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