Photo by Laurence Hoenig/MSF
In a Doctors Without Borders/Médecins Sans Frontières (MSF) tent in Garoua-Boulaï District Hospital in Cameroon, MSF nurse Gervais changes the bandages of a patient transferred from the MSF hospital in Bouar, Central African Republic (CAR). MSF supports the hospital in Garoua-Boulaï: in one week, the team provided more than 900 medical consultations. Between December 2013 and January 2014, several hundred thousand people fled abuse and violence in CAR, seeking refuge in Chad and Cameroon. After several months of displacement, the Central Africans who reach Cameroon arrive exhausted and traumatized. Their health status is alarming, particularly in terms of nutrition, with nearly half of the children suffering from malnutrition. “There are still massive deficits in the distribution of aid to the hundreds of thousands who managed to escape the violence and reach Chad or Cameroon,” said Dr. Mego Terzian, MSF’s international president. “The bare minimum that can be done for this population that has suffered incredible violence, lost family members, and been uprooted from their homes, is to provide them with humanitarian assistance.” Read more: http://bit.ly/1std1C2

Photo by Laurence Hoenig/MSF

In a Doctors Without Borders/Médecins Sans Frontières (MSF) tent in Garoua-Boulaï District Hospital in Cameroon, MSF nurse Gervais changes the bandages of a patient transferred from the MSF hospital in Bouar, Central African Republic (CAR). MSF supports the hospital in Garoua-Boulaï: in one week, the team provided more than 900 medical consultations. Between December 2013 and January 2014, several hundred thousand people fled abuse and violence in CAR, seeking refuge in Chad and Cameroon. After several months of displacement, the Central Africans who reach Cameroon arrive exhausted and traumatized. Their health status is alarming, particularly in terms of nutrition, with nearly half of the children suffering from malnutrition. “There are still massive deficits in the distribution of aid to the hundreds of thousands who managed to escape the violence and reach Chad or Cameroon,” said Dr. Mego Terzian, MSF’s international president. “The bare minimum that can be done for this population that has suffered incredible violence, lost family members, and been uprooted from their homes, is to provide them with humanitarian assistance.” Read more: http://bit.ly/1std1C2

Photo by Yann Libessart/MSF
Here, Doctors Without Borders/Médecins Sans Frontières (MSF) staff members provide a medical consultation inside the Muslim camp for internally displaced persons in Carnot Catholic Church in Central African Republic (CAR). Since December 2013, extreme violence in the Central African Republic continues, and frontlines continue to shift with regular clashes between anti-Balaka militias and ex-Séléka rebel groups, as well as criminal elements who act with impunity. Although international forces on the ground are growing in number, they are still unable to secure the protection of the civilian population, in particular the Muslim communities that have either fled or live in a few enclaves under international armed protection. In Carnot, around 900 Muslim internally displaced persons are staying at the Catholic Church in crowded and unsanitary conditions, guarded by African Union soldiers from Cameroon.MSF provides medical care, water and food, and sanitation. MSF has also been running  an HIV/TB project in the area  since 2010 and provides support to three health centers, mainly for conditions such as malaria, respiratory infections, and diarrhea. Read more: http://bit.ly/1std1C2

Photo by Yann Libessart/MSF

Here, Doctors Without Borders/Médecins Sans Frontières (MSF) staff members provide a medical consultation inside the Muslim camp for internally displaced persons in Carnot Catholic Church in Central African Republic (CAR). Since December 2013, extreme violence in the Central African Republic continues, and frontlines continue to shift with regular clashes between anti-Balaka militias and ex-Séléka rebel groups, as well as criminal elements who act with impunity. Although international forces on the ground are growing in number, they are still unable to secure the protection of the civilian population, in particular the Muslim communities that have either fled or live in a few enclaves under international armed protection. In Carnot, around 900 Muslim internally displaced persons are staying at the Catholic Church in crowded and unsanitary conditions, guarded by African Union soldiers from Cameroon.MSF provides medical care, water and food, and sanitation. MSF has also been running  an HIV/TB project in the area  since 2010 and provides support to three health centers, mainly for conditions such as malaria, respiratory infections, and diarrhea. Read more: http://bit.ly/1std1C2

Photo by Sylvain Cherkaoui/Cosmos
In a storehouse in Guéckédou, teams prepare solidarity kits for the families of people who are ill with or have died from Ebola. Mattresses, sheets, towels, mosquito nets and soap are offered to the community to replace what has been destroyed or burned in the patient’s room to avoid contamination. “Apart from the enormous workload, it is extremely challenging both physically and emotionally for our staff,” said  Dr. Hilde de Clerck, MSF doctor. ”Outreach teams often travel long ways to reach affected communities. Many also know the affected families themselves and are witness to heartbreaking moments when people must be taken from their family or community into the treatment center.”

Photo by Sylvain Cherkaoui/Cosmos

In a storehouse in Guéckédou, teams prepare solidarity kits for the families of people who are ill with or have died from Ebola. Mattresses, sheets, towels, mosquito nets and soap are offered to the community to replace what has been destroyed or burned in the patient’s room to avoid contamination. “Apart from the enormous workload, it is extremely challenging both physically and emotionally for our staff,” said  Dr. Hilde de Clerck, MSF doctor. ”Outreach teams often travel long ways to reach affected communities. Many also know the affected families themselves and are witness to heartbreaking moments when people must be taken from their family or community into the treatment center.”

Photo by Joffrey Monnier/MSF
Fatou (name changed) is an Ebola survivor. Her family was the first hit by Ebola in Conakry, the capital of Guinea. She spent two weeks inside the MSF Ebola treatment center before coming out cured and immunized. Fatou doesn’t want to have her face shown, as she fears rejection and discrimination. When she went home after isolation, her backyard, usually full of life, was completely empty. No one dared to go fetch water from the common well. Fatou remained cloistered in her home for several days before daring to come out. Thanks to the support of the MSF psychologists, she slowly learned to live again.
“People say, ‘It’s the Ebola backyard’. Nobody dares to come. Even when kids drop a ball in the backyard, no one comes to get it. When I got out, I learnt that my death had been announced in the students’ journal. I called my friends, they didn’t want to believe it was me, they were saying Fatou is dead. Some call me the living dead. People are very afraid of Ebola.” Today, she works for MSF as a health promoter. She welcomes the families who are coming to visit their sick relatives at the treatment center, but she doesn’t tell her own relatives that she works for MSF.

Photo by Joffrey Monnier/MSF

Fatou (name changed) is an Ebola survivor. Her family was the first hit by Ebola in Conakry, the capital of Guinea. She spent two weeks inside the MSF Ebola treatment center before coming out cured and immunized. Fatou doesn’t want to have her face shown, as she fears rejection and discrimination. When she went home after isolation, her backyard, usually full of life, was completely empty. No one dared to go fetch water from the common well. Fatou remained cloistered in her home for several days before daring to come out. Thanks to the support of the MSF psychologists, she slowly learned to live again.

“People say, ‘It’s the Ebola backyard’. Nobody dares to come. Even when kids drop a ball in the backyard, no one comes to get it. When I got out, I learnt that my death had been announced in the students’ journal. I called my friends, they didn’t want to believe it was me, they were saying Fatou is dead. Some call me the living dead. People are very afraid of Ebola.” Today, she works for MSF as a health promoter. She welcomes the families who are coming to visit their sick relatives at the treatment center, but she doesn’t tell her own relatives that she works for MSF.

Photo by Sylvain Cherkaoui/Cosmos
Gloves and boots are left to dry in the treatment area in Guéckédou, Guinea. After being in the the isolation zone, clothing and boots are disinfected with chlorine. If contracted, Ebola is one of the world’s most deadly diseases. It is a highly infectious virus that can kill up to 90 percent of the people who catch it, causing terror among infected communities. Because Ebola is highly contagious, staff treating patients suffering from the disease must wear protective equipment to prevent transmission.

Photo by Sylvain Cherkaoui/Cosmos

Gloves and boots are left to dry in the treatment area in Guéckédou, Guinea. After being in the the isolation zone, clothing and boots are disinfected with chlorine. If contracted, Ebola is one of the world’s most deadly diseases. It is a highly infectious virus that can kill up to 90 percent of the people who catch it, causing terror among infected communities. Because Ebola is highly contagious, staff treating patients suffering from the disease must wear protective equipment to prevent transmission.

Photo by Joffrey Monnier/MSF
Jannette is the first pregnant woman known to have survived Ebola in Guéckédou, Guinea, during the current outbreak. She arrived seven months pregnant with her sixth child at the Doctors Without Borders/Médecins Sans Frontières (MSF) Ebola treatment center in Guéckédou. Her prognosis was not good. Up until then, no pregnant woman had survived Ebola, but Jannette slowly started to recover.
After a few days her baby stopped moving. Medical staff confirmed the fetus was dead. A blood test showed that Jannette was cured and was testing Ebola-negative, but there was a risk that the baby might have been infected. Luckily, there was an obstetrician in the MSF medical team. She tested the amniotic fluid, and the results showed Ebola-positive. Jannette was cured, but her stillborn baby was still contagious.
Considering the risks of contagion linked to an unprotected delivery, the medical team had no choice but to proceed with the delivery inside the Ebola isolation structure. Jannette survived and went on to make a full recovery. Today she is cured and regularly comes to visit the medical team at the Ebola treatment center. Her village, Houdouni, suffered heavy losses due to the disease. Of the 110 official residents, 23 died of Ebola and only five, including Jannette, survived.

Photo by Joffrey Monnier/MSF

Jannette is the first pregnant woman known to have survived Ebola in Guéckédou, Guinea, during the current outbreak. She arrived seven months pregnant with her sixth child at the Doctors Without Borders/Médecins Sans Frontières (MSF) Ebola treatment center in Guéckédou. Her prognosis was not good. Up until then, no pregnant woman had survived Ebola, but Jannette slowly started to recover.

After a few days her baby stopped moving. Medical staff confirmed the fetus was dead. A blood test showed that Jannette was cured and was testing Ebola-negative, but there was a risk that the baby might have been infected. Luckily, there was an obstetrician in the MSF medical team. She tested the amniotic fluid, and the results showed Ebola-positive. Jannette was cured, but her stillborn baby was still contagious.

Considering the risks of contagion linked to an unprotected delivery, the medical team had no choice but to proceed with the delivery inside the Ebola isolation structure. Jannette survived and went on to make a full recovery. Today she is cured and regularly comes to visit the medical team at the Ebola treatment center. Her village, Houdouni, suffered heavy losses due to the disease. Of the 110 official residents, 23 died of Ebola and only five, including Jannette, survived.

Photo by Michael Goldfarb/MSF
A stretcher looted from the  Doctors Without Borders/Médecins Sans Frontières (MSF) hospital in Leer, South Sudan, lies on the edge of the town’s former airstrip, marked by fresh tank tracks. ”The conflict has at times seen horrific levels of violence, including against healthcare facilities,” said Raphael Gorgeu, MSF head of mission. “Patients have been shot in their beds and lifesaving medical facilities have been burned and effectively destroyed. These attacks have far-reaching consequences for hundreds of thousands of people who are cut off from medical services.” MSF’s hospital in Leer was destroyed along with most of the town in late January and early February. In May, MSF resumed some activities as people started to return to Leer. Staff members treated more than 1,600 children for malnutrition in the first three weeks alone. However, MSF is unable to provide anything like its previous services, including routine vaccinations and emergency surgery.

Photo by Michael Goldfarb/MSF

A stretcher looted from the  Doctors Without Borders/Médecins Sans Frontières (MSF) hospital in Leer, South Sudan, lies on the edge of the town’s former airstrip, marked by fresh tank tracks. ”The conflict has at times seen horrific levels of violence, including against healthcare facilities,” said Raphael Gorgeu, MSF head of mission. “Patients have been shot in their beds and lifesaving medical facilities have been burned and effectively destroyed. These attacks have far-reaching consequences for hundreds of thousands of people who are cut off from medical services.” MSF’s hospital in Leer was destroyed along with most of the town in late January and early February. In May, MSF resumed some activities as people started to return to Leer. Staff members treated more than 1,600 children for malnutrition in the first three weeks alone. However, MSF is unable to provide anything like its previous services, including routine vaccinations and emergency surgery.

Photo by Michael Goldfarb/MSF
The operating theater in  Doctors Without Borders’/Médecins Sans Frontières’ (MSF) hospital in the town of Leer in Unity State, South Sudan, was destroyed and ransacked.  Since armed conflict erupted in South Sudan in December, at least 58 people have been killed on hospital grounds, and hospitals have been ransacked or burned on at least six occasions. The hospital in Leer was the only facility providing secondary healthcare, including surgery and treatment for HIV and tuberculosis, in an area with approximately 270,000 people.

Photo by Michael Goldfarb/MSF

The operating theater in  Doctors Without Borders’/Médecins Sans Frontières’ (MSF) hospital in the town of Leer in Unity State, South Sudan, was destroyed and ransacked.  Since armed conflict erupted in South Sudan in December, at least 58 people have been killed on hospital grounds, and hospitals have been ransacked or burned on at least six occasions. The hospital in Leer was the only facility providing secondary healthcare, including surgery and treatment for HIV and tuberculosis, in an area with approximately 270,000 people.

Photo by Michael Goldfarb/MSF
This is the burned front gate of the Doctors Without Borders/Médecins Sans Frontières (MSF) hospital in the town of Leer, South Sudan as of February 2014. The hospital was thoroughly looted, burned, ransacked, and effectively destroyed, along with most of Leer, sometime between the final days of January and early February 2014, leaving hundreds of thousands of people cut off from critical, lifesaving medical care. The hospital, opened by MSF 25 years ago, was the only secondary health care facility in Unity State, South Sudan. Hospitals have been ransacked in the towns of Bor, Malakal, Bentiu, Nasir and Leer, often during periods of heavy fighting. The damage goes far beyond the acts of violence themselves as vulnerable people are cut off from healthcare when they desperately need it.

Photo by Michael Goldfarb/MSF

This is the burned front gate of the Doctors Without Borders/Médecins Sans Frontières (MSF) hospital in the town of Leer, South Sudan as of February 2014. The hospital was thoroughly looted, burned, ransacked, and effectively destroyed, along with most of Leer, sometime between the final days of January and early February 2014, leaving hundreds of thousands of people cut off from critical, lifesaving medical care. The hospital, opened by MSF 25 years ago, was the only secondary health care facility in Unity State, South Sudan. Hospitals have been ransacked in the towns of Bor, Malakal, Bentiu, Nasir and Leer, often during periods of heavy fighting. The damage goes far beyond the acts of violence themselves as vulnerable people are cut off from healthcare when they desperately need it.

Medical care has come under fire in South Sudan. Over 6 months, at least 58 people were killed on hospital grounds, including 25 patients and at least 2 Ministry of Health staff. Ambulances, medical equipment and hospitals were burned, looted, and destroyed. And hundreds of thousands of people have been cut off from health care. 

Medical care has come under fire in South Sudan. Over 6 months, at least 58 people were killed on hospital grounds, including 25 patients and at least 2 Ministry of Health staff. Ambulances, medical equipment and hospitals were burned, looted, and destroyed. And hundreds of thousands of people have been cut off from health care. 

Photo by Samantha Maurin/MSF
Refugees pose for a photo in the Clément center in N’Djamena, the capital of Chad. Six hundred Central African refugees are living in this transit center constructed by the government of Chad in order to accommodate the 15,000 people who were evacuated from Bangui, Central African Republic (CAR), by air. Doctors Without Borders/Médecins Sans Frontières (MSF) conducts medical consultations in each of the eight sites hosting the CAR refugees in N’Djamena. MSF’s mobile teams found many patients in need of basic health care, as well as several serious post-op cases that required follow-up. There is an increasing need of water and sanitation provision, which MSF teams are supporting. MSF has also set up operations in the south of Chad, in Bitoye and Sido, where an additional 25,000 refugees have arrived from CAR.

Photo by Samantha Maurin/MSF

Refugees pose for a photo in the Clément center in N’Djamena, the capital of Chad. Six hundred Central African refugees are living in this transit center constructed by the government of Chad in order to accommodate the 15,000 people who were evacuated from Bangui, Central African Republic (CAR), by air. Doctors Without Borders/Médecins Sans Frontières (MSF) conducts medical consultations in each of the eight sites hosting the CAR refugees in N’Djamena. MSF’s mobile teams found many patients in need of basic health care, as well as several serious post-op cases that required follow-up. There is an increasing need of water and sanitation provision, which MSF teams are supporting. MSF has also set up operations in the south of Chad, in Bitoye and Sido, where an additional 25,000 refugees have arrived from CAR.

Photo by Mario Travaini
“I was the only midwife on the day Sedra’s mother came to MSF’s hospital in Syria,” says Amanda Godballe, a Danish midwife for MSF. “She was only six months pregnant, but the delivery had already begun. She was expecting her first children – two twin girls. There was no way to stop the delivery as it was already too far along. In our hospital we had very limited possibilities of taking care of premature babies. We had no pediatricians, incubators, or medicine to treat babies this premature. And as I was the only midwife at the hospital that day I had to do some creative thinking, especially because I knew that the children were likely to need resuscitation to stabilize them enough to be transferred to a more fully equipped hospital over the border, where treatment was possible.”
“I got my Belgian co-worker and nurse to help me in the delivery room, although she had never assisted with a delivery before. But inexperienced hands are better than no hands! At the same time I had my good Syrian colleague to help me and also an interpreter.” 
“Both children were quickly born. First Sedra – bottom first – and then her sister – also with her bottom first. They each weighed about 1,200 grams. Sedra was reasonably well stabilized with the help of an oxygen mask and an electric radiator to keep her warm. Unfortunately, her sister did not do as well. She died only 30 minutes old. Sedra was transferred to the border, in one of MSF’s ambulances, along with her mother. And there I was, in the backseat of an ambulance with a teeny tiny vulnerable human being, who had so many odds stacked against her. At the border we had to wait, and when the medics finally came I had to hand them the small bundle across the barbed wire fence, drive back to our makeshift hospital, and hope for the best.”

Photo by Mario Travaini

“I was the only midwife on the day Sedra’s mother came to MSF’s hospital in Syria,” says Amanda Godballe, a Danish midwife for MSF. “She was only six months pregnant, but the delivery had already begun. She was expecting her first children – two twin girls. There was no way to stop the delivery as it was already too far along. In our hospital we had very limited possibilities of taking care of premature babies. We had no pediatricians, incubators, or medicine to treat babies this premature. And as I was the only midwife at the hospital that day I had to do some creative thinking, especially because I knew that the children were likely to need resuscitation to stabilize them enough to be transferred to a more fully equipped hospital over the border, where treatment was possible.”

“I got my Belgian co-worker and nurse to help me in the delivery room, although she had never assisted with a delivery before. But inexperienced hands are better than no hands! At the same time I had my good Syrian colleague to help me and also an interpreter.” 

“Both children were quickly born. First Sedra – bottom first – and then her sister – also with her bottom first. They each weighed about 1,200 grams. Sedra was reasonably well stabilized with the help of an oxygen mask and an electric radiator to keep her warm. Unfortunately, her sister did not do as well. She died only 30 minutes old. Sedra was transferred to the border, in one of MSF’s ambulances, along with her mother. And there I was, in the backseat of an ambulance with a teeny tiny vulnerable human being, who had so many odds stacked against her. At the border we had to wait, and when the medics finally came I had to hand them the small bundle across the barbed wire fence, drive back to our makeshift hospital, and hope for the best.”

Photo by Sylvain Cherkaoui/Cosmos.
Sia Bintou spent more than 10 days in MSF’s Ebola treatment center in Guéckédou, Guinea. There were many times when the medical team thought she would not make it, but Bintou beat the disease. Here, staff congratulate her as she is discharged. Right now, Ebola patients have been identified in more than 60 locations in Guinea, Sierra Leone, and Liberia. MSF is the only aid organization treating people affected by the virus.

Photo by Sylvain Cherkaoui/Cosmos.

Sia Bintou spent more than 10 days in MSF’s Ebola treatment center in Guéckédou, Guinea. There were many times when the medical team thought she would not make it, but Bintou beat the disease. Here, staff congratulate her as she is discharged. Right now, Ebola patients have been identified in more than 60 locations in Guinea, Sierra Leone, and Liberia. MSF is the only aid organization treating people affected by the virus.

Photo by Sylvain Cherkaoui/Cosmos.
Teams at the treatment center at Donka hospital, in Conakry, Guinea, work through the night and 24/7. Since the outbreak in West Africa began in March, MSF has treated 470 patients—215 of them confirmed cases—in specialized treatment centers in Guinea, Sierra Leone and Liberia. The scale of this Ebola epidemic is unprecedented in terms of geographical distribution and the numbers of cases and deaths. There have been 528 cases and 337 deaths since the epidemic began, according to the latest World Health Organization (WHO) figures.

Photo by Sylvain Cherkaoui/Cosmos.

Teams at the treatment center at Donka hospital, in Conakry, Guinea, work through the night and 24/7. Since the outbreak in West Africa began in March, MSF has treated 470 patients—215 of them confirmed cases—in specialized treatment centers in Guinea, Sierra Leone and Liberia. The scale of this Ebola epidemic is unprecedented in terms of geographical distribution and the numbers of cases and deaths. There have been 528 cases and 337 deaths since the epidemic began, according to the latest World Health Organization (WHO) figures.

Photo by Yann Libessart/MSF
The MSF-supported Mamadou M’Baïki health center serves a diverse neighborhood that has nonetheless seen the exodus of many Muslim inhabitants, who have fled violence. Between January, a month after MSF first began to provide support to the Mamadou M’Baïki center, and May 2014, the percentage of Muslim patients served has gone from 30% to less than 10%. "We have no other choice than to flee," said a displaced person waiting in a transit camp near Bangui airport in February.

Photo by Yann Libessart/MSF

The MSF-supported Mamadou M’Baïki health center serves a diverse neighborhood that has nonetheless seen the exodus of many Muslim inhabitants, who have fled violence. Between January, a month after MSF first began to provide support to the Mamadou M’Baïki center, and May 2014, the percentage of Muslim patients served has gone from 30% to less than 10%. "We have no other choice than to flee," said a displaced person waiting in a transit camp near Bangui airport in February.