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Feature Briefing

Global medical aid charities and allegations of sexual misconduct and crime

BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k2445 (Published 07 June 2018) Cite this as: BMJ 2018;361:k2445
  1. Sophie Arie, freelance journalist, London
  1. sophiearie{at}fmail.co.uk

Will recipients of medical aid in global humanitarian crises have a #MeToo moment, asks Sophie Arie

Has sexual misconduct been alleged?

In February news broke that some of Oxfam’s non-medical staff had allegedly paid local women for sex while delivering humanitarian aid in Haiti after the 2010 earthquake. Since then, it has become clear that many aid charities, including those providing healthcare, have dealt quietly over many years with allegations of sexual misconduct by their staff, including harassment or abuse.

How common is it?

The global medical aid agency Médecins Sans Frontières has 42 000 staff in over 70 countries. In 2016, it dismissed 10 staff because of sexual harassment or abuse, it said in a statement. In 2017, it dismissed 19 people, with five others receiving lesser sanctions for alleged sexual abuse or harassment. Two cases that year involved patients or the public. MSF acknowledges under-reporting: the real number of such cases is likely to be higher.1

International Medical Corps, a US non-profit organisation with around 6500 staff providing emergency response and training in 28 countries, has confirmed to The BMJ that it received 11 reports of suspected sexual exploitation and abuse in 2017. It sacked five employees. Several investigations continue.

Doctors of the World (Médecins du Monde), another key global medical aid agency, has not published figures. Its director, Joel Weiler, told French media that the Oxfam case was shocking but he insisted, “There is no culture of sexual abuse in the aid sector.

“On the ground it’s a young crowd, 25-35 years old. So you do get some dérapages [sexual indiscretions]. Humanitarians don’t escape that phenomenon,” he said.2

Allegations of sexual harassment by Save the Children’s senior staff in London led to the charity withdrawing from making bids for UK government funding pending a Charity Commission investigation.34 It told The BMJ that it knew of no cases of sexual harassment or abuse among its medical staff in the field.

What about the United Nations?

The UN confirmed that it received 40 reports of sexual abuse or harassment in the last three months of 2017, involving peacekeeping missions, UN agencies, country programmes, and partner organisations.5 UN organisations do not deploy medical teams internationally but coordinate humanitarian healthcare programmes delivered by other organisations.

One of the UN’s most senior doctors, Luiz Loures, deputy executive director of UNAIDS, denied high profile accusations of sexual harassment in Geneva this year. The organisation investigated and exonerated him. But the investigation was criticised for a lack of independence.6 Loures left UNAIDS in March but said his departure was not related to the allegations.

What do we know about allegations against doctors?

Very little. When The BMJ asked the non-governmental organisations that have published figures for more details of the alleged abuse or harassment, and how they had investigated, they declined to comment. MSF, which has been the most open about the problem, told The BMJ that it could not provide details of individual cases to protect the identities of complainants.

Have any doctors had their licence to practise revoked?

In 2012 the General Medical Council struck off Philipp Bonhoeffer, who had been head of cardiology at Great Ormond Street Hospital in London after finding him guilty of (among other things) sexually motivated conduct towards children in Kenya, where he had travelled as chair of the medical board of UK charity Chain of Hope.7 The charity provides treatment to children with heart problems in the developing world.

Are charities obliged to inform authorities?

Charities are obliged to report alleged criminal activity by their staff to police in the country where the crime takes place. UK charities are required to report all “serious events” to the Charity Commission, including “suspicions, allegations or incidents of abuse involving beneficiaries [of care].”8 Charities are under no legal obligation to notify a medical regulatory authority.

Footnotes

  • Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.

  • Provenance and peer review: Commissioned; not externally peer reviewed.

References

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