Last week, Doctors Without Borders announced that it had to close its operations in Russia after the Justice Ministry removed its affiliate office from the country’s foreign NGO register. Also known as Médecins Sans Frontières (MSF), this international non-governmental organization was among the first humanitarian missions to start working in Russia after the Soviet Union’s collapse. For more than three decades, MSF implemented dozens of important programs, helping vulnerable people across Russia through difficult situations. Since 2022, Doctors Without Borders has also offered humanitarian aid to civilians affected by the Russo-Ukrainian War. The Russian Justice Ministry didn’t offer an explanation for the decision, which made it impossible for MSF to continue working in the country. To mark the departure of Doctors Without Borders from Russia, Meduza looks back on their 32 years of work.
From Moscow to Chechnya
Founded in Paris by a group of doctors and journalists in 1971, Médecins Sans Frontières (Doctors Without Borders, in English) now operates in 70 countries, providing medical assistance to people in emergency situations and those excluded from health care. The organization relies on donations from companies, private foundations, and individual donors. In 2023, MSF raised 2.37 billion euros ($2.64 billion) to support its work, most of which came from some 7.3 million private donors.
Doctors Without Borders began working in Russia in 1992, distributing free food to children under three years old at “milk kitchens” in Moscow. Later that year, MSF began assisting the Russian capital’s homeless population, which numbered around 30,000 people — all of whom lacked access to medical and social services.
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In an interview with Moskvich Mag, Dr. Alexey Nikiforov, who later became the deputy medical coordinator of the MSF mission in Russia and Belarus, recalled the organization’s work in Moscow in those early days:
We agreed to supply some hospitals with, say, dressings and to buy additional medications, and in return they would admit the homeless persons we would send to them from our first-aid post. In the morning, we [treated] patients with urgent problems at the first-aid post, and if some homeless person needed hospitalization, then we’d make arrangements with a hospital. And in the afternoon we’d transport patients to the hospitals in our minibus.
MSF doctors also used their minibus to make regular visits to train stations and other places in Moscow where homeless people sheltered, to provide them with emergency medical consultations. The organization also worked closely with city officials to improve municipal services for the homeless population, such as shelters.
In addition, MSF worked to raise awareness about the problems unhoused people faced, running an ad campaign in the Moscow subway system and parking a bus outside the mayor’s office emblazoned with a running tally of the deaths from hypothermia on the city’s streets. As Nikiforov recalled:
[W]ith the help of our advertiser friends, we made a poster with a stylized snowman lying in a snowdrift; on the poster there were cutouts and you could change the numbers to how many people had frozen to death in Moscow since the start of the winter and overnight. We attached the poster [to the bus] and updated the data in the windows every day.
Battling tuberculosis
In 1995, Doctors Without Borders began tackling the spread of tuberculosis in Russian prisons. The initiative began at the Mariinsky penal colony in the Kemerovo region, after the prison hospital’s chief physician, Natalya Vezhnina, “paid her way to some international conference in Europe, where she announced that she was tired of burying her prisoners — they die every day,” Alexey Nikiforov told Moskvich magazine.
With permission from the Federal Penitentiary Service, MSF aid workers were allowed to visit the Mariinsky prison hospital, and thus began their treatment program for drug-sensitive tuberculosis in the Russian penitentiary system. “The necessary first-line drugs cost pennies now, but back then there were problems with medical supplies,” Nikiforov recalled.
In addition to distributing medicine, MSF organized a system for screening new prisoners, established diagnostic procedures, and managed to provide uninterrupted, months-long treatment for prisoners with TB. Its work soon extended to other prison facilities in the Kemerovo region, as well as to tuberculosis hospitals, where medical staff were taught how to administer more effective treatment, thereby preventing the spread of TB.
In 2004, Doctors Without Borders launched a tuberculosis treatment program in Chechnya. As Nikiforov said in interviews, the two wars in Chechnya had destroyed nearly all of the infrastructure needed to treat tuberculosis patients, leaving the entire region without a dedicated TB hospital and with just 12 tuberculosis specialists. In particular, MSF’s work consisted of distributing medications that weren’t available in the region at all. According to Nikiforov, the organization ultimately treated more than 5,500 tuberculosis patients in Chechnya.
MSF wound down its projects in Chechnya in 2017, handing over tuberculosis treatment to the Chechen Health Ministry. But the organization continued to launch shorter tuberculosis treatment programs in other parts of Russia, including in the Arkhangelsk and Ivanovo regions, most recently.
Russia’s wars
In 1999, Doctors Without Borders won the Nobel Peace Prize, “in recognition of the organization's pioneering humanitarian work on several continents.” In his Nobel speech, then-president of the MSF International Council, Dr. James Orbinsk, made an appeal to President Boris Yeltsin condemning Russia’s violence against civilians in Chechnya:
The people of Chechnya — and the people of Grozny — today and for more than three months, are enduring indiscriminate bombing by the Russian army. For them humanitarian assistance is virtually unknown. It is the sick, the old and the infirm who cannot escape Grozny. [...] I appeal here today to his excellency the Ambassador of Russia and through him, to President Yeltsin, to stop the bombing of defenseless civilians in Chechnya. If conflicts and wars are an affair of the state, violations of humanitarian law, war crimes, and crimes against humanity apply to all of us.
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Silence has long been confused with neutrality, and has been presented as a necessary condition for humanitarian action. From its beginning, MSF was created in opposition to this assumption. We are not sure that words can always save lives, but we know that silence can certainly kill.
Doctors Without Borders worked on the ground in Chechnya, Ingushetia, and Dagestan, performing consultations for residents and displaced persons, supplying hospitals and clinics with essential medicines, and providing psychological and medical assistance.
In 2001, armed individuals kidnapped the head of the Doctors Without Borders North Caucasus mission, U.S. citizen Kenneth Gluck, holding him hostage for a month. Armed men then abducted the MSF head of mission for Dagestan, Dutch national Arjan Erkel, in 2002. The organization suspended its operations in the Russian North Caucasus following Erkel’s kidnapping. He was finally released in 2004.
Following Russia’s full-scale invasion of Ukraine in 2022, Doctors Without Borders began providing humanitarian aid to Ukrainian refugees in Russia, as well as to displaced Russians (in addition to its extensive operations in Ukraine). “Since the start of our response in 2022, more than 52,000 refugees and displaced people were provided with humanitarian aid and more than 15,400 received free medical, mental health, and psychosocial support,” the organization said in a September press release.
Since October 2022, Doctors Without Borders had worked in Russia’s Belgorod region alongside the non-profit organization Path to the Future (Put’ v budushchee, in Russian). MSF also planned to provide humanitarian assistance in the Kursk region, but was ultimately forced to shutter its operations.
In the press release announcing the closure of its programs, MSF said it “would like to work in Russia again should the necessary conditions be provided by authorities.”
“We are very sad to conclude our programmes in the country as many people in need of medical and humanitarian assistance will now be left without the support we could have provided to them,” said Norman Sitali, the MSF operations manager responsible for programs in Russia. “MSF would like to still work in Russia again, if and when possible.”
Story by Meduza