«The humanitarian aid system in Ukraine is collapsed»

There is currently no doctor in charge of the Spanish section of Doctors Without Borders (MSF). Paula Gil, its new president, is a nurse and her access to that position is the result of a statutory reform. “It didn’t make sense that we couldn’t reach the top because we are a huge professional group that has been working on the front line for years and, in addition, each patient is cared for by a multidisciplinary team,” she argues. The recently appointed NGO leader has visited Bilbao to hold a working meeting.

– In African countries like Zimbabwe, nurses often run hospitals.

– There are important differences between the North and the South. In places with a lack of doctors, the staff have to assume responsibilities that they do not have here. Congolese, Central African, Sudanese or Yemeni professionals, with a very high level, have a great knowledge of local pathologies. Foreigners who come to these countries bring a vision of team management.

– The crises were huge and then Ukraine came.

– Unfortunately, we are needed more than ever. Last year there were 84 million forcibly displaced people, figures that had never been seen before. Ukraine represents an incredible geopolitical change. There are more and more needs and it is not possible to give answers to all of them. The humanitarian aid system is collapsed.

– How do you face the crisis in a country as large and populous as Spain?

– It is a terrible war, with a high level of violence against the population and health infrastructure, and lack of access to certain areas. But the Ukrainian health institutions are good, not like the Afghan, Yemeni or Malian ones, which endure years of crisis and lack of resources. We focus on training them to deal with the massive flow of war wounded, something they are not used to. Fortunately, we do not see refugee camps because Europe has opened its doors, although we are angry that this measure does not apply to people fleeing other conflicts.

– Humanitarian action is increasingly complex because hospitals no longer suffer only collateral damage, but also become targets.

– The laws of war are not respected. There are attacks on convoys of escapees, hospitals or stations. The work of humanitarian organizations is also criminalized. In the Sahel, to access patients, you have to negotiate with armed groups and governments, who associate us with them. The humanitarian space is shrinking more and more and much more care must be taken in security. Likewise, we are criminalized by associating ourselves with mafias, branding us as facilitators of emigration.

poor nutrition

– What are the global consequences of the conflict in Ukraine?

– Rains, it pours. After years of crisis, war in Ethiopia, covid and the impact of climate change, we are facing frightening malnutrition statistics. Much of the population of the Horn of Africa depends on humanitarian aid to eat and NGOs lack funds. The consequences will be dire.

– The crisis in Afghanistan has been completely displaced by recent events.

– The crisis is especially painful. It deserved attention for four days in the summer and it’s over. Bank accounts were frozen when the Taliban arrived, and since then half a million jobs have been lost. The improvement of security meant that its inhabitants flocked to hospitals and impossible health indicators have been discovered. Now, security has gotten worse. The country does not lift its head.

– What does the future look like in the field of emergencies?

– The outlook is not hopeful. We change the lives of the people we serve, but there is a lack of courageous leadership among those who make the important decisions. The vision of us first predominates, there is no awareness that there is no North and South, that everything is connected and that what happens today in Afghanistan will soon have consequences in Europe. The pandemic has taught us that there are no borders.