions of people will be refused entry, but will find ways to stay in the European Union more or less illegally, with few rights or no rights at all. We are out there and, with our medical expertise, we see the catastrophic health implications for these men, women, pregnant mothers, children, and people who are elderly or suffering from illness. We see the way people live in very poor countries -- and the way they live here, in a semi-underground world, half hidden, exploited at work. The situation is not only degrading for them, but also has serious consequences for public health such as infections, tuberculosis, etc.

We consider that the role of the European Union towards world poverty is a problem that should be brought out into the open. But it is an awkward issue, and one that politicians today don’t want to address. One of our roles is to make sure they do.

AN: So how does Médecins du Monde go about exposing a problem?

CM: By making public reports that cannot be disputed. Our experiences as doctors in the field enable us to make evaluations that carry weight because they are professional. Our reports are taken up by journalists, by the public and in time our message becomes a matter of public concern. And from that moment, politicians cannot ignore it, because their future depends on public opinion.

AN: Is everyone on the board of directors a doctor?

CM: No, not everyone. But 12 out of 15 are in the medical profession -- doctors, nurses, psychologists -- and there are other people who work closely with us and know more about running business.

AN: You are not only president of Médecins du Monde, but also a doctor. What work do you do?

CM: Yes, I’m a doctor, an anaesthetist. I work part-time in a private clinic in Paris. All board members are volunteers. We all have a professional activity on the side.

AN: How did you first get involved with Médecins du Monde?

CM: At the beginning I was a clinical practitioner for the public sector in Paris, working full-time in the resuscitation service, and in 1988 I went to Vietnam with Médecins du Monde to train doctors working in anaesthetics, resuscitation and emergency care who hadn’t had any training since 1975 and whose skills needed bringing up to date.

AN: How many people are employed by Médecins du Monde, and how many volunteer?

CM: There are about 220 permanent employees and many volunteers who go out into the field. There’s quite a big turnover in volunteers, as their work can be very tough, but today they number about 400. A great number of people are also employed locally to work in the field.

In France we have about 2,000 volunteers, on about a hundred projects in about 25 towns, working with those most excluded from conventional care.

AN: What work is done on the French projects?

CM: The goal of these projects is to provide care for people who are most destitute and often too lost to go and get help -- foreigners without official papers, homeless people, drug addicts, minorities… the most excluded, despite the French social services. Volunteer health professionals give what time they can, so a dentist may provide free treatment in a centre half a day each week, while a retired dentist may go there four days a week.

AN: What proportion of the organisation’s work is carried out abroad?

CM: Of our budget, 80 percent goes towards working abroad and we also have an international outlook as far as our activities are concerned. Abroad, we work on about a hundred projects in nearly 50 countries, whereas we’re present in 25 towns in France.

AN: What key missions has Médecins du Monde carried out this year?

CM: The three foreign missions that have most occupied us this year have been in Afghanistan, Chechnya and Palestine. The theme that concerns us most today is, of course, AIDS. We’re currently running twelve AIDS projects -- in eastern Europe, Africa, Asia and Latin America. We work on prevention through to treatment, including the prevention of maternal transmission.

AN: What has been the most important development in the organisation’s work in the past 10 years?

CM: I think we can say that the 1990s saw a substantial expansion of the organisation, in terms of size, operational capacity, personnel and annual operating budget. This has levelled out over the past few years. I think that the organisation matured greatly with the enormous humanitarian crises in, for example, Bosnia, Rwanda in 1994 and Kosovo in 1999. These events helped us organise ourselves, and accelerated our development.

AN: Do you expect any major changes in Médecins du Monde’s role in the future?

CM: I believe that, alas, organisations like Médecins du Monde will retain their essential role because the world’s major issues are deliberately hidden from the public eye. In other words, if there were no community-based organisations to criticise or question the policies of the World Trade Organisation, for example, then they may not be questioned. If organisations such as Médecins du Monde and others did not exist to speak out about the lack of access to specialised medicine for the treatment of AIDS, then there would not be the efforts today, which, sadly, have come about terribly late. So, I think that in a somewhat globalised world, with a rather dominant way of thinking, the role of organisations such as ours is essential in forcing the public, and in turn political decision-makers, to ask themselves about the plight of other people.