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Médecins Sans Frontières, the Rwandan experience, 1982– 97

Throughout the 1990s, Médecins Sans Frontières (MSF) was forced to face the challenges posed by the genocide of Rwandan Tutsis and a succession of major outbreaks of political violence in Rwanda and its neighbouring countries. Humanitarian workers were confronted with the execution of close to one million people, tens of thousands of casualties pouring into health centres, the flight of millions of others who had sought refuge in camps and a series of deadly epidemics. Where and in what circumstances were the MSF teams deployed? What medical and non-medical assistance were they able to deliver? Drawing on various hitherto unpublished private and public archives, this book recounts the experiences of the MSF teams working in the field. It also describes the tensions (and cooperation) between international humanitarian agencies, the crucial negotiations conducted at local, national and international level and the media campaigns. The messages communicated to the public by MSF’s teams bear witness to diverse practical, ethical and political considerations. How to react when humanitarian workers are first-hand witnesses to mass crimes? How to avoid becoming accomplices to criminal stratagems? How to deliver effective aid in situations of extreme violence?

This book is intended for humanitarian aid practitioners, students, journalists and researchers with an interest in genocide and humanitarian studies and the political sociology of international organisations.

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Stories about international organisations, non-State actors, and the formation of customary international law
Sufyan Droubi and Jean d’Aspremont

International lawyers relish telling stories about customary law, its contents, and its modes of ascertainment. There is hardly a question of international law that has continuously attracted as much passionate story-telling as customary international law. The present volume contributes to such scholarly self-indulgence. Yet, it does so by presupposing that there exists an approach to custom-forming that is adverse to the central role of international organisations and non-State actors and which it calls the dominant orthodoxy. According to this projected

in International organisations, non-State actors, and the formation of customary international law
Jarle Trondal, Martin Marcussen, Torbjörn Larsson, and Frode Veggeland

3436 Unpacking international organisations:2833Prelims 22/3/10 14:56 Page 65 4 The OECD Secretariat Many years ago the Organisation for Economic Co-operation and Development (OECD) was primarily an ‘economic’ organisation. Although many people will associate the OECD with its thorough economic analysis and frequent warnings regarding real estate bubbles, overheated labour markets, financial crises and unsustainable public spending, the OECD frames public discourse on a wide range of supplementary themes. Few people know, for instance, that the OECD is a

in Unpacking international organisations
Jarle Trondal, Martin Marcussen, Torbjörn Larsson, and Frode Veggeland

3436 Unpacking international organisations:2833Prelims 22/3/10 14:56 Page 156 8 Epistemic dynamics in international bureaucracies Science is much more than the mechanical production of data and analysis. Science has become an institution in itself which is loaded with authority and power. Scientific authority bestows its holder with legitimacy and a communicative platform that reaches far beyond the narrow scientific discipline. Scientific power grants access to constituting basic rules for cause and effect, distinguishing right from wrong, categorising

in Unpacking international organisations
The role of the United Nations Security Council
Alice Martini

This chapter investigates the standardisation and legitimisation of countering extremism at an international level. Based on Critical Discourse Analysis, this work examines the United Nations Security Council’s (UNSC’s) discourse on terrorism, specifically in its relation to extremism. Here, a significant shift took place and the concept of extremism became central to the UNSC’s counter-terrorism activity. It is therefore argued in this work that the concept has problematically been assigned discursively a wide range of meanings. These encompass phenomena that go from physical violence to behaviours and even narratives and ideas. The UNSC has reflected but also mutually constituted this shift in the global discourse on terrorism, broadening and legitimising states’, and its own, exceptional powers. Moreover, in virtue of its legal and political powers, the UNSC has not only produced a discourse on this menace but has also established international legal norms and bodies and enforced them on states of the international community. Describing and discussing these processes, the present chapter thus analyses what is better conceptualised as a Foucauldian dispositif of extremism. Through this, it will be argued, the international organisation enforced a global, standardised governmentality which encompassed the public and political realm but also the private and domestic sphere.

in Encountering extremism
Martin D. Moore

This chapter examines the development of new forms of general-practice-based diabetes management over the last quarter of the twentieth century. Although GPs had retained responsibility for ongoing patient care after 1948, the creation of the NHS consolidated the dominant role of the specialist clinic in post-war diabetes management. During the 1970s and 1980s, however, hospital clinicians and GPs began to devise more formal systems of structured and integrated diabetes care, with GPs assuming greater roles in disease management. For clinicians, deputing responsibilities to GPs offered a way to manage patient loads and increasing demands for surveillance in a context of constrained resources, and enabled consultants to refocus on challenging work. For GPs, new forms of care dovetailed with emerging professional projects connected with distinguishing GPs from hospital practitioners and moving GPs into team-based, proactive preventive health work. By the early 1990s, the Royal Colleges, the British Diabetic Association, the Department of Health, and international organisations all supported the increasing role of primary care practitioners in diabetes care. Medical politics, resource distribution, and epistemic change had once again combined to reshape approaches to diabetes management and reposition it as a form of long-term risk prevention.

in Managing diabetes, managing medicine
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Through the eyes of field teams’ members
Jean-Hervé Bradol and Marc Le Pape

Never before had MSF teams been the direct witnesses of genocide and repeated mass violence on such a huge scale. The method of observation adopted for this book was, as matter of priority, to focus on the work of field teams and reconstruct their perceptions, decisions and actions. The following sources were used: numerous reports submitted to MSF head offices by MSF teams; witness statements published by the Rwandans; public documents from international organisations and research studies based on field surveys. The history of Rwanda is also told through a series of events which shed light on the political dynamics of the 1990s. Lastly, a summary of MSF’s activities in the Great Lakes region since 1980 is also included.

Three very specific questions about Rwanda and the Great Lakes region during the period 1990 to 1997 are formulated:

Where were MSF’s teams working?

What work were they involved in?

Which of the obstacles they encountered became the subject of debate, and which of these went on to be made public?

in Humanitarian aid, genocide and mass killings
Jarle Trondal, Martin Marcussen, Torbjörn Larsson, and Frode Veggeland

3436 Unpacking international organisations:2833Prelims 22/3/10 14:56 Page 37 3 The European Commission The Commission systematically excludes territorial preferences, institutions and concerns from its agenda-setting processes. Departmental, supranational and epistemic behavioural dynamics are likely to reflect the organisational components of the Commission services. This chapter introduces the Commission organisation and personnel. As will be shown in Chapters 6 to 9, the Commission is indeed a compound system of international bureaucracy, balancing

in Unpacking international organisations
Hanna Pfeifer

Lebanese Hezbollah is arguably the most powerful armed non-state actor currently active. Founded as an Islamic resistance movement against Israeli occupation in the 1970s and 1980s, Hezbollah is considered a terrorist organisation by several Western states and, since 2016, by the Arab League and the Gulf Cooperation Council. Since 2015, it is known to have been involved in several armed conflicts in the Middle East, most importantly as a supporter of the Assad regime in the Syrian civil war, but also as a provider of military training for resistance groups in Iraq and Yemen.

At the same time, however, Hezbollah representatives have been part of all Lebanese governments since 2011 and they occupy a number of seats in Parliament. Finally, Hezbollah is also a very active provider of social and welfare services in the Lebanese South and the Beqaa.

For all of the roles it takes, Hezbollah has often been described as a hybrid organisation, which escapes established typologies of both Islamism and terrorism. The chapter, based on the author’s field research in Lebanon, seeks to explore and map the variety of recognition practices that revolve around Hezbollah. It analyses what kind of recognition Hezbollah seeks from different audiences, among them the Lebanese and transnational Shiite community, the Lebanese people, competing political parties in Lebanon, and Western and Middle Eastern states, as well as international organisations. It traces how recognition-granters react to Hezbollah’s claims and what consequences these parallel processes of recognition, non-recognition and mis-recognition have on inner-Lebanese and regional conflict dynamics.

in Armed non-state actors and the politics of recognition
Jarle Trondal, Martin Marcussen, Torbjörn Larsson, and Frode Veggeland

3436 Unpacking international organisations:2833Prelims 22/3/10 14:56 Page 111 6 Departmental dynamics in international bureaucracies This chapter demonstrates the existence of a foundational departmental dynamic within all the international bureaucracies studied – both with respect to contact, co-ordination and conflict patterns and to the identity and role perceptions among the personnel. International bureaucracies seem to have enduring impacts on the officials embedded within them. This strongly signifies that the organisational structures of

in Unpacking international organisations