Introduction
This essay argues that Médecins Sans Frontières’s (MSF) humanitarian logic in Palestine simultaneously relies on Palestinian voices and silences them, transforming political struggle into a humanitarian spectacle. Writing through the ongoing genocide in Gaza as a Palestinian humanitarian worker, I ask: how does MSF’s mode of operation, which claims neutrality and universality, actually reproduce structures of epistemic injustice, inequality, and depoliticize the Palestinian struggle? Drawing on Didier Fassin’s concept of the humanitarian politics of life and Ilana Feldman’s critiques of humanitarian histories in Palestine, I situate MSF within the longer history of humanitarianism in Palestine. I discuss how MSF’s practices are part of an effort to both erase and instrumentalize Palestinian narratives: Palestinians provide knowledge, labor, and even death for humanitarian legitimacy, while being excluded from authorship, decision-making, and bearing witness. I ask, who is the humanitarian spectacle for, and who does it benefit?
Notes on the Day-to-Day Life of a Humanitarian Organization
Médecins Sans Frontières (MSF), also known as Doctors Without Borders, is an international, independent medical humanitarian organization. It provides emergency medical assistance to people affected by armed conflict, epidemics, natural disasters, and exclusion from healthcare in over 75 countries. MSF was created in 1971 by several French doctors who resigned from the International Committee of the Red Cross (ICRC) in protest of ICRC’s neutrality in the Biafran War.
Every Sunday morning, the start of the work week at MSF’s coordination office in Jerusalem begins with an all-staff meeting. The meeting, which is held in English, is the only time when the Palestinian “local” staff and “expat” international staff meet together throughout the entire week. As the staff gathers, each head of department, always an expat, reports the updates of one of the seven departments in MSF. The meeting finally reaches the Communication Department, which this particular Sunday, announced the release of a new report condemning “Israel’s war in Gaza” and the ongoing blockade of humanitarian efforts in the Gaza Strip. The announcement is received by the expats with an approving nod, while the Palestinians, a majority of them silent for all of the meeting, respond with either a confused look or cast an indifferent glance.
Most of the Palestinian staff, despite their different assignments in the humanitarian organization, are neither involved in nor aware of the production of most of the reports by MSF. Many of MSF’s publications appear in international news articles with journalists inserting MSF’s “witness” and reportage to back up factual information about the ongoing crisis in Gaza, or cast doubt on the claims of politicians. Despite the consistent exclusion of the Palestinian staff in the knowledge production of these reports, they can sometimes speculate that the “expats” are generating a report. For example, an expat colleague could start delivering a series of focused questions to the Palestinian staff, with or without informing them that their answers will be included in an upcoming report. Meanwhile, the local staff are expected to run the administrative tasks of MSF: translating important documents and meetings; taking care of the bureaucracy; and streamlining the “context” or the local history for the expat half of the team. A lingering feeling of being used as a tool rather than a colleague leaves many feeling like they operate outside of MSF rather than in it, an experience shared by many locals working for MSF in different countries.
Encounters between the Palestinian locals and the “expat” workers are subordinate to a humanitarian logic of epistemic organization. Didier Fassin’s concept of the “humanitarian politics of life” describes how humanitarian organizations create a hierarchy of suffering, determining whose lives are considered worth saving and whose voices are recognized. In the context of MSF Palestine, Palestinian staff occupy the lower tier of this hierarchy: their labor and suffering are essential for operating, yet their voices and expertise are systematically excluded from any process of knowledge production. This hierarchy of knowledge and labor reproduces a contesting humanitarian narrative, unable to be the “socially acceptable narrative to absorb, sustain and circulate” Palestinian facts and histories.
The exclusion of Palestinian voices in MSF’s witness is underpinned by the organization’s adherence to supposed neutrality. Palestinians undergoing Israeli genocide cannot be neutral as defined by MSF; their experiences are disqualified precisely because they are political. Palestinian labor (and sometimes lives) are extracted, but they cannot be authoritative of their own story. Only a neutral narrator can “accurately” witness Palestinian history according to MSF’s logic. MSF’s claim of neutrally witnessing Palestinian suffering allows the organization to effectively create a parallel humanitarian history of Palestine. This version is more acceptable to Western stakeholders and replaces Palestinian narration and history. What is at stake is not only the inclusion of Palestinian voices within MSF, but rather the acceptable conditions through which Palestinian genocide can be understood. For MSF, this acceptable narrative is within the confines of a humanitarian tragedy and in need of humanitarian aid.
The Age of Humanitarianism
The 20th century has witnessed what Fassin describes as the replacement of ideology with humanitarianism’s politics of compassion. This anti-political framework centralizes the universality of human life, avoids engagement with structural oppression, and focuses on individual suffering. A humanitarian lens reduces conflicts into “those who belong to the axis of good and those who belong to the axis of evil.” Consequently, in a world in which the strong oppress the weak, humanitarian organisations are deployed to help the weak and denounce the strong.
Fassin describes the humanitarianization of politics and histories as running against the “thickness of biographies” and “complexity of history.” A humanitarian history is made of two figures: the first, a complete victim who requires aid, and eventually has their suffering witnessed. The second, an aid worker, who delivers aid and eventually witnesses the suffering of victims. MSF stands out as a prominent example of an international organization dependent on a human hierarchy in its structure and work. In contradiction to MSF’s belief in the equality of all human life, the organization insists on the need to send Western “experts” to areas of conflict as the main providers of aid. This mode of operation depends on the labor and knowledge of a silent local staff who do most of the humanitarian work, but have a minimal role in decision-making or bearing witness. The process of narrating, to bear witness to a crisis, is exclusive to a Western worker. Humanitarian organizations have thus succeeded in maintaining a conditional solidarity, dependent on “upholding an ontological inequality of lives.”
MSF in Palestine
Humanitarian action can be instrumentalized for oppression. In Palestine, early Zionist thinkers considered forcing Palestinians outside of Palestine under a humanitarian camouflage, as illustrated by Theodore Herzl’s declaration, “We must expropriate gently and to try to spirit the penniless population across the border by procuring employment for it in transit countries.” Herzl’s appeals to instrumentalize humanitarianism to ethnically cleanse historic Palestine reflect the awareness of the potential of humanitarianism to mask structural violence. Humanitarianism’s focus on saving the individual, clashes with the Palestinian aspiration of collective liberation. Indeed, humanitarian efforts in Palestine are “efforts [that] are sometimes deployed as a strategy for frustrating Palestinian political aspirations.” Conversely, many humanitarian organizations cling to an imagined neutrality, claiming to operate outside of history—a supposedly neutral sphere that neither changes with history nor is changed by it.
In the case of MSF, the frustration is evident through the production of a series of reports constructing specific truths about Palestinians. For example, during the second Palestinian intifada, MSF reported that Palestinian stone throwers were suffering from psychological injuries, erasing their image as resisters of Israeli colonial occupation and reducing them to victims of psychological injuries. The portrayal of Palestinian victims moves away from a politics of justice to the humanitarian politics of compassion, relying on victimhood to justify humanitarian intervention.
Since the start of the Gaza genocide, MSF has been at the forefront of the reporting. MSF, speaking through social media or through press releases, often cites one of its many Western humanitarian workers to describe the suffering of people in Gaza. In practice, Western humanitarians, through the brief witnessing of Palestinian suffering from the safety of MSF’s corridors, act as an extension, and therefore an authority, of Palestinian suffering to a Western audience. In their testimonies, the workers’ reports centralize the importance of humanitarian intervention in the ongoing genocide, often calling for “urgent action” and “increased humanitarian aid,” as an endpoint for the suffering of Palestinians. This process allows for the masking of the structure of settler colonialism, displacing the efforts for Palestinian liberation with humanitarian action.
MSF’s testimony of Gaza renders Palestinians as both subjects and instruments of knowledge production. This process produces a competing humanitarian narrative that Western universities, governments, and news outlets often accept as “impartial middle ground” between a U.S.-backed Israeli narrative and a marginalized Palestinian narrative. Throughout the dissemination of images of Palestinians as victims of a humanitarian catastrophe, MSF reinforces the indispensability of the global humanitarian economy, ensuring that Western “experts” remain necessary interveners. Funding, attention, and importance will thus be channeled towards the few humanitarians, in this example, MSF expats, while leaving the roots of Palestinian suffering untouched.
Epistemic Injustice and Beyond
In his famous essay “permission to narrate,” Edward Said called for people in solidarity with Palestinians to work for a world that accepts Palestinian truths. However, MSF’s solidarity with Palestinians is conditioned on the restructuring of Palestinian history. In Gaza, MSF’s bearing witness is underpinned by an already agreed-upon discourse on politics in the confines of MSF’s HQs in Paris, Brussels, or Amsterdam. This humanitarian discourse systematically excludes Palestinian narratives and attempts to “force facts, politics, and history” in an imaginary humanitarian middle ground. Therefore, Palestinian calls for justice are deemed as less ethical, illogical, and biased vis-à-vis a humanitarian narrative that calls for universal compassion.
MSF’s centrality as a reliable narrator in the Gaza genocide is a by-product of decades of knowledge control on Palestine. MSF’s narration fits within a Western imaginary of Palestinian perfect victimhood. Through MSF’s narration, the limits and requirements of Western solidarity are demarcated: disproportionate Palestinian death, the targeting of humanitarian spaces, and proof of mass famine have been proven as conditions for increasing pressures on the Israeli war machine. These a priori requirements explain the rise of doctors, epidemiological studies, and public health experts. Taking center stage in the Gaza genocide: a gradual process of medicalizing colonial violence through the focus on epidemiological data as an advocacy tool, and the departure of Palestinian history from the political to the biological. In this process, Palestinians are recognized only through the circulation of their wounds and bodies, while their political voice remains obscured.
In this imagined Palestinian humanitarian history, Israeli settler colonialism is enabled through the fulfillment of specific humanitarian conditions that allow it to camouflage and continue its operations. The selective entry of food trucks, the evacuation of injured children, and the establishment of humanitarian field hospitals have proved successful in easing the global political pressure on Israel. In effect, MSF and other humanitarian groups have created a space for a regime of settler colonialism to develop and adjust according to the recommendations of humanitarian reports.
Palestinian refusal to fully cooperate with MSF, and in extension the aid system, exposes the cracks and contradictions within humanitarian history. The destruction of Gaza is not a standalone humanitarian crisis, rather a continuation of a century-old Zionist project to colonize Palestine. However, the resistance of MSF to fully support Palestinians is not accidental; it is due to internal pressures to preserve MSF’s position as a Nobel-winning humanitarian organization with a central role in politics, history, and knowledge production. By taking the spotlight in Gaza’s “humanitarian” crisis, MSF safeguards its indispensability to individual Western donors, international media, and global policymakers. MSF’s calls for a mere ceasefire are not only to stop the killing in Gaza. They are also calls to self-preserve an ineffective humanitarian economy, which, in Palestine’s case, is actively harmful.
Case Studies of Narration
Within MSF’s hierarchy of humanity, Palestinian workers simultaneously uphold the organization’s mission and challenge the very narrative it seeks to construct. For example, Abdullah Hammad, whose labor MSF relied upon as a hygienist, was hired without a formal contract, exemplifying the organization’s reliance on Palestinian labor. This contractual setup excluded Hammad from any benefits or protection MSF provides for its full-time staff, such as food and shelter. Finishing his work on the 30th of June, Hammad left MSF and started looking for food for his family. This coincided with the disastrous launch of the Gaza Humanitarian Foundation (GHF). Hammad, like many other Palestinians, went to the GHF aid collection sites to receive aid and was shot by Israeli forces on the 3rd of July 2025. The death of Hammad was immediately mourned by MSF as the death of a colleague. The claiming of Hammad’s death extended MSF’s control over the narrative of Palestinian suffering. Hammad is a Palestinian laborer who was exploited and killed in the name of humanitarian work. In highlighting Hammad’s death, MSF appropriated Palestinian suffering to actively construct a narrative of heroic humanitarian intervention, masking the structural inequalities within its own operations, as if all the workers within MSF suffer equally. Hammad’s death is added to twelve additional exclusively Palestinian aid workers in Gaza, all from MSF, who were killed in the genocide.
The MSF narrative can also be challenged. An outspoken Palestinian on Israeli occupation, Dr. Ghassan Abu Sitta, found himself in the operating rooms of Al-Ahli Hospital on the 17th of October. The hospital, which was hit by a rocket, a strike that Israel has denied, led to the death of over 400 people. Witnessing the devastation firsthand, Abu Sitta took a makeshift podium in the confines of Al-Ahli hospital. Standing around him were Palestinian doctors, surrounded by the bodies of people killed by the rocket strike. At that moment, Abu Sitta declared his identity as: “A Palestinian British surgeon, and a volunteer for Médecins Sans Frontières.”
After his evacuation from Gaza, Abu Sitta went on to bear witness to the ongoing colonial violence in Gaza through Palestinian eyes, and his calls for political action and affiliation with MSF created a hole in the confines of an MSF-controlled humanitarian narrative. This was followed by a fallout between Abu Sitta and MSF, leading to the barring of the Palestinian surgeon from working for MSF in the Gaza Strip. MSF labelled Abu Sitta as too biased, despite his extensive experience in the area, and his Palestinian witness of Israeli violence was not welcomed by the organization. Abu Sitta’s experience is excluded from reports or media communications, isolating his act of speaking out as a Palestinian as too political and not neutral, therefore not humanitarian.
Conclusion
By bearing witness to MSF’s systematic injustices through Palestinian eyes, I aim to unsettle the celebrated images of Western humanitarian workers in Gaza. While the overwhelming majority of humanitarian aid workers killed in the Gaza genocide are Palestinians, including around 248 journalists as of the writing of this essay, international aid groups like MSF are increasingly prioritizing Western expat staff as witnesses. In addition to their work as aid providers, these Western MSF workers displace Palestinian truths, experiences, and narration. Ultimately, an imaginary Gaza is constructed, using epidemiological data, experiences, and biases of MSF.
Critical literature on humanitarian action is filled with critiques of humanitarian work as a perpetrator of the status quo. This critique leads to an aporia: even with its decisive flaws, humanitarian action may be able to create a world of lesser evil. However, in Palestine, a humanitarian lesser evil has been instrumentalized to obscure ongoing settler-colonialism. What is at stake here is not only the upholding of inequality within the humanitarian economy, but rather the radical reconfiguring of the method in which the Question of Palestine is asked.
Indeed, strategies of controlling the narrative, resources, and power are often strategies that Palestinians have resisted to liberate themselves. Recognizing these strategies in current international humanitarian interventions should be the first step towards disrupting the current state of humanitarian work. Humanitarianism’s failure in Palestine lies not only in upholding systems of oppression or “lesser” evil, but equally in ensuring that Palestine is seen as a humanitarian issue, rather than a struggle for independence and sovereignty.
The underestimated role of humanitarian organizations in shaping Palestinian history calls for the disruption of their work. A politics of rejection should guide how Palestinians engage with humanitarian organizations in the future. For new forms of politics to rise, humanitarian intervention must truly be temporary. The moment Palestinians will be able to reject humanitarian aid, both epistemologically and materially, will mark a new step toward reclaiming authority over their history. To reject the impositions of a humanitarian “lesser evil”; the illusion of a “better occupation”; and the complacent moral logic for ethical realism.
Rejecting humanitarian action is, ultimately, a rejection of humanitarian solidarity. The genocide in Gaza has shown that solidarity constructed on compassion alone can be both harmful and insufficient. Nevertheless, the rejection calls for a more historical type of solidarity, built on the understanding of the long history of silencing Palestinians. To be in solidarity with Palestinians is to be in solidarity with their narratives and experiences. Epistemic solidarity means refusing the humanitarian hierarchies of knowledge, centralizing Palestinian voices rather than the voices of Western humanitarian workers. The question is: can MSF and humanitarian action withstand the demands of a more just solidarity?
Authored by Mohammad Salaymeh
Mohammad Salaymeh is a Palestinian from Jerusalem. Since May 2024, he has been working for the international humanitarian NGO “Médecins Sans Frontières” as a Head of Mission Support and currently serves as a Medical Coordinator Support. Mohammad has degrees in Public Health and Pharmacy.
Art entitled “Boy with supplies bag” by Ismail Shammout
