Archive: GA 2015 (Göteborg)

Agenda for the 2015 General Assembly

Operations in High Risk Contexts


Statutes Changes Propsed by the Board - MOTION PASSED

Motion in regards to number of Board Members - MOTION FAILED

Motion recieved after the deadline: Motion on Closed Board Meetings - MOTION PASSED


Security Motion - MOTION PASSED

Rohingya Motion - MOTION PASSED

Institutional Funds Motion - MOTION PASSED

Harmonizing Statutes Motion - MOTION PASSED

MSF Sweden Board of Directors

The following were elected to the MSF Sweden Board of Directors

Luis Encinas, Regular Member (2015-2018)

Ingrid Maria Johansen, Regular Member (2015-2018)

Helene Lorinquer, Regular Member (2015-2018)

Helena Nordenstedt, Regular Member (replacement election) (2015-2016)

Sophie Graner, Deputy Member (2015-2017)

IGA Representative

Anneli Eriksson was elected IGA Representative (2015-2018)



2014 Annual Report

Minutes from the 2015 General Assembly


Operations in High Risk Contexts

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Today we are working in several highly insecure contexts where we are facing serious operational challenges affecting our work such as a limited humanitarian space due targeted health care facilities and health workers, access problems, radical groups, and increased number of security incidents including high abduction risk.  Meanwhile, some contexts where the needs are overwhelming we cannot get safe access to work at all. These constraints have had a high impact on our operations and have led to compromises and adaptations to the way we carry out operations.

In 2013, after working in Somalia since 1991, MSF took the decision to leave the country as a result of extreme attacks on our staff in an environment where armed groups and civilian leaders increasingly supported, tolerated, or even condones the killing, assaulting, and abducting of humanitarian aid workers. In Syria, we have found that impartiality through proximity is no longer possible, and that we are unable to maintain operations in any scale appropriate to the needs. Though we have chosen to leave countries like Somalia, we keep working in other high risk settings like Afghanistan, Syria, Iraq, Mali and the Central African Republic.  And even with the significant risk posed to our staff, both national and international, we are still working in the Ebola affected countries.

The increased security constrains put higher demands on our security analysis and response. In the case of Somalia, and other volatile contexts, we were facing compromises like having to keep supporting organizations involved in holding our colleagues hostage; of risking supporting terror organizations indirectly; low efficiency due to security constraints; impaired and sometimes violated humanitarian principles (neutrality, impartiality, independence), “profiling” of MSF staff, neglected duty of témoignage to name a few.

Another problem we are facing is the different security analysis and operational strategies adopted for the same contexts by the five Operational Centers.  For instance, Syria is considered too dangerous to have direct operations in according to OCB, but still possible to work in according to OCG and OCA. OCB left Libya due to the security constrains while OCP arrived for an assessment.

During this debate we will approach high risk contexts and security from different angles, and talk about operational choices and compromises in our response, what level of compromises we are willing to make, what risks we are willing to take as an organization, and what it means / how the different operational choices and security analysis are affecting our security in the field, and what our role as partner sections is on all of this.

Nils Petter Mørk, Head of Communications MSF-Norway, Assistant Project Manager for “Medical Care under Fire” will moderate the debate.


During this segment we will discuss some of the following:

  • How do we change and adapt to risks in rapidly changing environments?
  • What compromises are we forced to make, and do we compromise on our medical package in order to stay in high risk contexts?
  • Looking at the practicalities of operational choices and security constraints, where are the proverbial «lines in the sand»?
  • When is remote management the best, or sometimes only, option? Are we taking on a partnership approach, and what challenges does this entail?


Luis Encinas, Head of Operational Cell 2 OCBA, former Ebola Ops strategies focal point

Ahmed Abd-Elrahman, Deputy Coordinator of Operations OCB


During this segment we will discuss amongst other things:

  • What are the differences in approach to risk and security between Operational Centers? Are there real differences in how security is approached? Are the differences merely rhetorical or are they ethical differences? Or are the differences we are seeing simply variations on «flag planting»?
  • Why don’t OCs share incident information, critical incident reviews, security management policies and security protocols freely? What are the existing road blocks?
  • Is a common security stance desirable or is it better to work independently as OCs? What contextual variations impact on this, e.g. in the Middle East region?
  • What constructive role should Partner Sections take on this issue, in terms of management, HR and governance?


Michiel Hofman, Senior Humanitarian Specialist for the Humanitarian Innovation Team of OCB

Colin McIlreavy, MSF International Board Member

Wouter Kok, Field Security Advisor OCA

Christian Captier, SIMM project (Sharing Incident Memory and Mitigation) Médecins Sans Frontières

Johan Mast, General Director MSF-Sweden

Background Materials: 

MSF in Highly Insecure Settings: Principles and Practices

IB Resolution(s) on kidnappings & related comms

Kidnappings and Insecure Settings


Statutes Changes Propsed by the Board - MOTION PASSED

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In 2013 the General Assembly voted in favor of a motion instructing the Board that:

It is the will and vision of the General Assembly is that MSF-Sweden, as far as possible, should merge its association, board and office with the associations, boards and offices of the other Scandinavian MSF-sections in order to make “MSF-Nordic” a single entity, a de facto MSF-section. The General Assembly mandates the Board of Directors to work towards this objective and to report back to future General Assemblies on the progress made. (Approved May 18, 2013)

The motion came as a follow up from the 2014 GA where the members approved the following motion:

The members voted in favor of the so called 3rd model: Nordic United where we will have one Nordic Board, one Nordic President, one General Assembly, one Annual Action Plan, one long term Strategic Plan, one common vision, and one integrated Nordic budget. (Approved May 17, 2014)

The Swedish Board have worked with the Norwegian Board[1] (where similar motions were passed in 2013 and 2014) in order to fulfil the will of the Association.  During 2015 we have worked on integrating activities like having a joint Facebook group, a joint Nordic Newsletter, and a joint Nordic site on InsideOCB.  All of which are examples of administrative changes, not structural.  Since a few years back we have formalized how the Danish, Norwegian, and Swedish Boards work together, but apart from the PowWow there hasn’t been a place for the members to jointly make decisions. 

In August 2014 the Board of MSF-Sweden and MSF-Norway decided that in order for us to move forward in terms of making real structural changes in order to achieve the will of the Association as presented in the motions.  Work has been done on a common strategy and a joint communications plan for the Association.  But the biggest initiative is the 2015 General Assembly in two weeks where the members will meet, debate and vote for motions.

Looking over our statutes, we quickly realized that adjustments needs to be made in order to ensure that the members of MSF-Sweden and MSF-Norway have the same rights in terms of membership criteria and voting rights.  Many more changes will have to come in the coming years (we need to look at Board terms, how the President is elected and much more), but we thought that we would start by addressing what we perceived as being the most urgent discrepancies. 

As we were going over the statutes again we thought it was prudent to also include changes proposed by the International Movement as outlined in the International Statutes and the International Internal Rules. All sections will be asked to report back to the IGA in June on whether or not changes have been done.

The following statutes changes have been approved by a unanimous Board, and we hereby ask you the members to approve them as well

[1] The 2013 motion was not presented at the MSF-Denmark General Assembly.  And in 2014 the Danish assembly voted against a merger.  As a result MSF-Denmark is still a part of the greater MSF-Nordic collaboration, but have chosen to not be part of any work towards a merger.  For instance, they have chosen not to be a part of the joint General Assembly. 

Read the full document and the statutes changes here (English and Swedish)

Motion in regards to number of Board Members (submitted by Kristina Bolme Kühn) - MOTION FAILED

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The board of MSF Sweden is set to govern and safeguard the organization. To do this the representatives are elected by the members according to the statutes of MSF Sweden. These statutes were created in 1992 when MSF Sweden was founded. At the time the number of board members was regulated by both Swedish regulations for “Föreningar” and the international movement of MSF. MSF Sweden was founded as partner section under the board of MSF Belgium thus the board members were 7 elected members and 2 appointed board members by the mother section, Belgian MSF: Today MSF Sweden is no longer bound by this and the need for appointed members are long gone.

In 2013 a motion on abandoning the international members was accepted and today all members are elected on an equal basis. At the time we decided to replace the international members with normal members instead of taking them away and regulating the number of board members.

Internationally the number of elected board members varies from 5 to 19; the difference is not correlated to the size of the organization. But a smaller consolidated board might inspire to co-option of needed competences. The author of this motion cannot see any other reason why MSF Sweden should have 11 members other than a pure historical one.

This motion asks the General Assembly to take away two elected board members to be in line with a future of an MSF Nordic board and to consolidate the board work, something that should have been done in 2013 when the international members were taken away.

See appendix of number of board members internationally. 

Motion recieved after the deadline: Motion on Closed Board Meetings (submitted by Tim McCann, Gabriele Casini, Lennart Dahlberg) - MOTION PASSED

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Preamble: Firstly, this motion recognizes the valuable work of the board members in representing the MSF Sweden association in the challenging and fluid MSF environment.

Maturity is a constant in an organisation, as are the opportunities to improve. The authors to this motion have identified a challenging grey zone around the specific aspect of board meeting administration governing closed sessions. Whilst there is a logical need to be able to discuss certain matters privately amongst the board to mitigate the risk of misuse and misrepresentation of information, there is an equally logical need for transparency to allow for the interested association members to understand how the section is evolving, which is highly compromised by closed sessions with no meeting minutes.

Given the often conflicting nature of these two considerations, there does appear to be a real need to regulate this aspect of board meetings with greater consistency and clarity.

Motion: The motion requests that the association are made aware of a framework/ policy that specifies on what grounds closed sessions will be utilised in board meetings and that such a policy can be used as a reference for guiding this important aspect of board administration. 


Security Motion

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That the Norwegian Board proposes and actively works for the following through its representation in international fora:

That the Operational Centres and the International Board works towards closer cooperation within the MSF movement on security issues, firstly by mandating and monitoring the implementation of the following concrete actions in line with the May 2013 IB resolution:

  1. Creating one intersectional security incident monitoring system which is easy to use, capturing all significant incidents and staff groups equally, and available to all OCs for reporting, analysis, monitoring, learning and research purposes.
  2. Ensuring coordination and sharing of all field-based security information and risk analysis between missions in the same contexts (local, national or regional) in order to improve real-time risk analysis and mitigation efforts.
  3. Ensuring that reviews of be made of all serious incidents and near-incidents after their resolution, and ensuring that the findings of these reviews be made available in full to the RIOD, Excom and IB. In cases of extreme sensitivity or defined residual risk, explained redactions can be made before sharing beyond these levels. 

Background and explanation:

MSF Norway / Denmark / Sweden have followed with significant interest the internal discussion on operating in Highly Insecure Contexts and on resolution of kidnappings. The IB resolution of February 2015, reaffirming the May 2013 resolution, defines again the need for agreement on public positioning in the case of kidnappings.

Acknowledging the need for maintaining control of flow of information during the resolution of serious security incidents, we stress that internal transparency is a prerequisite for institutional memory, learning and staff training/preparation, and that these and other areas of our work are important for mitigating and reducing the risk for serious incidents in the first place.

The current intersectional dynamic is both a cause and consequence of what is an apparent lack of trust and functional cooperation between the Operational Centres. In many low risk missions, the consequences of this might be slight, but in rapidly changing insecure contexts, consequences might be of the most serious nature. Threats to the life, liberty and health of our staff and patients demand that the MSF movement takes significant and meaningful action to improve inter-OC sharing and cooperation to the benefit of all OCs, missions and ultimately our patients.

It is no longer good enough that HoMs and FieldCos must creatively find local ways and means of sharing security analysis and incident reports across sectional boundaries. Nor is it acceptable that the lessons learnt from security incidents are kept within closely guarded, but often undefined, need-to-know parameters, even long after their resolution.

We are ever growing as a movement, and we cannot continue to allow intersectional distrust to obstruct invaluable security information from reaching and improving our collective understanding of our security situation.

Having once more been resolved at the IB level, we hope and trust that progress can now be made on several related areas of how the MSF movement manages our work in insecure areas, in line with the May 2013 IB resolution.

Motion authors: Nils Mørk, Lindis Hurum, Alan Lefebvre, Bjørn Nissen, Johan Bjørkås

Rohingya Motion

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Confronted with the systematic persecution of the Rohingya, the dilemma faced by MSF in Rakhine State is emblematic of the broader MSF dilemma of 'temoignage versus access.' A dilemma which has produced a long-term strategy of public silence that continued even after the expulsion of MSF from Rakhine in February 2014. Despite limited medical access and despite that the Rohingya face an ongoing humanitarian crisis the strategy of public silence continues to this day.
As Association members we are concerned about this continued public silence and do not believe it to be in line with MSF principles and core values.1 Therefore we call on the IGA Representatives from MSF-Sweden and MSF-Norway to bring the following motion on MSF’s humanitarian strategy in Rakhine to the 2015 International General Assembly:
We request that témoignage remains at the core of our operations and urge the IGA to adopt a strong positioning on the ongoing humanitarian crisis in which the Rohingya population is living under in Rakhine State. Further we request an international and public, relevant and well-coordinated advocacy campaign be launched in order to highlight the plight of the population and to advocate for a change.
1 CHANTILLY: 2. Temoignage (Witnessing) – An integral complement
Temoignage is done with the intention of improving the situation for populations in danger. It is expressed through:
• the presence of volunteers with people in danger as they provide medical care which implies being near and listening
• a duty to raise public awareness about these people
• the possibility to openly criticise or denounce breaches of international conventions. This is a last resort used when MSF volunteers witness mass violations of human rights, including forced displacement of populations, refoulement or forced return of refugees, genocide, crimes against humanity and war crimes.
In exceptional cases, it may be in the best interests of the victims for MSF volunteers to provide assistance without speaking out publicly or to denounce without providing assistance, for example when humanitarian aid is “manipulated”.
LA MANCHA AGREEMENT (25 June 2006, Athens): 1.9. In the case of massive and neglected acts of violence against individuals and groups, we should speak out publicly, based on our eyewitness accounts, medical data and experience. However, through these actions we do not profess to ensure the physical protection of people that we assist.
Motion authors:
Peik Brundin, Medical Doctor, Rakhine State Myanmar, October – December 2012
Malin Fransson, Nurse, Rakhine State Myanmar, January - July 2013 & Active Recruitment, Learning & Development, Médecins Sans Frontières Sweden
Helena Frielingsdorf, Medical Doctor, Rakhine State Myanmar, January – April 2013, Board Member of Médecins Sans Frontières Sweden
Jonas Hågensen, Acting Head of Communications, Médecins Sans Frontières Norway
David Jansson, Nurse, Rakhine State Myanmar, December 2012– June 2013 & currently Medical Team Leader, Kutupalong, Bangladesh (serving the Rohingya community)
Ingrid Maria Johansen, Project Coordinator, Rakhine State Myanmar, January – July 2013
Christina Ljungberg, Medical Doctor, Rakhine State Myanmar January 2006 – January 2007
Background / Context
  • The Rohingya are an ethnic, Muslim minority numbering around 1.3 million living predominantly in Rakhine State in Myanmar (Burma).
  • The Rohingya are considered by many to be the most persecuted minority in the world. They are an ethnic minority that has suffered human rights abuses and persecution from the Myanmar government for decades. Even before the sectarian violence in 2012, the Rohingya already faced a discriminatory population control ‘two-child policy,’ required permission to marry and were not allowed to attend higher education.
  • Myanmar suffered a wave of anti-Muslim sectarian violence 2012-2014.
  • The two waves of sectarian violence in Rakhine State in 2012 forced a majority of the Rohingya living in the middle and southern parts of Rakhine state (around 137,000 persons though statistics vary) into squalid IDP camps that are effectively open air prisons, guarded ‘for their own protection’ and reliant on humanitarian aid and have no access to state health care.
  • While statistics vary, out of an estimated 800,000 - 1 million Rohingya living in Rakhine State, 100,000 are estimated to have left for other countries mainly via boat since the violence in 2012. This rate of exodus is likely to continue. Many die at sea or fall into the hands of human traffickers.
  • The term ‘Rohingya’ is systematically denied by all State authorities in favor of the term ‘Bengali.’ Even those within the international community working in Myanmar are afraid to publically use the term ‘Rohingya.’
  • Rohingya lost their citizenship under the 1982 law when they were declared not to be an ethnic minority in Myanmar. A critical mass of Myanmar’s Buddhists have become convinced that the Rohingya are not an ethnic group of Myanmar but rather immigrants from Bangladesh. The government is offering the Rohingya citizenship if they can prove three generations of residence in Myanmar and if they accept to be labelled as ‘Bengali’ however the Rohingya have thus far refused to do so or are afraid of the consequences if they do.
  • The anti-Muslim ’969 movement’ and its leading figure the monk Wirathu, have become powerful in Myanmar. Wirathu preaches hate speech and believes that Muslims are a threat to Myanmar.
  • MSF has been working in Rakhine State for 20 years however were kicked out in February 2014. Since December 2014 MSF has restarted medical operations estimated at around 50% of the level prior to being expulsed. These operations focus on primary health care (mainly through mobile clinics), HIV, mental health and malaria. MSF has never received permission to open secondary, or over-night health care facilities, meaning that patients in need of hospitalization cannot be treated by MSF but need to be transferred to a state hospital where MSF pays the bill but has little insight into the care provided.
  • MSF also has a project in Kutupalong, Bangladesh, described by many as one of the worst IDP camps in the world
  • For further reading/viewing see below. Note that the motion authors do not necessarily subscribe to all that is stated in these various articles and documentaries:
    • MSF in Myanmar:
    • Human Rights Watch Report:
    • Fortify Rights Report:
    • Al Jazeera documentary:
    • March to End Genocide report:

Institutional Fundraising

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Preamble: MSF is currently facing a somewhat unique situation: despite our operations growing at a very quick pace, the expected income is growing even faster. In order to not have unreasonable reserves and as such money we cannot make use of for our patients, MSF has decided to reduce the income in both private and institutional funds to the same levels as the operational growth.

As occasionally in the past when MSF enters a period of financial stability, some voices are raised on the balance between private funds (PF) and institutional funds (IF).  Is this not an opportunity to stop institutional funding altogether? In the past, by the time the question has reached the discussion table, the financial situation had changed again and MSF by then would have seen the need to maintain the IF (or even increase them) and that foolish idea (whatever it was) has quickly been forgotten. In the new Resource Sharing Agreement, which regulates income and expenses in MSF sections around the world, the plan is to reduce the share of institutional funds in relation to the programmes expenses from around 15% to 6% in the next couple of years, combined with a reduced investment in private fundraising

We believe now is the right time to start discussing the advantages and disadvantages of moving to a fully privately funded organisation. Could that improve access, increase quality and enhance the range of services MSF can offer? Could that improve credibility for our advocacy and campaign efforts? Or will it isolate us from governments we try to influence, and reduce our operational flexibility?

Moving to 100% private funds is more than a budgetary decision. It would be a political choice quite difficult to reverse. If the purpose of such a move would be to project a different public and bilateral image of MSF as a fully independent organisation, it is a decision made to stay.

Advantages of such a fundamental change of policy are clear: accepting government funding is a compromise with your independence, as the funding is tied to the political considerations of the donor. As in many regions, especially in conflict settings, many of the nations and multilateral institutions also have a political and sometimes military stake in the countries where we work, this has always been an uncomfortable compromise. Our current policy is to steer clear of such funding when donor government involvement in the conflict is obvious, but this is a weak position as it means we need to explain to belligerent parties that we do accept government funding, including governments in opposition to their objectives, elsewhere, just excluding funding for projects in their particular location. This strategy, in a globalised world where almost everyone has instant access to information including MSF’s funding choices, can be difficult to justify on the frontlines. A simple message ‘MSF does not take any money from governments’ will remove one of the barriers of gaining trust of armed groups as well as suspicious national governments that need to grant us access and refrain from attacking our patients, staff and resources.

The arguments against such a policy is that we may lose our leverage with donor governments, that the institutional funds bring flexibility in case of a surge in needs that we cannot meet with private funds, that it promotes accountability systems within MSF, that it diversifies income and thus reduces risk and that it can have a quick impact on our steering ratios. The progress over the past years in developing common approaches to anticorruption within MSF is to a large part attributable to the collaboration with institutional donors. They are often very responsive and quick to fund MSF operations, and the political risk involved is very low as humanitarian funds are much less steered and controlled than development funds. However, the humanitarian funds that are quick to access, are mostly available in exactly the conflict areas we try to privately finance because of donor government, military or political interests.

Now, there are many opinions and much less facts on the advantages and disadvantages of institutional funds. What we do know however is that a decision to move to being fully privately funded is a political decision with identity implications that should not be taken in a rush, or on the back of an unexpected surge of income. And even if such a decision is taken, it would take a few years to turn it into practice.

However, not having this discussion at this stage, whilst considering other long term strategic investments and cutting a successful private fundraising machine, is not consistent with MSFs continued ambition to be truly independent and needs driven. For this reason, we urge the general assembly to hold the executive of MSF to account on delivering a credible answer, before the next general assembly, to the question “what happens if we aim for 100% private funds?” so that the members can take an informed decision on which way to take.

Motion: The general assembly requests the executive of MSF operational centres to report to the members at the IGA 2016:

The advantages and disadvantages of reducing institutional funds from states and multilateral state institutions to zero procent, thus becoming fully privately funded, and the recommendation of the executive in this regard.

Harmoized Statutes

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Harmonizing Statutes (presented by Alexander Buchmann, Lindis Hurum, Stefan Liljegren, and John Tzanos) In order to give clear direction to the MSF Nordic vision process, the associations of MSF Norway and MSF Sweden mandates the board of MSF Norway and MSF Sweden to present a shared set of legal statutes, fully harmonized between both associations and also towards the statutes of MSF International, and applicable for the general governance of both associations. The proposed set of common statute changes should be presented for approval by the associative at the joing General Assembly in 2016. 

By: Rebecca Cederholm