Doctors Without Borders Prez Hosts a Reddit AMA

Reddit advertises itself as “the front page of the internet.” Users of Reddit submit content in the form of text or links, and other users vote the content “up” or “down.” This acts as a ranking system: the content with the largest number of “up” votes earns a position on the front page. There are many “subreddits,” in which content is organized by different subject areas, such as science, technology, and news.

One of the most popular subreddits includes the “AMA,” or “Ask Me Anything,” subreddit. Here, users can submit questions to those who host an “Ask Me Anything.” Some notable individuals who have hosted AMAs include President Barack Obama, Bill Gates, and, most recently, Unni Karunakara.

Unni Karunakara, the current president of Médecins Sans Frontières (MSF), more commonly known as Doctors Without Borders, hosted a Reddit AMA on July 22nd, 2013. Karunakara has joined many other organizations and leaders who are using various types of social media as a powerful tool for advocacy and communication.

Médecins Sans Frontières (MSF) is an international humanitarian organization created in France in 1971 that provides medical assistance to people who have been afflicted with violence, natural disaster, malnutrition, ineffective health care, and epidemics. In 1999, MSF received the Nobel Peace Prize for their medical philanthropy and advocacy around the world.

Unni Karunakara was elected president of this organization in June 2010, but has been working with MSF since 1995. He has much experience in the realms of medical treatment and coordination, having set up tuberculosis control programs in Ethopia as well as having worked as a medical coordinator for programs in Azerbaijan, Brazil, and the Democratic Republic of Congo.

Unni Karunkara managed to answer around two dozen questions about both his personal life and MSF posed by Reddit users before having to sign off. The following includes some of the dialogue, verbatim, among Karanakara and Reddit users regarding Médecins Sans Frontières:

Alx3m: What do you think the biggest problem the organization faces?

Karunkara: There are broadly two challenges that we face. a) to reach populations in distress. For example, in Syria or in the Sahel. b) to provide these populations with good quality treatments and ensure that they have access to essential quality diagnostics and medicines.

Heyjude321: How do you deal with countries that are difficult to operate in due to security risks. Also: Will MSF ever operate in Somalia? Has the kidnapping (and release) of the two Spanish aid workers limited your operations in the horn of Africa?

Karunakara: MSF has been operational in Somalia for more than 20 years and we continue to provide much needed health services in several parts of the country. Somalia is one of the most difficult humanitarian contexts in the world today. We are focused on meeting the health needs of Somalis in the very narrow humanitarian space we have today.

Salacious: Does Doctors Without Borders do anything to improve permanent medical facilities and conditions in countries, or is it all short-term aid for disaster situations?

Karunakara: In many countries, we work with health authorities to build capacity in order to meet health needs. While construction of facilities is not an objective in itself, we do from time to time, work to upgrade facilities so that the right sort of environment for effective health care delivery exists.

Caffeine_Infused: MSF currently makes every attempt to hold itself accountable to its many private donors. What are MSF’s plans to hold itself accountable to its patients?

Karunakara: Accountability is an important concern for us. How do we hold ourselves accountable to patients? This is a difficult question. Can a patient hold an organisation accountable if the patient does not have the ability to sanction that organisation? Reporting to the government is a poor proxy, as they may not legitimately represent the interests of patients. Ultimately, what I would like to see is transparency. How do we make programmatic choices and the quality of implementations. I have seen patients tweeting in Haiti and Somalia and social media has the great potential to be a game changer.

Chilaca: Where does most funding come from at MSF?

Karunakara: Around 90% of our funding comes from 4.5 million individuals around the world. We get some funding foundations, corporations, and other organizations. MSF does not accept funding from the US government for example.

Anriarer: Could you discuss the interaction between MSF (and other aid organizations) and military forces in your work? What role do international military forces play in stabilizing disaster areas and war zones that you work in? What role do you think they should play?

Karunakara: Our interaction with the military depends on their mode of engagement. For example, in Haiti we referred many patients to the US military doctors operating on a ship outside Port-au-Prince. Here they were in a humanitarian mode. In Afghanistan for example, the military is in a belligerent mode and that makes engagement difficult. As you may know, our ability to work in difficult contexts and access remote populations depend on our independence and neutrality. We are concerned that in many conflict areas, that the military often, very deliberately, blurs the line between humanitarian assistance and military assistance. This can be confusing for those who rely on humanitarian assistance for survival and may also put our teams in danger.

TheCasemanCometh: What was the MSF response like in Haiti after the earthquake and the Indian Sub-continent after the Tsunami?

Karunakara: We rushed to meet the immediate medical needs that arose after those natural disasters. The Tsunami provided fewer opportunities for humanitarian medical action as much of the needs, within a few of weeks, were rehabilitative and reconstructive in nature. In Haiti on the other hand, the earthquake resulted in a great loss of local capacity and was followed by a massive cholera epidemic that we responded to.

Beanstein: What are your thoughts on media coverage of disasters and how this affects the way people give donations? For example, a hugely covered crisis like the earthquake in Haiti vs. underreported, perhaps slower and more pervasive but no less dire situations such as a famine? How do you deal with the imbalance of donations that can arise?

Karunakara: We work constantly to raise awareness about “forgotten” or “ignored” crises. For example, the Central African Republic. We request that donors consider leaving their donations unrestricted. By not restricting your donations for a specific emergency or project, you will enable us to allocate resources more efficiently to people most in need.

In addition to talking about the operations of MSF, Unni Karunakara explains how a normal individual can have a significant impact on the lives of many without being trained as a doctor or nurse. It is a combination of lobbying, policy makers, and humanitarian organizations that will most effectively alleviate unnecessary suffering in the world.

TakTakyon: What are other ways people can help those who need assistance when they lack the qualifications required for professional work in the field?

Karunakara: One does not need to get on a plane to Africa to be a humanitarian. Policies made in Washington and Brussels have huge impact on the live of people we work for for. I would urge all supporters to hold your parliamentarians, politicians, and governments, for the policies they make. For example, a couple of trade treaties that are being negotiated by the US as well as by Europe has the potential to limit the availability of affordable, effective, quality medications for people in resource poor settings.

Sources: Reddit, Doctors Without Borders
Photo: RebelMom