Medical humanitarianism, human rights and political advocacy: The case of the Israeli Open Clinic

In the context of neo-liberal retrenchments humanitarian NGOs have become alternative healthcare providers that partially fill the vacuum left by the welfare state’s withdrawal from the provision of services to migrants and other marginalized populations. In many cases they thus help to build legitimacy for the state’s retreat from social responsibilities. Human rights organizations play an important role in advocating for migrants’ rights, but in many cases they represent a legalistic and individualized conceptualization of the right to health that limits their claims for social justice. This paper analyzes the interactions and tensions between the discourses of medical humanitarianism, human rights and political advocacy using the example of an "Open Clinic" run by an Israeli human rights organization as a case-study: In 2007 dramatically increasing patient numbers provoked an intense internal debate concerning the proposal to temporarily close the "Open Clinic" in order to press the government to take action. Based on protocols from internal meetings and parliamentary hearings and in-depth interviews, we have analyzed divergent contextualizations of the Clinic’s closure. These reflect conflicting notions regarding the Clinic’s variegated spectrum of roles – humanitarian, political, legitimizing, symbolic, empowering and organizational – and underlying conceptualizations of migrants’ “deservingness”. Our case-study thus helps to illuminate NGOs’ role in the realm of migrant healthcare and points out options for a possible fruitful relationship between the divergent paradigms of medical humanitarianism, human rights and political advocacy.

► Our case-study on an Israeli "Open Clinic" provides insights into the role of NGOs involved with migrants’ health rights.
► It shows how structures of citizenship and neo-liberalization frame migrants’ “deservingness” and NGOs’ scope of actions.
► It illustrates NGOs’ challenge to negotiate variegated roles – humanitarian, political, legitimizing, symbolic, empowering, organizational.
► It adds to the discussion on tensions between medical humanitarianism, human rights and political advocacy.
► It thus contributes to an analysis of "the right to health" and the shapes it takes in NGOs’ discourses and practices.