MOTION 6 - 2018 - Feedback

2018 MOTION 6 -

Humanity, respect and non-tolerance of abuse

 

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MOTION 

This motion requests the OCB Board to propose that the international movement of MSF should systematically include concepts reflecting humanity, respect and non-tolerance of abuse alongside the existing ‘guiding principles’ that accompany the MSF Charter,

 

RATIONALE

Whilst discussions on abuse of power have galvinised an institutional response, the core institutional texts stating MSF’s principles (the MSF Charter and the associated ‘guiding principles’ as presented on MSF.org) are silent on the subject of abuse and only refer to respect in terms of respecting medical ethics in our dealings with patients, with a notable absence of reference to respect in interactions with MSF colleagues or members of the societies in which we work.

 

FEEDBACK (Final draft)

Following the above motion that was voted through at the 2018 OCB General Assembly a number of steps have been taken both at OCB and movement level in order to prevent, detect, manage and follow up cases of abuse of power, sexual harassment and inappropriate behavior in the workplace.

One significant achievement at movement level, has been the production, approval and implementation in June 2018 of the Behavioral Commitments (BC), which at OCB level has formally replaced our employees’ charter. Its implementation started in July 2018 through a first communication message sent from Director of Operations and Director of HR to the missions requesting the dissemination and implementation of those commitments in each mission. Some communications materials were produced in order to facilitate the dissemination, the implementation and the understanding of the objectives of these Behavior commitments at mission level. Many field teams used the opportunity of this communication to trigger debates among teams around ethics. Since September 2018, the process of seeing this BC being integrated in the contracts of all HQ field staff is ongoing and their reference is expected in all new internal regulations. Compared to other OCs, OCB has gone one step further, by asking missions to ensure that the implementation of the BC is also a reality for MSF’s partners such as MoH staff.

A specific module on the BC, management values and the GAREC is now also included in the PPD. With the support of the Learning and Development team the intention is to ensure the dissemination of those Behavior commitments in all our local & international induction session + in our training programs Innovative Field workshop and E-learning module on behaviors are concrete tools we are currently looking into.

Alongside the behavior commitments, the MSF movement has taken further steps for the prevention of abusive behaviors by reinforcing the Intersectional Platform on Behaviors (IPOB), whose core aim is to ensure good collaboration between OCs regarding the prevention, the detection and the management of abusive behaviors. This platform helped OCs to share experiences, collaboration and best practices. Reinforcement of the IPOB platform will ensure that a number of areas can be collectively boosted such as the new tools for prevention, awareness sessions, quality of case management and increase support to the field.

When it comes to the management of cases, the Garec team was reinforced (number of peer reviewers reaching now 10 volunteer staff with 1.5 FTE until August as Facilitator, in order to improve the Garec capacity to timely manage the complaint process). In comparing 2018 with 2017, statistics show an increase of 27 % of the ‘complaints received’ [62 as compared to 49] and an increase of 111% in ‘cases confirmed’ [19 as compared to 9]. Promoting the role of the Garec, its functioning and an adequate understanding of its scope requires continuous efforts. Increasing the visibility of the different wellbeing platforms has also been crucial to ensure the GAREC does not become a bottleneck for cases outside of the GAREC scope, and to ensure the GAREC maintains its capacity to respond to field cases within the scope. A disciplinary committee is under development within the human resource department to follow up on non-ethics related cases that are received by the GAREC. In order to support our field team to manage behavior commitment, we are currently exploring the possibility to develop at mission level mechanism of “personne de confiance” similar to those existing at HQ.

A working group on ethics and management values has been set-up at HQ level in December 2018 with the objective to feed into the OCB strategic orientations 2020-23 with new priorities and identified areas for improvement. There are a many areas where more needs to do done, namely to tackle abusive behaviors towards patients and beneficiaries, including medical errors. We need to ensure to our patients and beneficiaries that mechanisms exists and are accessible to them in order to report abusive behavior. We are currently engaging with the OCs to explore options and ensure concrete improvement in that regards. As for the medical errors and malpractices, the Medical department is critically revising the current process in place and will propose a new set up by June 2019.

  1. DEFINITIONS AND IMPLEMENTATIONS OF THE BEHAVIORAL COMMITMENTS:

One of the main achievements in this area was the production and the approval by the Full Excom in June 2018 of the new Behavioral Commitments and their definitions. This document replaces the previous Employee Charter.

The implementation started in July and followed these different steps:  

  • 25/07/2018, a first communication from Ops Dir and HR Director has been sent to missions asking all of them to implement the BS by the 7th September. The message included a reminder on Garec mechanism.
  • 16/08/2018: communication materials (posters, ppt. and a Q&A) were sent to the HRCOs.
  • Sept 2018: Integration in HQ and expats contracts + in Internal regulations.   
  • 21/01/2019, a last communication has been sent to all HoM and HRCo regarding implementation of BC with partners.

In general, we got a positive feedback from missions and some of them have been really creative producing giant board for signatures, presentations, workshops, sensitization activities, etc. We didn’t get any negative feedback mentioning a refusal from mission to implement. We got few questions (see below).

It’s important to note that the fact that the implementation has been launched very quickly was a good thing, but has also generated some issues:

  • Small inconsistency between OC: We ask OCB mission to include MoH staff. Some OC refuse to communicate this to missions as they consider very difficult for MSF to ensure MoH staff will respect it
  • Implementation was launch without proper supporting tools that came later on (for some, after the deadline for implementation)
  • Some questions from the field were not answered since we don’t have the answers yet. One of those is, what if the staff refuse to sign as he is married with a 15 years old woman? Guidance have been asked to the International office and the answer is still pending.

In conclusion, in less than one year, a lot of communication has been done around the issue of harassment, abuse and degrading treatment. Very concrete steps happened:

  • Integration in the staff contracts (HQ, IS, NS -> work in progress)
  • Progressive integration in the internal regulations,
  • Integration in the PPD: Session on behavioral commitments, management values & GAREC (method role play; discussion + presentation)

Nevertheless, this is still work in progress. We need to make sure that the BCs are well implemented in all locations (part of the policies, but also integrated in all local induction and training programs) and that regular sensitizations are done to be sure it’s known by everyone.

Follow-up and monitoring is to be done in the near future.  

  1. REINFORCEMENT GAREC
  1. Strategic orientations:

Some focus group discussions took place in Brussels in December 18th and February 19th to identify the priorities for the coming years. The discussion was inclusive, where priorities was set to challenge obstacles related to management of behavior in the field as in the HQ.  

  1. Operational steps undertaken

Staffing:

  • 1.5 FTE until August 2019. 

Brussels Support: 

  • Internal sensitization / Information sharing: for the Mid Managers, Development advisers, HROs, HR Department.  

Mission Support:

  • Sensitization in mission: Pakistan, Greece
  • Feedback on Processes: S Sudan, Venezuela
  • Roll out and Interpretation of the Behavioral Commitments in the field
  • Partner Section / Office Support
  • South Africa: Social and Ethical Committee (SEC) being supported to take on case management
  • Brazil: support in the setting up of in-country mechanism

Prevention:

  • 13 De/Briefings undertaken in 2019 – mainly HoM, Medco, Deputy positions. 

Reinforcing Garec:

  • Process, techniques and capacity building

HR initiatives:

  • Work in HR department to set-up a disciplinary committee for the management of the non-ethics related issue (management issue).
  • Increase of the visibility of the different wellbeing platforms for office staff. Those are 7 options to manage interpersonal behaviors.
  • Working group on Ethics and management values for the Strategic orientations 2020-23.
  1. Work-in-progress:
  • Support of external experts: understanding rape and sexual abuse;
  • Reinforcing investigation techniques.
  • Case Management guidelines
  • E-learning module on behavior (modifying OCG tool)
  1. Planned
  • Appeal mechanism
  • Data management tools
  • Information management within HR department
  • Updating Sanctions and streamlining typology
  • Updating Garec brochure

 

 

More on the association? https://www.insideocb.com/