The right to life is a fundamental Human Right . . . so is the right to access life-saving medicines . . .

Image: www.sciencemuseum.org.uk

First, I shall include a press release from the team of noble international life-savers, Médecins Sans Frontières (MSF or Doctors without Borders) below:

The Indian Network of People Living with HIV/AIDS (INP+), the Manipur Network of Positive People (MNP+), and the Lawyers’ Collective HIV/AIDS Unit officially submitted their opposition to a patent application filed in the Kolkata patent office by Glaxo Group Limited for Combivir, a fixed-dose combination of two AIDS drugs (zidovudine/lamivudine, or AZT/3TC). The opposition is based on technical and health grounds. If India grants a patent on this AIDS drug, it will set a precedent that will hamper access to affordable AIDS medicines worldwide.

“Affordable generic AIDS medicines have been one of the cornerstones of our ability to keep more people alive, including here in India where we began treating people with AIDS this year,” said Dr. Pehrolov Pehrson, of MSF’s treatment project in Manipur, where all patients on antiretrovirals receive generics produced in India. “Without a reliable supply of low cost AIDS drugs – made possible because medicines patents did not exist in India for many years – national governments and treatment providers alike will be faced with an uphill battle, and patients risk having vital treatment interrupted or priced out of their reach.”

Of the over 60,000 patients in nearly 30 countries in MSF projects, 84% receive generic AIDS medicines made in India. Over 90% of all patients using AZT/3TC in MSF projects are on generic versions of the drug. National treatment programmes in India, Burkina Faso, Mongolia, Central African Republic, Malawi, Peru, the Republic of Kyrgizstan, Cambodia, Ukraine and Swaziland heavily rely on generic AZT/3TC. The availability of affordable quality generic versions of Combivir (AZT/3TC) and other anti-retroviral medicines has allowed developing countries to put more people on treatment and thus extend their lives.

The Indian groups opposing the patent are arguing that Glaxo’s Combivir (AZT/3TC) is not a new invention but simply the combination of two existing drugs. They say the granting of such a patent risks increasing the cost of anti-retroviral treatment for many people living with HIV/AIDS, thereby further increasing the burden on developing countries already struggling to treat patients.

“Universal Access to AIDS medicines will remain an elusive goal if there isn’t a steady supply of affordable medicines. Decisions made by Indian patent offices are a question of life or death for people living with HIV/AIDS worldwide who rely on the availability of these drugs made in India,” said Ellen ‘t Hoen, Director of Policy Advocacy at MSF’s Campaign for Access to Essential Medicines.

Last year, India changed its patent law to comply with the World Trade Organization’s patent rules. Three weeks ago, India granted its first ever patent to Roche for a hepatitis C treatment.

However, the Indian Patent law allows oppositions to a patent application before it is granted. Indian cancer patients and generic drug manufacturers recently opposed a Novartis patent application for Gleevec (Imatinib Mesylate), an anti-cancer drug, on the grounds that the application claimed a new form of an old drug. The patent was subsequently rejected by the patent office. Petitioners are now demanding that the Combivir patent application be rejected on similar grounds.

Here is a part of another press release that shows how people are being blinded by denying them access to affordable medicines:

Many patients with advanced HIV/AIDS can fall prey to the infection, cytomegalovirus (CMV) which will if untreated, lead to total and irreversible blindness in a very short space of time – sometimes just weeks.Blindness caused by CMV is preventable, but the most available treatments are invasive and far from ideal – injections directly into the affected eye or intravenous, twice-daily treatment requiring a long stay in hospital.There is a better medicine available – an oral medication, valganciclovir, produced by Roche. This drug is patented in China and the company charges US$ 10,000 for a four-month supply – simply too expensive for the vast majority of people most at risk of going blind. It's a similar situation in both India and Thailand – both middle- income countries where the product is patented. While the manufacturer offers discounts to the poorest countries – mainly in sub-Saharan Africa – middle-income countries including China are offered no such discount and are charged the same as wealthy countries.Dr. Peter Saranchuk has worked in China in both of MSF's HIV projects – in Nanning and the recently closed XiangFan project treating patients with HIV/AIDS. He describes his experiences in treating CMV and the frustration of seeing patients suffer because the best medicines are unaffordable.

My previous post Patients versus Patients! focussed on one Swiss company Novartis. Here is another Swiss company, F Hoffman-La Roche that seems to have been involved in a shady deal to obtain a patent in India. A case is going to be filed in the Madras(Chennai) High Court against the violation of fundamental rights as well as the weakened patent law.

Here is the link to another battle that is taking place in the Indian courtrooms, this time between the Brazilian AIDS advocacy group ABIA (Brazilian Interdisciplinary AIDS Association) and the Indian NGO SAHARA (Centre for Residential Care & Rehabilitation) on one side and the American firm Gilead Sciences on the other.

Also, take a look at this link to an interesting discussion from the XVI International AIDS Conference.

It is clear from all these links that the Indian courts have become the battleground in a war which will determine the fate of millions of humans around the world. The evil forces will use the dirtiest tricks to succeed in their nefarious designs of killing people by denying them access to life-saving medicines and deriving pleasure in watching them suffer and die. They are true sadists! Shame on them!

(To be continued)

Related post:

Patents versus Patients! (Part 1)

The MSF accuses Kenya's military and police of “meeting violence with more violence.” The international organization fears that unless the root causes of the Mt Elgon conflict are addressed, “the situation is unlikely to improve substantially and the suffering will continue.”

On its part, the Kenyan government has denied using excessive force in its Operation Okoa Maisha (Operation Save Lives). Top Army commanders and police chiefs say local residents are happy with the security operation against the Sabaot Land Defence Force (SLDF). The operation has succeeded in disabling the SLDF especially after the killing of its commander in a forest ambush.

In a Kenya Police video, released to counter the accusations of brutality, local residents in Mt Elgon can be seen narrating horrific experiences perpetrated by the SLDF. Women talk of rape, while men describe forceful conscription under the threat of death.

The video shows Kenya Army interrogators treating prisoners humanely contrary to allegations by relief agencies and local politicians. The Army colonel in charge of the operation explains in great length that his forces are operating within international humanitarian law. The video ends with shots of a return to normalcy in Mt Elgon, with schools and shops re-opening.

The conflict in Mt Elgon began in 2006, when a local clan protested over discrimination in the allocation of farm land. The SLDF was formed in reaction to these grievances, some of which date to the 1960s. At the time, government reaction was slow. During the worst of the ethnic and political clashes that erupted in Kenya after disputed elections, the SLDF expanded its recruitment and took over more territory

With the signing of a peace deal between Kenya's government and the opposition in March, the Kenya Army was dispatched to Mt Elgon to resolve a problem that was out of control.

Details of the report on the MSF website.

     

Cette série exceptionnelle a déjà été plébiscitée un peu partout tant elle est attachante par ses récits comme par sa composition.

Didier Lefèvre quitte Paris, fin juillet 1986, afin d’accompagner une équipe de Médecins Sans Frontières (MSF) en Afghanistan, en pleine guerre entre soviétiques et Moudjahidins.

De cette première grande mission photographique, il ramène un témoignage et des documents très poignants. Les albums nous invitent à marcher avec l’équipe médicale, à découvrir les conditions dans lesquelles elle peut intervenir, ses contacts, ses anecdotes. Puis le retour que Didier Lefèvre décide d’effectuer seul, sans la protection du groupe, sans parler la langue… avec les conditions extrêmes qu’il va devoir traverser.

Ces albums ont un art exceptionnel de faire « jouer » ensemble photos prises sur place et dessins. Le travail épuré d’Emmanuel Guibert y puise des paysages et des atmosphères qui ont l’âpreté du pays et parfois la magie de ce que ces hommes et ces femmes peuvent tenter dans des conditions extrêmes. Ce va et vient entre dessins et clichés photographiques tisse un récit qui gagne étonnamment en ampleur par les échos, les ellipses ou les métaphores qui sont ainsi construites. C’est superbe !

Didier Lefèvre est décédé d’une crise cardiaque à son domicile de Morangis le 29 janvier 2007. Il ne nous a pas laissé simplement un reportage mais une grande leçon de témoignage !

Hommage à tous pour ce monument de la BD !

Le Photographe, série complète en 3 tomes (S : Didier Lefèvre; D : Emmanuel Guibert et Frédéric Lemercier) édités chez Dupuis, Collection « Aire Libre » d’octobre 2003 à janvier 2006

Delisle stavolta non è stato inviato in Birmania alla ricerca di manodopera "globalizzata" per il suo editore, come succedeva nei suoi precedenti reportage da Shenzen e da Pyongyang, ma molto più semplicemente ci è andato al seguito della moglie che lavora per Medici senza frontiere, col compito di prendersi cura del loro bambino piccolo mentre lei era impegnata nelle missioni mediche.

In ogni caso, la tentazione è irresistibile e il nostro canadese racconta la pesantissima dittatura birmana, le piccole, infrangibili resistenze umane nascoste nelle pieghe delle città, la segregazione di Aung San Suu Kii, la vita delle famiglie dei diplomatici occidentali scandita in ogni caso da feste e ricevimenti, e le tante cose che al netto di ogni situazione geo-politica non cambiano mai e fanno l'umanità quella che è: amicizia, dedizione, rispetto... e l'effetto speciale di portarsi in giro un bambino nella culla.

Come sempre io applaudo al lavoro di Guy Delisle, sia per come realizza testi e disegni, sia perchè riesce a farci vedere e sentire parti del mondo che ci sarebbe gran bisogno (per noi e soprattutto per loro) di avere molto più presenti... bravo, bravo.

AMREF's Deputy-Director General, Dr Florence Muli-Musiime has warned that emergency institutions, both local and international, risk misdirecting their humanitarian crisis response if they are not sensitive to community dynamics that are not always visible in times of upheaval. In a powerful message to hundreds of delegates at the 35th Global Health Council Conference taking place in Washington DC, Dr Muli-Musiime described a 'silent emergency' that nobody spoke about following the post-election violence in Kenya, whose implications for healing and recovery has more serious implications for post-conflict health and social development than the more widely publicised plight of internally displaced people in the country.

'When the crisis broke out,' she said, 'the focus of the health system was to mitigate the physical injuries, while that of the donor community and emergency institutions was on the Internally Displaced People. But we realised that there was a silent emergency which none of the two groups was looking at – that of thousands of people who were caught up in their own homes, unable to go to IDP camps because they would have had to go through hostile territory to get there, and unable to access health or any other basic services. To make matters worse, they were physically assaulted and sexually abused in their own homes.'

Dr Muli-Musiime one of four panelists in a discussion on how current affairs affect health care in the community, with a specific focus on the recent crisis in Kenya. The others were Dr Sylvester Kimaiyo, Programme Director for AMPATH; MAP International's Senior Director for was Health and HIV/AIDS Policy, Dr Peter Okaalet; and Dr. Salvador de la Torre, Country Director for the Catholic Medical Missions Board, all based in Kenya.

The purpose of the session, according to moderator Sheila Mitchell, Senior Vice-President at the Institute for HIV/AIDS, Family Health International, was to draw lessons from the experiences of organisations that were working on the ground at the time of the crisis in Kenya and come up with recommendations for what to do in similar situations.

AMREF has worked for many years in one of the areas most affected by the violence and attendant humanitarian crisis – Kibera, a vast informal settlement that is home to close to a million people.

'Our northern-based partners focused on only a fraction of people in need,' said Dr Muli-Musiime. 'For example, only 5,000 of Kibera's 750,000 people were in the camps. Very few organisations – AMREF, MSF and some faith-based institutions – stayed where the majority of people were. Here, we observed the emergence of significant new health challenges. One of these was gender-based violence, which was systematically used as a tool to promote the political violence. Then there was a total breakdown of the health system, and disruption of household life. People were unable to cross from one section of Kibera to another to access even the most basic of health services.' This scenario was repeated in all the regions where the violence was intense; the Rift Valley, Nyanza and Western provinces.

'A very scary phenomenon that is difficult to explain was the psyche of the violence – it had no restraint. In Kibera, when a mob descended on a house, sexual violence was unprecedented and unrestrained: everyone – men, children and women – was raped. In Africa, it is not usual for men to admit that they raped other men, but it happened during this violence. The most frightening aspect was that it was all so silent, a silence that was perpetrated by the media, which was more interested in the bleeding, not where there was hurting and the bleeding was in secret. This was extremely sad.'

HIV and TB programmes were severely affected. Systems that had been established to monitor and track patients collapsed. In Kibera for example, where AMREF had established an efficient monitoring system for TB and HIV patients, the organisation lost track, within the first two weeks, of 70 per cent of AIDS patients and 30 per cent of TB patients registered at the AMREF clinic and with community support groups for drug adherance and household support. Dr Muli-Musiime warned that the fallout from this disruption was certain to erupt in coming months as the effects of missing critical dosages took effect on hundreds of patients across the country.

Countrywide, the crisis had a heavy impact on the health system. Supply was affected between the two groups. Initially, when the crisis broke out, the health system was very quick to react, thanks to the 1998 bomb blast that hit Nairobi, leading to the creation of an emergency response plan. The plan immediately kicked in when the crisis broke out last December. Those affected were quickly evacuated and moved to hospitals, although this was hampered by the fact that medical personnel could not move about freely due to ethnic animosities. Hospitals were also able to respond to the crisis adequately for the first two weeks, but as the fighting continued, they began to run out of supplies, especially surgical equipment and drugs. People were disconnected from the services because of inability to access certain areas, because of being displaced, and the inability of service providers to move into the communities as they had been doing before. This was further complicated by the fact that the health workforce was also a target of the violence depending on their ethnic origin.

'Our response was to work on both sides,' said Dr Muli-Musiime of AMREF's activities. 'We went into the IDP camps and stepped in to do the things that emergency organisations were not doing, such as water and sanitation – building bathrooms and latrines, providing clean water and keeping the camps clean – as well as providing laboratory services. Within the communities, we responded by reaching out and going where the communities were trapped and unable to get out. This required serious dialogue and negotiation with all the actors, working with households, and creating a presence on the ground. Instead of waiting for the people to come to us, we went to them. We set up mobile clinics in each village, as people were unwilling to seek services in sections of Kibera inhabited by different communities. We also had to negotiate with the communities to allow our staff and government workers to move through Kibera to provide services.

The role of the media

Dr Muli-Musiime expressed great disappointment in the media's handling of the crisis and of the victims. 'I was deeply saddened that journalists could be so insensitive to the people they were reporting about. The media needs to report painful incidents in a manner that does not magnify the pain and trauma as a result of exposure, repetition of clips showing wanton violence, or blatant insensitivity, particularly when reporting about sexual violence. When you ask a woman whether she was raped and she is surrounded by her family, she will not tell you the truth because of shame and fear of ostracisation, but they told us in private what they had been through.'

With the increased incidence of violence and aggression in communities, she suggested integration of mental health and gender-based violence into whatever work an organisation is doing. 'The underlying principle is integration. Let us not create silos – we need to ensure that we look at the spiritual and mental, as well as physical health of the people. Similarly, we need to move away from verticalising the various responses within a crisis based on the interests of different intervention partners including donors. This only ends up creating many parallel, segregated systems within the same communities. The international community is involved in patchwork; we want to create a mosaic.'

The healing process

Dr Muli-Musiime suggested that civil society has a huge role to play in the country's healing process. 'We need to reach out to politicians, interact with them, and create avenues for dialogue. We may not always agree with them, but at least we will be talking. We must also learn as Africans to appreciate our diversity, because the friction created by diversity is necessary and is needed to drive social change. We must recognise, promote and celebrate the strengths of different communities. The onus is also on each one of us as individuals. We need to change our actions and attitudes. We cannot wait for the politicians or the government to reconcile us. We need to empower communities to be conscious of the issues that cause misunderstanding, to address them and to find solutions for themselves. AMREF believes that there can be no progress in a community, whether in health or any other field, if the people themselves are not fully involved.'

The panelists emphasised the importance of putting emergency plans in place regardless of a country's past experiences. 'Kenya has been a haven of peace in a volatile region, and a refuge for many exiled people from troubled countries in the Horn of Africa and central Africa. Nobody expected anything like this would happen there. It taught us that we must always be prepared, and that we must have a plan in collaboration with other players on the ground.'

The need for coordination, honesty and integrity were also emphasised, as many organisations and individuals were involved in the humanitarian efforts, but there was a lot of duplication of activities, and even exploitation of victims of the crisis.

ReliefWeb

I am currently reading James Orbinski's "An Imperfect Offering: Humanitarian Action in the Twenty-first Century" and am having trouble putting it down. Orbinski is one of the founders of the Canadian branch of Médecins Sans Frontières (Doctors Without Borders/MSF); in 1994 he served as Chef de Mission for MSF in Kigali, Rwanda during the horrific civil war and genocide.   As president of MSF, the doctor and humanitarian accepted the Nobel Peace Prize on their behalf in 1999; his remarkable Nobel Lecture is available here.

George Stroumboulopoulos interviewed Dr. Orbinski on CBC's "The Hour"; watch it here.

CBC's "Sunday" interviewed Dr. Orbinski about his new book; watch it here.

This link will take you to a radio interview with James Orbinski on CBC's "Sounds Like Canada".

CBC's documentary, "Evil Revisited", was awarded the 2005 Canadian Radio Television News Directors Association Award. Dr. Orbinski returns to Rwanda with CBC journalist Sasa Petricic in this incredibly moving piece.

Dr Orbinski is one of the founders of the Drugs for Neglected Diseases Initiative, a not-for-profit pharmaceutical research and development entity focused on the diseases of the South. He recently co-founded Dignitas, an organization focused on community based treatment, care and prevention of HIV in the developing world.

This book, and this man speak to me on a very deep level. Each of us is responsible for each other, and each of us needs to act. As Vikram Seth so eloquently puts it in his book, "Two Lives: a Memoir":

"May we see that we could have been born as each other."

Médicos Sin Fronteras, tal y como anuncié en este blog hace un par de semanas, sigue trabajando en Birmania. He recibido un correo electrónico (un newsletter en jerga internet, o sea, un boletín de noticias) de MSF con noticias actualizadas sobre la situación que a lo mejor queréis leer haciendo clic en el siguiente enlace:

Myanmar: MSF pide que las operaciones de ayuda aumenten de forma inmediata y sin obstáculos

• Donazioni on line con carta di credito tramite sito internet>>
• Ccp 000087486007 - causale Myanmar/Birmania

Il 2 maggio il ciclone Nagir ha devastato il Myanmar (Birmania), provocando la morte di decine di migliaia di persone. Le equipe di Medici Senza Frontiere presenti nel paese hanno subito iniziato a valutare e rispondere ai bisogni della popolazione a Yangoon e nelle zone circostanti, distribuendo cibo e teli di plastica e avviando interventi per la potabilizzazione dell'acqua.

Altre equipe di MSF sono in stand-by in attesa dei permessi necessari per potere entrare nel paese, mentre sono partiti i primi aerei cargo con materiale di soccorso.
Leggi gli approfondimenti >>

I passed my Motorcycle Skills Test today.  That means I have had the supervisor and skill restrictions removed from my licence.  I can now legally exceed 60 km/h and drive without a supervisor.

I have my drivers test on Thursday at 10:15am.  I need to get some practice in before then - I'm hoping this head cold pulls a vanishing act.

I'm still hoping to take a motorcycle course sometime soon.  This can get me commuting though.  Props to all those who gave me a hand with practice time etc. when I needed it!

La película 'El Orfanato', de José Antonio Bayona y producida por Rodar & Rodar Cine y Televisión, S.L. y Producciones Cinematográficas Telecinco S.A.U., obtuvo ayer por la noche el XIII Premio José María Forqué, dotado con 30.050 euros y dejó a las puertas del galardón a los finalistas 'Bajo las estrellas', 'Las 13 rosas', 'La soledad' y 'Siete mesas de billar francés'.

Los productores de 'El orfanato', Joaquín Padró, Mar Targarona y Álvaro Augustín, recogieron el premio de la mano de la actriz Natalia Verbeke en una gala celebrada en el Palacio de Congresos de Madrid y presentada por la cabaretera Dnoe y por el actor José Coronado. Padró achacó el éxito de 'El orfanato' al equipo, a los espectadores y a Belén Rueda, "el gran milagro de la película", y aprovechó para pedir "que se tome en serio la piratería", un tema que consideró "muy grave".

Además, el Premio al Mejor Largometraje Documental y de Animación, dotado con 6.010 euros, recayó en 'Invisibles', producida por Reposado Producciones y Pinguin Films. El productor de la cinta, el actor Javier Bardem, y la presidenta de Médicos Sin Fronteras (MSF), Paula Farias, recogieron el premio de la mano del actor Miguel Ángel Silvestre.

Bardem dijo que intentó interpretar el "difícil" papel de productor y afirmó que el equipo de producción "hace que los sueños se hagan realidad". Además, dijo que su película sirve para recordar el trabajo que realiza MSF en los "campos del olvido", así como ver "a las personas que hay detrás".

Por su parte, la presidenta de MSF, Paula Farias, afirmó que 'Invisible' se realizó con la intención de "dar voz a la gente que no la tiene" y de "hacer visible lo invisible".

BORAU RECOGE LA MEDALLA DE ORO DE EGEDA

El presidente de EGEDA (Entidad de Gestión de Derechos de los Productores Audiovisuales), Enrique Cerezo, otorgó su medalla de Oro al director y productor aragonés José Luis Borau por su trayectoria profesional como productor y por "haber subordinado su vida a la ilusión de hacer cine".

Borau afirmó que otorgarle ese premio era un "error muy dulce" porque no se considera un gran productor. Según él, sus películas "han sido pocas" y no han contribuido al desarrollo de la industria cinematográfica en España, ya que sus trabajos nacieron fruto de su "capricho y empecinamiento".

El productor aragonés y presidente de la SGAE explicó que se considera "un poco infantiloide y caprichoso" y que sus películas eran "un desbarate completo". Además, dijo que la España "no tiene un mercado cinematográfico" y que posee "una industria ramplona y tambaleante".

La gala de entrega de los premios homenajeó al cabaret, "los clubs que marcaron toda una época", según Coronado. Para ello, contó con la presencia de cabareteros y de la orquesta EGEDA Big Band, dirigida por el Maestro Leiva y de cantantes de Ópera que interpretaron 'Color Esperanza', entre otros temas.

Además, en el acto los participantes mostraron su interés por que se acabe con la piratería. El presidente de EGEDA incidió en que España es uno de los países de la Unión Europea con mayor índice de piratería y dijo que "la situación debe acabar porque no se puede tener un acceso gratuito a la cultura". Por ello, pidió a los poderes públicos y a los partidos políticos su "defensa de la libertad intelectual".

Por su parte, el ministro de Cultura, Cesar Antonio Molina, acudió al acto y dirigió unas palabras a la película premiada, 'El Orfanato', la más vista en España en 2007. Además, se mostró "optimista" por la cinematografía española y dijo que el cine nacional es "susceptible de atraer espectadores" y que existe un "extraordinario patrimonio fílmico" en España.

Las otras cuatro películas finalistas de estos premios que difunden la importancia de la industria audiovisual española e impulsan la figura del productor cinematográfico fueron 'Bajo las estrellas', de Félix Viscarret, producida por Fernando Trueba P.C.; 'La soledad', de Jaime Rosales, producida por Fresdeval Films, S.L., Wanda Visión, S.A. y In Vitro Films, S.A.; 'Las 13 rosas', de Emilio Martínez-Lázaro, producida por Enrique Cerezo P.C. y Pedro Costa P.C; y 'Siete mesas de billar francés', de Gracia Querejeta, producida por Antena 3 Films, S.L., Enrique Cerezo P.C. y Elías Querejeta P.C.

Al acto también acudieron los actores Manuel Alexandre, Álvaro de Luna, Gemma Cuervo, Laura Valenzuela, Kira Miró, Verónica Forqué, Javier Bardem, Silvia Marsó, Manuel Cervino, Mar Flores, Carmen Morales y Alex Angulo; la presidente de la Academia de Cine, Ángeles González-Sinde, y el consejero de Cultura y Turismo de la Comunidad de Madrid, Santiago Fisas, entre otros.

Foto: EP

.....

From Ethiopia to Chechnya: Reflections on Humanitarian Action
5.15.08
7-9 PM
Medecins Sans Frontieres
Eisner and Lubin Auditorium
Kimmel Center - Fourth Floor
New York University
60 Washington Square South NYC

Manufacturing Consent - What's on the Table in the Doha Round Negotiations on Non-Agricultural Market Access?
5.16.08
1130-130 PM
German Marshall Fund
1700 18th St NW Washington DC 20009

Born in England to Irish parents, Orbinski immigrated to Canada with his family in 1967 and grew up in Montreal. In his quest to do something practical to relieve the suffering of others, he went to medical school and after graduating, got a one-year research grant to work on HIV/AIDS research in Africa, more specifically, Rwanda. His year in Africa led him to join MSF and witness many of the horrors of the late 20th century. In 1992-93 he was in Somalia during the civil war and famine, in Rwanda in 1994 during the genocide, in Zaire in 1996 dealing with the refugee crisis caused by the genocide, and the list goes on. In 1999, during his tenure as president, MSF won the Nobel Peace Prize. He eloquently described the work of MSF during his acceptance speech at Oslo:

Our action is to help people in situations of crisis. And ours is not a contented action. Bringing medical aid to people in distress is an attempt to defend them against what is aggressive to them as human beings. Humanitarian action is more than simple generosity, simple charity. It aims to build spaces of normalcy in the midst of what is abnormal. More than offering material assistance, we aim to enable individuals to regain their rights and dignity as human beings. As an independent volunteer association, we are committed to bringing direct medical aid to people in need. But we act not in a vacuum, and we speak not into the wind, but with a clear intent to assist, to provoke change, or to reveal injustice. Our action and our voice is an act of indignation, a refusal to accept an active or passive assault on the other.

His words, on that day nearly 9 years ago, strike a cord even today while we watch the drama of Myamar unfold:

Humanitarianism occurs where the political has failed or is in crisis. We act not to assume political responsibility, but firstly to relieve the inhuman suffering of failure. The act must be free of political influence, and the political must recognize its responsibility to ensure that the humanitarian can exist. Humanitarian action requires a framework in which to act.

In conflict, this framework is international humanitarian law. It establishes rights for victims and humanitarian organisations and fixes the responsibility of states to ensure respect of these rights and to sanction their violation as war crimes. Today this framework is clearly dysfuntional. Access to victims of conflict is often refused. Humanitarian assistance is even used as a tool of war by belligerents. And more seriously, we are seeing the militarisation of humanitarian action by the international community.

I strongly recommend the rest of his speech, which has much to say about his view of humanitarianism, the role of the state and of the international community.

In 2004, Orbinski went to Malawi accompanied by James Fraser, who also worked for MSF. Devastated by AIDS, Malawi was simply unable to care for the 14% of its population which was HIV-positive. During that trip, he visited a hospital in Zomba crammed with sick patients, 90% of whom were HIV-positive. The hospital was so full, some patients were lying outside, under the trees. There was one nurse, and no doctor.  In his recent book, An Imperfect Offering: Humanitarian action in the twenty-first century, describes the episode and its consequences in detail:

I spoke with Alice [the nurse], and she wept when I asked simple questions about how she had seen the disease spread. In a feeble effort to console her, I said, "There is always hope." She wiped away her tears and said, "Yes, Dr. James, there is hope, but it's a long way from here."

James Fraser and I decided at that moment to leave MSF and start a new organization, one that would actively help communities face the crisis on their own terms. We called it Dignitas International, and it is committed to community-based care for people living with HIV in the developing world. Working with village health workers, doctors, nurses and officials from Malawi's Ministry of Health, and in alliance with a team of international researchers, we have developed a prevention and treatment program at the hospital and in the villages of Zomba. We have ten thousand HIV-positive patients under our care and bring to them the best tools and treatment that medical science has to offer. And with Malawi's Ministry of Health working with us, there will be more who get treatment. Thousands want it, and they will get it. In creating a world of practical possibility, there is hope.

Orbinski's work has been showcased in a couple of documentaries:

Evil revisited follows his return to Rwanda 10 years after the genocide and the recent Triage: Dr. James Orbinski's Humanitarian Dilemma follows him to not only Rwanda, but also to Somalia and Congo searching for the true meaning of humanitarianism.

As an undergraduate student, I was very involved with genocide studies. Concordia is home to the Montreal Institute of Genocide Studies and I use to attend most of their workshops. I also took a seminar on humanitarian intervention in the 20th century, in which I had to opportunity to read many books from the fields of history, political science and international relations on the crises of the past century. Although I have moved on to a different field of history, as a human being, I continue to be interested on the topic and follow the work of people like James Orbinski, Stephen Lewis, and Roméo Dallaire. Part of the reason why I'm behind in revising my conference paper is that I haven't been able to put down Orbinski's book in the past few days. He has brought me to tears many times and has left me with my biggest struggle: how can I make myself useful to the world around me? How can I live right?

As a young man, Orbinski constantly struggled with right living. He once asked Benedict, a very wise monk at Oka Monastery, in Montreal, how he knew the way to right living. The monk answered, "Well, like everyone else, James, I get out of bed and put one shoe on at a time. I walk around this log and I break these small branches as I step. I am acting and being acted upon. Meaning is in the living, not simply in the thinking or feeling. And it seems to me that living well is mostly about loving well." After a pause, he continued, "Correct answers can rarely be given. We can though, be conscious of the questions so that we can live ourselves into the answers, into what in retrospect can be right living."

Dass die Situation in Birma nach dem Zyklon Nargis vor einigen Tagen nach wie vor katastrophal ist, ist allgemein bekannt. Die Ärzte ohne Grenzen (Österreich) wollen helfen und bitten um Spenden. Und wie ich finde, betreiben sie dazu sehr zeitgemäßes Online-Fundraising. Aufmerksam geworden bin ich auf die Fundraising-Aktion über Twitter - und zwar durch einen Aufruf der Organisation selbst, die Twitter seit einigen Wochen als Kommunikationskanal nutzt [Update, 10.5.: Dieser Tweet wurde inzwischen leider gelöscht]. Ein paar Minuten später haben andere Twitter-Nutzer meines Netzwerkes das Thema weiter getragen. Genau das ist das Ziel der Kampagne: Im Mittelpunkt der Fundraising-Aktion steht die Idee, Blogger und andere Bewohner des Web in die Kampagne einzubinden und zur Word of Mouth-Kommunikation zu bewegen. Hierzu gibt's natürlich eine Microsite, auf der Material zur Verfügung steht - beispielsweise verschiedene Banner.

Elegant empfinde ich, dass die erwähnte Microsite "Schnelle Hilfe wirkt" dauerhaft im Netz ist und über eine Menge Social Media Features verfügt: Da kann man mit Hilfe von Google Earth sehen, wo Mitarbeiter der NGO unterwegs sind, es gibt einen Podcast, Handy-Downloads, einen Newsletter, den Twitter-Feed, die einfache Möglichkeit der E-Mail-Weiterleitung und den restlichen Social Media-Schnickschnack. Damit ist der Aufwand für einen aktuellen Spendenaufruf gering: Aktuelle Flickr-Bilder, eine Erklärung der Aktion und die entsprechenden Banner genügen, so dass für die Fundraising-Kommunikation in der heißen Projektphase nicht zu viele Kräfte gebunden sind. Gleichzeitig entsteht ein hoher Wiedererkennungswert, wenn Fundraising-Aktionen immer auf "Schnelle Hilfe wirkt" ihre Heimat haben. Ein wichtiger Aspekt wurde übrigens auch bedacht: Links als Währung des Social Web. Denn wer über die Kampagne berichtet, wird auf der Microsite erwähnt und verlinkt.

Insgesamt aus Kommunikationssicht eine gut gelungene Aktion, der man viel Erfolg wünschen kann. Nur einen kleinen Schönheitsfehler habe ich entdeckt. Doch womöglich ist der nicht ganz unbedeutend: Ich vermisse auf der Fundraising-Seite die allerneuesten Informationen zur Situation vor Ort, und zwar aus Sicht der NGO. [10.5.: Nehme alles zurück: De facto werden die neuesten Infos mit Hilfe des eingebundenen Twitter-Feeds auf die Microsite geschaufelt - also doch rundum vorbildlich :-)] Denn da gerade bei dieser Katastrophe für die Öffentlichkeit (und die Organisationen) zum großen Teil unklar bleibt, ob und wie unter den politischen Rahmenbedingungen die Hilfe funktioniert, ist der Informationsbedarf potenzieller Spender mit Sicherheit besonders groß. Dieses Problem hat sich in den letzten Stunden verschärft: Denn im Moment macht die Meldung die Runde, dass die Vereinten Nationen ihre Hilfe ausgesetzt haben, da die Junta die letzten beiden UN-Lieferungen konfisziert habe. Auf der Website der Ärzte ohne Grenzen steht jedoch unter "Aktuelles" noch ein Artikel vom 6. Mai, in dem vom Anlaufen der Hilfe die Rede ist. Dies kann von potenziellen Spendern als unbefriedigend wahrgenommen werden. Selbst wenn aktuell aus dem Krisengebiet kein Bericht möglich ist, würde ich mir doch konkretere Informationen zu den Prinzipien der NGO in solch schwierigen Situationen direkt auf der Fundraising-Microsite wünschen.

[Korrektur, 17:20 Uhr: Während ich diesen Beitrag geschrieben habe, wurde eine PresseinformationStartseite von MSF ein Update zur Situation in Birma gibt.] veröffentlicht. In ihr wird erklärt, dass die MSF die Birma-Hilfe verstärken. Da die Info nicht direkt auf der Fundraising-Seite eingebunden ist und inhaltlich nicht auf die die heute dominierenden Medienberichte eingegangen wird, löst dies aus meiner Sicht das beschriebene Kommunikationsproblem noch nicht vollständig.] [Update 2, 10.5.: MSF weist mich darauf hin, dass es nun auch auf der Startseite von MSF ein Update zur Situation in Birma gibt.]

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