Humanitarian medicine: up the garden path and down the slippery slope

doi:10.1136/bmj.329.7462.398

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Deborah Harding-Pink, former medical officer (harding@bluewin.ch)1

¹ Geneva, 1203 Switzerland

Accepted 22 December 2003

Doctors dealing with asylum seekers need clearer direction on how to manage human rights issues and avoid being drawn into abuses

Introduction

Twelve years ago, I joined an International Committee of the Red Cross mission to visit detainees in South African police stations under apartheid. As I was leaving, a colleague gave me Medicine Betrayed, the BMA's pioneering report on the participation of doctors in human rights abuses.1 It seemed so relevant to the issues with which I was confronted as a “humanitarian” doctor. My missions with the Red Cross and then with Médecins Sans Frontières took me to countries at war such as Liberia, Tajikistan, Rwanda, Burundi, and Kosovo. These experiences reinforced my conviction that humanitarian medicine was a powerful antidote to the violations I had read about in Medicine Betrayed. I now worry that it can also become an unsuspecting accomplice of these same violations.

Asylum seekers and migrants

In 1995, I joined the International Organisation of Migration (IOM), another organisation with a humanitarian mandate. As its occupational health officer, I followed the work of IOM staff in over 70 countries, many of which I visited, including Afghanistan and East Timor. My work has slowly made me realise how easy it is to be absorbed in a system and to slide down the slippery slope of failing …