Humanitarian health workers operate in dangerous and uncertain contexts, in which mistakes and failures are common, often have severe consequences, and are regularly repeated, despite being documented by many reviews. This Series paper aims to discuss the failures of medical humanitarianism. We describe why some of these recurrent failings, which are often not identified until much later, seem intractable: they are so entrenched in humanitarian action that they cannot be addressed by simple technical fixes. We argue that relief health-care interventions should be contextualised. Perhaps medical humanitarianism deserves a better reputation than the one at times tarnished by unfair criticism, resulting from inapplicable guiding principles and unrealistic expectations. The present situation is not conducive to radical reforms of humanitarian medicine; complex crises multiply and no political, diplomatic, or military solutions are in sight. Relief agencies have to compete for financial resources that do not increase at the same pace as health needs. Avoiding the repetition of failures requires recognising previous mistakes and addressing them through different policies by donors, stronger documentation and analysis of humanitarian programmes and interventions, increased professionalisation, improved, opportunistic relationships with the media, and better ways of working together with local health stakeholders and through indigenous institutions.

人道主义卫生工作者在危险和不确定的环境中开展工作，尽管经常被错误地记录在案，但错误和失误很常见，经常会造成严重的后果，并经常重复发生。本系列文章旨在讨论医疗人道主义的失败。我们描述了为什么这些反复出现的失败（通常直到很久以后才被发现）似乎是棘手的：它们在人道主义行动中根深蒂固，无法通过简单的技术修复来解决。我们认为救济医疗保健干预措施应根据具体情况而定。也许由于不适用的指导原则和不切实际的期望，医疗人道主义主义应该比有时因不公正的批评而受到损害的人道主义更好。目前的状况不利于人道主义医学的根本改革；复杂的危机激增，看不到政治，外交或军事解决方案。救济机构必须争夺财政资源，而财政资源的增长速度却不能与卫生需求同步。要避免重复失败，就需要认识到先前的错误，并通过捐助者的不同政策来解决这些错误，对人道主义方案和干预措施进行更强有力的记录和分析，提高专业化水平，与媒体建立更好的机会主义关系，并与地方卫生利益相关者和合作方建立更好的合作方式。通过土著机构。