Doctors without Borders: How Trust in the Hierarchy Reduces Frustration

Behind the traditional smile of the humanitarian workers, the reality is shadier. Tensions, tiredness and frustration can arise on the fields of intervention (conflicts, epidemics, natural disasters, etc.). Within the non-governmental organization Doctors Without Borders (MSF), two different kinds of international workers can be identified: the "frustrable" and the "non-frustrable". What are their respective profile? To which extent is frustration related with trust?

The "frustrable" are usually committed. They expect MSF to have a political impact, to save lives and to be ‘efficient’. Depending on the context, they can come back from their humanitarian mission highly frustrated. The non-frustrable are more ‘career-oriented’. They expect a salary from the organization, a career evolution that MSF actually provides. There is no space for frustration. And they affirm they are "never disappointed". Indeed, I show how frustration lies in the intersection of the expectations of the individual and the “zones of uncertainties” of the organization (Crozier and Friedberg, 1977).

However, by looking more in the details, I show that frustration is also a matter of trust. Most of the “frustrable” mistrust the headquarters and discuss the decisions taken by the managers whereas the “non-frustrable” are humbler and say they “do not have all the parameters” to challenge the decisions of the headquarters. Trust seems to reduce the perceived uncertainties of the humanitarian activities and reduce the feeling of frustration. Rephrasing the original German title of Niklas Luhmann’s book “Trust and Power” (Luhmann, 1968), my talk will try to explain how trust can be seen as a mechanism that reduces uncertainties, and consequently frustration.

My communication relies on fifty interviews with MSF expatriates and notes taken during ten humanitarian missions on three continents.