In this interview, Caroline Abu Sa’Da, General Director of SOS MEDITERRANEE Suisse,
discusses search-and-rescue operations in the Mediterranean Sea, in particular those conducted
by her organisation. She explains that as a European citizen movement, SOS MEDITERRANEE has
adopted a hybrid and politicised approach, which represents a new kind of humanitarian
engagement. And she reflects on the challenges of protecting and supporting those crossing the
London, 10 September 2018
Since 2015, more than one and a half million people have traversed the Mediterranean, seeking
asylum in Europe. The EU has been negotiating their screening and resettlement outside of Europe.
European governments have closed some ports and borders to them. And neofascist groups from
across Europe have rallied on the ground and online to prevent their entry. Thousands have died
Multinational NGOs like Médecins Sans Frontières and Save the Children have
carried out search-and-rescue missions. But it is citizen movements that have been at the
forefront of the emergency response. Similarly inspired by cosmopolitan ideals, these groups tend
to use more political language than conventional NGOs, presenting their relief activities as a
form of direct resistance to nationalist politics and xenophobia. As liberal humanitarianism is
challenged in its European heartland, they are developing – through practice – a
new model of humanitarian engagement.
SOS MEDITERRANEE is an ad hoc citizen initiative founded in 2015 to prevent the death of people
crossing the Med. Caroline Abu Sa’Da is General Director of its Swiss branch.
Juliano Fiori: SOS is very much a product of contemporary Europe. It’s a
civic response to refugees and migrants in the Med but also to nationalistic politics, or to the
return of nationalist movements to the forefront of European politics. How, then, does SOS differ
from European humanitarian NGOs founded in past decades?
Caroline Abu Sa’Da: SOS is a European citizen movement. Besides our
search-and-rescue activities, we aim to give to the greatest number of people access to
information – facts – on the situation in the Mediterranean, so that they at least
are able to form their own judgement on it. They can then decide whether they have a
responsibility. Definitely the need is there.
After eleven years with MSF, it was really this kind of political and social engagement that
interested me. SOS is a ‘hydroponic NGO’, if I may put it like that –
nourished from below. Working with the organisation in Switzerland is particularly interesting,
given that the country is not very open-minded on migration. It has really been a challenge to
see how exactly we can engage with and mobilise people.
SOS was not conceived as something to exist forever. It is an ad hoc initiative, which will
stop as soon as there is an institutionalised, legal way for people to cross the Mediterranean to
seek asylum without drowning. So it’s really not built as an NGO. It’s a gathering
of people from different backgrounds who are willing to work together for a very specific reason,
and it will be dismantled as soon as the political answer is considered satisfactory, even if
that takes a while.
JF: SOS might, then, be considered part of a new movement in emergency response,
which includes Alarm Phone, Sea Watch and Open Arms. But its operational approach bears some
similarity to that of older humanitarian NGOs. Indeed, it works closely with Médecins Sans
CAS: Yes, we are in touch with Open Arms, Sea Watch and so on, but SOS sits
somewhere between citizen activism and humanitarian work. Other search-and-rescue groups,
particularly those in Germany, are much more involved in discussing asylum systems in Europe,
while our focus is rescue and testimony.
Most of the time, we are in reactive mode; it is an emergency mission but of a different kind.
Right before leaving MSF for SOS, I was Head of Mission for Syria and Iraq, overseeing operations
in Mosul. The level of intensity since I started with SOS is the same. But SOS is smaller. The
team on board the Aquarius [the rescue ship operated by SOS and MSF] never includes more than
fifteen people and our budget is only 4 million euros. It is mobilisation on land, rather than
operational issues at sea, that take most time.
JF: How has SOS positioned itself politically in relation to European governments
and institutions that have sought to prevent people crossing the Mediterranean to Europe?
CAS: What I thought was interesting about SOS when I joined was how it provided an
opportunity for people, particularly young people, to engage politically on issues of migration
but outside of political parties. We have had a lot of people aged 20–35, who have been
willing to get involved because they don’t identify with political parties on this topic,
they want to do something about it and they can’t necessarily join NGOs like MSF because
they don’t have professional experience in humanitarian work. They specifically want to do
something in Europe rather than going to Bangladesh or Syria or Iraq. It is really this idea of
dealing with a European issue, in Europe, in a way that might bring about political change,
without being embedded in a political party.
This is a new type of political engagement and politics – different to that which
inspired previous generations of humanitarian workers. SOS acknowledges the fact that dealing
with migration today in Europe is extremely political. It points to existing maritime law and
international humanitarian law to remind states of their obligations. And what’s really
interesting since the end of June is that we have ended up in a situation in which rogue European
states are deliberately throwing the law to the dogs. Now we know exactly what’s going on
in Libya. We know that European states are responsible for refoulement, sending
people back to torture, rape and detention in Libya. This is completely unlawful but European
institutions are endorsing it. So SOS says: ‘No! Actually, according to international law,
these are the obligations of states.’ It’s kind of a vigilante of the
Right now, my problem with NGOs like MSF and Save the Children and Oxfam is not what they do
out in the field. It is that their staff generally don’t act as citizens. They go out to
Uganda or DRC or whatever but they don’t engage with politics in their own home countries.
Perhaps this is a result of the way NGO workers see themselves. My PhD research was on
‘NGO-isation’ in Palestine, which has had a depoliticising effect. SOS is an
emergency initiative that nonetheless provides opportunity for people who seek to engage
JF: The arrival of more than one and a half million refugees and migrants on the
shores of Europe since 2015 has tested the idea of a ‘humanitarian Europe’. It has
tested the self-identity of many Europeans. To what extent do these younger activists see their
political engagement as part of a struggle against ethno-nationalisms to define European
CAS: Switzerland is interesting in this regard. During the Yugoslav War, a lot of
people – hundreds of thousands – came to Switzerland seeking asylum. Many of them
were later granted Swiss nationality. They were well integrated. Nothing like that has happened
since in Switzerland. Those born after the mid 1990s – about half of the people working
for SOS in Switzerland today – have never seen these supposedly ‘European
principles’ in action. So for them, it’s more about defining the kind of society in
which they actually want to live.
Although Switzerland has always had an ambiguous and difficult relationship with the EU, the
Swiss see themselves as defending European values and, particularly, humanitarian law. But Swiss
neutrality has a mixed legacy. Swiss youths today question whether their country’s
supposed neutrality is a denial of responsibility. Where does neutrality end and cowardice start?
So now they say: ‘No, we’re not going to stand by and watch people suffering
without getting involved. We’re not going to allow our identity to be defined by others
who would deny these people’s rights.’
JF: To what extent do these ‘others’ – presumably opponents
of search-and-rescue missions in the Med – pose direct challenges to the work SOS is
CAS: The Defend Europe people actually aren’t much of a burden. They
organise a demonstration every time we arrive somewhere, and they are extremely active on social
networks – much more so than we are, that’s for sure. When we publish something on
Facebook or Twitter, we end up with thousands of comments from them. I’ve gone from
working with MSF in highly insecure environments, where there are IEDs and shootouts, to
receiving death threats on social media. It’s not that easy to handle and it can take a
toll on morale. But these people aren’t really an operational impediment.
The much bigger problem is that states and the EU are ignoring conventions and laws. The Dublin
Regulation – for what it’s worth – is being undermined. It is now, in
Europe, that the refugee protection regime is being buried. In June , the Aquarius,
carrying 630 people to Europe, was refused entry to Italian ports. France has also prevented
people from disembarking from ships docked at its ports. The deals that were made with Libya and
Turkey [for the return of migrants and refugees] have caused a domino effect. Other countries are
increasingly turning refugees away. And UNHCR doesn’t seem prepared to stand against this.
There’s no solidarity. Solidarity and burden-sharing and protection are dead.
JF: If this is the case, if we are witnessing the death of the international
protection regime that sets the terms for responses to forced displacement, what should be the
response of those who support liberal humanitarian institutions?
CAS: Probably the only response currently possible is to fight back, to try to
maintain the international protection regime – to campaign for humane and dignified
responses to forced displacement in a broad citizen movement that might force states, including
via elections, to stick to their responsibilities.
This article explores the actions of Médecins Sans Frontières
during the 2018–20 Ebola outbreak in Nord Kivu, in the Democratic
Republic of Congo. Based on the experiences of practitioners involved in the
response, including the author, and on the public positioning of MSF during the
first year of the epidemic, it argues that although the actions of response
actors were usually well intentioned, they could rarely be described as
lifesaving, may have exacerbated disease transmission as much as limited it and
had the perverse effect of fuelling corruption and violence. The article
documents and analyses contradictions in MSF’s moral and technical
positioning, and the complicated relationship between the organisation and the
international and Congolese institutions leading the response. It argues that
the medical and social failure of the response was the result of an initial
belief in a strategy designed at a time when the only realistically attainable
outcome was to relieve suffering, and of the later inability of the organisation
to convince the authorities in charge of the response to adjust their approach.
It suggests that for future success new protocols must be elaborated and agreed
based on a better social and political comprehension and a better understanding
of the tools now available.
Despite a concerted international effort in recent decades that has yielded
significant progress in the fight against HIV/AIDS, the disease continues to
kill large numbers of people. Although there is still no definitive cure or
vaccine, UNAIDS has set an ambitious goal of ending the epidemic by 2030,
specifically via its 90-90-90 (‘treatment cascade’) strategy
– namely that 90 per cent of those with HIV will know their status, 90
per cent of those who know their status will be on antiretroviral therapy and 90
per cent of those on antiretroviral therapy will have an undetectable viral
load. These bold assumptions were put to the test in a five-year pilot project
launched in June 2014 by MSF and Kenya’s Ministry of Health in Ndhiwa
district, where an initial NHIPS 1 study by Epicentre (MSF’s epidemiology
centre) in 2012 revealed some of the world’s highest HIV incidence and
prevalence, and a poor treatment cascade. Six years later, a new Epicentre
study, NHIPS 2, showed that the 90-90-90 target had been more than met. What
explains this ‘success’? And given the still-high incidence, is it
truly a success? MSF Deputy Director of Operations Pierre Mendiharat and
physician Léon Salumu, Head of MSF France Kenya programmes, discuss the
political, scientific and operational challenges of the Ndhiwa project in an
interview conducted by Elba Rahmouni.
The COVID-19 pandemic has exposed multiple fault lines in the performances of
health services at every level – from community to national to global
– in ensuring universal, equitable access to preventive and curative
care. Tragically, this has been to the detriment of those who have suffered and
died not only from COVID-19, but also from the myriad other ailments affecting
people around the world. Of those, we wish to highlight here some key categories
of diseases that have caused a greater burden of illness and deaths as a
consequence of the policies and political decisions made in relation to the
COVID-19 pandemic. In our view, these should be considered epidemics or, more
accurately, syndemics – the clustering and interactions of two or more
diseases or health conditions and socio-environmental factors – of
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.