Who is Doctors without Borders?
An international nongovernmental organisation that provides humanitarian help in regions that are struggling with war and disease, Doctors without Borders was founded in France. The organisation has over 30, 000 employees providing medical aid to 70 countries. The doctors and nurses working for Doctors without Borders are volunteers who strive to provide solutions to issues impacting on health in the globe. Since it was first started, Doctors without Borders has provided treatment to well over a hundred million patients. The organisation has also been a recipient of the Nobel Peace Prize getting the award in 1999 in recognition of the amount of humanitarian work that Doctors without Borders has done in a number of continents (Medicins Sans Frontieres, 2016b).
Doctors without Borders operates on the belief of Providing medical help driven by a respect for the rules of medical ethics in particular the duty to provide care without causing any additional harm to either groups or people. It also aims at gaining respect for the freedom of their patients, their confidentiality and the right they have to informed consent and treating patients in a dignified manner respecting their cultural and religious thoughts. The organisation also aims at providing medical care that is of the highest quality to each and every patient and also offering assistance founded on an independent examination of the needs of people. Moreover, it speaks out publicly against acts of violence that have been set out against either individuals or groups (Medicins Sans Frontieres, 2014b)
“To provide assistance to populations that are facing distress from disasters that are natural or manmade and those involved in armed conflict regardless of race, religion as well as political beliefs” (Medicins Sans Frontieres, 2016b).
Provide emergency medical help to people in areas around the world which are considered as in the greatest need especially those impacted by conflict, disasters or those who have been excluded from efficient health care
Doctors without Borders mobilises funding to enable it provide primary health care, carry out surgeries, rehabilitate hospitals as well as clinics and run programs catering to the provision of nutrition and sanitation
Doctors without Borders is fully committed to ensuring the protection of human rights, which is achieved by speaking out against the causes of the suffering that they treat. In many instances, the organisation has placed itself in instances where humanitarian law violations are being carried out and speak out for the victims of numerous crimes while providing medical help (Neo & Pettigrew, 2011).
Doctors without Borders also responds to areas struggling with war and disease. In coordination with local partners, Doctors without Borders makes uses of the skills of its personnel to reduce the suffering of those who are injured and provide support to those who provide medical care in these instances.
Doctors without Borders is impartial operating on a basis of serving every affected person regardless of their gender, race or religion and political affiliation” (Medicins Sans Frontieres, 2016b).
Doctors without Borders does not accept the perception that people who are people only deserve medical care that is less than standard and therefore works to provide care that is high in quality to these patients.
Doctors without Borders has put in place campaigns and partnerships such as those with the Drugs for Neglected Diseases Initiative to enable the lowering of treatment for HIV/AIDS. It has also encouraged research as well as development for medicines that aim to treat” (Medicins Sans Frontieres, 2014b).
Doctors without Borders Executive Board
The International General Assembly is the highest authority in Doctors without Borders and is made up of representatives from each of the organisation’s 24 associations. It is tasked with electing the International President with each of the representatives and the President having one independent vote on issues that are brought before the assembly (Medicins Sans Frontieres, 2016). The International General Assembly is tasked with the responsibility of providing protection to the medical humanitarian mission of Doctors without Borders and provides a strategic direction to all of the organisations working under the organisation. It entrusts duties to the International Board and holds the board to accountability for the achievement of these tasks” (Medicins Sans Frontieres, 2016b).
The International Board of Directors is the body tasked with governing Doctors without Borders; it provides support as well as oversight for the organisation in line with the policy guidelines set out in the Doctors without Borders Charter. It is characterised by representatives of operational directorates and also a group that has been elected by the International General Assembly chaired by the International President (Neo & Pettigrew, 2011).
The board of Directors also makes a review of the activities carried out by Doctors without Borders and makes a determination of whether they should be approved as well as its programmes in the numerous countries that it operates in and their constituent budgets. This Board is based in Geneva and also ensures coordination, information as well as support to the Doctors without Borders movement and also puts in place international projects as well as initiatives as have been requested. All the programs, allocation of budgets as well as critical activities within the organisation are taken through a review and approved by the International Board of Directors (Neo & Pettigrew, 2011).
Planning, Strategic Planning and Resource Allocation
Doctors without Borders strategic plan aims at ensuring the organisation realises its goal of providing medical assistance by emphasizing on training of its employees. It aims at focusing on areas in the world that are characterised by the greatest amount of disadvantage and ensure that they are provided with the necessary medical aid (Medicins Sans Fromtieres, 2013).
The strategic plan is made up of five core outcomes, which are contained within the training framework for Doctors without Borders. The strategic objectives are driven by the need to carry out training of staff in a way that will link their training to the organisation’s social mission. Below is a list of the expected outcomes:
Source: (Medicins Sans Fromtieres, 2013)
Doctors without Borders philosophy for strategic planning is based on its core mission statement, and its Charter which have been adopted by all the International General Assembly. Its present strategic planning is in a medium strategic plan which runs from 2014 to 2019
Doctors without Borders medium strategic plan provides a strategic context for both institutional as well as integrated budgets. The core principles guiding the medium strategic plan are outlined below:
Ensuring that all work that is done by Doctors without Borders is driven by data, present knowledge as well as the lessons that accompany experience in international areas. In addition, it works together with partners and also within Doctors without Borders to ensure that medical aid is delivered in a way that positively impacts on those who are in affected areas with an equal focus on ensuring achievement of protection of vulnerable groups
The organisation also strives to ensure the achievement of high levels of efficiency, value for the money brought into the organisation and overall excellence in the management of Doctors without Borders within the framework that is set out in the strategic plan and monitoring its effectiveness on a continuous basis. It brings in a perspective that focuses on the achievement of human rights in all the areas that Doctors without Borders staff are sent to work in (Neo & Pettigrew, 2011). In addition, the organisation aims at promoting and advocating for the rights of populations that are suffering through violence and distress in every instance.
The Strategic Plan set out does not provide a link to the budget and therefore does not make a clear identification of the manner in which resources will be allocated not only to the outcomes of the organisation’s programmes but also the training of the staff. The strategic plan for Doctors without Borders has a number of core focus areas including, ensuring continuity in the missions carried out by Doctors without Border and preparation of specific skills related to the work that Doctors without Borders staff will take part in. Moreover, it aims at providing basic education of the staff on the requisite attitudes and behaviour that they should exhibit as members of Doctors without Borders with a focus on humanitarian activities
Doctors without Borders has an integrated resource plan and is part of their medium term strategic plan. It is taken through revision and examination on a continuous basis and submitted annually to the International General Assembly in order to be approved. The Integrated resource plan is one of the tables touching on a budget and is included when information on the budget. The integrated resource plan has become a replacement for the financial plan as a result of the fact that they provide the same type of information
Doctors without Borders presents a financial plan to the International Board of Directors through two distinct routes, an association document is presented to for approval to the International Board at the beginning of the cycle for a project, a budget for the institution that is presented once a year (Neo & Pettigrew, 2011).
Resources to ensure effectiveness of the organisation as well as efficiency in results are allocated based on a methodology set out by Doctors without Borders and budgeting that is based on project outcomes and it is approved by the international board of directors. Resources are allocated to associations and these associations are expected to find a link between their results and the resources provided to them. Effectiveness of the programmes are closely related to the overall outcomes of the program and modalities of delivery that are unique to each association. The resources for ensuring effectiveness of development within Doctors without Borders are presented based on three core functional areas, which are policy, humanitarian action as well as effectiveness in the procurement as well as management of the supplies that are gained.
Individual Doctors without Borders associations are tasked with the collection of donor funds and creating a relationship with these donors. The large percentage of income for Doctors without Borders comes from private donations, which the organisation uses to maintain the organisation’s independence from political interests and subsequently ensuring the flexibility of the response that they give. Doctors without Borders also gains its resources from grants from governments and this is used for specific programs that have been approved by the International Board of Directors.
Planning and Resource Allocation Recommendations
Doctors without Borders needs to put in place a more efficient system of financial planning and to put in place a more comprehensive strategic plan to align further with the wider organisational goals in order to meet its set out objectives. This programme plan will not only be more effective but will ensure that Doctors without Borders is able to put in place goals that are appropriate and by extension enable the setting of plans that are efficient. These particular processes should also provide the chance for the organisation to more efficiently measure its outcomes and to determine the extent to which its resources are being used in a manner that will be positive for the organisation. In addition, these processes will enable the organisation to hold all its employees accountable for the use of these resources ensuring that they are efficient.
Budgeting and Budget Execution
Budgeting is a critical process within non-profit making organisations such as Doctors without Borders. This is because while enterprises that cater to profits place focus on maximising on profits and value for the shareholder while on the other hand, an organisation that does not focus on the creation of profit only strives to focus on its goals (Medicins Sans Frontieres, 2016a). As with the large majority of non profit organisations, Doctors without Borders makes use of zero based budgeting since it presents the organisation with the chance to examine every decision in detail and by extension serves as a tool that can be used to systematically examine and perhaps abandon any projects that are found to be unproductive (Medicins Sans Frontieres 2014c).
Budgeting is the responsibility of finance teams of all the individual organisations that operate under Doctors without Borders. Doctors without Borders Creates operational budget based on defined operational needs as well as priorities, by using zero based budgeting, it can overcome any deficiencies that exist within traditional budgeting since it provides the chance for the organisation to begin on a basis of zero at every period almost as if all the activities being undertaken were beginning similar to the first time (Medicins Sans Frontieres, 2016b). Using zero based budgeting has provided Doctors without Borders with the chance to make a clear classification of which projects should be allowed to continue and which should be stopped as well as the ones that should be focused on. In addition, zero based budgeting presents the chance for a comparison to be made of the numerous departments within the organisation that can ensure the management is in a better position to rank each of the projects that are being undertaken (Neo & Pettigrew, 2011).
Doctors without Borders budget is spread out over a period of one year and is also integrated into the results for the budget and the framework for the resources those are to be used within the organisation. The Integrated budget is a core section of the organisation’s strategic plan since it is made up of all the budgetary needs that are required to provide a complement to the plan (Medicins Sans Frontieres, 2016b).
Doctors without Borders associations provides a budget every year to the International board of directors and in each of the budgets, aspects are put in place that can be used to provide support to the next strategic plan that will be created. The Operations or the finance team liaises with the fundraising departments internationally in order to ensure that funds are raised to meet all the outlined goals. It is also important to note that well over 90% of the funds that are raised are not restricted which means that funds are directed towards medical projects that are classified as priority (Medicins Sans Frontieres, 2014a).
The budget that is set out includes a budget for all the programmes and projects that will be undertaken by Doctors without Borders and a budget for providing resources to support ongoing projects or emergency situations(Neo & Pettigrew, 2011). The budget for the programmes and projects sets out funds that are needed for putting in place programmes that cater to individuals who have been identified as vulnerable as approved by the international board of directors. The budget for support programmes includes all the costs that might not be directly linked to a particular project but are critical to ensure maintenance of the presence within a given country but also the costs of management and administration of the headquarters that is set up within a given country (Medicins Sans Frontieres, 2014b).
Budget analysis and Recommendations
Doctors without Borders zero based budgeting needs to have a number of core aspects including the activities that will be undertaken in the course of the projects, the results that will be expected and what exactly will be achieved (Medicins Sans Frontieres, 2016b). In addition, all the financial managers will need to provide justification for each of their budgets in a manner that is detailed. It is only when these aspects are integrated can the organisation be able to clearly distributing funds by the needs, objectives as well as priorities. It is evident that Doctors without Borders has over a number of periods been unable to present a budget that is comprehensive and that can clearly be justified to the international board of directors (Doctors without Borders, 2014).
Doctors without Borders is also vulnerable to going well beyond its budget as a result of problems that had not been expected or emergencies that came up in the countries that the organisation might have set up its projects in. The large majority of the areas that Doctors without Borders goes into countries that are either ravaged by war or those characterised by disease epidemics which means that the infrastructure is not as stable giving the chance for problems that might not have been seen while planning the project to come up(Neo & Pettigrew, 2011). This means additional costs that were not considered and in this particular instance, I would provide the recommendation that the organisation places focus on the creation of a program that strictly adheres to a set out program and the budget that has been outlined. In this way, resources would be allocated in a manner that aligns to the organisation’s annual projects (Medicins Sans Frontieres, 2016b).
This would ensure that the organisation is in a better position to efficiently track its income as well as the manner in which the funds that have been raised are allocated to the different projects especially considering that projects are carried out based on priorities. Moreover, keeping track of the organisation’s resources would ensure that the expenditure outlined for the different programs is done to cater to purposes that are very specific thereby eliminating the danger of wastage of resources (Medicins Sans Frontieres, 2016b).
I also recommend that the organisation put in place a separate budget for emergencies and support in order to ensure that funds as well as resources can be spread out in the instance that the expenditure that has been set out goes beyond what is expected as a result of circumstances that had not been considered. Collection of income that is based in zero based budgeting needs to be examined much closely especially in the different field offices which are vulnerable to wastage of resources (Medicins Sans Frontieres, 2016a).
There is the danger that accompanies the use of zero based budgeting which is the large amount of work that will need to be carried out consuming a significant amount of time since it requires collection and analysis of information. In addition, it requires managers to have a clear realisation of the operations at different levels in order to prepare for budgeting. This might be one of the reasons why the budgets for Doctors without Borders are not as comprehensive as they should be (Medicins Sans Frontieres, 2016b). However, I recommend that the organisation can consider partially implementing zero based budgeting at the field offices since this will not only reduce the amount of time that is spent collecting data to create the budget. In turn this will play a role in enabling the organisation to solve the problems of allocation of resources that it is presently dealing with (Doctors without Borders, 2014).
Financial management is overseen at Doctors without Borders by financial administrators working for the organisation are tasked with controlling the budget and financing, managing staff who have been hired both locally and internationally and administration of the finances and salaries. The key role for these administrators is to protect the financial resources that have been provided to Doctors without Borders in order to provide benefits for people who require medical aid in areas that are characterised as war zones or those that are facing certain epidemics (Medicins Sans Frontieres, 2016a). In this regard, these financial administrators are expected to actively maintain as well as improve the systems of management that have been put in place in order to cater to both the finances as well as administration and all the requisite procedures that would ensure Doctors without Borders runs in a manner that is not only cost efficient but also transparently makes use of the funds that the organisation has been able to acquire from donors and government grants (Medicins Sans Frontieres, 2016a).
In this regard, financial administrators at Doctors without Borders are tasked with ensuring that financial records of the organisation are kept up to date and that there is a clear audit trail for all the transactions that have been carried out within the organisation. They are also expected to provide protection to the organisation against such aspects as fraud and also theft and ensuring that all the funds that belong to the organisation are kept safe and those that need to be banked are done in a manner that is prompt. In addition, they are expected to ensure that the management of all the field offices as well as the board of directors have a clear understanding of what their financial responsibilities mean (Medicins Sans Frontieres, 2016b). These individuals are also expected to ensure that the board aligns with all the regulations on tax including those that cater to the payroll and any fringe benefits that might be given to the staff at Doctors without Borders. Financial Administrators also engage in carrying out a review of all of the processes within the organisation and providing reports on a monthly basis and also ensuring that income as well as expenditure for the organisation is tracked all through the year (Doctors without Borders, 2014).
Doctors without Borders is taken through internal as well as external auditing. The internal auditing is done by the Audit and Risk Standing Committee, which is headed by the treasurer. This internal audit helps in the evaluation of the levels of governance as well as processes of controlling management and the level of financial risk that the organisation has ((Medicins Sans Frontieres, 2016a). On the other hand, external auditing is done by PriceWaterHouseCoopers, an auditing firm that presents its own independent opinion on the organisation’s financial statements and its overall financial health. PriceWaterHouseCoopers also provides the observations it might have on the procedures as well as controls and overall practices of management that are present in Doctors without Borders and is the only firm that has been contracted to carry out auditing of Doctors without Borders (Medicins Sans Frontieres, 2016b).
Doctors without Borders has in place a policy for managing of risk whose core objective is to integrate an approach that is both systematic as well as consistent. It aims at not only making identification, assessment as well as management of risks that might occur across the entire organisation. The Policy put in place to manage risk with a clear chain of responsibility regarding management of security. In addition, projects are measured in terms of whether they are low medium or high risk (Clementine 2014).
Project coordinator is tasked with the management of the security of the team while the head of mission is responsible for the security management of the whole mission within a specific country. Every staff member is tasked with a personal responsibility to integrate the policy on risk management examining the negative potential for any words or actions they take (Neo & Pettigrew, 2011).
Human resource coordinators working for Doctors without Borders on the other hand are tasked with the responsibility for carry out comprehensive risk as well as control assessment for the organisation at field offices. These individuals examine risks that are related to mobilisation of resources including those that include numerous offices, have a greater impact on Doctors without Borders and require action from the board of directors or a change in the policy that has been put in place within the organisation (Medicins Sans Frontieres, 2016b).
Doctors without Borders philosophy on management of risk are involves encouraging every individual’s member of staff to consider management of risk as a personal responsibility. In this regard, all the members of Doctors without Borders are encouraged not to accept risks that are considered as unnecessary (Medicins Sans Frontieres, 2016a). Moreover, they are also expected to both anticipate as well as effectively manage risk by engaging in planning and are also asked to make recognition of opportunities and subsequently make decisions in a prompt manner (Medicins Sans Frontieres, 2016b).
Putting in place such a policy will ensure that Doctors without Borders is in a position to actively facilitate decisions that are informed by the amount of risk especially with regard to the setting of objectives and also the selection as well as management of what is considered as the key course of action. It will also enable the organisation to put in place a mechanism to ensure the creation of a change within the organisation’s practice for managing risk (Medicins Sans Frontieres, 2016b).
Risk Management Analysis and Recommendation
The risk management policies as well as methodologies that have been adopted by Doctors without Borders is an efficient one since all individual members of the organisation across the different levels are provided with the responsibility of accessing the different types of risks that could have an impact on them and personally ensuring that they deal with these risks in order to create the least amount of impact for the organisation (Neo & Pettigrew, 2011).
Financial reports as well as the audits for Doctors without Borders are presented on an annual basis to the international board of directors. Reporting on the budgeting is a core aspect of its management (Doctors without Borders, 2014). It is expected that by the time the budget cycle comes to an end, the administration of each of the Doctors without Borders associations set out a formal report on performance to the board of directors setting out the manner in which resources in the budget have been utilised and explaining any differences that might have occurred between the budget that was first set out and the real expenditure that has been spent and also the projects that have been achieved over the period of the budget cycle(Medicins Sans Frontieres, 2016).
On an annual basis, the International Board of Directors submits a report to the International General which sets out the results as well as analysis of progress of the projects and what has been achieved in the context of the performance of the entire organisation (Medicins Sans Frontieres, 2014b). Financial reporting is done as a part of all the controls on management that have been put in place by Doctors without Borders and is subsequently reported to the international board of directors and thereafter to the International General Assembly (Medicins Sans Frontieres, 2016b).
There is not a large amount of information regarding the accounts of Doctors without Borders. However, its Financial Statements are often regarded as a way in which the organisation can provide proof of its transparency as well as level of accountability thereby providing an overview of the work carried out by the organisation (Medecins Sans Frontieres, 2014).
As of 2014, the income for the year came to a total of 1, 066 million Euros, which was an increase of about 113 million Euros from 2013. This income is broken into 858 million Euros, which was spent on social mission, and 208 million Euros that was spent on expenses such as fundraising, management as well as income tax. By income 1142 million Euros came from private income, 115 million Euros from public institutions and 24 million Euros which was derived from other sources (Medecins Sans Frontieres, 2014).
I wasn’t able to find any information about knowledge Management at doctors without borders. Knowledge management is the process of capturing, distributing, and effectively using knowledge. I would recommend that doctors without borders apply knowledge Management system into their organization, because knowledge Management will improve the mission’s of doctors without borders. Doctors without borders should share their knowledge and experiences of past projects to give an idea to those who work to the same projects, because some of the projects that doctors without borders are similar such as war crises. Also they could have a shared system where anyone of their employee can upload and comment on work by themselves or others. Giving feedback one of the important tools to use, and having feedback would allow doctors without borders to develop their plan. The last recommendation in this section, doctors without borders should implement a system and call it “ lesson learned “ where information that are retrieved from people who have already tackled a problem and found a solution. This will allow the organization to solve any problem that similar to the one they have dealt with.
Performance reporting refers to the mechanism that is put in place by an organisation to ensure progress is monitored in terms of achievement of the set out objectives and is therefore critical if the body tasked with governing the processes of the organisation and the public are provided with a clear understanding of the achievements that an organisation. Doctors without Borders have in place a system for monitoring performance which provide the chance for the organisation to measure as well as track the outcomes that exist from the collection systems of data on an annual basis (Neo & Pettigrew, 2011).
A performance monitoring system has been put in place, which provides the chance for the organisation to analyse and monitor the progress of both the projects put in place as well as the numerous employees. Doctors without Borders has in place a system for evaluating the employees where they present individual reports on their progress within the field and the challenges that they have gone through (Medicins Sans Frontieres, 2016b). These reports also provide a chance for the Independent board of directors to carry out a formal examination of projects and the extent of the problems within the countries that the organisation has set up operations in. These reports are largely encouraged since they provide key feedback on the situation of the offices and create significant information on the performance of their employees and more importantly the effectiveness of their programmes (Medicins Sans Frontieres, 2016a).
Performance management analysis and recommendations
One of the key problems that Doctors without Borders is dealing with performance that is not consistent with their activities in many of the projects that they are involved with. In this regard, the organisation needs to ensure that a better strategy for reporting on performance and mechanisms for management that are used to engage in reporting and also explaining the differences between the original budget and the real expenditure that is used, the manner in which resources are utilised and how the results that are expected will be fulfilled (Medicins Sans Frontieres, 2014b). There is also a need to put in place indicators that can be used to monitor performance such as the amount of worker turnover, the effectiveness of the projects that are implemented by the organisation and how motivated staffs are in carrying out their work. In this way, the organisation can determine the impact that projects will have not only on the population but also in advancing the mission statement of the organisation (Medicins Sans Frontieres, 2016b).
Business Continuity plan
Doctors without Borders is well aware of the fact that numerous issues as well as risks have the potential of arising in instances when there is a business environment that is negative and filled with a large amount of confusion. In this regard, the organisation has put in place strategies to enable it effectively deal with these challenges and one of these strategies is the integration of a programme for managing Business Continuity (Medicins Sans Frontieres, 2016ba). To this end, Doctors without borders has put in place a strategic system for managing issues, which is constantly being taken through a review and examination. This is done with the thought of aligning the goals and objectives driving the organisation with the constant changes occurring in both the globe as well as the local environment that the organisation has set up its projects in (Ne0 & Pettigrew, 2011).
Business Continuity planning is well integrated within Doctors without Borders process of planning as well as its organisational culture, which aims at making sure every individual staff member, and stakeholder of the organisation protects the organisation’s goals (Medicins Sans Frontieres, 2014b). Doctors without Borders makes use of the Business Continuity plan as part of its strategic process and a tool for management that enables the organisation to deal with any issues that might not have been planned for without impacting negatively on the overall well being of the organisation. This tool has also been seen as key in ensuring the continued survival as well as flexibility of the organisation especially considering that the environment that the organisation is involved in is one that is unpredictable and which if not dealt with in the right manner could have a negative effect on the purpose of the organisation (Medicins Sans Frontieres, 2016b).
Clementine, O. (2014). Risk Management and Humanitarian Aid: An Impossible Marriage? Crash-Foundation Medicins Sans Frontieres, Retrieved Apr 12, 2016 from:
Doctors without Borders, 2014, Financial Statements 2014 retrieved Apr 11, 2016 from:
Medicins Sans Frontieres 2014b, “How MSF Works: Questions Answered, Explored and Raised”, Alert, vol. 15, no.2, pp. 3-16.
Neo, HN., & Pettigrew, L 2011, “ An Interview with Medicins Sans Frontieres”, Br J Gen Pract, 61(592), pp. e761-e762.
Medicins Sans Frontieres. (2016b). About Us. Retrieved Apr 12, 2016 from:
Medecins Sans Frontieres. (2014c). Financial Report: Key Figures. Retrieved Apr 12, 2016 from:
Medicins Sans Frontieres. (2016a). Our Funding. Retrieved Apr 12, 2016 from:
Medicins Sans Frontieres .(2013). OCHA Training Strategy: 2014-2019. Retrieved Apr 12, 2016 from: