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Original Articles

Deterritorialised territories, borderless borders: the new geography of international medical assistance

Pages 827-846 | Published online: 04 Nov 2014

Notes

  • Some have equated this phenomenon with the notion of chronopolitics. See James Der Derian, Antidiplomacy: Spies, Terror, Speed, and War, Cambridge, MA: Blackwell, 1992; and Paul Virilio, Speed and Politics: An essay on Dromology, New York: Semiotext(e), 1986.
  • Paul Virilio, Open Sky, trans Julie Rose, New York: Verso, 1997, p 70.
  • See, for example, Cynthia Weber, Simulating Sovereignty: Intervention, the State and Symbolic Exchangea, Cambridge: Cambridge University Press, 1995; or Roxanne Lynn Doty, Imperial Encounters: The Politics of Representation in North-South Relations, Minneapolis, MN: University of Minnesota Press, 1996.
  • See R B J Walker, Inside/Outside: International Relations as Political Theory, Cambridge: Cambridge University Press, 1993.
  • John Agnew & Stuart Corbridge, Mastering Space: Hegemony, Territory and International Political Economy, New York: Routledge, 1995, p 14.
  • Waltz and the neorealists may indeed be held accountable for such a territorial inscription. This is what Thom Kuehls suggests when he states that ‘having inscribed international space by locating the sovereign state within it, Waltz draws the border of the state by opposing it to the interstate—that which required the state to already be there to give it its character. The structure, for all intents and purposes, is in the place. All that is needed is all that is there—states in anarchy.’ Thom Kuehls, Beyond Sovereign Territory: The Space of Ecopolitics, Minneapolis, MN: University of Minnesota Press, 1995, p 33.
  • As Agnew & Corbridge intimate, ‘the dissolution of the Cold War, the increased velocity and volatility of the world economy, the emergence of political movements outside of the framework of territorial states (arms control, human rights, ecological, etc.), all call into question the established understanding of the spatio-temporal framing of “international relations.”—’ Agnew & Corbridge, Mastering Space, p 80.
  • Gilles Deleuze & Félix Guattari, A Thousand Plateaus: Capitalism and Schizophrenia, Minneapolis, MN: University of Minnesota Press, 1987, pp 474–475.
  • Gilles Deleuze & Félix Guattari, Anti-Oedipus: Capitalism and Schizophrenia, Minneapolis, MN: University of Minnesota Press, 1983.
  • Or ‘romantics’ perhaps. My thanks to Nick Onuf for pointing out the romantic modernist current which appears to sustain most of the movements in favour of deterritorialisation.
  • Deleuze & Guattari, A Thousand Plateaus, p 10. Examples of this co-imbrication of smooth space and striated space are common today. In many societies, one often sees grassroots environmental protection movements coexisting with state agencies and making their voice heard within governmental and bureaucratic structures. Conversely, one also sees the state take into account the call of smooth space and designing open and zoning free areas, territories left open and untouched (yet clearly delineated and designated as such).
  • Kuehls, Beyond Sovereign Territory, p 49.
  • The Charter of Médecins sans Frontières is available in most of MSF'S publications in French. Interestingly, in its English publications, the Charter is rarely reproduced. It is now made available (in English) on MSF'S internet home-page at www.msf.org. See also Médecins sans Frontières, Populations en Danger, 1995: Rapport Annuel sur les Crises Majeures et l'Action Humanitaire (Populations in Danger 1995: Annual Report on Major Crises and Humanitarian Action), Paris: La Découverte, 1995, p 174.
  • For convenience's sake, I am using the translation provided by MSF on its internet site. As such, I cannot precisely provide a page number for the citations. I once again refer the reader to www.msf.org. This is valid for any subsequent direct quotation from the Charter used in this article. As I continue to quote the Charter, I will not repeat this statement. I simply urge the reader to refer to the MSF home-page.
  • I am grateful to Nick Onuf for making me realise how legally loaded the term ‘neutral’ can be.
  • Indeed, as Nolan suggests, neutrality is ‘a permanent status and attitude proclaimed by a state, such as Switzerland, rejecting adherence to any alliance’. Neutrality is a principle of territoriality centred around the notion of state preservation and interest. Instead of joining alliances or accepting to follow the politics of the interstate system, the neutral state decides to remain confined to its territorial borders as its main guarantee against foreign invasions, disruptions and engagements. See Cathal Nolan, The Longman Guide to World Affairs, White Plains, NY: Longman, 1995, p 261.
  • The notion of ‘self-awareness’ that I use to describe the fourth segment of MSF'S Charter may not be the most appropriate denomination. Even if it calls for the full awareness of the ‘member’, this point is truly about self-sacrifice, a total rejection of self-preoccupation. Thus, to be a ‘self-aware’ MSF ‘member’ one needs to know how to sacrifice oneself.
  • Henri Dunant, A Memory of Solferino, Washington, DC: American Red Cross Publication, 1939.
  • As MSF mentions on its home-page in a statement which follows and seeks to briefly explain and summarise the Charter.
  • As medical epidemiologist and MSF member Mike Toole suggests, ‘it is the relief organisation that makes the big decisions: namely where, when and how to respond to identified disaster situations’. Toole continues: ‘Agency policies, guidelines, and medical kits determine what diseases will be treated and how…One could argue that few decisions remain in the domain of the individual relief worker.’ Mike Toole, ‘Frontline medicine: the role of international medical groups in emergency relief, in Médecins sans Frontières (eds), World in Crisis: The Politics of Survival at the End of the 20th Century, New York: Routledge, 1997, p 32.
  • According to a pamphlet that I recently received from MSF, everyone is encouraged to look at the MSF home-page on the web. This is a practice that MSF now calls ‘Surfing without Borders’. The notion of ‘Surfing without Borders’ is doubly interesting. First, it represents MSF'S own desire to be ‘watched in action’ on its own web-site. Second, the very idea of ‘surfing without borders’ is an apt description of MSF'S peculiar spatial status as an organisation. Indeed, as a deterritorial movement, MSF ‘surfs’ across and without borders. See MSF special pamphlet ‘Help Us Save a Life Today’, no publication place and date provided.
  • On the architecture of digital spaces, see Christopher Couples, ‘Digital duplicities: techniques of the self(s) in digital spaces’, paper presented at the Annual Meeting of the Southern Political Science Association, November 1997.
  • As an interesting example of such a phenomenon, MSF provides on its home-page a new map of the world based on the multiple MSF missions all over the globe. The viewer can point and click on either the different operations listed underneath the map or on the map itself to have a detailed account of MSF'S work in the selected place. Next, the map opens in front of the viewer to reveal a list of achievements by MSF in the selected place clicked, with photos of MSF in action. On its home-page, the map of the world according to MSF traces the contours of a new world. The world of MSF is a medico-humanitarian globe. This new map is the map of a world made better thanks to the medical/altruistic work of the MSF ‘members’.
  • Here again the direct quotations are taken from MSF'S home-page. No page number is provided. Once again, I refer the reader to www.msf.org.
  • Bernard Kouchner, ‘Le mouvement humanitaire’ (The humanitarian movement), Le Débat, November—December 1991, p 35 (my translation). Kouchner's statement echoes Toole's explanation that, among other things, MSF membership is a ‘craving for new experiences and foreign adventures’. See Mike Toole, ‘Frontline medicine’, p 31.
  • There is actually a third subject position which is recognised but does not play a direct role in the mapping of MSF. This third positioning is that of the generous money-donator, another kind of volunteer, so to speak. MSF'S mission, at least as it appears through its home-page, is also to sell a product: medical humanitarianism. Because it refuses to ask states for funding (to remain ‘neutral’), MSF'S home-page seeks to attract donations too.
  • See Médecins sans Frontières, Life, Death and Aid: The Médecins sans Frontières Report on World Crisis Intervention, New York: Routledge, 1993.
  • See Gearóid Ó Tuathail, ‘At the end of geopolitics? Reflections on a plural problematic at the century's end’, Alternatives, 22(1), 1997, p 38.
  • In order to let both the potential victims and victimisers know that it is here, that it exists to provide relief to suffering across borders and, perhaps a more political (and no longer ‘neutral’) argument, to mobilise the international community against blatant human violations. On the need to turn to the media, see Rony Brauman, Devant le Mal, Rwanda: Un Génocide en Direct (Faced with Evil, Rwanda: A Genocide Live on TV), Paris: Arléa, 1994.
  • See Virilio, Open Sky.
  • Ibid, p 69.
  • Ibid, p 70.
  • For a description of the humanitarian crisis and the work of MSF in Rwanda, see Brauman, Devant le Mal, Rwanda: Un Génocide en Direct, and Vincent Faber, ‘Rwanda two years after: an ongoing humanitarian crisis’, in Médecins sans Frontières (eds), World in Crisis: The Politics of Survival at the End of the 20th Century, pp 161–180.
  • Médecins sans Frontières, Populations in Danger, 1995: Annual Report, New York: Routledge, 1995, p 38.
  • I am here referring to Jean Baudrillard's controversial piece, La Guerre du Golfe n'a pas eu Lieu (The Gulf War did not Take Place), Paris: Galilée, 1991.
  • Not all proponents of medical humanitarianism agree with this approach to humanitarian action. In recent years, Rony Brauman, former President of Médecins sans Frontières, has steered clear of the line of action and ideological operation now advocated by MSF. In fact, Brauman has been an ardent critic of MSF'S use of the media, and of the médiatisation of victimhood. In one of his most virulent essays, Brauman cynically remarks: ‘what a great opportunity to thus see a genocide transformed into a vast humanitarian theater where everyone, from the survivors and the accomplices to the innocents and the torturers, finally plays what from now on is their only desirable role, that of the victim’. In this statement, Brauman not only reveals his will to ‘humanitarian purity’ (a romantic return to the letter of the medical Charter perhaps), but also his disgust with the treatment of humanitarianism as a global accident. With his concern for what is lost in the médiatisation of events, Brauman appears to be close to Virilio's position. Brauman, Devant le Mal, Rwanda: Un Génocide en Direct, p 83 (my translation).
  • Or, as MSF puts it using an overtly sentimental tone: ‘Just when these victims think that they are completely forgotten by the world, they see the Doctors without Borders team arrive and their hope is rekindled’. See pamphlet on MSF ‘Help Us save a Life Today’.
  • Once again, one way of exercising more caution about this phenomenon is perhaps to use the term ‘transversality’ instead of deterritorialisation.
  • If I may borrow and revise a little this expression of John Agnew & Stuart Corbridge. See Agnew & Corbridge, Mastering Space: Hegemony, Territory and International Political Economy.

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