longstanding bilateral relationship with Fatah. In Jordan and Iraq, non-state actors' strategies had to be understood in order to negotiate with them to gain access to vulnerable populations without compromising the security of MSF teams. Engaging elites in the Middle East in a constructive debate on the impact that humanitarian medical action can have on their societies is also important. Humanitarian principles need to be explained and demonstrated operationally. However, it is also important to explain to the wider public the reasons behind operational and programming choices. For example, some have questioned MSF's neutrality because it does not have medical activities in Israel. The reality is that MSF does not need to intervene in Israel, where medical needs are already met by a sophisticated healthcare system. This also requires improving our knowledge on how to intervene effectively in urban settings. In fact, Palestinian camps in Lebanon or in the Gaza Strip and IDPs in Northern Iraq are challenging contexts partly due to their urban settings. In 2008, but published in 2011, MSF conducted research on perceptions of the agency in the region. [6] From the research it was clear that, while MSF's identity as a health organisation is recognised and valued, most people were not aware of the high proportion of independent funding MSF has at its disposal. In the Middle East, several criteria are used to judge the effectiveness and coherence of an organisation: its public position towards the conflicts in the region, its sources of funding and its