To the onlooker, a humanitarian response probably implies an act of charity; an action predicated on goodwill, inspired by altruism and not automatically associated with fi nancial reward. Something not necessarily carried about by ‘professionals’. But those who are recipients of a humanitarian response may be (should be?) expecting a certain minimum level of skill and training from the humanitarian actors and an accountability to them for their actions. Something necessarily carried out by ‘professionals’. This apparent dichotomy can be best explored through the medical lens, where treating the sick and wounded in austere and hostile environments will be seen as a ‘good’ thing to do, but to do so when unprepared, unqualifi ed, unskilled, unregistered and unaccountable will be seen as a ‘bad’ thing to do. That the two have been shown to run side by side in the same mission serves to show the importance of establishing which has the ethical supremacy. ‘Any help may be better than no help’ may be acceptable in some circumstances but not for surgery. And if not for surgery, why not for other activities normally carried out by ‘professionals’?