Published 12 July 2021; updated with new figures 28 July 2022.
In 2020, MSF had more than 63,000 individual staff movement-wide. We saw a total of 444 complaints made across our staff working in medical and humanitarian projects in the field (389 complaints) and across international headquarter offices (55 complaints). Further details below break down field and headquarters cases separately, as they are not necessarily comparable in terms of terminology and reporting processes.
The overall number of complaints received increased by 22 percent in 2020 compared to 2019. While MSF continues to face a challenge of under-reporting of behaviour incidents, this increase can be seen as a sign that MSF is starting to address this long-term problem. It indicates that complainants and witnesses have increasing confidence to speak up, and that there is growing awareness of the various reporting mechanisms and channels that have been reinforced and put in place.
The pandemic has led to a reduction in face-to-face activities to prevent unacceptable behaviour, however significant effort has been put towards virtual training. The total number of staff trained to deal with behaviour issues actually increased compared to 2019.
Despite these improvements, under-reporting continues to be an issue. Of particular concern is the limited (if increasing) number of complaints from patients, care givers and community members. This indicates the need to focus on prevention and to develop adapted community complaints mechanisms for these groups.
Complaints from our projects in the field
Over 90 per cent of MSF staff (57,429 individuals in total) in 2020 were working in the field. A total of 389 complaints were made relating to this category of staff, up from 318 in 2019.
Of those complaints, after investigation, 149 were confirmed as either situations of abuse or of inappropriate behaviour (156 in 2019).
This includes 82 cases which were qualified as abuse, compared to 106 confirmed cases of abuse in 2019 (this covers different forms of abuse: sexual abuse, harassment and exploitation; abuse of power; psychological harassment; discrimination; physical violence). A total of 40 staff members were dismissed for all forms of abuse in 2020 (55 dismissals in 2019). Depending on the severity of the case, other sanctions were also issued, such as suspension, demotion or formal written warnings.
Of the 82 confirmed cases of abuse, 55 were cases of sexual harassment, abuse, or exploitation (SEAH), compared to 63 in 2019. Twenty-eight (28) staff were dismissed as a result of those SEAH cases in 2020 (40 in 2019).
The other confirmed cases of abuse consisted of: psychological harassment (14 confirmed cases); abuse of power (8 confirmed cases); physical violence (3 confirmed cases); and discrimination (2 confirmed cases).
There were also 67 confirmed cases of inappropriate behaviour, up from 50 in 2019 (inappropriate behaviour includes: mismanagement of people; inappropriate relationships; inappropriate behaviour not in line with societal standards or affecting team cohesion; and substance use).
We have continued to see small but notable increases in the number of complaints submitted by previously under-represented groups, though there remains a lot of work to be done:
The total number of complaints submitted by locally hired staff increased again in 2020 to 172 (up from 144 in 2019). While this may be a marginal success in improving awareness and trust for colleagues to submit complaints, there is still more to be done considering that locally hired colleagues account for 80 per cent of the MSF work force.
The total number of complaints submitted by patients, caregivers, community members and other external parties showed no increase, at 23 in 2020 (also 20 in 2019). Considering that MSF undertakes millions of medical consultations each year in all our various projects, along with many other forms of contact with the communities we assist, this is very likely to be significant under-reporting. Existing complaint mechanisms need to be further adapted and improved to better reach patients and communities in individual project locations, especially given the extremely vulnerable position of many of those people whom MSF assists.
Complaints from our offices worldwide
2020 is the first year for which MSF has compiled complaints from our offices around the world, in addition to the data gathered from our medical projects in the field. Around 10 per cent of the total MSF workforce is based in these international offices.
As we have noted in previous years, the absence of these figures has led to a significant gap in our data. There is no prior year comparison. It is also worth noting that, while efforts have been made to standardise reporting, this data relates to a large number of different legal and HR processes, and so may not yet be fully harmonised.
Out of 37 headquarter offices (non-operational entities) which accounted for 5,596 staff (10 per cent of MSF workforce) in 2020, 55 cases were reported either through management lines or office-specific behaviour reporting mechanisms.
After investigation, 38 cases were confirmed as either abuse (20) or inappropriate behaviour (18).
Out of these cases, 20 people were either dismissed or received other sanctions, such as formal warnings, depending on the severity of the facts.
Achieving and maintaining a work environment free from abuse and harassment is an ongoing endeavour, for which we are all responsible. We also commit ourselves to do no harm to vulnerable people we are striving to help.
We continue to urge staff, patients or anyone else who comes into contact with MSF to report any incidents of unacceptable behaviour which they come across.