The Current - Ebola, Bombs and Migrants: MSF’s Dr. Joanne Liu

Episode Date: October 28, 2026

Dr. Joanne Liu was the International President of Medecins Sans Frontiers from 2013 to 2019, and came face to face with the world's biggest humanitarian crises of that time. Since leaving her role at MSF, Dr. Liu has been reflecting on her work, and thinking about how best to provide humanitarian aid in a new world order — as crises continue across the globe. She joins us to talk about her new book, “Ebola, Bombs, and Migrants: Humanitarian Crises in a Security-Obsessed World,” and what still keeps her hopeful. 

I just tallied up my cost for this semester, and between tuition, campus fees, and a very expensive textbook I've barely opened, my budget is stretched thin. Yeah, it's a lot to juggle at once. Right? It feels like everyone else somehow got a manual on how to navigate student life and figure out their finances, and I missed the memo. Trust me, nobody got a manual. When I started school last year, I felt the exact same way. Everyone's just figuring it out as they go. Honestly, just knowing other people are asking the same questions makes me feel a whole lot better. You're definitely not the only one trying to make sense of it all.

Navigating school and your finances comes with a lot of big questions. If you're figuring out your next steps, check out Count Us In. A web series where host Michelle Spina sits down with members of Gen Z to share real perspectives and experiences on money, life, and what comes next. Paid content with Desjardin. Now streaming on CBC Gem. This is a CBC podcast. I'm Catherine Cullen.

This is the current podcast. Ebola, bombs, and migrants. That's how Dr. Joanne Liu summarizes her time with Medinsins en Frontier, which you may know as MSF or Doctors Without Borders. As the international president of MSF from 2013 to 2019, she came face to face with the world's biggest humanitarian crises of that time. and many of those crises have proved to be unrelenting. Yet another deadly Ebola outbreak is spreading.

Wars continue to rage, and the number of people migrating, often not by choice, has tripled this century. Since leaving her role at MSF, Dr. Liu has been reflecting on her work and thinking about how best to provide humanitarian aid in a new world order. Today, Dr. Joanne Liu is a pediatric emergency physician and professor at McGill University's School of Population and global health. Her new book is Ebola, bombs and migrants, humanitarian crises in a security-obsessed world. Dr. Liu, hello. What do you mean when you say the world has become security obsessed? Well, I think this is something that somehow slowly crystallize itself with time, but with the event, mostly with the 9-11 in 2001. And at that moment, everybody found out that, oh my God, I am not safe.

And we got into the era of fear. And that era of fear brought what I call the security obsession. And that security obsession is really all we are looking at events through the lens of security. Am I safe? Is my country safe? And it's a re-roading what I call our solidarity mechanisms when crisis happened elsewhere. You write in the book, you quote a microbiologist, in fact, one of the men who discovered Ebola, who says to you, there are only two things that matter to states. Security and economy, the rest is literature.

Do you believe that? Well, I think that somehow there's some truth in there. When we look at how we are doing things here down in Canada, and then our prime minister call himself the trade minister, somehow there's some truth to that. How does this interest or even obsession with security affect the ability to help people in need? Well, when you are so, I would say, obsessed by security, it is really hard to look forward elsewhere. And so you will not do that unless you feel threatened by something coming elsewhere. So, for example, for the Ebola outbreak in 2014, 2016, the global north only reacted when cases of infected people started to be repatriated in the United States. And then all of a sudden, he was knocking out the door, said, oh, this is real, I can get infected.

We started to pay attention. You, of course, saw that from the inside, because you were leading MSF at the time. you were leading the international response to the West African Ebola epidemic that began in 2014, and you visited an Ebola treatment center in Sierra Leone. Now, this is right around the time that the world is starting to pay attention after some initial resistance that you describe in the book, and the WHO has at this point declared this a global public health emergency. When you went to that treatment center, what did you see?

This is such hard memory. I remember when I walked and then I saw people on their own and just waiting. And I remember seeing a child screaming, screaming of fear. And I just told myself, since I'm a pediatrician, I said no child in Montreal would be on his own trying to fight a deadly disease. But this one is alone. And this is what happened with that disease is because it's so highly infected. and lethal, which is between 40 to 70%, you're on your own.

And then the people around you are wearing personal protection equipment. So there's nothing personal. Everything is impersonal. And so it's so hard. And I remember when I did the first round that time, I saw six people who were dead. And I told myself, my God, at St. Justin in Montreal, this is more or less what we see in one year. what we see in one year in my emergency room.

That was one-hour ward wounds. You described the eight-step process of putting all this personal protective equipment on, and you say the only thing that could penetrate that uniform was fear. Yes, because you are protected, but the burden of carrying fear is remain, whatever and how many layers of protection you may have. So you are seeing these heart-wrenching, gut-wrenching scenes, this suffering, people dying alone in difficult conditions. When you meet with world leaders, senior officials at the World Health Organization, how are they responding?

Yeah, this is quite interesting because initially I remember when I was meeting high official, I was telling them, you have to be aware there's this deadly disease in West Africa. the countries are overwhelmed and if we want to make sure that we can save as many lives and as well that it doesn't keep propagating elsewhere, we need to fight it where it's happening. And somehow people were paying attention but not that much. But I remember that when I started to say, listen, this is a really, really tough disease. And I find it very odd that the only people who have the know-how to treat patients with Ebola would be an international private organization. Don't you want to know more?

Don't you want to develop your understanding and your competences to fight Ebola? And that resonated more. And this is why when I say only two things that count, it's economy and security. This is why. You have to convince them that they'll be able to better protect their citizens by getting involved in helping other countries. Yes, it's an investment. You write in the book about how when, and you mentioned it a moment ago, when Americans become infected, the attitude towards this change is a kind of hysteria you describe. But I wonder if you think that in this instance that fear helped get the world's attention.

That's an excellent question. And I think that fear is something that can be useful if it's channeled well. If you have fear and you do like we're doing somehow now with the Democratic Republic of Congo and we're closing our border and then we're not giving them a hand, then it's not really that useful anyway for the community impacted. But if you are undergoing a sort of intense fear about what's going on and you want to do something, then that could become a real good driver. And this is why I think that it can go both ways.

What is it like for you watching the outbreak of Ebola that's playing out now? I mean, you just described a lesson that it sounds like you feel wasn't learned from the first outbreak. I think watching what's going on in Democratic Republic of Congo in the province of North Kivu and Ituri is so devastating. It's a tragedy. This is our worst-case scenario that we feel. feared so much in 2016 at the end of the Ebola outbreak in West Africa, which I said, if it happened in a place where it's a war zones, where there are displaced population, where they are mistrust, rampant mistrust across communities, that's going to be really tough. And this is what we're facing

in DRC, unfortunately. More than 9,500 people have been infected. Kenya and Nigeria have also reported their first cases this month. You write in the book, nothing happens. happens without political leadership. It is certain that new pandemic threats will emerge, but full-blown pandemic are a political choice. What do you mean? Well, I think that the reality is there's going to be outbreak. They're always going to be outbreak because there's going to be spillover,

meaning that a virus that's living in an animal would jump into the human being and then an outbreak will happen. And that we cannot really prevent for it. much. On the other hand, to make sure that an outbreak doesn't become a regional epidemic and then a pandemic, we have a choice. We always have the choice to act and act early on and not wait, for example, that our own security here in Canada get threatened. And so the best way to fight an epidemic is to fight it where it's happening. Do you see any sign, though, that the world is learning that lesson? I wish. I think that we are

slow learner. I want to talk about the humanitarian crises in war. You write about the bombing of an MSF hospital in Kunduz, Afghanistan in 2015. U.S. air strikes killed 42 people, including 14 staff. You described that night in painful detail in your book, patients under sedation being burned alive. At the time, you described this publicly as an attack on the Geneva Convention. One MSF leader publicly called it a war crime. How did the world react? The world reacted in use support to the organization of Medesinsins Enfranier, because we have given our GPS coordinates in it. We have talked with everybody. And everybody knew in that country that one lit building in the area in the area of Kunduz was Kunduz's trauma center.

And it was the place that if you had, everybody knew that if you had a bone broken, this is where you would get fixed. And so when people found out at a fully functioning hospital where there was no military activities inside or in the vicinity of it was bombed. And not only once, but it was five airstrikes over a period of one hour. I think the insistence of those airstrikes were very, I would say, very upsetting to the general public. And so I think that we got the general public with us to a certain extent. But then after that, how do you translate that to something operational to avoid that it happens again? Was the real, I would say, challenge. I just tallied up my cost for this semester.

and between tuition, campus fees, and a very expensive textbook I've barely opened, my budget is stretched thin. Yeah, it's a lot to juggle at once. Right? It feels like everyone else somehow got a manual on how to navigate student life and figure out their finances, and I missed the memo. Trust me, nobody got a manual. When I started school last year, I felt the exact same way.

Everyone's just figuring it out as they go. Honestly, just knowing other people are asking the same questions, It makes me feel a whole lot better. You're definitely not the only one trying to make sense of it all. Navigating school and your finances comes with a lot of big questions. If you're figuring out your next steps, check out Count Us In. A web series where host Michelle Spina sits down with members of Gen Z to share real perspectives and experiences on money, life, and what comes next.

Paid content with Desjardin. Now streaming on CBC Gem. Right now, Canadians are choosing to support each other like we'd never have before. So shouldn't our website domains show that same strong support? Choosing a dotCA domain does that and much, much more, because proceeds from dotCA domain sales help support local projects that improve digital access, online safety, and build stronger Canadian communities. Your website may be where your dotCA starts, but its impact goes much further. See the difference a Canadian online choice makes. Visit choose.ca today. One of the extraordinary parts in your book is the details of

your phone call with the U.S. President at the time, Barack Obama. He called you. What did you take away from that phone call? The phone call. So actually, the phone call was, we got called by the White House about two days after the attack, after the U.S. has taken responsibility for theirstrikes. And they call us. Initially, it was Samantha Power, the ambassador, the ambassador, of the U.S. at the UN in New York was calling us. And we just said, we cannot take the call. And after that, it was a White House. And then my advisor said, do not pick up your phone.

We're not taking the call because we were doing a press conference. And we wanted to make sure that this will not somehow dilute the effect of the press conference. And so we turned down. You feared they were going to try to talk you out of being overly critical of them? Well, we thought that they would just say, we fixed it, we gave our apologies and it's all good. And we wanted the world to hear that it happened. They took responsibilities and then we want an independent investigation. And so we wanted that to be out before having all the limelight taken by Barack Obama giving his apologies to MS.

So when you do have this phone call, you offer a transcription of it, the president calls this a mistake. You say you wonder if this attack happened because the hospital was treating injured combatants. You also say because MSF had won the Nobel Peace Prize, you say to him, talking from one Nobel Peace Prize winner to another, I am really, really asking you to consent to an independent investigation. He replies, in very personal terms, it makes absolutely no sense what you're saying. There's no plausible, conceivable reason why we would be interested in hitting a hospital. And he does not agree to that independent investigation. You suggest you lost respect for him that day.

I think there was disappointment because for many people, the stature of the U.S. being at that. that time, a sort of a high moral ground state was a disappointment to see that they didn't want to live up to this request of independent investigation, knowing that it was confidential, that nobody would know the outcome. Only the countries were involved. And so we thought that if we were lowering the bar that low from a country of the stature of the U.S., what will happen the next time with another country? And so that's what. That was our biggest worried.

And to a certain extent, we were right in faring that because after that, everybody called it once they bombed hospital a mistake. How did you feel as he was saying these things to you? It's interesting because I think there were a lot of mixed emotion back then. It was only like a few days after the loss of our colleagues, so there were a lot of grieving. There was some anger and then as well, the huge, huge disappointment. And I thought that somehow the level of empathy was at what I was expecting. But the reality is he was doing his job as a president of the US.

And when we look back at things in the hindsight and the gesture of calling us was actually a massive, I would say, body language. It sent a message in itself that he would call you like that. Yes. You say that overall, at that moment, MSF wanted to send a message to other countries. We are still now seeing attacks on hospitals and medical workers in Gaza, in Ukraine. How do you make sense of the fact that the world still seems to be unable to protect these places? Yes, I think that.

I make sense of this in the fact that when there's no consequences, when you bomb a hospital, then it's full impunity. And this is why people keep doing it, because there's no cost. There's no political cost. There's no reputational cost. There's no financial cost. It's impunity. So it's up to us to just say that the rules of war exists and to enforce them.

and make sure that when there is violation, there's a cost. But right now, there's not enough political courage to do so. Where would you see that coming from at this moment? Where do you keep hope? Well, I think that any state could stand up and say, this is not right. And then there should be an investigation and there should be explanation. But right now, everybody is quite silent.

So we wish you will come from the UN Security Council, but if it doesn't, it could come up from any state who could ask. Like it happened recently when some country just said, we are asking the International Criminal Court to step in in some conflict with respect to war crimes. So it's a question of having a state standing up, sticking out their neck, and saying. saying there's mechanisms, we can call upon that and we are asking for accountability. A lot of your book deals with conflict within MSF or certainly debate within the organization about how vocal to be about some of these issues. Has your mind been changed about how political an organization like Medinsinsins-Renfranchier should be? That's a good question.

And I think that to a certain extent, what I learned, with Ebola outbreak in 2014, 2016, is we were one of the rare organization, internal organization that had financial independence. And so because we had financial independence, we could speak up. We could bear witness and even denounce situation. And many people, after that, always came up to me and whisper, if MSF doesn't say it, nobody's going to say it. And so I I think our biggest saving grace to a certain extent is we have financial independent and I'm thinking all the less than our donors. We have more than seven million donors to Med Césant-Franter doctor's border across the world.

And that's what is giving us our edge. But this is as well what is giving us our capacity to bear witness, speak up and even denounce situation. I want to talk about the last major focus of your book, which is migration. You quote a mother you met in Greece in 2014. She told you, if I knew I was going to lose all my dignity, I would have preferred to die under the bombs in Syria. What was it like to hear that?

It was devastating. I remember telling myself, are we ever failing them? And although they are rules, although they are rights for refugees, we are failing them. And I remember she even told me, she added, we thought we would get the best of Europe and we are getting the worse of Europe. I had nothing to reply to her.

But it was a huge reality check. And then this is why I really, with the rest of MSF, we decided that we needed to speak up on what's going on, on the lack of protection, on people who are forcibly displaced, and then to make sure that their basic rights of access to health, to protection, was being respected. You say in the book, recalling an event you attended in January 2016 in Davos,

in my eyes, the members of the global elite were pretending to be moved by the hardships of the globe's poorest people, while they themselves were often the cause of the injustices. when you see the world that way, how do you find hope that states will take on a more compassionate stance going forward? Well, I remain hopeful despite everything. And I believe that we have done things, we are still doing things, and we're still going to do things that will make a difference in people's life. And regularly somehow few people come together and do it. And then for example, for the migration, we did the global compact on migration. Not a perfect deal that was the governor, Louis Arboe, was leading that effort.

But we were clear on the rule of having migration that would be orderly, regular and safe. And we have already a playbook out to care for people who are forcibly displaced. And then some people are doing some of this. But we, it's not because it's not perfect. And it's not because things are not running the way it should be that we need to give up all at once. I still believe that we can make change even as incremental and small as it is because it makes sometimes a life difference for people. You mentioned Louise Arbor and in fact she writes the preface to your book. now the Governor General, but a longtime friend and a mentor of yours.

She praises you, she praises the book. But she also writes that she is more skeptical than you, saying, I believe significant reform of multilateral bodies, as has been discussed for decades, is not on the agenda. Leaders are guided solely by short-term political interest, especially given your admiration for her. I wonder what you think when she questions your optimism. It's always hard to be questioned by Louise Arbor, let me tell you.

But I think that this is some of there's some truth to that. On the other end, I think the bottom line message of my book is I want to tell people that everybody has agency. I think that whatever you're going to do, you can do a small thing that would make a difference in someone else's life. And you don't need to be at the front line of Ukraine war or you don't need to be in DRC caring for patient with Ebola. But we all can do something that will make a difference in someone else's life. And that's good enough for me. And this is why I'm not hopeless. I am not hopeless.

I think that the change will come, would be grassroots, will come from community. and then people will get, they will consolidate their agency to make change. And we have done it in the past. And we have done it in, I remember I always bring this example about Iraq war when we all went into the street as Canadian. It was just saying, we don't want to go there. When Canadians don't want to do something, they don't do it. When they want to do something, they do it.

And then right now when we see the resilience towards the tariff war that we're going through and our Canadians are holding it together, despite little hiccups, but we still are trying to stand up for ourselves. Dr. Liu, it was very nice to meet you. Thank you so much for this conversation and congratulations on the book. Thank you. Dr. Joanne Liu was the international president of Medline San Frantier. Her new book is Ebola, bombs, and migrants, humanitarian crises in a security-obsessed world.

She is now a pediatric emergency physician and professor at McGill University School of Population. and global health.