Doctors Without Borders

Doctors Without Borders/Medecins Sans Frontieres (MSF) is an international medical humanitarian organization that assists people whose survival is threatened by violence, neglect, or catastrophe. Its mission is to provide medical relief to the victims of war, disease, and natural or man-made disaster, without regard to race, religion, or political affiliation. The organization's work is based on the humanitarian principles of medical ethics and impartiality. MSF does not take sides in armed conflicts, provides assistance on the basis of need alone, and advocates for independent access to victims of conflict and other disasters.
Mar 19, 2014

An Innovative Project in Mali

MSF’s innovative program in the Sikasso region of Mali seeks to prevent and treat illness and malnutrition among children with the ultimate goal of reducing child mortality. The project was launched in 2009 in collaboration with the Malian Ministry of Health and will be run by MSF through 2017. It aims to simultaneously build the capacity of the local health system while providing high quality services.

The program has a major nutritional component in which most malnourished children can be treated as outpatients at the public health centers. The program uses weekly outpatient visits to monitor patient progress and a take-home nutritional product called therapeutic ready-to-use food (RUF), a peanut butter-like paste made with milk and other important nutrients. Severely malnourished children who have complications, such as severe malaria or measles, continue to be referred to Koutiala hospital’s inpatient feeding center. But with the outpatient approach, the majority of children can be treated at home with their families

At the project in the Konséguéla health zone, in addition to services described above, MSF provides extensive preventative care soon after birth. These comprehensive early intervention activities are structured to give children living in this remote area a better chance at survival.  

Begun as a pilot project in 2010, healthy children up to age two are examined frequently at scheduled “well baby check-ups” and their growth is closely monitored. These children also receive ready-to-use food supplements to prevent malnutrition and insecticide-treated mosquito nets to help prevent malaria transmission. MSF trains lay community members from each of the 17 villages in the area to test for and treat simple malaria, and to vaccinate infants according to the approved vaccination calendar in Mali. Because pneumonia follows malaria as the second leading killer of children in Mali, all children are being vaccinated with PCV, a pneumococcal vaccine. Children with malnutrition or more serious cases of malaria and other illnesses are referred to the health centers for follow-up care. The family participation rate in this program is 95 percent and more than 5,600 children have completed it. The project’s success is clear: only five percent of children have an episode of severe acute malnutrition per year and 97 percent of children have received their vaccinations. Furthermore, results indicate that stunting was reduced by 34% at 2 years of age.

Jan 29, 2014

CAR: "The Violence is Relentless" in Bangui

CAR 2014  Raphael Piret/MSF
CAR 2014 Raphael Piret/MSF

Bangui, the capital of the Central African Republic, has been convulsed by violence for weeks, but most of the city’s hospitals are no longer functioning. Doctors Without Borders/Médecins Sans Frontières (MSF) runs the only trauma unit in the city, at Community Hospital, where staff have treated more than 800 patients—most with bullet or knife wounds—since fighting broke out in early December. Here, project coordinator Jessie Gaffric, who manages MSF’s operations at Community, describes the situation:

“Last November, we had already identified a significant need for surgical care and had begun working [at Community] on December 2. No one suspected then that the situation would explode three days later.

“That day, we received 120 wounded patients and another 60 the following day. We were submerged. We had to manage the situation under extremely difficult conditions. It was chaos. Because the hospital did not have enough room, we set up tents next to the building to house patients who needed post-operative care. Over time and as the emergency continued, we improved the patient pathway, management of the emergency department and the quality of care.”

“On January 11, following the resignation of former president Mr. Djotodia, we received more than fifty patients referred by other MSF health centers located in Bangui or in IDP camps in the town.

“One man came by ambulance. He had been shot in the foot and tried to treat his injury himself. The infection was so severe that his foot had to be amputated. Another had had a motorcycle accident. A third had knife wounds. Patients stream in every day and every case is different. On average, 20 wounded people come to the hospital every day, with the flow peaking on certain days.

“Our primary challenges have to do with insecurity and time management, specifically because we must leave the hospital no later 6 pm, when curfew begins. Nine expatriates and approximately 50 Central African staff work in this facility. Of those, some are living in the displaced persons camps. They cannot come to work when fighting occurs or must even stay and sleep in the hospital. What is also striking is the severity of the wounds, whether from a knife or machete. They attest to the level of violence and its relentlessness.”

MSF has managed both of the Community Hospital’s two operating rooms until now. The International Committee of the Red Cross (ICRC) recently took over one of them. Ultimately, the ICRC is expected to assume responsibility for the entire surgical department and MSF is preparing to work in another hospital in the city.

Bangui, the capital of the Central African Republic, has been convulsed by violence for weeks, but most of the city’s hospitals are no longer functioning. Doctors Without Borders/Médecins Sans Frontières (MSF) runs the only trauma unit in the city, at Community Hospital, where staff have treated more than 800 patients—most with bullet or knife wounds—since fighting broke out in early December. Here, project coordinator Jessie Gaffric, who manages MSF’s operations at Community, describes the situation:

“Last November, we had already identified a significant need for surgical care and had begun working [at Community] on December 2. No one suspected then that the situation would explode three days later.

“That day, we received 120 wounded patients and another 60 the following day. We were submerged. We had to manage the situation under extremely difficult conditions. It was chaos. Because the hospital did not have enough room, we set up tents next to the building to house patients who needed post-operative care. Over time and as the emergency continued, we improved the patient pathway, management of the emergency department and the quality of care.”

“On January 11, following the resignation of former president Mr. Djotodia, we received more than fifty patients referred by other MSF health centers located in Bangui or in IDP camps in the town.

“One man came by ambulance. He had been shot in the foot and tried to treat his injury himself. The infection was so severe that his foot had to be amputated. Another had had a motorcycle accident. A third had knife wounds. Patients stream in every day and every case is different. On average, 20 wounded people come to the hospital every day, with the flow peaking on certain days.

“Our primary challenges have to do with insecurity and time management, specifically because we must leave the hospital no later 6 pm, when curfew begins. Nine expatriates and approximately 50 Central African staff work in this facility. Of those, some are living in the displaced persons camps. They cannot come to work when fighting occurs or must even stay and sleep in the hospital. What is also striking is the severity of the wounds, whether from a knife or machete. They attest to the level of violence and its relentlessness.”

MSF has managed both of the Community Hospital’s two operating rooms until now. The International Committee of the Red Cross (ICRC) recently took over one of them. Ultimately, the ICRC is expected to assume responsibility for the entire surgical department and MSF is preparing to work in another hospital in the city.

- See more at: http://www.doctorswithoutborders.org/news/article.cfm?id=7268&cat=voice-from-the-field#sthash.65TT61ZG.dpuf
Dec 31, 2013

"This Hospital Is A Blessing"

Philippines 2013  Florian Lems/MSF
Philippines 2013 Florian Lems/MSF

Thank you so much for your support of our programs in the Philippines in the wake of Typhoon Haiyan.  With your help, we were able to reach our funding goal!  Below you'll find our final report from the field about the medical treatment that our teams have been able to provide with help from donors like you.

Should wish to support our work in the future, please consider giving to our Emergency Relief Fund (http://www.globalgiving.org/projects/doctors-without-borders-emergency-relief-fund/), which allows our teams to react whenever the next disaster strikes.

Thank you again for your extraordinary contribution.

A Doctors Without Borders/Médecins Sans Frontières (MSF) tent hospital set up in Guiuan in the aftermath of Typhoon Haiyan is currently the largest medical facility in this devastated region of eastern Samar Island. Ten-year-old Ayron was the first child to undergo surgery in the hospital’s inflatable operating theater.

"When Ayron was a little boy of three, he fell from a bridge and his leg got stuck between some wooden planks," says Ruby Sanchez Abendaño, Ayron’s aunt. "Ever since then he has had problems with his left leg."

Abendaño sits outside the inflatable operating theater with Ayron's father, a shy rickshaw driver, who is nervously waiting for his son to come out of surgery. While they wait, Abendaño tells her nephew’s story.

"We were always worried he would lose his leg," she remembers. When Ayron was five, his left thigh started to swell. His parents travelled with him to the Philippine island of Mindoro to see an orthopedic doctor.

"The doctor advised amputation," says Abendaño, "but Ayron’s parents couldn’t afford it, so they went back home." After some time, Ayron’s leg became infected and developed abscesses. Ayron was unable to walk, so his father carried the boy around on his back. "The child was suffering so much," says Abendaño. "He was given antiobiotics, but his leg only got worse and worse."

"Then the typhoon came and destroyed our houses," says Abendaño. The two families, who lived next to door to each other in a small town on the coast of Samar island, sought shelter in a neighbor’s house.

They survived the storm without injury, but, Abendaño says, "The storm took our livelihoods away. We relied on processing coconuts, but now most of the palm trees are destroyed. If we plant new trees now, it will take ten years before we can harvest them."

After the storm subsided, Ayron’s family brought him to Guiuan to have his leg checked by one of MSF’s doctors, who are providing free medical care in the tented hospital there, as well as in a number of rural health centers in the surrounding area. Ayron was admitted immediately.

"The doctor said that he would have to undergo surgery, but that there is no need for an amputation," says Ruby. "We told the doctor we had no money to pay for an operation, but she told us she didn’t need our money. We were so happy."

Three weeks later, after receiving supplementary therapeutic food to build up his strength, Ayron went into surgery. The team working in MSF’s inflatable operating theater is filling the gap left by the destruction of the district hospital which had been the only health facility in the region offering surgical treatment.

Ayron’s operation was a success. Rowena Evangelista, a Filipino surgeon working with the MSF team in Guiuan, says Ayron has a good chance of recovery and will probably be able to walk again—but it will take time.

"He suffered from chronic osteomyelitis, which is an infection of the thigh bone. It was probably caused by a viral infection when he was five, rather than his fall from a bridge," she says. "He will have to stay with us in hospital for at least six weeks to recover, he’ll need to take antibiotics and we will give him more therapeutic food to keep him strong. Finally, Ayron will have to learn to walk again." This is not going to be easy. "He will need special shoes, as his left leg is some centimetres longer than his right leg."

Ayron and his family are prepared for the challenge, says his aunt. "We thought he would lose his leg, but now it has been saved," she says. "The typhoon was a disaster, but this hospital is a blessing."

"In total, five municipalities or 110,000 people depended on this hospital before the storm," says Anne Khoudiacoff, who coordinates MSF's medical activities in Guiuan. "It had a very good reputation, and parts of it had actually just been renewed. The next hospital for referrals is in Tacloban, which is three hours [away] by road and has also been devastated.

"Therefore, we decided to set up a temporary hospital in Guiuan. We started with only a few beds, now we have 60 beds and up to 100 admissions per week. During the first week we carried out six Caesarean sections and surgeries for seven other patients." 

MSF is providing medical and humanitarian assistance on three islands that were battered by the typhoon. MSF supports hospitals in Tacloban and Burauen (on Leyte Island), Balasan (on Panay Island), and Guiuan (on Samar Island) with the aim of helping to restore normal medical services as quickly as possible. The support includes repairing damaged buildings; providing medical supplies, drugs and staff; and setting up an ambulance service. 

 

A Doctors Without Borders/Médecins Sans Frontières (MSF) tent hospital set up in Guiuan in the aftermath of Typhoon Haiyan is currently the largest medical facility in this devastated region of eastern Samar Island. Ten-year-old Ayron Sanchez was the first child to undergo surgery in the hospital’s inflatable operating theater.

"When Ayron was a little boy of three, he fell from a bridge and his leg got stuck between some wooden planks," says Ruby Sanchez Abendaño, Ayron’s aunt. "Ever since then he has had problems with his left leg."

Abendaño sits outside the inflatable operating theater with Ayron's father, a shy rickshaw driver, who is nervously waiting for his son to come out of surgery. While they wait, Abendaño tells her nephew’s story.

"We were always worried he would lose his leg," she remembers. When Ayron was five, his left thigh started to swell. His parents travelled with him to the Philippine island of Mindoro to see an orthopedic doctor.

"The doctor advised amputation," says Abendaño, "but Ayron’s parents couldn’t afford it, so they went back home." After some time, Ayron’s leg became infected and developed abscesses. Ayron was unable to walk, so his father carried the boy around on his back. "The child was suffering so much," says Abendaño. "He was given antiobiotics, but his leg only got worse and worse."

"Then the typhoon came and destroyed our houses," says Abendaño. The two families, who lived next to door to each other in a small town on the coast of Samar island, sought shelter in a neighbor’s house.

They survived the storm without injury, but, Abendaño says, "The storm took our livelihoods away. We relied on processing coconuts, but now most of the palm trees are destroyed. If we plant new trees now, it will take ten years before we can harvest them."

After the storm subsided, Ayron’s family brought him to Guiuan to have his leg checked by one of MSF’s doctors, who are providing free medical care in the tented hospital there, as well as in a number of rural health centers in the surrounding area. Ayron was admitted immediately.

"The doctor said that he would have to undergo surgery, but that there is no need for an amputation," says Ruby. "We told the doctor we had no money to pay for an operation, but she told us she didn’t need our money. We were so happy."

Three weeks later, after receiving supplementary therapeutic food to build up his strength, Ayron went into surgery. The team working in MSF’s inflatable operating theater is filling the gap left by the destruction of the district hospital which had been the only health facility in the region offering surgical treatment.

Ayron’s operation was a success. Rowena Evangelista, a Filipino surgeon working with the MSF team in Guiuan, says Ayron has a good chance of recovery and will probably be able to walk again—but it will take time.

"He suffered from chronic osteomyelitis, which is an infection of the thigh bone. It was probably caused by a viral infection when he was five, rather than his fall from a bridge," she says. "He will have to stay with us in hospital for at least six weeks to recover, he’ll need to take antibiotics and we will give him more therapeutic food to keep him strong. Finally, Ayron will have to learn to walk again." This is not going to be easy. "He will need special shoes, as his left leg is some centimetres longer than his right leg."

Ayron and his family are prepared for the challenge, says his aunt. "We thought he would lose his leg, but now it has been saved," she says. "The typhoon was a disaster, but this hospital is a blessing."

"In total, five municipalities or 110,000 people depended on this hospital before the storm," says Anne Khoudiacoff, who coordinates MSF's medical activities in Guiuan. "It had a very good reputation, and parts of it had actually just been renewed. The next hospital for referrals is in Tacloban, which is three hours [away] by road and has also been devastated.

"Therefore, we decided to set up a temporary hospital in Guiuan. We started with only a few beds, now we have 60 beds and up to 100 admissions per week. During the first week we carried out six Caesarean sections and surgeries for seven other patients." 

MSF is providing medical and humanitarian assistance on three islands that were battered by the typhoon. MSF supports hospitals in Tacloban and Burauen (on Leyte Island), Balasan (on Panay Island), and Guiuan (on Samar Island) with the aim of helping to restore normal medical services as quickly as possible. The support includes repairing damaged buildings; providing medical supplies, drugs and staff; and setting up an ambulance service. 

- See more at: http://www.doctorswithoutborders.org/news/article.cfm?id=7233&cat=field-news#sthash.RZgN5Ojm.dpuf
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