Médecins Sans Frontières (Doctors Without Borders) was awarded the Nobel Peace Prize for 1999 in recognition of the organization's pioneering humanitarian work on several continents. Dr. James Orbinski, a Canadian physician who is currently President of the Médecins Sans Frontières International Council, delivered the acceptance speech at the award ceremony in Oslo on Dec. 10, 1999.

Dr. John Hoey, Editor-in-Chief of CMAJ, reached Dr. Orbinski at the Médecins Sans Frontières offices in Brussels and conducted a telephone interview on Feb. 4, 2000, for eCMAJ. You can listen to their complete conversation (30 minutes) or you can select individual questions. You'll need RealAudio software, which can be downloaded free of charge.

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Dr. Hoey's questions

1. I'm speaking today with James Orbinski, who is the international president of Médecins Sans Frontières … You and I had an opportunity to have a brief conversation about this interview and you raised the issue that providing medical care for the sick and injured seems like a straighforward set of tasks and objectives, but to provide it in an area of political conflict and social upheaval makes it infinitely more complex and brings in a whole variety of other issues. One of these issues is presumably your organization's mission to try and raise awareness about the plight of people that you're helping. Can you talk a little bit about the complexity of providing medical care and at the same time trying to raise awareness? [play audio]

2. In your Nobel acceptance speech, the first part of your address was directed to the Russian ambassador, who I gather was present at the ceremony. You were talking about the tragedy in Chechnya, so you chose during that speech to in fact "witness" that situation – is that why you did it? [play audio]

3. When you're recruiting volunteers to work for the organization and they're going into the field, do you expect them to bear witness as well – in the field – or is this a higher level function? It must be very difficult to bear witness in the field. [play audio]

4. One of the issues that you raised in your acceptance speech was the notion that in providing [humanitarian] assistance you need to have some safe space in which to work and to provide space for the victims. Providing [this space] often requires the use of force … [which is] almost the antithesis of providing the safety. [play audio]

5. In the speech you allude several times to the importance of separating the UN actions for providing the secure space … from the humanitarian [work]. You go on to talk, in the speech, about the euphemization of political speech, and how important this is. What is it, and just how important is it? [play audio]

6. Even the word genocide, although it has a definite, complex meaning, is used so often that I have the impression that it's become meaningless, almost – we don't pay attention to it anymore. [play audio]

7. In part of your speech, I think you dealt with this [the importance of using language precisely] very effectively in describing your work in Kigali and there's a description [in your speech] of a woman who you say was not just attacked with a machete but her entire body was rationally and systematically mutilated; her ears had been cut off and her face had been so carefully disfigured that a pattern was obvious in the slashes. That … makes it vividly come alive. Can you talk a little bit about what it is actually like to be in a situation like that? You were the head of mission in Rwanda at that time [during the genocide of 1994]. [play audio]

[The interview resumed after a short pause.]

8. James, I wanted to ask you whether in fact general medical journals have done enough – or have they done anything? – in terms of drawing to their readership's attention the plight of these populations. I wondered if you have any advice for us. [play audio]

9. In your speech you talked quite early on … about the dignity of the excluded, and you were referring there to children in Europe, particularly the illegal refugees; [was] your message to physicians … that there are things we can do in our own backyard? [play audio]

10. I was in Nigeria in 1968 during the civil war, and I think MSF was founded a year later by French physicians in Biafra. I'd left [feeling] really discouraged. I had a very naïve view of what humanitarian assistance was; I probably still do. You obviously have a … very sophisticated view of the complexity of [these issues]. Did you know all that before you started? How did you get to where you are? [play audio]