The Chain of Hope

June 2017. In Mossul, the Iraqi Army and their allies have freed the city from the Isla­mic State’s control. Amongst those who are getting ready to rebuild the battered city, Professor Éric Cheysson. At 66, he is the Head of Vascular Surgery at the Pontoise hospital, and he has dedicated his life to humanitarian medicine.

It all started when he was a young intern. Éric met Bernard Kouch­ner, co-founder of Médecins Sans Frontières2 and already famous as the “French Doctor” who started the operation A Ship for Vietnam. It was 1979 and intellectuals such as Simone Signoret, Yves Montand, Jean-Paul Sartre or Raymond Aron had called on the President of France, Valéry Giscard d’Estaing, to save the Sino-Vietnamese who were fleeing the communist regime. Médecins Sans Frontières was authorized to charter a boat: L’Île de Lumiere.3 Éric embarked with doctors and journalists. Their goal was not only to save the migrants fleeing by boat;4 they wanted to draw the world’s attention to the ongoing human rights violations in the area. “That first mission was a staggering experience. I was so young. The monsoon, the Khmer Rouge and, in the middle of the South China Sea, all those migrants to save. We went up the Mekong until we reached Phnom Penh.


Following his expedition, Cheys­son co-founded Médecins du Monde in 1980 with Bernard Kouchner and others. Éric became one of the first humanitarian doctors to treat both civilians and Mujahideen groups in Afghanistan, which was at the time suffering from the invasion by the Red Army. He then operated in Cambodia, Chad and Kosovo.

Over the course of his missions, Éric realized that in order to fix bodies, you have to rebuild hospitals and train doctors. “When you have a pathology but no surgery can be performed because you have no operating theater, no resus­citation and no anesthetist, it is the ultimate congenital inequality.” Out of this observation, the organization La Chaîne de l’Espoir was born, launched with Professor Alain Deloche in 1988. Its mission: to heal the poorest of children. Today, 100,000 children are examined each year and 6,000 are ope­rated on, thanks to the organization.

“Initially, we would bring children all the way to France to treat them,” Éric tells us. “We would cover the cost of the operation and volunteer families would host them post-operation.” But in accordance with its goals the NGO now favors local action and is buil­ding hospitals in Asia, Africa and the Middle East.

For instance, in Kabul, La Chaîne de l’Espoir is rebuilding the only hospital respecting Western norms and is trai­ning its staff. “Imagine this: open heart surgery can be performed despite the situation Afghanistan has come to,” the professor shares. “This means access to water and electricity in order to power operating theaters and an intensive care unit.” Thanks to their efforts, a new generation of Afghan surgeons is now operating in Kabul. The main mission of La Chaîne de l’Espoir is to support and train local surgeons throughout their career, to guarantee the quality of healthcare. “The French school of medicine is held in such high regard that it makes all these adventures possible,” according to Éric. “It is a kind of magic touch, the envy of the whole word.” But to guarantee its presence in 35 coun­tries, the NGO has to call upon doc­tors from all of Europe. “By finding candidates willing to join us abroad, we can alleviate our failing medical demo­graphy. We are lacking anesthetists, pediatricians, obstetricians, at a time when we are about to open a maternal care unit in Abidjan.”


For the most high-risk areas, La Chaîne de l’Espoir develops specific programs. “Our doctors might be taken hostage. When we can’t guarantee their security, we use remote digital solutions to train local doctors.” It is especially the case in Africa. “The French Foreign Office, sometimes strongly, advises against travelling to 80 % of African countries. Five years ago, there was no warning against many of them.”

Beyond the security risks, very few NGOs dare to get involved in running a hospital, which is excessively costly. “From the second you turn a hospital’s lights on, it is complicated to turn them off. You need to think about opera­ting costs. Without a proper budget, a hospital doesn’t cure, it kills.” To gua­rantee this balance, Éric supports a “Robin Hood policy” – in other words, making the rich pay. “We have a well-tried concept: to set up right next to the hospital a ward welcoming the poorest of the poor, at no cost to them.” Fun­draising and financial partnerships finance these operations. But these sources have been weakened by the worldwide decline of public fundings. To add insult to injury, “Donald Trump has decided to diminish the budget going to the big agencies.”


Access to surgical care remains however a key marker for the health of millions of people in the 21st century. Éric saw it coming when he launched La Chaîne de l’Espoir.

“We used to focus on pandemics like malaria or AIDS. Fortunately, foun­dations like the Bill & Melinda Gates Foundation have hugely improved the situation.” However, very few organiza­tions or social entrepreneurs have the necessary experience to build, equip and run a hospital. The market belongs de facto to profitable private compa­nies. “China delivers turnkey hospitals, which end up closing fifteen days after their opening due to lack of staff.”

“If you don’t have the adequate human resources, a hospital is a white elephant.” Thus, the colossal work initiated by La Chaîne de l’Espoir remains crucial. “We started as caregivers, but we became builders and trainers. And now, we also employ architects, administrators and engineers.” In an age of upheaval, every single link of the chain matters.


By Fleur Weinberg


1. “The Chain of Hope” in French.

2. “Doctors Without Borders.”

3. “The Island of Light.”

4. After the capture of Saïgon by the People’s Army of Vietnam.