Internal membership democracy and motions for change : The case of the Medécins Sans Frontières Association

Abstract: The world is changing and humanitarian organisations need to be equipped to change with it. This case study has examined the internal democracy within the association of Medécins Sans Frontières (MSF), the creation of social capital and how it can be used to create bottom-up medical organisational change though motions. The selection of 6 motions was made to investigate if they have created the change they intended to create. The aim of this study is to test the hypothesis that members have the power to create organisational change and that such changes depend on a high degree of internal membership democracy. Internal democracy is in turn a precondition for the formation of social capital. In total were 12 in depth interviews conducted with members, former and current board members as well as the executive. In addition to this has an analysis of video recoded motion debates and feedback session been analysed along with other relevant internal documentation. The study has found that the association of MSF is founded on democratic principles as a mean to guide and hold the executive responsible and fulfils formal criterion for a democracy. The internal democracy has a series of weaknesses in it, like lack of participation from members and unequal weight of influences of different members and national associations. It is also facing threats of executive manipulation due to weak boards. Despite this the association has created a strong social capital that unfortunately is unevenly distributed among the members and its social capital is at risk of declining. Regarding motions there is a lot of potential in this formal tool of influence, but often it is not the motion itself but what the motion writers and audience do with the information as well as if the executive agrees with the motions that create the intended change. It can be interpreted as if down-top approaches to operational medical organisational change only will be achieved if the “top” agrees to the change. In conclusion, the assumption of this thesis has thus been proven to a certain extent. Members have the power to create organisational change through motions but their ability to do that depends on a high degree of internal democracy but also on informal contacts. Social capital is built in the process in the social networks that each association form individually as well as together with all MSF associations. However it is not necessarily a precondition to organisational change even though it is a product of the existing internal democracy. MSF has the opportunity to strengthen the democratic process and to be better equipped to create organisational change in the future.