CHALLENGE: South Africa has many socioeconomic problems. With 150 000 registered NGOs all asking for help, how do you get a nation caught up in their own problems to help a global organisation like MSF?

PRIMARY OBJECTIVE: Raise awareness of MSF's humanitarian work amongst middle-class South Africans with disposable income. SECONDARY OBJECTIVE: Mobilise South Africans to donate to MSF’s global causes – essentially speaking to new donors.

STRATEGY: Create strong PR content with an idea that has the biggest impact for a small amount of money. Insight: The 'tough' decisions made by online South Africans pale in comparison to the life-and-death decisions MSF fieldworkers face every day. Idea: Use the existing #ToughDecisions hashtag to launch a social media campaign dramatising our insight and asking for help.

EXECUTION: #ToughDecision tweets from two local celebrities were responded to directly with hard-hitting clips to start a conversation with their followers. Next, MSF doctors shared their real-life #ToughDecisions online. The media took notice – TV, radio and press clips soon followed.

A #ToughDecisions launch event featuring MSF ambassadors and celebrities was well received by the media and public. Then Ebola happened and the campaign was urgently adapted – MSF doctors shared their Ebola #ToughDecisions at a large press conference.

Every #ToughDecision interaction drove people to the microsite to donate.

OUTCOME: With no money to spend on media, we used social media as the primary driver of interaction, which led to free PR worth R3 415 271 (from 22 September - 31 December 2014).

It shifted public perspective and influenced people to make the ‘easy’ decision to donate or become regular donors to this good cause.

#ToughDecision Tweets from two South African celebrities were responded to directly with hard-hitting clips to start a conversation with their followers. The clips played online and on TV. We also replied directly to existing #ToughDecision Tweets with our push to donate. Next, MSF doctors shared their real-life #ToughDecisions on Twitter, Facebook and with blog posts on the MSF SA web page. The media took notice and the campaign developed a life of its own – TV and radio interviews focusing on MSF #ToughDecisions soon followed. Ebola happened and the campaign was urgently adapted – MSF doctors shared their Ebola #ToughDecisions at a press conference and online. Every interaction drove people to the microsite to donate. PR exposure skyrocketed. The campaign ran from 22 September - 31 December 2014.

IN THREE MONTHS: 1) The MSF SA Facebook page grew by 36% (12 times the benchmark of 3%). 2) MSF was mentioned every 78 seconds. 3) Even though the primary campaign focus was generating awareness, online donations went up by 160,19% (compared to the same period the previous year). 4) From a modest investment of R150 000 for campaign production, the total value of earned media was R3 415 271. (A 2167% return on investment.)

#ToughDecisions also built a lasting platform for MSF SA – something they can leverage in the event of any crisis. EG: Ebola.