Charity Journal sat down with Fouzia Bara, Head of the Migration Program for Médecins Sans Frontières (MSF) in West and Central Africa (WaCA), for this week’s edition of Global Heroes.
Fouzia Bara is a senior humanitarian strategist and health advisor with over 20 years of field experience under her belt. Her experience includes stints in the Balkans and the Middle East, where she led the responses to crises like the Beirut port explosion, the Syrian conflict, and displacements in Iraq.
Every week, Charity Journal interviews experts, philanthropists, and volunteers moving the needle to provide humanitarian aid and support globally.
Fouzia Bara: Early beginnings in Africa
You have been in the field for over 20 years. What was the specific moment or case early in your career that made you realize you were built for high-risk humanitarian work?
My first mission outside Europe was in Chad in 2006. It was a surgical program treating war-wounded patients. I had never worked in such a sensitive, high-risk environment before. The influx of casualties was constant. We were performing triage daily, deciding, sometimes within minutes, who could be saved first, who could wait, and who, despite everything, we could not save. Those decisions never become easy. They just become necessary.
It was there that I learned humility in its purest form, the kind that comes when events are bigger than you, when violence and instability dictate your rhythm, and when medicine is practiced under pressure and scarcity. But I also discovered something equally powerful: the strength of teamwork.
In an isolated and dangerous setting, collaboration was not optional. It was sheer survival. Surgeons, nurses, logisticians, and the local staff relied on one another completely.
Yet the mission was not only about trauma and loss.
In the nutrition center, I witnessed transformations that felt almost miraculous. Children arrived severely malnourished, some at the edge of death, silent, fragile, barely responsive. And then, weeks later, those same children were running in the hospital courtyard, laughing, chasing each other. That contrast between near-death and life returning stays with you forever.
I also met women whose courage reshaped my understanding of resilience. They crossed dangerous zones to reach their fields, risking their lives simply to grow food for their children. Their strength was quiet, uncelebrated, and absolute.
That first mission was an emotional concentration of fear, exhaustion, grief, laughter, solidarity, and hope, often all within the same day. But what strikes me, looking back, is that I never questioned my presence there. Despite the risks, despite the emotional weight, I never felt misplaced.
It wasn’t a single case that confirmed my commitment. It was the repetition of responsibility. The accumulation of moments where, even in chaos, I felt exactly where I was supposed to be.
The Atlantic migration route is brutally unforgiving, says Fouzia Bara
Most people see the news, but you see the reality. What is the biggest thing the public gets wrong about the Atlantic migration route?
Most people see numbers. Arrivals. Death tolls. Interceptions. Percentages. The debate becomes political, statistical, and securitized. But on the ground, there are no “flows” or “figures.” There are human beings.
The Atlantic route is not just dangerous. It is brutally unforgiving. People board fragile boats knowing that the ocean does not negotiate. They face dehydration, fuel shortages, storms, and engine failures. Some spend days drifting under a merciless sun. Others are thrown into freezing nights. Many never arrive.
But the sea is only the final chapter of a much longer ordeal.
Before reaching the coast, many migrants have already endured violence, exploitation, detention, extortion, or sexual abuse. They travel through territories where they are completely unprotected, invisible to any legal or humanitarian safeguard.
When they finally reach medical care, we see what statistics cannot show: infected wounds from beatings, bodies exhausted by hunger and dehydration, and above all, invisible injuries, trauma, broken trust, and fear that sits permanently behind the eyes.
The media often frames the Atlantic route as a security issue. On the ground, it is a protection crisis. These are men, women, and adolescents who have left their mothers, fathers, siblings, and friends. They carry dreams, not abstract ambitions, but simple hopes: safety, dignity, the possibility of work, and the chance to support a family back home. When we reduce them to numbers, we strip away that humanity.
“When we reduce them to numbers, we strip away that humanity,” added Fouzia Bara.
What stays with me most are the silences, the moments when someone begins to tell their story and then stops, because some experiences are too violent to put into words. The public sees migration as movement. We see survival.
The first 60 minutes after a crisis hits are crucial, says Fouzia Bara
You led the response to the Beirut port explosion and the Syrian conflict. When a crisis of that scale hits, what is the very first thing that goes through a strategist’s mind in the first 60 minutes?
When a crisis of that magnitude hits, whether it’s the Beirut port explosion or an escalation in the Syrian conflict, the first instinct is not panic. The first 60 minutes are not about reacting emotionally. They are about rapidly transforming chaos into coordination.
The very first thought is: What exactly are we dealing with?
In large-scale crises, information is fragmented, contradictory, and often unreliable. Rumors circulate faster than facts. The situation is unstable and evolving. So the immediate priority is to gather verified information: What happened? What is the scale of damage? How many casualties? What are the security risks? Are facilities operational? What are the access constraints?
At the same time, this is never an individual effort. Crisis response is fundamentally collective. Everyone has a defined role. Leadership in those moments means ensuring clarity of responsibilities and preventing duplication or confusion.
Within that first hour, we begin mapping available resources: human capacity, medical supplies, surgical teams, logistics, transport routes, and communication systems. What do we have immediately? What do we need urgently, and what can be mobilized within hours?
Simultaneously, we establish contact with key actors, local authorities, health facilities, other humanitarian organizations, and sometimes even parties to the conflict. Coordination is critical. In high-impact crises, acting alone is not only inefficient but it can be dangerous.
Those first 60 minutes are about assessment, alignment, and prioritization. They set the tone for everything that follows. You move quickly, but not blindly. Because in a crisis of that scale, speed without structure creates more chaos. Strategy, in the first hour, is about building that structure so that rapid and effective action becomes possible.
As a Senior Practitioner Mentor, how do you teach younger humanitarians to stay “human” without burning out when the environment is rapidly evolving and high-risk?
The people I accompany on their first missions already carry a strong sense of humanity. That is precisely what led them into humanitarian work. They care deeply and are moved by injustice. Right off the bat, they want to alleviate suffering. That sensitivity is their greatest strength. But it is also their greatest vulnerability.
In high-risk and rapidly evolving environments, emotions run high. Exposure to trauma, injustice, and extreme living conditions can quickly become overwhelming. Burnout is a very real occupational risk, and it’s not something that is a distant possibility. So the work of prevention begins even before departure.
Preparation is essential. They are thoroughly briefed about the context, the security environment, the cultural dynamics, and the operational constraints. We normalize the idea that they will feel challenged, emotionally, physically, and ethically. There is nothing abnormal about being affected by abnormal situations.
Once in the field, my mentorship becomes more personal. I remind them constantly: you cannot take care of others if you are neglecting yourself. Rest is not weakness. Boundaries are not selfishness. Asking for help is not failure.
I encourage communication, honest, unfiltered communication. They must feel safe expressing fear, frustration, sadness, and even anger, without the fear of being judged. We create a confidential and benevolent space where emotions are allowed. Because suppressing emotions does not make someone stronger, it only postpones the collapse.
At the same time, I teach them the importance of professional protection. Remaining human does not mean absorbing everything. It means feeling but also knowing how to step back, how to compartmentalize, when necessary, how to protect one’s inner balance.
We are all human. Emotional sensitivity is not a flaw in this work, rather, it is the engine. The challenge is to manage it wisely.
Fouzia Bara: High-level negotiations require respect, clarity, and alignment
Fouzia, you are often a negotiator with governments. What is your secret to staying calm when you are across the table from people whose policies might be making your work harder?
It’s true, sometimes I sit across the table from people whose policies are making our work significantly harder. Policies that restrict access to patients and complicate medical care. Policies that, intentionally or not, increase suffering.
But the key to staying calm is remembering one thing: the objective is not to win the argument. The objective is to gain access.
If you enter the room in a confrontational mindset, you’ve already limited your options. A power struggle might feel satisfying in the moment, but it rarely opens humanitarian corridors.
So the first principle is respect. Calm, consistent respect, even when we disagree deeply. Not because we agree, but because maintaining dialogue is essential.
Clarity is equally important. I am transparent about our objectives: access to patients, medical neutrality, impartial care. People distrust what feels hidden or manipulative. When you are clear about your mandate and your boundaries, you reduce suspicion.
Then comes alignment. I try to demonstrate that humanitarian access is not a threat. I emphasize that it can actually serve broader stability. When negotiations show mutual benefit, even minimal common ground, they become less adversarial.
At the same time, calm does not mean weakness. You must know your red lines. There are principles we do not compromise on. We maintain a firm stance on medical ethics, patient confidentiality, and impartiality. Being firm does not require being aggressive.
“Calm does not mean weakness. You must know your red lines,” said Fouzia Bara. “There are principles we do not compromise on.”
And finally, atmosphere matters more than people think. Tone, posture, and even a simple smile can lower defensiveness. When the room feels less tense, solutions become possible. Diplomacy is often about managing emotion as much as policy.
In the end, most negotiations improve when people truly listen to each other. Across political differences, there are still human beings in the room. If you can reach that level, professional, respectful, steady, you create space for agreement.
What is the hardest “no” you have ever had to say in the field?
I don’t have in mind a hard no…
The landscape for handling refugees has changed significantly
In 20 years, what has changed the most about how we handle refugee flows, and is it for the better or the worse?
Borders have become increasingly securitized. Surveillance technologies have expanded. Physical barriers have multiplied. But beyond that, we’ve seen the externalization of migration control, where responsibility is shifted to transit countries, sometimes in contexts where respect for human rights is fragile or inconsistent. The practical result is that people are often stopped farther away from public visibility, but not necessarily safer.
Another major change is the narrative. Migration has increasingly been framed as a threat, economic, cultural, demographic, and even civilizational. Refugees and migrants are sometimes portrayed as destabilizing forces rather than individuals fleeing conflict, persecution, or extreme hardship. Fear has become a political tool. In some contexts, migration is used strategically in electoral campaigns to mobilize public anxiety and polarize debate.
What has also changed is the growing criminalization of humanitarian actors. Organizations and individuals assisting, rescuing at sea, providing medical care, and shelter, have at times been accused of facilitating irregular migration or even enabling trafficking. That shift has created an environment where offering humanitarian aid can become legally and politically contested.
Is it for the better or worse, Fouzia Bara?
From an operational perspective, coordination mechanisms and data systems have improved. Early warning systems are more sophisticated. But ethically and politically, the space for humanitarian action has narrowed in many contexts.
The challenge today is not only responding to displacement but defending the principles of protection itself. Migration has always existed. What has changed most profoundly is how we choose to interpret it. And that choice shapes policy, public perception, and ultimately, human lives.
You have a Master’s in Social Sciences and a healthcare degree. If you could add one “survival skill” to the university curriculum for future aid workers that isn’t currently there, what would it be?
Managing Moral Distress Under Operational Constraints: How to live with impossible decisions without losing your ethical compass.
Fouzia, what is the one item you never travel to a conflict zone without?
An updated contact list
If you had to summarize the “truth” of the humanitarian sector in one sentence for our readers, what would it be?
“Stay human, stay professional.”