Canadian physician Joanne Liu became international director of the humanitarian aid organization Doctors Without Borders in 2013. More familiarly known as MSF--the French-language acronym for Médecins Sans Frontières--the Switzerland-based nongovernmental organization (NGO) oversees medical missions in refugee camps, combat zones, and other high-risk areas around the globe. Liu is the second Canadian to head MSF and the first executive ever to serve two consecutive terms.
Born in 1965 in Quebec City, Liu was raised in an immigrant family with roots in Guangdong, China. Her parents founded a restaurant, China Garden, in the early 1970s on the Boulevard Sainte-Anne and were part of a small community of Chinese Canadians in the provincial capital. At times, Liu was one of just a few students of Asian heritage in classes in the suburban Charlesbourg schools she attended. In 1986 she graduated from St. Lawrence College--Champlain, one of the bilingual province's junior colleges known as CEGEPs (Collège d'enseignement général et professionnel) that prepare students for university education.
Inspired by Volunteer Experience
During her formative young-adult years, Liu traveled extensively, even hitchhiking across Canada once, and sought enriching volunteer opportunities. The first was with Katimavik, a national service organization that places recruits in six-month assignments across Canada. It was Liu's visit to the African nation of Mali, however, at age 20, that affirmed her career ambition to become a humanitarian-relief physician. She traveled to Mali under the auspices of Crossroads International, an agency that helps refugees and other at-risk populations in trouble zones around the world, and was overwhelmed by conditions in the drought-stricken, strife-torn part of the African Sahel region. "That was the really lifetime-changing experience," she told Eric Andrew-Gee, a reporter with the Toronto Globe & Mail. "It really deeply touched me. And I remember, when I came back, I said: 'This is it--I'm going to go into medicine.'"
Liu had become interested in medical humanitarianism when she read a book by French physician Jean-Pierre Willem, Et la paix, docteur?: Un médecin sur tous les fronts (And Peace, Doctor? A Doctor on All Fronts). Willem founded Médecins Pieds Nus, or Barefoot Doctors, and devoted his career to providing modern medical care to some of the world's most impoverished areas. He also had ties to Bernard Kouchner, one of the founding figures of Médecins Sans Frontières (Doctors Without Borders, or MSF).
MSF was founded in 1971 by Kouchner and other physicians who had worked in Nigeria during its Biafran War, which began as a secession movement in 1967. Kouchner's group was disconcerted by the ineffectiveness of the Red Cross mission in this West African trouble zone. The prim neutrality that had been the decades-long hallmark of Red Cross missions in war zones had, in this case, obviated opportunities to alleviate suffering. Willem, Kouchner, and others contended that healthcare professionals risking their lives to aid the injured and sick should ignore artificial boundaries created by governments and military operations, hence the "without borders" mandate. MSF was also committed to the principle of témoignage, or bearing witness--in other words, actively revealing their experiences to the world in an attempt to raise awareness for oppressed peoples. Témoignage is especially vital, the MSF cofounders believed, when deliberately amoral actions of governments posed grave health risks to innocent civilians.
Trained in New York City
Following her stint in Mali, Liu settled in Montreal and enrolled in medical school at McGill University, graduating in 1991 with her M.D. She completed her residency in pediatric medicine at the Centre Hospitalier Universitaire Sainte-Justine (CHU Sainte-Justine) in Montreal, part of the University of Montreal system, and also spent two years in New York City to train as a pediatric emergency medicine fellow at Bellevue Hospital Center, which is affiliated with New York University School of Medicine. Returning to Montreal, she became a pediatric emergency-medicine specialist at CHU Sainte-Justine, where she later taught as a medical-school faculty member. In 1996 she embarked on her first MSF posting, giving up her paid vacation leave to travel to a refugee camp in Mauritania that was home to thousands of refugees from Mali.
For the next 17 years, Liu served at multiple MSF missions, some of which are permanent medical facilities in underserved areas whereas others are temporary relief centers established by rapid-deployment teams in the region in response to natural disasters, such as the 2004 Indian Ocean tsunami or Haiti's devastating 2010 earthquake. Liu volunteered for some of the most perilous MSF assignments, including the Darfur region of Sudan and the Democratic Republic of Congo, two African nations beset by decades of civil war. From 1999 to 2002 she served as a program manager at MSF's Paris office.
In 2004 Liu became president of MSF-Canada, one of the national offices that recruits and trains physicians and public-health professionals for international deployment. She helmed MSF-Canada for five years and continued to serve on international MSF missions during that time. From the Kalma refugee camp in Darfur, for example, she told a reporter for Edinburgh's Scotland on Sunday newspaper that infant and child mortality rates were exceeding 20 deaths per day in a camp that sheltered 75,000 Sudanese in grim conditions. "People are still fleeing from villages into camps which are already over-capacity and under-resourced," she told the newspaper's diplomatic correspondent Ian Mather. "There simply aren't enough resources to deal with the crisis. We can't even fulfill basic needs."
Earned Health Leadership Degree
Liu first entered the election to become the international MSF president for the 2010-13 term, which she lost to Indian-born, American-educated Dr. Unni Karunakara. Seeking a greater mastery in her chosen field, she won a place at a renowned program at McGill University that brought together leading medical and public-health faculty members with experts from its school of management; jointly they taught courses in the International Masters for Health Leadership (IMHL) program at McGill. Typically, just a small number of established, mid-career professionals are chosen for this advanced-degree program. Among Liu's classmates were Conrad Sauvé, head of the Canadian Red Cross, and Rafael Bengoa, who had served as regional health minister for Spain's Basque region. Bengoa encouraged Liu to use the skills she burnished in the McGill IMHL program to seek the MSF directorship once again at the 2013 international meeting.
Liu submitted her candidacy application documents ahead of the MSF general assembly in September of 2013 and was elected to a three-year term. She was not the first woman to head MSF, nor even the first Canadian physician: Dr. James Orbinski led to the organization in the late 1990s and accepted the Nobel Peace Prize on its behalf in 1999. One of Liu's first trips as MSF director was to Syria, by then well into the second year of a catastrophic civil war that began in 2011. Liu embedded with a regular rotation of MSF volunteer physicians who arrived in Syria, parts of which had been taken by antigovernment militants while Syrian Armed Forces under President Bashar al-Assad unleashed their full military capacity to quash the opposition and maintain control of other parts at risk of falling to anti-Assad rebels.
When Liu returned from Syria, she spoke with CNN News host Becky Anderson in a December 2013 broadcast of Connect the World, detailing daily airstrikes on neighborhoods and bombs directed at school facilities. She described the MSF "field hospital of 25 beds, and we were treating patients with 30 percent burns of the body. And then, for children, we've got, two of them were above 40 [percent], and then we send them to another hospital, and one of them died on the way because the burn was so extensive," she told Anderson. "We cannot bomb children. This level of violence on civilians is way beyond what is acceptable."
Voiced Criticism Over Ebola Response
Liu faced an even grimmer crisis during her first year as international director of MSF: Ebola virus disease, a highly contagious hemorrhagic fever, erupted in several West African nations. Health officials began tracking a spike in infections in Guinea in early 2014, and there was some action from the World Health Organization (WHO), the United Nations (UN) agency with broad powers to respond to epidemic diseases that pose the risk of becoming pandemics, or global-scale outbreaks. During the worst period of the crisis, Liu was one of the many MSF personnel who donned protective clothing and toured healthcare facilities in Liberia and other sites. She also met with the president of Liberia, Ellen Johnson Sirleaf, and pledged to follow the MSF mission of témoignage and use her position to stir public interest.
MSF often relies on help from UN agencies and field personnel, who can provide transport, supplies, and communications services in otherwise high-danger zones where foreigners cannot safely travel. As the international director of MSF, Liu wields some leverage at the UN and can request meetings with senior UN officials. She can also apply for a highly coveted speech-making slot in front of the UN General Assembly, which convenes every September in New York City.
In September of 2014 Liu made her first high-profile UN address, chastising the international response to Ebola virus disease. In Monrovia, the Liberian capital, there was one 150-bed facility equipped to handle Ebola patients, whose symptoms progressed rapidly to organ failure and death. Its ability to admit new patients, she revealed, was dependent on how many patients had died during the night. "The sick continue to be turned away, only to return home and spread the virus among loved ones and neighbors," Liu pointed out to the UN General Assembly, according to a New York Times report. "The isolation centers you have promised must be established now."
Stoked Outrage Over Kunduz Airstrike
Meanwhile, the crisis in Syria continued apace and it presented escalating challenges for MSF personnel as Italy, Greece, and other Mediterranean Sea-bordering European Union member states became the destination for hundreds of thousands of refugees. MSF set up hospital ships in Mediterranean waters to assist nearly 20,000 migrants in the summer of 2015. In October of 2015 Liu's name turned up in international news headlines when she took a strong public stance in the wake of an egregious airstrike on an MSF field hospital in Kunduz, Afghanistan. The attack was part of a U.S.-led military effort to route the Islamic fundamentalist Taliban group from northern Afghanistan, and MSF officials had provided U.S. military officials with the hospital's precise global positioning system (GPS) coordinates to prevent aerial strikes just days before. At first, Pentagon officials stated that it had mistaken the building--a state-of-the-art medical center in operation since 2011--for a Taliban compound.
It was Liu who used her prominent position as international director of MSF to publicize the details of the Kunduz airstrike and call for an independent inquiry. Thirteen MSF personnel died in addition to another 30 casualties. "Everybody who's been in a hospital or had a loved one in a hospital, we all relate to the idea that if you're in a hospital in the lowest point of vulnerability, the last thing you expect is to get a bomb on your head," she told Kareem Shaheen in the Guardian in 2016. "And I think that everybody, in Beirut, in Montreal, in Homs or Madaya, thinks the same thing, I think everybody believes that. That's our common humanity."
Liu spoke to the Guardian in March of 2016, a few months before she was reelected by the MSF to a second three-year term as international director. Other physicians have served multiple terms at the helm of MSF's headquarters in Geneva, Switzerland, but Liu is the first to hold that office who has ever willingly sought a second term. "Every day I meet amazing individuals in the field," she told Financial Times writer Charlotte Clarke about her job, which gives her a wide-angle glimpse into suffering and misery on a global scale. "When I see a mother who has walked for three weeks to come to a MSF clinic, with two kids on her back and her belongings on her head, facing intimidation and physical abuse on her way, I am inspired by her resilience--her desire for life."
Born November 4, 1965, in Quebec City, Quebec, Canada; daughter of restaurateurs; married. Education: McGill University, M.D., 1991, I.M.H.L., 2014. Addresses: Home--Geneva, Switzerland. Office-- Médecins Sans Frontières (MSF), 78 rue de Lausanne, Case Postale 1016, 1211 Geneva 1, Switzerland. Web site--https://twitter.com/joanneliu_msf.
Pediatric emergency-care physician, Centre Hospitalier Universitaire Sainte-Justine (CHU), after 1996; volunteer physician, Médecins Sans Frontières (MSF), after 1996; program manager, MSF Paris office, 1999-2002; director, MSF-Canada, 2004-09; elected international director, MSF, 2013, 2016.
National Order of Quebec, Province of Quebec, 2015; Teasdale-Corti Humanitarian Award, Royal College of Physicians and Surgeons of Canada, 2016.
- Financial Times (London, England), January 19, 2014.
- Globe & Mail (Toronto, Canada), May 28, 2016.
- Guardian (London, England), March 7, 2016.
- New York Times, September 26, 2014.
- Scotland on Sunday (Edinburgh), January 30, 2005.
- "Pavel Dmitrichenko Sentenced; Thai Government, Protesters for Truce for Monarch's Birthday; Azerbaijan, Iran Fight Over Origins of Polo," Connect the World, CNN News, http://www.cnn.com/TRANSCRIPTS/1312/03/ctw.01.html (November 25, 2016).