MSF CANADA MAGAZINE | Digital Edition | Spring 2017

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MSF speaking out: Syria

Ambulances destroyed by missile strikes in East Ghouta, Syria. Photo ©MSF

By Stephen Cornish


In the six years since the war in Syria began, Doctors Without Borders/Médecins Sans Frontières (MSF) has steadily lost access to patients in many parts of the embattled country. The government has declared that providing treatment to opponents of the regime amounts to terrorism under Syrian law, and has forbidden MSF from accessing many of the war’s victims who need our help most.


In some areas outside of government control, MSF can provide direct care; in other parts of Syria, we can only offer support from afar. In the earlier days of the conflict, MSF often chose pragmatic medical action over témoignage. In places we couldn’t work directly, we delivered vital medical supplies and training, and provided doctors on the ground with crucial structure and support. These physicians and their colleagues formed our trusted networks inside the parts of the country we couldn’t reach with permanent external presence. They were our lifesaving arms in the hardest to reach locations, and through their medical work became our eyes and ears on the ground, informing MSF of the types of cases they were seeing, and providing critical medical data on the health status of the populations in their areas.




Sometimes these reports included medical evidence suggesting patients had been victims of chemical-weapon attacks. Such isolated accounts were disturbing, but extremely difficult  to confirm. They also could not prepare us for the magnitude of what was to come. I was in the region with MSF teams when, on August 21, 2013, three MSF-supported hospitals in the Damascus area reported receiving close to 3,600 patients within a span of three hours, all displaying the devastating neurotoxic symptoms indicating the use of chemical weapons.


A chemical attack of such size on civilians is a mockery of the rules of war, and of all MSF believes in. If the reports were true, we had a responsibility to tell the world. Our information was second-hand, but came from our trusted medical colleagues. The risks and implications, however, were enormous, including the possibility our témoignage could be exploited by opposing sides in the war. We had no way of knowing who was responsible for what our teams were seeing. But the use of chemical weapons was also one of the “red lines” the United States said would compel it to take direct military action in Syria’s war.


Would speaking out result in US missiles raining down on Syrian cities? Would it cause reprisals against our doctors inside Syria, and our expulsion from places where we were directly providing care? On the other hand, how could we allow ourselves to keep quiet when our medical colleagues were apparently witness to an atrocity that the rules of war were meant to protect humanity from in the first place? Would remaining silent make us complicit in the horror unfolding and allow it to be repeated in other places?

A chemical attack of such size on civilians is a mockery of the rules of war, and of all MSF believes in. If the reports were true, we had a responsibility to tell the world

In the end, MSF decided to go public with our evidence, which corroborated the use of chemical weapons in Syria’s war, and we made clear the source of our information. The US did not use it as a pretext for military involvement, but our testimony was seen by some as a denunciation of the Syrian regime.


Did we do the right thing? Only history can judge. We were accused by some of compromising our neutrality, but we stood by the accounts of our medical colleagues and our decision to bear witness to reprehensible acts against civilians in Syria.


In real time there is seldom a clear division between right or wrong, no certainty and no clear road to follow. Only a gut feeling, a complex moral duality, a mix of anxiety and the awareness of a deeply abnormal situation of suffering.


In these instances, we must remain guided by the best knowledge we can gather and a willingness to re-evaluate in the face of new evidence. But above all, we must find the courage to adhere to our fundamental humanitarian values, and continue to stand up and be heard when confronted with violations of international law, ethics and basic human decency.


Stephen Cornish is Executive Director of Doctors Without Borders/Médecins Sans Frontières (MSF) Canada

Video: Meet staff working in the Al Salamah hospital in Syria, the largest directly run MSF facility still inside Syria, managed by nearly 150 Syrian staff.

In this Issue

from the executive director

msf Speaking out: Cover Story

msf Speaking out: Our History

The responsibility to bear witness

Reporting what we see on the front lines of humanitarian crises is a fundamental component of MSF’s purpose

A timeline of MSf’s témoignage

From before our founding in 1971 to the present, MSF has always advocated on behalf of our patients

why does Msf speak out?

To improve the situations of people in danger, to advocate on behalf of our patients and to raise awareness in order to alleviate human suffering

msf speaking out: case studies

no easy answers

MSF takes a hard look at some of our decisions to speak out in earlier times of crisis

msf speaking out: syria

red lines

Evidence of chemical weapons in Syria’s war forced MSF to confront some complicated ethical dilemmas

canadians on mission: profile

walking the talk

Communications specialist Sandra Smiley helps MSF advocate on behalf of our patients; now that she's returning to school, she may soon be treating them, too

about dispatches

The MSF Canada magazine

Stories and updates about MSF's lifesaving work, as seen through the eyes of our staff, patients and donors