It’s a Sweet Job

Humanitarian work pays. You get to fly all over the world, live in really cool places, and are granted a level of autonomy in your work that is rewarding. But the material benefits are even more impressive.

MSF international staff make a salary dependent on the number of years they have been working for MSF. An employee of seven years makes a salary of more than $6,000 per month. International staff have no expenses in the field, so they can save almost all of this.

Elegant housing is provided, along with a driver, a cook, a cleaner, and a per diem that covers eating and drinking regularly at the most expensive restaurants in town. In one month, I traveled to the beach, went on safari, ate out regularly, and went to the bars, and I still did not spend my per diem. MSF international staff can truly live like the elite. The nicest place I’ve lived in was my first MSF house. MSF housing in Nairobi has an indoor pool. In Nairobi, international staff are reimbursed for all taxis, even those taxis that are taken to and from bars.

MSF claims that more than 85% of funds go to Program Expenses, but this number includes a huge amount of waste. A manager once considered having marijuana air dropped into a remote location, rather than risk buying it locally. Managers have used MSF funds to fly to cities they enjoy under the pretense of work, but seem to spend the week partying. Money is wasted on taxis to and from the bar. The culture at MSF encourages a party lifestyle. On my first mission, my supervisor drove me through the red light district so I would know where to find that kind of thing.

There are many aspects that make working for MSF a great job for international staff, but it’s easy to overlook the most obvious. When you tell people where you work, they’re impressed, and it feels really good to get that kind of reaction. Unfortunately, they are impressed because of an image of MSF that is not accurate.

Aid work and humanitarian work is viewed as selfless, but the truth is that many of the people in the field are living lavish lifestyles. They dine at the best restaurants and rub shoulders with the country’s elite. National staff enjoy almost none of these perks. They receive no housing allowance, no driver, and in my experience, were rarely included in the frequent dinner parties with international staff. It is a situation that brews jealousy and mistrust between national and international staff. These divisions perpetuate colonial attitudes, structures, and power dynamics, and often build resentment towards the organization.


Protecting the brand

Doctors Without Borders is nearly a one billion dollar per year organization. They raise most of that money from private donors, with the majority coming from the US. Small donors make up a large portion of the donations, and bad press can seriously hurt the financials. For this reason, MSF is obsessive about protecting their brand. Staff are not allowed to blog about their work or even post about it on social networking sights. Three staff were removed from a project in Arua, Uganda after posting negative comments about MSF on Facebook.

MSF has had its share of scandals. In an organization that allows staff to use sex workers, it’s no surprise that employees have committed statutory rape.

(Sexual) Relationships

MSF provides housing to the international staff. Men and women are asked to live together, and this naturally leads to a lot of sex among the staff. Alone, this is not a problem, but these relationships often complicate working together and bring additional stress into an already stressful working environment.

Some of the locations where MSF works do not adhere to the same beliefs as the people that MSF sends to work there. International staff have started relationships that are culturally forbidden. This has led to staff being quickly flown out of the country to avoid prosecution, a plethora of uncomfortable situations, and likely unthinkable consequences to local people in the places they work.


International staff at MSF are provided housing in the places they work. The housing is far from modest. The MSF house in Nairobi has an indoor pool. The homes are located in in the nicest parts of town. A cook/cleaner goes to the house daily to make meals, do the laundry, and clean the place immaculately. In Mozambique, even T-shirts and underwear were ironed. In addition to a salary paid in their home country (of several thousand US Dollars per month), international staff receive a per diem equal to the salary of entry level national staff. MSF international staff live like the elite in the places they work. Spending only their per diem, international staff can frequent the fanciest restaurants and bars. Places filled with only the richest nationals and expats. This is in stark contrast to the image of a selfless aid worker, but the truth is that aid workers enjoy a lifestyle that is totally out of reach for nearly everyone in the places they work.


MSF’s leadership is almost completely white. The organization has five operational centers, all based in Europe. Race is very visible in international development. In public, organizations appear sensitive to race and culture, but in private, individual biases come through. The following example was provided by a female doctor employed as national staff in South Africa.

I was once in a meeting with a few senior managers from MSF in Brussels, discussing plans for a survey in KwaZulu-Natal (South Africa), when one of the highly respected directors who’s spent more than 10 years working in Khayelitsha burst into a racist rant about how South African national staff are all “victims” and how “everyone wants something”. He went on to compare South African nationals to Kenyans and Malawians saying that we have no work ethic, this was to make the point that employing staff for the survey was not going to be easy. Sadly, I was the only South African national of colour at the table and I was so shocked that I didn’t say anything. The incident was never discussed or mentioned again. But if this is the attitude from someone who’s spent so long working in the country, what can we expect from people who come there for a few months at a time?