In 2023, over 69,000 individuals worked for the MSF movement worldwide. During that year, we saw a total of 823 complaints about abuse or inappropriate behaviour made across the MSF movement. Of these, 714 were related to our medical and humanitarian projects, and 109 related to our international headquarter offices. Of those complaints, after investigation, 300 were confirmed to be cases of abuse or inappropriate behaviour, with some complaints still being investigated at the end of 2023. The paragraphs below break down data from project and headquarters cases separately, as they are not necessarily comparable in terms of legal and reporting processes.
The overall number of complaints received related to our medical and humanitarian projects increased by 18 per cent in 2023 (714 complaints), compared to 2022 (606 complaints). Complaints received in our international headquarter offices in 2023 (109 complaints) increased by 22 per cent compared to 2022 (89 complaints). MSF remains concerned about under-reporting of abuse and inappropriate behaviour given the breadth of our activities and the reach of our operational footprint – especially from patients, their caregivers, and from community members in the areas where we work.
Complaints received related to our medical and humanitarian projects in 2023:
- Around 89 per cent of MSF staff (69,100 people in total) in 2023 were working in MSF’s projects. A total of 714 complaints were made about the behaviour of staff in these projects, up from 606 in 2022.
- Of those complaints, after investigation, 264 were confirmed to be cases of abuse or of inappropriate behaviour (204 in 2022), with some cases still being investigated at the end of the year.
- This includes 187 cases which were confirmed as abuse, compared to 121 confirmed cases of abuse in 2022 (this includes different forms of abuse: sexual exploitation, abuse and harassment [SEAH]; abuse of power; harassment and bullying; discrimination; exploitation; aggression; abuse of the case management process – including retaliation, false reporting, interference in a case, and breach of confidentiality).
- A total of 85 staff members were dismissed for different types of abuse in 2023 (52 dismissals in 2022). Depending on the severity of the case, other types of sanctions were also issued, including but not limited to suspension, demotion, formal written warning, or mandatory training.
- Of the 187 confirmed cases of abuse, 85 were cases of SEAH, compared to 67 in 2022. Forty-five (45) staff were dismissed based on the findings of investigations related to those SEAH cases in 2023 (35 in 2022), noting that behaviour like sexual harassment covers a range of behaviour.
- The other confirmed cases of abuse included cases of harassment or bullying (31 confirmed cases); abuse of power (30 confirmed cases); aggression (23 confirmed cases); exploitation (13 confirmed cases); discrimination (9 confirmed cases); and abuse of the case management process (4 confirmed cases).
- There were also 77 cases of inappropriate behaviour found (83 in 2022). Inappropriate behaviour means behaviour which does not amount to the forms of abuse outlined above, but which are not in line with MSF’s behavioural standards. This includes, but is not limited to, mismanagement of people; inappropriate relationships; inappropriate behaviour not in line with societal standards or affecting team cohesion; inappropriate communication; and substance (mis)use.
We have continued to see some increases in the number of complaints submitted by previously under-represented groups, like locally hired staff, though there is still much room for improvement, especially with patients and community members.
The total number of complaints submitted by patients and their caregivers was 33 in 2023, and 36 from community members (which may also include patients and others in the community whom MSF staff encounter) for a total of 69 (67 in 2022). There were also 24 complaints submitted by “other” external parties – a category which includes suppliers, media, other organisations, partners, ex-MSF staff, non-MSF contracted staff.
It remains concerning that the number of complaints from patients, their caregivers, and community members has remained so low. Increased efforts are needed to reach out to patients and community members by making them aware of their rights and MSF expected standards of behaviour, and to ensure there are accessible, appropriate complaints mechanisms available to them to hold MSF accountable for any abuse or inappropriate behaviour.
The total number of complaints submitted by locally hired staff increased from 232 in 2022 to 328 in 2023. Efforts to encourage and support these staff to report need to be continued, as locally hired staff account for around 78 per cent of the global workforce, but are responsible for only 58 per cent of complaints made by MSF staff.
In reviewing all complaints from both MSF staff and individuals outside of the organisation, there have been a relatively low number of complaints made about discrimination – despite ongoing movement-wide efforts to address it. A total of 45 complaints relating to discrimination were received in 2023, up slightly on the total of 40 in 2022. This suggests that continued and sustained efforts are needed on diversity and inclusion, to ensure people affected by acts of discrimination in any form, report it.
Complaints from our offices worldwide
Since 2020, MSF has also compiled complaints from our offices around the world, in addition to the data gathered from our medical projects. Eleven per cent of the total MSF workforce is based in these international offices.
While efforts have been made to standardise reporting, this data relates to many different legal and human resource processes, and so may not yet be fully harmonised.
From all of the headquarter offices, 109 complaints were received in 2023 (up from 89 in 2022).
Of these, 36 cases were confirmed to be abuse or inappropriate behaviour (with 11 complaints still under investigation at the end of the year, noting that some complaints made were not about abuse). There were 34 cases related to abuse and 21 to inappropriate behaviour. This compares to 38 confirmed cases of abuse and 30 of inappropriate behaviour in 2022.
Overall, 13 staff members were sanctioned (ranging from coaching to verbal or written warnings) and 15 staff members were dismissed for abuse in 2023.
