At the end of a long day, Dr. Martin John Jarmin III (left) and anesthesiologist Katrine Finsnes go to check on a patient in the intensive care unit. Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed. In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.More photos: Trauma Care Where There Was None in Northern Afghanistan *All patients’ names have been changed.Photos: Afghanistan 2012 © Michael Goldfarb/MSF

At the end of a long day, Dr. Martin John Jarmin III (left) and anesthesiologist Katrine Finsnes go to check on a patient in the intensive care unit.

Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed.

In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.

More photos: Trauma Care Where There Was None in Northern Afghanistan

*All patients’ names have been changed.

Photos: Afghanistan 2012 © Michael Goldfarb/MSF

Munir*, 8, who broke his leg in a fall, plays in his hospital bed.More photos: Trauma Care Where There Was None in Northern Afghanistan *All patients’ names have been changed.Photos: Afghanistan 2012 © Michael Goldfarb/MSF

Munir*, 8, who broke his leg in a fall, plays in his hospital bed.

More photos: Trauma Care Where There Was None in Northern Afghanistan

*All patients’ names have been changed.

Photos: Afghanistan 2012 © Michael Goldfarb/MSF

US and EU Derailing Ten-year Process to Create Health Research & Development Convention The US and European Union delegations to the World Health Assembly are currently blocking efforts to move towards a binding convention on health R&D aimed at filling critical medical gaps for people in developing countries. MSF urged the US and European governments, who are leading the developed country effort, to stop obstructing a process that has been 10 years in the making and has broad support from developing countries. MSF called on developing countries to continue efforts to progress towards a convention. Such a convention would require all governments to contribute financially to support R&D in key priority areas and would crucially separate—or de-link—the cost of R&D from the price of medical products, so that these are made affordable.Photo:The new MenAfriVac vaccine. 2012 © MSF

US and EU Derailing Ten-year Process to Create Health Research & Development Convention

The US and European Union delegations to the World Health Assembly are currently blocking efforts to move towards a binding convention on health R&D aimed at filling critical medical gaps for people in developing countries. MSF urged the US and European governments, who are leading the developed country effort, to stop obstructing a process that has been 10 years in the making and has broad support from developing countries.

MSF called on developing countries to continue efforts to progress towards a convention. Such a convention would require all governments to contribute financially to support R&D in key priority areas and would crucially separate—or de-link—the cost of R&D from the price of medical products, so that these are made affordable.

Photo:The new MenAfriVac vaccine. 2012 © MSF

The heat does odd things to the body, the mind and energy levels. In the day I drink between 6–8 litres of water, and still only pee once or twice in the day. It is hard to concentrate and I am so tired that I want to sleep, but no matter how many wet clothes I wear at once, sleep just doesn’t come. This past week I was searching desperately for a solution, or at least a coping mechanism. Creativity was necessary but inspiration was lacking. Then I saw the buckets..
Trish Newport is working for MSF as a community outreach nurse in Chad. This is her fifth mission for MSF. When not on mission, she lives and works as a nurse in the Yukon, Canada.
Dr. Juan Robinson, an orthopedic surgeon, reviews a patient’s X-ray with other medical staff during rounds in the inpatient ward. Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed. In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.More photos: Trauma Care Where There Was None in Northern Afghanistan *All patients’ names have been changed.Photos: Afghanistan 2012 © Michael Goldfarb/MSF

Dr. Juan Robinson, an orthopedic surgeon, reviews a patient’s X-ray with other medical staff during rounds in the inpatient ward.

Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed.

In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.

More photos: Trauma Care Where There Was None in Northern Afghanistan

*All patients’ names have been changed.

Photos: Afghanistan 2012 © Michael Goldfarb/MSF

Ahmed*, 31, lies in his hospital bed as a relative looks on. A farmer in Kunduz, Ahmed suffered serious abdominal and leg injuries after setting off a hidden explosive in his field. Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed. In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.More photos: Trauma Care Where There Was None in Northern Afghanistan *All patients’ names have been changed.Photos: Afghanistan 2012 © Michael Goldfarb/MSF

Ahmed*, 31, lies in his hospital bed as a relative looks on. A farmer in Kunduz, Ahmed suffered serious abdominal and leg injuries after setting off a hidden explosive in his field.

Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed.

In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.

More photos: Trauma Care Where There Was None in Northern Afghanistan

*All patients’ names have been changed.

Photos: Afghanistan 2012 © Michael Goldfarb/MSF

A young Afghan man is transferred to another bed before undergoing an emergency operation in the surgical ward. The man had suffered a gunshot wound to the lower chest. Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed. In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.More photos: Trauma Care Where There Was None in Northern Afghanistan *All patients’ names have been changed.Photos: Afghanistan 2012 © Michael Goldfarb/MSF

A young Afghan man is transferred to another bed before undergoing an emergency operation in the surgical ward. The man had suffered a gunshot wound to the lower chest.

Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed.

In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.

More photos: Trauma Care Where There Was None in Northern Afghanistan

*All patients’ names have been changed.

Photos: Afghanistan 2012 © Michael Goldfarb/MSF

MSF surgeon Martin John Jarmin III interacts with a patient during rounds. Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed. In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.More photos: Trauma Care Where There Was None in Northern Afghanistan *All patients’ names have been changed.Photos: Afghanistan 2012 © Michael Goldfarb/MSF

MSF surgeon Martin John Jarmin III interacts with a patient during rounds.

Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed.

In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.

More photos: Trauma Care Where There Was None in Northern Afghanistan

*All patients’ names have been changed.

Photos: Afghanistan 2012 © Michael Goldfarb/MSF

Abdallah* displays his artwork. Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed. In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.More photos: Trauma Care Where There Was None in Northern Afghanistan *All patients’ names have been changed.Photos: Afghanistan 2012 © Michael Goldfarb/MSF

Abdallah* displays his artwork.

Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed.

In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.

More photos: Trauma Care Where There Was None in Northern Afghanistan

*All patients’ names have been changed.

Photos: Afghanistan 2012 © Michael Goldfarb/MSF

Abdallah*, 12, undergoes exercises in a specially equipped physical therapy room. He suffered a serious leg fracture in a car accident and receives regular physical therapy. Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed. In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.More photos: Trauma Care Where There Was None in Northern Afghanistan *All patients’ names have been changed.Photos: Afghanistan 2012 © Michael Goldfarb/MSF

Abdallah*, 12, undergoes exercises in a specially equipped physical therapy room. He suffered a serious leg fracture in a car accident and receives regular physical therapy.

Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed.

In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.

More photos: Trauma Care Where There Was None in Northern Afghanistan

*All patients’ names have been changed.

Photos: Afghanistan 2012 © Michael Goldfarb/MSF

A man and an injured young boy wait outside the triage ward. Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed. In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.More photos: Trauma Care Where There Was None in Northern AfghanistanPhotos: Afghanistan 2012 © Michael Goldfarb/MSF

A man and an injured young boy wait outside the triage ward.

Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed.

In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.

More photos: Trauma Care Where There Was None in Northern Afghanistan

Photos: Afghanistan 2012 © Michael Goldfarb/MSF

After being served numerous rounds of tea, one of the nutritional surveyors brought forth a father carrying his tiny child – a baby of 4 weeks, who had been sick with diarrhea for one week, and now looked like an emaciated bird. The father sat on the edge of the pink frilly mattress, and cried while I asked questions about the baby’s illness. The father, speaking fluent French, described how days earlier he had walked 4 hours each way with the baby in search of help from the nearest health centre. The health centre had been closed, and he had returned home with the baby.
Trish Newport is working for MSF as a community outreach nurse in Chad. This is her fifth mission for MSF. When not on mission, she lives and works as a nurse in the Yukon, Canada.

Read from her blog.
Fighting Unusually High Malnutrition Rates in Chad and Preparing for Worse As a food crisis continues to spread and levels of severe acute malnutrition continue to rise in Chad, MSF is expanding the number of emergency malnutrition treatment programs it is operating in the country. Even in a normal year, Chad has one of the highest rates of chronic malnutrition in the world. This year is showing signs of being worse than usual. In early 2012, in some areas of the country, rates of global acute malnutrition as high as 24 percent have already been reported among children under the age of five.Why are there such alarming rates of malnutrition in Biltine? February is the beginning of the hunger gap in Chad, when families traditionally begin to run out of their food stocks. This year MSF found high rates of severe acute malnutrition rates among children under five, because only 46 percent of the harvest required to feed the population was harvested, which is well below the average. Many Chadians who worked in Libya also lost their jobs and returned home. Those men have moved to other parts of Chad to find work, but the salaries are much lower, so they are sending home less money.A staff member uses a MUAC to check a child for malnutrition at an MSF hospital in Chad. Chad 2012 © Andrea Bussotti/MSF

Fighting Unusually High Malnutrition Rates in Chad and Preparing for Worse

As a food crisis continues to spread and levels of severe acute malnutrition continue to rise in Chad, MSF is expanding the number of emergency malnutrition treatment programs it is operating in the country. Even in a normal year, Chad has one of the highest rates of chronic malnutrition in the world. This year is showing signs of being worse than usual. In early 2012, in some areas of the country, rates of global acute malnutrition as high as 24 percent have already been reported among children under the age of five.

Why are there such alarming rates of malnutrition in Biltine?

February is the beginning of the hunger gap in Chad, when families traditionally begin to run out of their food stocks. This year MSF found high rates of severe acute malnutrition rates among children under five, because only 46 percent of the harvest required to feed the population was harvested, which is well below the average. Many Chadians who worked in Libya also lost their jobs and returned home. Those men have moved to other parts of Chad to find work, but the salaries are much lower, so they are sending home less money.

A staff member uses a MUAC to check a child for malnutrition at an MSF hospital in Chad.

Chad 2012 © Andrea Bussotti/MSF

The front gate at the MSF trauma hospital in Kunduz. Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed. In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.More photos: Trauma Care Where There Was None in Northern AfghanistanPhotos: Afghanistan 2012 © Michael Goldfarb/MSF

The front gate at the MSF trauma hospital in Kunduz.

Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed.

In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.

More photos: Trauma Care Where There Was None in Northern Afghanistan

Photos: Afghanistan 2012 © Michael Goldfarb/MSF

An MSF physiotherapist assists Suleiman*, a 15-year-old boy in the intensive care unit. He underwent an emergency laparotomy the night before after suffering a complete bowel obstruction due to a traumatic injury. Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed. In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.More photos: Trauma Care Where There Was None in Northern Afghanistan *All patients’ names have been changed.Photos: Afghanistan 2012 © Michael Goldfarb/MSF

An MSF physiotherapist assists Suleiman*, a 15-year-old boy in the intensive care unit. He underwent an emergency laparotomy the night before after suffering a complete bowel obstruction due to a traumatic injury.

Before the opening of the MSF surgical hospital in Kunduz Province, northern Afghanistan, people in the region suffering from severe injuries had two options. They made the long and dangerous journey to Kabul or Pakistan, or they visited an expensive private clinic. As a result, few patients received the trauma care they needed.

In less than a year, the MSF trauma center, equipped with an emergency room, two operating theaters, and an intensive care unit, has seen more than 3,700 patients. The majority are victims of so-called “general trauma”—road traffic accidents, domestic violence, or civilian gunshot wounds.

More photos: Trauma Care Where There Was None in Northern Afghanistan

*All patients’ names have been changed.

Photos: Afghanistan 2012 © Michael Goldfarb/MSF