Nicholas Tessier, a clinical and forensic psychologist with Doctors Without Borders, spoke at a WashU talk (photo courtesy of Camila Micán Rondón).

Clinical and forensic psychologist Nicholas Tessier discussed his experience delivering medical humanitarian aid with Médecins Sans Frontières (MSF) in critical global conflict zones at a WashU talk on April 1.

MSF, which is commonly referred to as Doctors Without Borders in the United States, provides medical humanitarian aid in more than 75 countries to people affected by natural disasters, armed conflicts, disease outbreaks and epidemics, and other crises. 

Tessier has worked in numerous conflict zones with the organization, including the Democratic Republic of Congo, Yemen, Gaza, Lebanon, Sudan, and Iraq. He now serves as MSF’s Head of Mission in Haiti. The talk was part of a speaker series hosted by French Connexions, WashU’s Franco-American Center within the Department of Romance Languages and Literatures.

During the event, Tessier noted the profound suffering that humans face around the world, but also the remarkable resilience he has witnessed while working in global conflict zones. 

“Humanity itself is one of the most resilient organisms on Earth,” he said. “We live in every environment, even the most inhospitable. People are continuing their lives despite constant bombings, or Ebola in the village, or losing their entire family, or having unfortunately been chronically raped or chronically tortured. These people still survive.”

Tessier outlined MSF’s core principles, which include impartiality, neutrality, medical ethics, bearing witness, transparency, and accountability, and explained how his field experiences have shown the importance of these values in practice. 

To emphasize the importance of MSF’s independence from governments and institutions, Tessier explained that authorities sometimes refuse to allow the organization to enter certain areas. However, because the organization does not rely on funding from national governments and institutions such as the United Nations, its team members are not bound by those restrictions and can still find ways to enter and save lives, according to Tessier. 

In Sudan, border closures with neighboring countries made it extremely difficult to deliver essential health services to civilians, Tessier said. Because of this, he traveled to the Chad-Sudan border and arranged illicit passage into Darfur, a region in western Sudan.

“MSF had to find creative and often dangerous ways to enter Darfur, then find ways to bring in sufficient medication, medical equipment, and cash to open several hospitals, primary health care centers, launch a vaccination campaign, and do this kind of work,” he wrote in a later statement to Student Life. 

Tessier currently works in Haiti and said that about 80% of the capital city is controlled by gang leaders, and the government is often corrupt. He said there are also rampant human rights violations and an increasing “dehumanization” of individuals living in gang-controlled areas.

“[These civilians are] seen now as less than. This is the setup for catastrophe when we start dehumanizing our neighbor. This can be really, really bad because then their lives [don’t] matter, their death doesn’t matter. It’s the cost of doing business,” he said.

Tessier noted that because civilians are too often mislabeled as threats or dehumanized, a central part of MSF’s work is to try to restore dignity to people caught in conflict by telling their individual stories and challenging how they are perceived. He added that telling civilians’ stories is especially important in the context of military interventions. 

“We hope that that will help the police and now the international force to be gentler in the military intervention, to remember that there are civilians, and have a plan to house these civilians,” he said. “A lot of conflicts are led by the military, and the military doesn’t think about human rights, about the consequences. It thinks about action.”

Tessier also emphasized the importance of engaging with community members to build trust and learn how to best support them. In the Democratic Republic of the Congo, reports indicated that rates of sexual violence were alarmingly high. Yet, after the MSF team members opened and operated a clinic for nearly a month, almost no patients came. To understand why, Tessier met with the “old wise women of the village.”

The women described a deep mistrust of Western medicine stemming from colonial-era experimentation in the Congo. They also said that survivors of sexual violence face serious risks if they speak out. In many cases, perpetrators hold power, and reporting an assault could lead to retaliation, ostracization, or even being forced to marry the attacker. 

To address these fears, Tessier told the women that patient information would be confidential. Providers at the clinic would avoid recording identifiable details and use coded systems so that even if records were accessed, individuals could not be identified.

“This kind of transparency is how she was convinced,” he said. “The very next day, she showed up with over 100 women. That is how you approach these situations. You talk, you ask them what they’re going through.” 

Tessier also told the audience that the majority of MSF workers on the ground come from the local community and include not only physicians, but also psychologists, nurses, administrative staff, rare disease researchers, journalists, and other professionals. He emphasized that the organization’s variety of staff members is important for expanding its work beyond traditional medical interventions to include larger public health and prevention efforts.

He showed this with an example from Haiti, where MSF has worked with water and sanitation experts to improve clean water infrastructure and public health. This effort is partly driven by the prevalence of scabies, a contagious skin infestation of microscopic mites that is often linked to poor access to clean water. 

Additionally, Tessier emphasized that MSF treats hospitals as “neutral spaces” where individuals are not prioritized for treatment based on power or affiliation. 

“We do not care if you are a VIP. You could be the president of the country, you could be homeless. The one that is most [at] risk will be treated first,” he said. “I’ve had hospitals where I’ve put two soldiers from opposing sides in beds next to each other, and had to talk to them to make it very clear what was going on. Everyone is disarmed, everybody is out of uniform, and you are now patients. You are no longer a foreign fighter.” 

Tessier also spoke about the importance of being multilingual and how learning a new language gives you a more comprehensive understanding of the world. Each language and culture has its own perspective and biases, and knowing more than one lets you compare viewpoints instead of relying on just one version of reality, he said. 

“A different linguistic structure will actually alter how your brain works and immediately allow you to understand how two things can be true at the same time — because the word for love is slightly different in French, there are different ways of saying things.”

Lionel Cuillé, professor and director of French Connexions, organized Tessier’s talk and works closely with MSF’s New York office to bring MSF speakers to campus in support of a French for Health Professionals pathway at WashU. He told Student Life that his collaboration with MSF has shown him that “humanitarian work requires more than English.”

“Our MSF guests have emphasized that knowledge of another language is often essential in the field, whether for building trust, understanding patients, or working effectively across cultures.”

Editor’s note: This article was reposted to the Student Life website on Apr. 10 at 4:18 p.m. It was updated after Nicholas Tessier requested that his quote regarding methods of entry into Darfur be reworded to more accurately reflect his experience.