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Moving forward on Diversity, Equity, and Inclusion at MSF

This project is addressing MSF’s structural barriers to inclusion; creating a Repository and Community of Practice to share best practices across movement; and progressing on the vision and journey
to an inclusive, fair and diverse organization that strengthens MSF’s social mission.

Tell us about the problem you are trying to solve.

The collective call for action on Diversity, Equity and Inclusion (DEI) at MSF is longstanding and rooted in our history. From the Chantilly principles, La Mancha, the Full ExCom’s statement on “People, People, and People”, and the International Board’s “Call for Change”[1], the movement has expressed a strong and sustained desire to be fair and inclusive. This ambition has manifested itself in various initiatives including the TIC-supported “Phase I – People, Respect and Value” project. This program, “Phase II People Respect and Value – Diversity Equity and Inclusion”, builds on the outcomes of the incubator project and aims to achieve the following:

Our ambition is to help create an inclusive, thriving and inspirational workplace community that enables our staff to contribute their full potential to our social mission: assisting individuals and communities in crisis. Addressing our DEI challenges will strengthen how our work aligns with our principles and amplify our medical and humanitarian impact.
We intend to proactively identify and remove any internal structural barriers to inclusion (systemic, cultural, individual) that may result in workforce injustice and ineffectiveness. And we hope to go much further and progress on the vision and journey to becoming an inclusive, fair and diverse organization.

Several MSF Operational Centers/Partner Sections (OCA, OCG, MSF-Canada, MSF-Southern Africa, MSF-Sweden, MSF-UK, MSF-USA) are driving this movement-wide commitment as program sponsors[2]. There are already many talented and passionate colleagues across the movement driving DEI initiatives. Our approach includes an intention to harness their knowledge, strengthen the existing foundation, and encourage broader usage by making knowledge/tools widely available.

MSF medical staff work together to assess the condition of a patient living with advanced HIV at Nsanje District Hospital, Malawi.

What is your solution? What motivates you to work on addressing this problem?

The complexity within our movement (structure, strategies, systems, capabilities, cultures, values) has forced us to think deeply about how to structure this program to deliver tangible results. We’ve developed a three-pillar approach, which allows us to achieve clear results in the first year of this three-year program and sets us up to capture learnings and accelerate our solutions.

•Mission-Driven Needs (“Uncover and Implement/ Bottom-Up”) – MSF is very diverse and autonomous in nature. Since every mission is set up in a purpose-driven way, missions may share DEI-related opportunities while potentially facing some unique challenges. As part of this project, we plan to conduct pilots in six missions, including in Central African Republic, Ethiopia, Bangladesh, and Mexico. In these missions, we will collaboratively develop a mission-based perspective on what diversity, equity and inclusion looks like in an “ideal mission”. We will then start developing and executing a plan based on this perspective. This bottom-up approach is aimed at delivering early mission driven results (including policies) and learning. We want to enable our missions to define their DEI vision and to start moving towards that vision. With different priorities, the DEI visions of our pilots might be different – this we don’t yet know. But what we do know is harnessing many voices and perspectives will bring new knowledge and relevant change. Furthermore, these different perspectives will allow us to envisage how the program will optimally be brought to scale.

•Current Action and Knowledge (“Repository, Connect and Communicate”) – We’re taking a networked approach to bring together various DEI champions across the movement and designing a repository to build on existing knowledge and expertise. We want to capitalize on past and current initiatives as well as the expertise already present in our movement. Furthermore, if other missions and sections not already engaged in the program intend to move forward on DEI efforts, they will be able to connect to the experts, expertise and material already available. To support this effort, we have set up a dynamic communication strategy that will include a Community of Practice and a centralized digital hub so that we can communicate more widely. Christiane Essombe, our Repository Lead, will soon be connecting with and inviting focal points to work with us in amplifying our shared drive.

•Strategic Fit and View (“Orchestrate, Optimize, and Accelerate”) – Our third pillar encompasses a top-down approach to collaboratively review the strategic plans of various OCs/Partner Sections. This review is based on an evolving DEI framework, which helps OCs and Sections extract the choices articulated in their strategic plans; evaluate the direction taken; and compare it to the framework. It also helps link strategic visions and actions to a broader vision for DEI in the movement. We have developed a rough framework and are currently working on a pilot in India to further develop this tool. Under this pillar, we will also define the plan for upcoming years, based on knowledge gathered in the other pillars. Finally, we’ll set-up peer-reviews to evaluate elements of the overall program.

Our plan in the first year is to progress on all program goals to achieve real-life impact and use our learnings to shape efforts in subsequent years. Results of year one may be less than perfect, but they will be meaningful and will move us in the right direction to attaining the full program ambition at the end of year three.

How has your project been impacted by the COVID-19 pandemic?

The COVID-19 pandemic has created an additional burden in many MSF missions – including the ones that are committed to spearheading our program pilots. As a result, we’ve had to pause efforts on this pillar of work for the time being and will resume with an adapted approach once feasible. In the meantime, we continue working on the other program pillars and deliverables.

The pandemic is challenging MSF to think and work differently. We are being shaken up and as always, our teams are innovating and adapting to meet the challenge. This means that post-COVID-19, we’ll have new insights but also there will be a backlog of work and significant fatigue.

The pandemic is forcing us to rethink the approach of our program to fit the “new reality” that might emerge. We will make sure to build on the lessons learned through measures taken to counter the challenges faced with the pandemic. We remain flexible and ready to shift priorities as the needs of our missions change in the evolving COVID-19 context.

What challenges have you faced? What lessons have you learned? What is next?

In a decentralized organization such as MSF, there are many perspectives on how to address diversity, equity and inclusion. We’ve had countless conversations with individual staff, conducted numerous presentations, and continued to engage the buy-in of our leaders at all levels. We’ve seen a variation in emphasis between different groups – some believe there is an ongoing inequity that must be solved immediately, while others see the positive hidden potential of adopting DEI policies and practices. What matters is that we move from analysis to relevant action in our various contexts. By adopting a “good enough” analysis and empowering missions to define their DEI vision, they can articulate what is needed and start executing.

Another lesson we’ve learned is that our approach itself must be fully inclusive and centered around operational realities. To truly be successful, it is critical to ensure that our program activities are embedded into operations right from the start. This means being vulnerable and being open to criticism.

Finally, it’s critical to find momentum and start moving with a small team. We will start small, work closely with our mission teams, engage local experts, and iterate to ensure that our solutions are inclusive and fit-for-purpose. We will share our findings to support the strategic intentions defined in different parts of the movement.

Are there any interesting partners that you are collaborating with?

We are very much taking a networked approach to engage as many DEI champions across the movement as possible. In building our repository, we will start to engage with internal focal points – including different Human Resource leads, DEI leads, Learning & Development leads, and interest groups like MSF’s Rainbow Network for the LGBTQ+ community, MSF USA’s DE&I Council and the Kaleidoscope Network.

We are also planning to engage with regional academia and consultants located closer to our missions with local knowledge and expertise.

What is the expected long-term impact of the project? How will this project improve MSF’s lifesaving work?

Diverse and inclusive teams are proven in management literature to lead to superior performance, including in the humanitarian sector.

By defining our vision and taking action on diversity, equity and inclusion at MSF, we will contribute to people feeling safe and treated fairly, sharing our collective knowledge and expertise for better decision-making, and ultimately providing better medical and humanitarian interventions for our patients and the communities we assist.

We must lead from a place of humility, integrity, and a genuine curiosity to learn. In doing so, we will collectively be able to engage in an honest and vulnerable dialogue and move closer to realizing our vision.

Header Photo Caption: MSF medical and supervisory staff gather for a seminal meeting in Kyrgyzstan.

[1] Chantilly principles, La Mancha, the Full ExCom’s statement on “People, People, and People”, and the International Board’s “Call for Change” are strategic-level MSF statements from the Executive Leadership and/or International Board.

[2] Many other MSF sections underline the importance of DEI and have both expressed their support and willingness to cooperate with this TIC program (e.g. OCBA). Wherever possible these partnerships will be shaped to ensure we move coherently forward together and build on our mutual strengths.