Images that Cut into You, c/o MSF

by Elysée Nouvet

I was referred to this ad campaign by Picturing Humanitarian Healthcare co-editor Philippe Calain. As I opened up the file with its set of MSF posters, I felt my stomach harden and my chest grow tight. I imagine most persons will have a visceral response to this campaign featuring sutures formed into words and symbols on torsos. It is also probably not accidental that the bodies that form the ‘canvases’ of this campaign are white given the campaign’s intended French speaking and European audience. Was I myself sickened? Outraged? No. The images are hard to look at and shocking. They are also, in my view, highly effective in promoting the intrinsic ethical value of MSF’s work.

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There is more than one way to convince morning commuters or magazine readers that transnational humanitarian healthcare is worthwhile. Shock is not the only way. But I would find it difficult to accept any objection to this campaign based on the claim that such shock is gratuitous. We are constantly bombarded with images of suffering and solicitation for donations for humanitarian efforts. If we were completely rational, as Peter Singer argues, we would not hesitate to assist those facing death and intolerable suffering abroad any more than we would hesitate to assist our neighbour or colleague if we saw that they were facing death and intolerable suffering. Distance does, however, for most of us affect our sense of ethical obligation: as practice evidences, we find it easier to be detached from suffering and violence that is not geographically or psychically in our lives. Embodied rather than logical, such routine responses are not easy to change or even realize. This is why MSF’s campaign—based on provocation, rather than information—is so distinctly effective and appropriate.

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MSF is an independent organization that relies on public donors. Its mandate, since its birth in 1971 in the aftermath of the Biafran war, has been to act independently of any state so as to have the ethical agency to bear witness to zones or mechanisms of suffering that might otherwise be ignored. For me, the images in this 2001 MSF campaign powerfully convey the importance of MSF’s work, and as such are good advertising. But what really makes this campaign work is that it does make me intensely uncomfortable. I do not feel suffering, but I am somehow made aware of its absence in my life: of the difference between my relatively unscathed body and life and the one symbolized by the sutured torso. This makes the images I see disturbing and memorable.

MSF like most organization makes its pitch by presenting itself as a savior and those it assists as victims. Here is a pretty problematic convention of North-South giving campaigns MSF seems unprepared to relinquish. But in this campaign at least, MSF is differentiating itself from other humanitarian healthcare efforts. Too many ad campaigns are, let’s say it, banal. Whether depicting victims or success stories, these are easy to consume, easy to feel detached from, and easy to forget. If one humanitarian organization in its campaigns eschews a ‘documentary’ aesthetic in favour of provocation, and if this campaign in its context of dissemination challenges and moves audiences where other campaigns fail, this to me is not only ok: it is ethical.

Elysée Nouvet ( is a Post-Doctoral Fellow in Humanitarian Healthcare Ethics at McMaster University, Hamilton, Canada.

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