National staff make up the vast majority of MSF staff. These people are hired in country, and with few exceptions, are nationals of the country where the project is taking place. In my experience, national staff are generally dedicated people who have been working for MSF for years. But because they are national staff, they don’t enjoy the same privileges are the international staff.
The most striking example of this occurred when two members of our team had children. The first, an Argentinian international staff member, was flown back to Argentina and given 3 months of leave when his wife went into labor. MSF paid for his flight and those of his entire family. But when an African national staff’s wife was ready to give birth, he was forced to wait for two weeks after his child was born to see his baby. His wife was staying with family in a different part of the country while pregnant, and an international staff member was taking vacation the week his child was born. That person, a Canadian logistician, has been working for MSF for less than 4 months, yet had the authority to tell a staff member of more than 5 years that he had to wait a few weeks to see his newborn baby.