At this year’s annual Scientific Days conference held by Médecins Sans Frontières (MSF) in London, delegates were dared to embrace fear. From the fear of unknown challenges to the known threats that we see on the frontline of humanitarian aid, presenters encouraged us to run towards that fear to create real change.

Dr James Orbinski’s provoking keynote presentation reminded us that the most significant issues are multi-layered and need to be embraced as a whole.Drawing lines between complex geopolitical systems and climate change, Dr Orbinski considered that the root of innovation is in dignity and respect – for the people and planet.

Dr James Orbinski delivers his keynote address on Medical Research Day. Dr Orbinski has been associated with MSF since 1990 and is currently the Inaugural Director of the Dahdaleh Institute for Global Health Research at York University, Canada. ©MSF

Within this thesis, 14 presentations on MSF field research broke down into four arguments:

  1. Including patients in decisions about their own care;
  2. Responding to the complexity of human behavior;
  3. Focusing on those left behind; and
  4. Defining MSF’s role within the challenge of climate breakdown

“We are not living on this planet: we are living in and through it.” – Dr James Orbinski

By including people in making decisions about their own care, we enable agency. We learned about how women who are at risk of HIV feel empowered through access to daily PrEP medication, and that it’s the small things that make a real difference in palliative care.

But, stigma and shame is a powerful deterrent to care – especially for disfiguring or sexually transmitted infections. From HIV and Visceral Leishmaniasis co-infections to the growing need for snakebite antivenins, those affected are the most vulnerable. This year, MSF campaigned successfully for the WHO to recognize snakebite treatment on their neglected tropical disease list. This success shows MSF’s strength in advocacy, but we still have more to do.

Within these considerations was the overarching issue of climate change. What will we do when unlivable climates displace more people? The conversations are still ongoing as stories from the field continue to emerge. We will learn how to use our voice to continue advocating for the forgotten.

“Go where the fear is! Wherever you sense fear, that’s when you know change is coming.” – Eddie Obeng

What is research without innovation? The second day of Scientific Days launched into activity with Eddie Obeng’s interactive and energetic keynote speech. He challenged the audience to scrap the ego, reminding us that humility and really listening are crucial to innovation.

Presenters developed this go where the fear is mantra. Work from Nigeria, Lebanon, and Greece showed the power of social media as a collaborative tool for health advocacy. We heard a debate about the issues and opportunities in big data, and a panel encouraged the audience to analyze and question the current approaches to palliative and ‘women’s healthcare’.

An engaged MSF Scientific Days delegate posing a question to the panel. ©MSF

Big data affects us all, but data collection has unique concerns in a humanitarian context. An inter-sector panel debated problems of data protection and security, creating ripples of agreement and disagreement across the room. Alexandrine Pirlot de Corbion reminded us that the core of MSF’s humanitarian mandate is to protect data – so we need to make decisions about how to use that data responsibly.

“We have to stop seeing abortion as a women’s issue and start seeing it as a healthcare issue.” – Dr Manisha Kumar

There is a false dichotomy between palliative and curative care. We saw how MSF teams have implemented successful neonatal palliative care frameworks in Afghanistan by integrating palliative care within existing curative care frameworks. Dr Nikola Morton expressed her hope that all MSF operations will integrate palliative care as a core part of their humanitarian work.

In her compelling presentation, Dr Manisha Kumar called to MSF staff to accept abortions as a core aspect of healthcare. She called out a lack of knowledge as the root of misconception – in both those seeking abortions and those providing them. We learned that not only do 1 in 4 pregnancies end in abortion, but also the procedure is safer than an injection of penicillin.

“What is humanitarian without humanity and humanity without human. At the center of it all, we are just people.” – Muneera Williams

The crowd favorite at Scientific Days? Muneera Williams, poet and activist, who roused the audience with her thunderous summaries of each session. She captured the heart of the conversation to reflect the work and vision of MSF.

In her final summary, Muneera dared us to change. She dared the audience to be brave – to embrace the space in which we can say “I don’t know”. The founders of MSF built the organization to fill a gap that made them feel uncomfortable and fearful. Within that gap, they found that we have the power to witness, restore dignity, and hope. That mission is as real today as it ever was as MSF continues to rise to that challenge: let’s see what obstacles we can run towards next.

MSF welcomed Rapporteur Muneera Pilgrim to Scientific Days 2019. Muneera joined us to observe and humanise the medical research being discussed by writing and reciting her unique brand of poetry. ©MSF