MSF's primary mandate is to bring emergency medical assistance to populations in need. To reach those who need our help the most, we often work in conflict and post-conflict regions. Each region involves different risks according to the context in which our humanitarian intervention takes place.

As an MSF field worker you will often find yourself in an insecure environment; working in these particular regions implies an inherent risk or danger is present. Some potential risks are described below.

Managing risk

Although we accept that it is impossible to exclude all risks, we do our utmost to manage these risks through our strict security protocols.
Before starting a new project, and throughout its period of activity, we carry out a process of risk analysis.

Each field mission has specific and detailed safety regulations and plans in place, outlining strategies and specific security measures and responsibilities.
These protocols take into account the nature of the risks facing MSF personnel in the field and provide procedures to follow when confronted with various security threats.

Security rules

All MSF staff must strictly observe security rules and regulations. Ultimately, your behaviour and attitude is your best safeguard. Working for MSF is a voluntary choice which should be a well-balanced and personal one.

Through your work with MSF, you accept MSF’s organisational choice to work in environments with various safety and security threats. Failure to follow these regulations may result in dismissal.

The risks

To understand the kind of security measures you might expect, it is useful to consider our projects in terms of low, medium and high-risk.

Low risk

On low-risk missions and projects, regulations may not be so strict. There may not be a curfew and you may be permitted to take public transport or even your holidays in the country.

Medium risk

In many MSF missions, there is a medium level of risk. Depending on the context, the following regulations may be in place:

  • curfew
  • limitation on movement
  • culturally sensitive behaviour
  • use of MSF identification

In medium level risk situations, personnel are often required to report their movements and positions and carry communications devices such as radios or mobile phones at all times.
In some contexts, relationships with local staff and residents, choice of clothing, or open consumption of alcohol may be restricted because these actions pose a security risk to you and/or MSF.

When working on an MSF project, you will be perceived as a representative of MSF and your words and actions will have an impact on your own and your team’s security. There may be no time off from this responsibility.

High risk

On missions where there is a high level of risk, your movements may be severely restricted and you will be required to follow very specific instructions and procedures.
In some situations, you may have to temporarily suspend your activities and travel to a safer location. In most cases, once the situation settles down, you will be able to return to your work.
Finally, in extreme situations, insecurity may not allow you to leave a situation, even though you may desperately want to leave. In these situations, it may be safer to stay put than to evacuate.

Chain of responsibility

Field workers must abide by security rules and procedures throughout their mission. There is a clear chain of responsibility regarding security management.
The project coordinator is responsible for managing team security at the project level. The head of mission is responsible for security management for the entire MSF mission in a specific country and overall responsibility lies with staff at headquarters.

Medical doctors, and sometimes nurses, may share responsibility for the health of other field workers with the medical coordinator who is based in the capital.
Team members must respect and follow their instructions.

Personal responsibility

The elaborate risk management policy and procedures of MSF constitutes a responsibility shared by the staff member and the organisation.
In addition to this shared responsibility, every staff member must be able to assess the potentially negative impact of their words or actions, for themselves and for others, as a function of their role in the field.

If you do not feel comfortable with the security situation you may choose to leave the project (or mission) as soon as the project coordinator or head of mission deems it safe to do so.
MSF will endeavour to ensure you are aware of the necessary precautions before your departure, but the final responsibility is yours.
MSF does not delegate the management of our security to other organisations.

Specific risks

You may encounter a wide range of risks while working on an MSF project. These risks can include:

Environmental hazards

Environmental hazards like disasters, disease and high levels of stress are common in MSF projects.
There are many ways to reduce the risk of diseases like malaria, TB, HIV, meningitis and hepatitis – by taking anti-malarial drugs, getting vaccinated and using condoms.

Traffic accidents

Traffic accidents are the most common cause of injury and death among field workers. Risk is increased by the unfamiliar driving habits and traffic discipline encountered in foreign countries. Traffic conditions may be especially chaotic and dangerous in conflict situations.
Most often, MSF uses local drivers, as field workers are not insured to drive in MSF missions.

Petty crime

Petty crime happens everywhere, especially in crowded public places. You may become disoriented in unfamiliar surroundings and thieves can take advantage of this.
Foreign staff are also at increased risk of fraud and targeted robbery, including armed robbery and carjacking.


Violence is often a risk. Women may also be at risk of sexual violence in some circumstances and need to exercise particular caution. In extreme contexts, armed groups may engage in looting, kidnapping or attacks targeted at MSF and other NGOs.
Workers may be caught in the crossfire, or be at risk of serious injury or death due to unexploded ordinance, landmines, shelling and aerial bombardment.

Despite being diligent about our security, there continue to be no guarantees. It comes down to understanding the risks, minimising these risks as much as possible, and making sure those who are taking the risks are fully informed.