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The Politics of ‘Proximity’ and Performing Humanitarianism in Eastern DRC
Myfanwy James

This article explores the everyday practice of security management and negotiations for access conducted by Médecins Sans Frontières (MSF) in North Kivu, in the Democratic Republic of the Congo (DRC). Based on ethnographic fieldwork, interviews and archival exploration, it examines the experience of MSF Congolese employees, who navigate a complex politics of humanitarian fixing and brokerage. Their role in MSF is simultaneously defined and circumscribed by their political and social situation. MSF’s security management relies on local staff’s interpersonal networks and on their ability to interpret and translate. However, local staff find themselves at risk, or perceived as a ‘risk’: exposed to external pressures and acts of violence, while possibilities for promotion are limited precisely because of their embeddedness. They face a tension between being politically and socially embedded and needing to perform MSF’s principles in practice. As such, they embody the contradictions of MSF’s approach in North Kivu: a simultaneous need for operational ‘proximity’, as well as performative distance from everyday conflict processes.

Journal of Humanitarian Affairs
Debates Surrounding Ebola Vaccine Trials in Eastern Democratic Republic of the Congo
Myfanwy James
Joseph Grace Kasereka
, and
Shelley Lees

Two experimental Ebola vaccines were deployed during the tenth Ebola epidemic (2018–20) in the Democratic Republic of the Congo (DRC). The first, the Ervebo vaccine manufactured by Merck, was used as part of a ring vaccination in the epicentre of the epidemic in North Kivu. In 2019, the prime- (Ad26.ZEBOV) and boost- (MVA-BN-Filo) vaccine manufactured by Johnson & Johnson (J&J) became the second vaccine against Ebola, deployed by the DRC-EB-001 vaccine trial in Goma, North Kivu. There was international debate as to the value and ethics of testing a second vaccine in an epidemic context. This article examines how this debate unfolded among actual and potential DRC-EB-001 trial participants in Goma. Drawing on ethnographic observation, interviews and focus groups, it explores how the trial was perceived and contested on the ground and situated in broader debates about the ethics of clinical trials, especially during the COVID-19 pandemic. We illustrate how debates around the ethics of clinical research are not simply centred on bioethical principles but are inseparable from local political dynamics and broader contests about governance, inequality and exclusion.

Journal of Humanitarian Affairs