MÉDECINS SANS FRONTIÈRES (MSF)
RESPONDING TO EMERGENCIES
Belet-Weyne Hospital (Somalia): through local staff, MSF is still providing
secondary health care, including emergency surgery in a town of 60,000
Médecins Sans Frontières (www.msf.org) is an international, non-profit organization created in 1971, and currently represented by nineteen sections worldwide, including five operational centres. MSF’s charter puts medical action at the centre of its operations, responding to the needs of populations in distress, victims of natural or man-made disasters, and victims of conflicts. MSF adheres to the humanitarian principles of neutrality, impartiality and independence. The organization is currently operating medical projects in more than seventy countries.
From the onset of its history, MSF has been developing a considerable expertise in responding to medical and humanitarian emergencies. Although outreach strategies are sometimes more appropriate, medical and logistical assistance to existing health facilities and infrastructures remain, whenever possible, the core objective of emergency responses by MSF teams of volunteers. Given the nature of environments where MSF classically operates (war zones, politically unstable areas, outbreaks, displaced populations), the safety of beneficiaries is often one of the most challenging problems to be addressed in emergencies. This can take a number of dimensions, depending on the level where individuals’ safety is threatened.
Access to health care facilities to seek emergency care is often undermined by ongoing wars, either directly or indirectly. Insecurity on the way to hospitals can result incidentally from the fallout of current combats or worse, from the deliberate contempt of humanitarian conventions protecting civilians or wounded combatants. Together with the International Committee of the Red Cross, MSF is one of the few organizations which have both ambitions and resources to access populations during ongoing conflicts.
Ebola haemorrhagic fever in Bundibugyo,
December 07 – January 08
In other circumstances, rampant conflicts involving uncontrolled militias lead to civilian populations chronically being exposed to lawlessness and to utter deprivation, particularly women and children. Offering safe access to care to such victims of protracted conflicts is among the endeavours of MSF. This involves keeping facilities running and offering minimal services, under circumstances where they would naturally fall out of operation by lack of personnel and supplies.
Outside of any particular conflict, underresourced health facilities can be themselves the theatre of unsafe medical practices generating additional disease burden. This can take acute, emergency proportions during outbreaks of cholera or viral haemorrhagic fevers for example. MSF is recognised worldwide for its capacity to respond to such outbreaks within days, bringing expertise in safe patients’ care and sanitation within affected health facilities.
Finally, there are circumstances whereby the personal safety of MSF volunteers themselves can no longer be guaranteed, as a result of the intensity of ongoing conflict or the targeting of humanitarian actors, regardless of their neutrality and impartiality. In Somalia, MSF teams of regional and international expatriates have recently been compelled to withdraw from permanent field presence due to escalating insecurity. Skilled MSF national staff members keep operating MSF facilities on the ground. Organised from Nairobi by coordination team members, flash visits, programme monitoring, and comprehensive trainings allow quality of care to be maintained from a distance.