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Dr. Grigory Volchenkov, Chief Doctor of the Vladimir Regional TB Control Centre, and Lira Dzhaparova, MSF Medical Activity Manager, in a meeting.
Dr Grigory Volchenkov, chief doctor of the Vladimir Regional tuberculosis control centre, and Lira Dzhaparova, MSF medical activity manager, in a meeting. Russia, August 2022.
© Alexandra Sadokova/MSF

MSF closed our programmes in Russia in 2024.

MSF worked in Russia from 1992 until August 2024. The focus of our work was providing care to people with tuberculosis.

We collaborated with health authorities and academic partners in the Arkhangelsk and Vladimir regions to reduce the burden of drug-resistant tuberculosis

Our teams also worked on a study in collaboration with the Ministry of Health, which aimed to prove the effectiveness of all-oral novel short-course regimens for patients with drug-resistant tuberculosis. In 2021, more than 60 people were enrolled into the study in the regions of Arkhangelsk and Vladimir. By the end of 2021, the first patients completed their treatment and started the follow-up stage.

In Moscow and St. Petersburg, MSF partnered with two community-based NGOs, offering healthcare to vulnerable people, including those living with HIV.

Following the escalation of the war in Ukraine in 2022, MSF provided refugees seeking safety in Russia and displaced Russians with humanitarian aid. More than 15,400 received free medical, mental health and psychosocial support.

MSF Speaking Out Podcast: MSF and the Rohingya 1992-2014

This podcast is adapted from the MSF Speaking Out Case Study “MSF and the Rohingya 1992–2014”.  

It brings to light two decades of MSF advocacy activities as part of its humanitarian assistance to the Rohingya people in Bangladesh and Myanmar.  

It examines the challenges that MSF teams in the field and headquarters encountered when deciding whether and how MSF could publicly speak out about the plight of the Rohingya facing persecutions and violence in Myanmar and Bangladesh. During the 1992-2014 period, MSF worked mostly through diplomatic channels “behind closed doors” to advocate about the Rohingya’s plight with foreign diplomats and United Nations agencies. This “silent advocacy” was challenged within MSF by those who felt that the lack of public speaking out meant MSF was abandoning a persecuted population.  They considered that maintaining an operational presence without speaking out publicly was not an ethically justifiable option for an independent and impartial humanitarian organisation like MSF.

Over 7 episodes, the podcast explores the challenges, dilemmas and internal disagreements underlying MSF’s humanitarian response to assist the Rohingya under the Myanmar authoritarian regime.  

This podcast is available on all podcast platforms.

In 1991–1992, Myanmar’s military repression forced over 250,000 Rohingya to flee to Bangladesh, where they settled in refugee camps. In the camps near Cox’s Bazar, MSF observed dire living conditions and violence, while Bangladeshi authorities limited aid and force repatriations. MSF engaged in “silent advocacy,” raising concerns only with political stakeholders to maintain activities in the camps. This episode highlights enduring dilemmas in MSF’s humanitarian approach with the Rohingya: publicly speaking out versus staying silent to preserve access.

Photo credits:  © Generic MSF

In Myanmar an increasingly authoritarian regime was taking shape, inhibiting the return of refugees and making the lives of the Rohingya who’ve remained in Rakhine State increasingly difficult. MSF documented systematic persecution but is divided over how to approach the dilemma of access versus speaking out. While from 1994, MSF Holland opted for “silent diplomacy” to expand its malaria and HIV/AIDs programmes in Myanmar, MSF France decided to withdraw in 2006, denouncing the authorities lack of transparency.

Photo credits: © Carlos Quarenghi

In 2006, following MSF’s internal reorganisation, MSF Operational Centre Amsterdam (OCA) refocused advocacy on the Rohingya marking a shift in its approach to testimony. To bypass Myanmar’s restrictions, strengthened through violent crackdowns on protesters after 2007’s Saffron Revolution, most of the speaking out concerned the fate of unregistered refugees in Bangladesh. Nonetheless, in Myanmar, MSF OCA spoke out on the humanitarian consequences of state-sponsored discrimination, repression, and lack of access to healthcare for both the Rohingya and people living with AIDS.

Photo credits: © Giulio Di Sturco

In 2008, Cyclone Nargis devastated Myanmar’s Irrawaddy Delta, killing over 130,000 people. The crisis opened a humanitarian space. From 2009 onwards, MSF intensified its advocacy on the Rohingya including the “Fatal Policy: How the Rohingya Suffer the Consequences of Statelessness” report that highlighted the health consequences of restrictive policies in Myanmar. Though never publicly published, it becomes a key tool in bilateral advocacy. Throughout, MSF balanced the need for advocacy with operational access, gradually developing a comprehensive regional strategy that highlighted the Rohingya crisis as a major humanitarian and political issue.

Photo credits:  © Generic MSF

In 2012, violence broke out in Myanmar’s Rakhine State between Buddhists and Rohingya after a Buddhist woman was allegedly killed by Rohingya men. Retaliatory attacks displaced tens of thousands and created widespread insecurity. MSF struggled to provide healthcare amid harassment, access restrictions, and arrests of Rohingya staff, forcing a suspension of operations. MSF faced ethical challenges in maintaining neutrality and impartiality while being seen by other communities in Rakhine as biased toward Muslims. With the regime detaining two MSF staff members, the organisation found itself once again in a difficult position when it comes to speaking out.

Photo credits:  © Kaung Htet

In January 2014, in Du Chee Yar Tan, Rakhine State, MSF OCA treated wounded Rohingya after a violent attack and issued a public statement. The Myanmar government denied the violence, pressured MSF for patient details, and accused it of exaggeration. Over the following weeks, MSF issued cautious public statements emphasising neutrality and commitment to medical needs. Teams face harassment, protests, and accusations of misinformation from the Myanmar government. Negotiations over the renewal of MSF’s Memorandum of Understanding in the country collapsed. On 27 February 2014, MSF OCA was ordered to close all programs in Myanmar. 

Photo credits:  © Chris Huby

Eventually, the Myanmar Government backed down and limited the ban to MSF activities in Rakhine. This still left the organisation with a dilemma: speaking out on Rohingya persecution versus preserving life-saving programmes in other states. After tense debates, MSF OCA leadership decided to withdraw from Rakhine to retain access elsewhere. Many argued that this compromises principles for access. In 2017, mass violence drove Rohingya into Bangladesh with thousands killed, which MSF documented and publicly denounced. International legal cases accused Myanmar of genocide, while abuses persisted. MSF continues to question its 2014 choices and the balance between speaking out and access.

Photo credits:  © Eddy McCall/MSF

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A 25 year old lady sets fire outside her tent in a refugee camp on the outskirts of Sittwe, February 2, 2013. photo by Kaung Htet
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Podcast: MSF and the Rohingya 1992-2014
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Description
This podcast is adapted from the MSF Speaking Out Case Study “MSF and the Rohingya 1992–2014”.
It brings to light two decades of MSF advocacy activities as part of its humanitarian assistance to the Rohingya people in Bangladesh and Myanmar.
It examines the challenges that MSF teams in the field and headquarters encountered when deciding whether and how MSF could publicly speak out about the plight of the Rohingya facing persecutions and violence in Myanmar and Bangladesh. During the 1992-2014 period, MSF worked mostly through diplomatic channels “behind closed doors” to advocate about the Rohingya’s plight with foreign diplomats and United Nations agencies. This “silent advocacy” was challenged within MSF by those who felt that the lack of public speaking out meant MSF was abandoning a persecuted population. They considered that maintaining an operational presence without speaking out publicly was not an ethically justifiable option for an independent and impartial humanitarian organisation like MSF.
Over 7 episodes, the podcast explores the challenges, dilemmas and internal disagreements underlying MSF’s humanitarian response to assist the Rohingya under the Myanmar authoritarian regime.
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A 25 year old lady sets fire outside her tent in a refugee camp on the outskirts of Sittwe, February 2, 2013. photo by Kaung Htet
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Podcast: War Crimes and Politics of Terror in Chechnya 1994–2004

This podcast is adapted from the case study “War Crimes and Politics of Terror in Chechnya, 1994–2004”. Over 9 episodes, it explores the challenges and dilemmas MSF faced during the two wars in Chechnya between 1994 and 2004. These wars raised many questions for MSF on when and how the organisation should speak out publicly about the war crimes its staff witness and the chilling effects of the politics of terror on the Chechen people. 
Through MSF press releases, internal reports, speeches, and news articles of the time as well as eyewitness testimonies from MSF staff, this podcast series examines the challenges MSF faced when access to those in need was repeatedly blocked by the Russian authorities, forcing international staff to operate and train Caucasus teams at a distance. Later on, when staff members were kidnapped, MSF was confronted with a new dilemma - whether to raise a voice or lay low until their colleagues were released?

This podcast is available on all podcast platforms.

The first war of independence of Chechnya with the Russian Federation starts in 1994 and runs for two years during which access was regularly blocked by Russian forces. MSF feeds the press with information on the rapidly deteriorating conditions and the Russian’s refusal to let them into many areas of the country. 

Photo credits: © Generic MSF

 

In 1999, while the country and its people are still struggling to recover, the Russian authorities start bombing Chechnya again. The Russian Federation President, Boris Yeltsin talks publicly about a peace plan but his forces carry out a ruthless bombing campaign on rebel-held villages in southern Chechnya. MSF sections are united in wanting to speak out about what their staff witnessed before being forced out of the region. So what is the best way to draw the world's attention to the plight of the Chechen population, without endangering the national staff who continue to work in southern Chechnya?

Photo crédits: © Olivier Jobard/MYOP

With hostilities in Chechnya flaring up again in what the Russian Federation terms as “anti-terrorist operations”, MSF leaders decide to take advantage of the ceremony of the reception of Nobel Peace Prize to call on the international community to intervene. But MSF teams are struggling to work in a Chechnya facing all-out war and dangerous security problems. Instead, MSF starts support refugees in the neighbouring republics where they collect first-hands accounts. Inside Chechnya, operations are run through staff members from the Caucasus who are trained, supported, and managed from afar by international teams in the region. MSF is in a difficult situation that raises many questions: Should MSF be speaking out based on refugees’ testimonies if there are no operational activities with international staff permanently on the ground sin Chechnya? When dealing with a regime in denial of the realities of a war, why is it important to use the word ‘war’? Is it up to MSF to call for this qualification?

Photo crédits: © Sandra Aslaksen

 

Throughout the year 2000, MSF seizes every opportunity to raise the alarm on the Chechen’s fate with governments and institutions around the world, but to little concrete effect other than general condemnation. With still no international staff in the country, MSF sections resort to so-called ‘remote control’ management, using locally hired employees to deliver aid on the ground. Concerns over the organisation’s legitimacy in speaking out remain and soon one of the sections starts making unauthorised and dangerous trips over the border into Chechnya from Dagestan where they ran distributions of basic care items. Under attack in the Russian media, MSF wonders whether it should ignore or address the accusations of espionage regularly thrown at the organization?

Photo credits: © Gazelle Gaignaire

MSF’s operations in Chechnya are slowly starting back up again after 3 years of being run remotely. Although the bombing stops, general insecurity is pervasive and restarting these programmes is not without risks.
With an international team back on the ground in Chechnya, everyone agrees on the need to document the situation more thoroughly. A collection of patients’ accounts in the report “Chechnya: The politics of terror” is handed over at a press conference. The various MSF sections agree on a coordinated media strategy for getting news out of Chechnya and into the press, in particular the Russian media.

Photo credits: © Gazelle Gaignaire

Kidnappings are becoming more commonplace in Chechnya and closer to home for MSF as various staff members are held for questioning. At the start of 2001, a key member of the team in the North Caucasus is taken hostage and questions are asked as to whether there's a causal link between MSF’s decision to speak out in the media and the kidnapping? MSF is faced with the following dilemma: should the organisation speak out in the media to create visibility and hopefully bring their colleague some much-needed protection? Or should MSF be as discreet as possible to avoid a rise in the hostage’s so-called ‘market value’? Is it wise to take active steps to secure the hostage's release, such as publicly denouncing the responsibilities, negligence or even complicity of the government controlling the territory where the kidnapping took place?

 Photo credits: © Eddy Van Wessel

MSF’s operations have been closed down in Chechnya in response to the MSF Coordinator’s kidnapping. After his release, three weeks later,  MSF tries to restart its operations in Chechnya but there are delays due to security issues, and for now, the only programmes in the country are run through remote control management from Dagestan, on Chechnya eastern border. Most of MSF’s Caucasus staff are behind the return and support MSF speaking out in the media. Meanwhile and in a statement after the September 11th 2001 attacks in New York and Washington, Vladimir Putin, President of the Russian Federation links Russian military operations in Chechnya with the anti-terrorist combat launched by the American government. 
After the events of 11 September 2001, the West's attitude and view of Russia became more complacent, which weakened the impact of MSF's efforts to raise awareness of the plight of the Chechen population.

 Photo credits: © Olivier Jobard

The situation in the North Caucasus is becoming increasingly violent. The Russian federal authorities are forcing Chechen refugees to return to Chechnya, where they reign terror. They are also putting pressure on humanitarian organisations to stop helping refugees in 'Ingushetia, which would encourage them to return. When colleagues at other organisations are kidnapped in Chechnya, MSF closes down all operations in the country again. With a diminishing international presence in the warzone, MSF is once again faced with dilemmas - should it continue to speak out about human rights abuses its staff haven't witnessed? How can they help those in need and in danger in the region? And how long will it be before one of their own staff is once again held hostage?

 Photo credits: © Simon Norfolk

In August 2002, the threat to MSF becomes a reality and another Coordinator, a Dutch national for the MSF Swiss section, is kidnapped in Dagestan. The organisation is once again faced with the dilemma of how and when to speak out on the situation in the North Caucasus while one of its members is held hostage. MSF opts to keep quiet at first, but as the weeks turn into months and the MSF Coordinator is still not released, MSF starts questioning whether it should take active steps to secure the hostage’s release by publicly pointing out a government’s responsibilities, negligence, or even complicity when a kidnapping occurs on its soil, or should it not enter into these conversations to avoid the potential for a government to dig in its heels? Tensions are running high, especially between MSF, the Dutch authorities and the family of the hostage, and some feel the structures within the organisation are not helping the situation.

Photo credits:  © Michael Yassukovich

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Shali,Russian tank, next to the market.
After the reelection of Kadyrov, for people inside the Chechen republic aswell as in neighboring Ingushetia the situation has not improved, Kadyrov is seen as a Russian marionet who betrayed the Chechens, his army is rudeless and has no interest in protecting the population.
 In ingushetia the refugees from Chechnya are forced out of their tents,just before winter fall's, back into Chechnya where they claim to have the situation under control.
Living conditions in and around Chechnya are inhuman after almost a decade of war and destruction.
 People inside Chechnya are terrorized as well by the Russian occupation as the Kadirov army in a daily and structural way and the disappearance and execution of people are more rules than exception.
 The Chechen fighters are divided and not able to finance the war, if they have the money they buy their weapons from the Russian enemy who are underpaid for their services.
 
 For the Chechens who fled their country during the war the situation is almost as bad, mostly ending up in neighboring Ingushetia, living in camps with little or no facilities in tents who fall apart after the strong winters and even in stables normally used for animals.
 Since also drug smugglers and criminals fled Chechnya, an increasing number of the refugees become drug addicted.
 
 Most  NGO's working in Ingushetia can not enter Chechnya to do their important work as the risk of being kidnapped is too high and Russian government is not supporting in any way.
Headline
Podcast: War Crimes and Politics of Terror in Chechnya 1994–2004
Background
Image
Schedule content for publication
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Description
This podcast is adapted from the case study “War Crimes and Politics of Terror in Chechnya, 1994-2004”. Over 9 episodes, it explores the challenges and dilemmas MSF faced during the two wars in Chechnya between 1994 and 2004. These wars raised many questions for MSF on when and how the organisation should speak out publicly about the war crimes its staff witness and the chilling effects of the politics of terror on the Chechen people.
Through MSF press releases, internal reports, speeches, and news articles of the time as well as eyewitness testimonies from MSF staff, this podcast series examines the challenges MSF faced when access to those in need was repeatedly blocked by the Russian authorities, forcing international staff to operate and train Caucasus teams at a distance. Later on, when staff members were kidnapped, MSF was confronted with a new dilemma - whether to raise a voice or lay low until their colleagues were released?
Thumbnail Image
Shali,Russian tank, next to the market.
After the reelection of Kadyrov, for people inside the Chechen republic aswell as in neighboring Ingushetia the situation has not improved, Kadyrov is seen as a Russian marionet who betrayed the Chechens, his army is rudeless and has no interest in protecting the population.
 In ingushetia the refugees from Chechnya are forced out of their tents,just before winter fall's, back into Chechnya where they claim to have the situation under control.
Living conditions in and around Chechnya are inhuman after almost a decade of war and destruction.
 People inside Chechnya are terrorized as well by the Russian occupation as the Kadirov army in a daily and structural way and the disappearance and execution of people are more rules than exception.
 The Chechen fighters are divided and not able to finance the war, if they have the money they buy their weapons from the Russian enemy who are underpaid for their services.
 
 For the Chechens who fled their country during the war the situation is almost as bad, mostly ending up in neighboring Ingushetia, living in camps with little or no facilities in tents who fall apart after the strong winters and even in stables normally used for animals.
 Since also drug smugglers and criminals fled Chechnya, an increasing number of the refugees become drug addicted.
 
 Most  NGO's working in Ingushetia can not enter Chechnya to do their important work as the risk of being kidnapped is too high and Russian government is not supporting in any way.
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Podcast: The Hunting and Killing of Rwandan Refugees in Zaire-Congo 1996-1997

This podcast is adapted from the case study “The Hunting and Killing of Rwandan Refugees in Zaire-Congo 1996-1997". In 8 episodes, it investigates MSF's experience in the aftermath of the 1994 Rwandan Tutsi genocide, and in particular, with the impact on local populations and refugees living in the Democratic Republic of Congo (formerly Zaire).
The series expresses on the constraints, questions, and dilemmas faced by MSF teams attempting to bring relief to Rwandan refugees and local populations.

This podcast is available on all podcast platforms.

In 1996, MSF attempts to alert the international community about the resurgence of conflict in eastern Zaire, as witnessed by teams on the ground. The perpetrators of the Rwandan Tutsi genocide, living in refugee camps, threaten and attack the Zairean civilian population. The same perpetrators are holding Rwandan refugees that fled the 1994 genocide, hostage within the camps. The new Rwandan regime and its Zairian ally, the Alliance of Democratic Forces for the Liberation of Congo-Zaire (ADFL), launches counter attacks on the refugee camps.

Photo credits : © Wim Van Cappellen

 

As the instability of the region increases, MSF and other humanitarian organisations are eventually forced out of eastern Zaire entirely. MSF suspects that thousands of refugees are suffering and at risk of dying. The organisation decides to launch an appeal for an armed international intervention and communicates about the plight of the population, predicting a health catastrophe, if access for aid agencies is not provided.

Photo credits: © Frederic Sautereau  

 

In November 1996, the offensive led by the ADFL and Rwandan forces empties the camps in eastern Zaire of their population. Some refugees were repatriated to Rwanda and others fled into the neighboring forest. MSF denounces the repatriation conditions and is reproached by the press for "catastrophic" forecasts made a few weeks earlier.

Photo credits: © Frederic Sautereau

 

 

Finally allowed into South Kivu, a province in eastern Zaire, the MSF teams discover that refugees are being massacred by the ADFL and its allies, particularly in the Massisi and the Shabunda regions. MSF realises that MSF teams are used as bait by the ADFL to lure the refugees out of the forests and kill them.

Photo credits: © Wim Van Cappellen

 

The ADFL takes control of all of the Kivu province and refugees continue to flee their rapid advance eastwards through the forest.  MSF struggles to maintain access to the refugees amidst the violence, restrictions, and threats to team safety, while receiving continued reports about refugee massacres.

Photo credits: © Wim Van Cappellen

 

MSF's exploratory mission teams complete their reports on their Masisi and Shabunda visits. Details of mass graves, massacres, and the fact that the ADFL used humanitarian teams as bait to lure refugees out of the forests, sent shock waves through MSF offices. A debate about the use of the information collected ensued: should it be made public or not?

Photo credits: © Wim Van Cappellen

 

In May 1997, MSF published a new study describing the movements of refugees in the Great Lakes region of Africa and the fate of refugees. MSF planned to distribute the report to a small group of journalists, asking them not to cite MSF as the source of the information. However, a lack of communication between MSF offices and with the teams in the field, exacerbates tensions.

Photo credits: © Frederic Sautereau

 

From mid-1997, MSF teams try to work together again. The organisation publishes retrospective studies that trace the odyssey of the Rwandan refugees through the Zairean jungle and contributes testimony to international investigations on human rights violations in the region. 

Photo credits: © Wim Van Cappellen 

 

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Refugies Rwandais a Tingi Tingi. A partir du mois de septembre 1996, un mouvement rebelle, soutenu par le Rwanda et l’Ouganda, emerge dans le Kivu, region frontaliere de ces deux pays. En octobre et novembre 1996, les troupes rebelles attaquent les camps de refugies rwandais et burundais situes le long de la frontiere du Zaire, provoquant le retour d’une partie d’entre eux vers le Rwanda (entre 400 et 500.000 refugies) et le Burundi (environ 60.000 refugies). Les refugies rwandais, encadres et otages des ex-FAR et interhamwes comme dans les les camps sur la frontiere, sont disperses, pourchasses, perdus dans la foret zairoise. Debut decembre 1996, su l’axe routier Kisangani-Bukavu, un groupe  de 80.000 refugies se regroupe sur le site de Tingi-Tingi, un autre groupe de 20 a 25.000 est localise a Amissi. MSF intervient sur le camp de Tingi Tingi en mettant en place les structures medicales permettant de prendre en charge les pathologies les plus graves (malaria, diarrhee, malnutrition): hopital, centre d’isolement, CNT e CNS, approvisionnement en eau.
Headline
Podcast: The Hunting and Killing of Rwandan Refugees in Zaire-Congo 1996-1997
Background
Image
Schedule content for publication
Off
Description
This podcast is adapted from the case study “The Hunting and Killing of Rwandan Refugees in Zaire-Congo 1996-1997". In 8 episodes, it investigates MSF's experience in the aftermath of the 1994 Rwandan Tutsi genocide, and in particular, with the impact on local populations and refugees living in the Democratic Republic of Congo (formerly Zaire).
The series expresses on the constraints, questions, and dilemmas faced by MSF teams attempting to bring relief to Rwandan refugees and local populations.
Thumbnail Image
Refugies Rwandais a Tingi Tingi. A partir du mois de septembre 1996, un mouvement rebelle, soutenu par le Rwanda et l’Ouganda, emerge dans le Kivu, region frontaliere de ces deux pays. En octobre et novembre 1996, les troupes rebelles attaquent les camps de refugies rwandais et burundais situes le long de la frontiere du Zaire, provoquant le retour d’une partie d’entre eux vers le Rwanda (entre 400 et 500.000 refugies) et le Burundi (environ 60.000 refugies). Les refugies rwandais, encadres et otages des ex-FAR et interhamwes comme dans les les camps sur la frontiere, sont disperses, pourchasses, perdus dans la foret zairoise. Debut decembre 1996, su l’axe routier Kisangani-Bukavu, un groupe  de 80.000 refugies se regroupe sur le site de Tingi-Tingi, un autre groupe de 20 a 25.000 est localise a Amissi. MSF intervient sur le camp de Tingi Tingi en mettant en place les structures medicales permettant de prendre en charge les pathologies les plus graves (malaria, diarrhee, malnutrition): hopital, centre d’isolement, CNT e CNS, approvisionnement en eau.
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Grozny, Chechnya, Russian Federation. MSF OCA project staff in the yard of the office.
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