What Doctors Without Borders Really Teaches You About Culture

In the world of global healthcare, few experiences are as profoundly transformative as working with Doctors Without Borders (Médecins Sans Frontières, MSF). For many physicians, the decision to work with MSF begins as a mission to provide care in regions with urgent medical needs—but what unfolds is often a journey rich with unexpected cultural lessons, ethical challenges, and personal revelations.

This article explores what it’s really like to practice medicine across continents, focusing not just on the medical aspect, but on the deep cultural insights that shape every interaction.

The First Lesson: Medicine is Not Universal

Medical training is often rooted in Western standards. But once you step into a field hospital in rural South Sudan, a mobile clinic in Yemen, or a maternity ward in Haiti, you quickly realize: your definition of “standard care” may not apply.

Even common practices—like how to approach end-of-life care or pain management—are filtered through a cultural lens.

• In some cultures, it is the norm not to disclose a terminal diagnosis to the patient.
• In others, families may be involved in medical decisions to an extent that challenges Western ideals of patient autonomy.
• You learn quickly that listening matters more than lecturing, and that building trust begins with respecting local customs.

Cultural Misunderstandings Aren’t Just Inevitable—They’re Inevitable Learning Moments

Consider this scene: you’re treating a child with pneumonia in a remote Afghan village. You reach for oxygen, but the family insists on burning specific herbs beside the child instead. What do you do?

Here’s what MSF doctors learn:

• Don’t dismiss traditions—understand them.
• Engage local health workers to bridge the gap between biomedicine and traditional beliefs.
• Recognize that cultural resistance is not ignorance—it’s often a form of protection based on historical trauma, colonial history, or mistrust of outsiders.

Lesson in Humility: The Local Nurse May Know More Than You

Doctors Without Borders relies heavily on local staff—nurses, midwives, community health workers—who’ve been practicing in that region far longer than any foreign doctor.

Many MSF doctors report a critical shift in mindset:

• You’re not “saving” anyone.
• You’re not “fixing” a broken system.
• You’re joining a pre-existing health ecosystem—and your job is to support, not dominate.

A Belgian physician once recalled that during a cholera outbreak in the DRC, it was a local nurse who anticipated the spread pattern better than any of the Western epidemiologists. Respecting this kind of knowledge is not optional—it’s essential.

When “Informed Consent” Looks Very Different

Another cultural curveball: the concept of informed consent can vary widely.

In Western medicine, patients are expected to sign detailed documents. But in many of the regions MSF serves, oral consent—sometimes given by a village elder or head of household—is standard.

What does this mean for the physician?

• You must balance respect for cultural norms with ethical medical practice.
• Informed consent becomes a dialogue, not a formality.
• The goal is understanding, not legal protection.

This forces you to relearn communication. To explain diagnoses without jargon. To navigate conversations where language barriers and cultural metaphors challenge your assumptions.

Death, Grief, and Spirituality: A Cultural Mosaic

In one West African mission, a doctor was puzzled when the family refused to bury a deceased child until a specific community member arrived to perform a ritual. Delaying burial, in that region, had deep spiritual implications.

This moment reflects a broader truth:

• Grieving processes differ wildly across cultures.
• In some places, open weeping is expected. In others, stoicism is respected.
• Religious rituals may dictate when and how death is acknowledged, and doctors must learn to step back and make space.

These experiences leave doctors not just more empathetic, but more human.

Language: The Most Surprising Barrier

It’s not just about medical terminology. In some languages:

• There is no direct translation for “cancer.”
• Pain is described not as a sensation, but as a metaphor—"like a snake inside me."
• Mental illness may be interpreted as a spiritual disturbance, not a neurological disorder.

MSF doctors rely heavily on interpreters, but they also pick up critical phrases, tones, and non-verbal cues. You learn that a slight pause, a certain gaze, or a gesture may speak volumes.

Cultural Etiquette in the Exam Room

Think about how a typical Western doctor might say:

“Let’s talk about your sexual health.”

In some cultures, that sentence is impossible to say directly—especially if the physician and patient are of opposite genders.

MSF physicians are trained to:

• Work through culturally appropriate intermediaries, like community health educators.
• Be gender-sensitive—sometimes requiring same-gender care providers.
• Understand when eye contact is respectful—and when it’s invasive.

Every moment becomes a negotiation of professionalism and cultural humility.

Moral Dilemmas You Never Trained For

You’re in a country where abortion is illegal, but the patient is bleeding from a failed attempt. What do you do?

You’re in a refugee camp with limited antibiotics—do you give it to the child with higher survival chances or to the one whose family is begging?

Doctors Without Borders staff often face:

• Resource rationing, where they must choose who gets care and who doesn’t.
• Navigating political and religious taboos while trying to save lives.
• Risking personal safety in regions under military siege, where doctors become targets.

These moments define not just your medical judgment, but your moral character.

Culture Shock Doesn’t Just Go One Way

When MSF doctors return to their home countries, many report a kind of reverse culture shock:

• They question the over-medicalization of everything.
• They become more skeptical of hospital bureaucracy and excessive documentation.
• They often feel out of place in a world where patients complain about hospital food while others die from lack of basic supplies.

Their experiences abroad leave them forever changed—not just in how they practice, but in how they view medicine as a social, moral, and cultural act.

Final Takeaway: Medicine is as Cultural as It Is Clinical

Doctors Without Borders is more than a humanitarian organization—it’s a crucible for cross-cultural learning. Physicians who work with MSF walk away with more than stories of hardship. They gain a new vocabulary of empathy, an ability to adapt clinical skills across worldviews, and most importantly, an unshakable belief that dignity in care transcends culture.

So if you’re planning to work internationally, or if you're just curious about what it takes, know this: the hardest part isn’t the medical crisis—it’s the quiet humility it takes to unlearn and relearn everything you thought you knew.