Posts tagged Doctors Without Borders

2am “Oncall, oncall for ICU – we have one child yes, they are convulsions…” I jolt into wakefulness and am out of my bed and running over to the hospital as fast as I can go telling the nurses to prepare IV diazepam down the radio as I go. This could be anything, but always think worst case scenario… I arrive on the ward and yes, this is actual convulsions, a four-year-old with cerebral malaria.
MSF nurse Emma writes about the of variety people she treats when on-call in South Sudan. Please leave your comments for Emma on her blog. 

A Young Syrian Woman Shot By a Sniper Gets Assistance as a Refugee

Salwah, 18 years old, was shot by a sniper in Aleppo, and now she cannot walk. After seeking treatment in several hospitals in Syria, she became a refugee in Turkey where she is now receiving assistance. Doctors Without Borders/Médecins Sans Frontières (MSF) is providing her with mental health care. Photographs by Anna Surinyach.

FREE EVENT | Live Webcast Crisis Update on Syria Join us Thursday, May 9, for a LIVE ONLINE panel discussion featuring three distinct on-the-ground perspectives on the crisis in Syria and on MSF’s various operations.Featuring:Stephen Cornish, Executive Director, MSF-Canada, who recently returned from a fact-finding assignment that took him to a number of MSF programs in and around Syria.Deane Marchbein, MD, President of the Board of MSF-USA and MSF Anesthesiologist, who spent a month earlier this spring providing surgical care within Syria.Michael Goldfarb, Media Relations Manager, MSF-USA, who recently documented living conditions and the humanitarian situation facing Syrian refugees in Lebanon and northern Iraq.

FREE EVENT | Live Webcast Crisis Update on Syria


Join us Thursday, May 9, for a LIVE ONLINE panel discussion featuring three distinct on-the-ground perspectives on the crisis in Syria and on MSF’s various operations.

Featuring:

Stephen Cornish, Executive Director, MSF-Canada, who recently returned from a fact-finding assignment that took him to a number of MSF programs in and around Syria.

Deane Marchbein, MD, President of the Board of MSF-USA and MSF Anesthesiologist, who spent a month earlier this spring providing surgical care within Syria.

Michael Goldfarb, Media Relations Manager, MSF-USA, who recently documented living conditions and the humanitarian situation facing Syrian refugees in Lebanon and northern Iraq.

Photo: Salwah Mekrsh was shot by a sniper in Aleppo. In this photo, taken in April 2013, she is about to start a mental health consultation with MSF staff in Kilis. Turkey 2013 © Anna Surinyach “I feel better, but I can’t walk.” Eighteen-year-old Salwah Mekrsh is unable to walk. Her mother and her sister push Salwah’s wheelchair through the streets of Kilis, a Turkish city near the border with Syria, then enter a small courtyard and stop under the shade of a lemon tree. While Salwah waits for her mental health consultation with MSF to begin, they talk about how their lives have changed. “Before the war, we used to have everything,” says Salwah, “but since it started we have suffered too much.” Salwah was pushed into marriage shortly before the first wave of protests in Syria, in March 2011, when she was 15. Soon she became pregnant; her daughter was born just as the country’s strife was becoming an all-out civil war. After her husband tried to assault her, their marriage disintegrated, and he left, taking the baby. “He took my daughter and doesn’t let me see her,” says Salwah. “I have no way to contact them. I haven’t seen my daughter for a year.”

Photo: Salwah Mekrsh was shot by a sniper in Aleppo. In this photo, taken in April 2013, she is about to start a mental health consultation with MSF staff in Kilis. Turkey 2013 © Anna Surinyach

“I feel better, but I can’t walk.”

Eighteen-year-old Salwah Mekrsh is unable to walk. Her mother and her sister push Salwah’s wheelchair through the streets of Kilis, a Turkish city near the border with Syria, then enter a small courtyard and stop under the shade of a lemon tree. While Salwah waits for her mental health consultation with MSF to begin, they talk about how their lives have changed.

“Before the war, we used to have everything,” says Salwah, “but since it started we have suffered too much.”

Salwah was pushed into marriage shortly before the first wave of protests in Syria, in March 2011, when she was 15. Soon she became pregnant; her daughter was born just as the country’s strife was becoming an all-out civil war. After her husband tried to assault her, their marriage disintegrated, and he left, taking the baby. “He took my daughter and doesn’t let me see her,” says Salwah. “I have no way to contact them. I haven’t seen my daughter for a year.”

Photo: A little girl waits against the gates of the camp registration center in Domeez. Iraq 2013 © Pierre-Yves Bernard/MSF Providing Care in Syria and in Neighboring Countries: An Overview of MSF programs in and around Syria The conflict in Syria remains extremely intense. Frontlines continue to shift. The medical system is in shambles. An estimated 6.8 million people are in urgent need of humanitarian aid, but whole enclaves are cut off from assistance of any kind. Despite the very real challenges of operating in the country, MSF is now running four hospitals inside Syria and is increasing mobile clinic activities to the extent possible. Simultaneously, the organization is actively seeking to open new projects where it is safe to do so. And, it should be noted, MSF is using only private donations for its work in Syria in order to remain entirely independent of all political positioning around the crisis. MSF is also working in the neighboring countries of Iraq, Jordan, Lebanon, and Turkey, where some 1.4 million Syrians have fled in search of sanctuary. These countries have been overwhelmed by the influx of refugees and returnees, and the humanitarian response has thus far been unable to meet their needs.

Photo: A little girl waits against the gates of the camp registration center in Domeez. Iraq 2013 © Pierre-Yves Bernard/MSF

Providing Care in Syria and in Neighboring Countries: An Overview of MSF programs in and around Syria

The conflict in Syria remains extremely intense. Frontlines continue to shift. The medical system is in shambles. An estimated 6.8 million people are in urgent need of humanitarian aid, but whole enclaves are cut off from assistance of any kind.

Despite the very real challenges of operating in the country, MSF is now running four hospitals inside Syria and is increasing mobile clinic activities to the extent possible. Simultaneously, the organization is actively seeking to open new projects where it is safe to do so.

And, it should be noted, MSF is using only private donations for its work in Syria in order to remain entirely independent of all political positioning around the crisis.

MSF is also working in the neighboring countries of Iraq, Jordan, Lebanon, and Turkey, where some 1.4 million Syrians have fled in search of sanctuary. These countries have been overwhelmed by the influx of refugees and returnees, and the humanitarian response has thus far been unable to meet their needs.

Dear GAVI Campaign | Vaccines: The right tools for this job? 

You know what it’s like when you don’t have the right tools for the job?

We do - because to protect children right now, we have to use vaccines that aren’t well suited to the job they have to do. We need better-adapted vaccines to reach the one in five children currently unprotected by full immunisation.

Find out more: msfaccess.org/vaccines

Photo: A young refugee in Domeez camp, where more than 55,000 people have settled. Iraq 2013 © Pierre-Yves Bernard/MSF Providing Psychological Care in Syria: “Flashbacks, Nightmares, and Baby Clothes” People have lost their identity. Older men cannot find their place in society and in the family. They have lost their job or stopped being a fighter. Maybe they have responsibility for a family but they have had to move house several times in quick succession. “I don’t have to find them; they come and ask for help …” I don’t have to find them; they come and ask for help, saying things like, “I’m starting to be violent towards my wife and children. Please help me, I cannot be like that.” Psychologist Audrey Magis recently returned home after spending two months working with Doctors Without Borders/Médecins Sans Frontières (MSF) in Syria, where she set up and ran a mental health program in one of MSF’s projects in the north of the country. Magis, who had previously worked for MSF in Gaza, Libya, and in a camp for Syrian refugees, explains how the war has affected people and what MSF is doing to help.

Photo: A young refugee in Domeez camp, where more than 55,000 people have settled. Iraq 2013 © Pierre-Yves Bernard/MSF

Providing Psychological Care in Syria: “Flashbacks, Nightmares, and Baby Clothes”

People have lost their identity. Older men cannot find their place in society and in the family. They have lost their job or stopped being a fighter. Maybe they have responsibility for a family but they have had to move house several times in quick succession.

“I don’t have to find them; they come and ask for help …”

I don’t have to find them; they come and ask for help, saying things like, “I’m starting to be violent towards my wife and children. Please help me, I cannot be like that.”

Psychologist Audrey Magis recently returned home after spending two months working with Doctors Without Borders/Médecins Sans Frontières (MSF) in Syria, where she set up and ran a mental health program in one of MSF’s projects in the north of the country. Magis, who had previously worked for MSF in Gaza, Libya, and in a camp for Syrian refugees, explains how the war has affected people and what MSF is doing to help.

Photo: The sign outside the health center in Pinga, where armed conflict has made provision of care difficult. DRC 2013 © MSF DRC: Thousands Flee Violence in Pinga, North Kivu Thousands of people have fled the town of Pinga in recent days amid a new wave of armed conflict in the Democratic Republic of Congo (DRC)’s North Kivu Province, making it very difficult to ensure that they receive essential medical care. “Civilians are routinely exposed to this violence—this is the eighth time Pinga has changed hands since 2012,” said Jan Peter Stellema, MSF’s operations manager in Goma. “A number of patients had to be transferred for emergency surgery to Goma, among them a 70-year-old woman shot in the arm.”

Photo: The sign outside the health center in Pinga, where armed conflict has made provision of care difficult. DRC 2013 © MSF

DRC: Thousands Flee Violence in Pinga, North Kivu

Thousands of people have fled the town of Pinga in recent days amid a new wave of armed conflict in the Democratic Republic of Congo (DRC)’s North Kivu Province, making it very difficult to ensure that they receive essential medical care. “Civilians are routinely exposed to this violence—this is the eighth time Pinga has changed hands since 2012,” said Jan Peter Stellema, MSF’s operations manager in Goma. “A number of patients had to be transferred for emergency surgery to Goma, among them a 70-year-old woman shot in the arm.”

Photo: Many migrants pass through Haradh town on their way to Saudi Arabia, whose border is just a few kilometers away. Yemen 2013 © Anna Surinyach Yemen: Migrants Abused, Tortured by Smugglers Authorities in Yemen have freed more than one thousand migrants from Somalia and Ethiopia, many suffering from torture and sexual abuse while forcibly held by human smugglers. “Many of the migrants are physically and mentally exhausted and are suffering from severe mental trauma due to the horrific conditions and treatment they experienced during their detention,” said Angels Mairal, an MSF psychologist in Haradh.

Photo: Many migrants pass through Haradh town on their way to Saudi Arabia, whose border is just a few kilometers away. Yemen 2013 © Anna Surinyach

Yemen: Migrants Abused, Tortured by Smugglers

Authorities in Yemen have freed more than one thousand migrants from Somalia and Ethiopia, many suffering from torture and sexual abuse while forcibly held by human smugglers.

“Many of the migrants are physically and mentally exhausted and are suffering from severe mental trauma due to the horrific conditions and treatment they experienced during their detention,” said Angels Mairal, an MSF psychologist in Haradh.

Being able to go to the hospital at night requires a proverbial blade, its attachment and a handle. Practically speaking we need drivers, cars, petrol, guards and radio operators to make it happen. We need nurses on duty, who first discover something is wrong. We need logisticians who ensure there are generators to give light to the hospital at night. We need non-medical team members to also order key medications that I or other medics might prescribe at night. We need a coordination team in the capital to reach an agreement with the Ministry of Health that we can work here in Amtiman. And we need donors and supporters who generously give to make all of this possible.

Late at night we need a doctor. But we need a lot more too.

Dr. Raghu, a Canadian doctor working with MSF in Chad, on what it takes to make a night call in Chad. 
Photo: A child is tested for malaria in Orientale Province. DRC 2012 © Aurelie Lachant/MSF DRC: Urgent Action Needed to Prevent Malaria Deaths in Orientale Province An upsurge in malaria is likely to have serious consequences for people in Orientale Province in Democratic Republic of Congo (DRC) unless immediate action is taken. “Too many health centers lack the supplies necessary for coping with a new outbreak, and this is completely unacceptable,” said Dr. Narcisse Wega, MSF emergency coordinator.

Photo: A child is tested for malaria in Orientale Province. DRC 2012 © Aurelie Lachant/MSF

DRC: Urgent Action Needed to Prevent Malaria Deaths in Orientale Province

An upsurge in malaria is likely to have serious consequences for people in Orientale Province in Democratic Republic of Congo (DRC) unless immediate action is taken. “Too many health centers lack the supplies necessary for coping with a new outbreak, and this is completely unacceptable,” said Dr. Narcisse Wega, MSF emergency coordinator.

Photo: A street view in Basra. Iraq 2009 © Khalil Sayyad Healing Iraq: The Challenges of Providing Mental Health Care

Photo: A street view in Basra. Iraq 2009 © Khalil Sayyad

Healing Iraq: The Challenges of Providing Mental Health Care

Photo: Basra, where MSF established an international team in 2008. Iraq 2009 © Khalil Sayyad Increased Mental Health Care Needed in Iraq “Many Iraqis have been pushed to their absolute limit,” said Helen O’Neill, MSF’s head of mission in Iraq. “Mentally exhausted by their experiences, many people struggle to understand what is happening to them. The feelings of isolation and hopelessness are compounded by the taboo associated with mental health issues and the lack of mental health care services that people can turn to for help,” she said. Since 2009, MSF and the IMoH have introduced psychological counseling services in two hospitals in Baghdad and one in Fallujah. The programs focus on non-pharmaceutical approaches to address anxiety and depressive disorders commonly experienced by people exposed to violence and uncertainty. There are plans to replicate this counseling model across the country, with the IMoH starting programs in Kut, Karbala, and Sulaymaniyah hospitals.

Photo: Basra, where MSF established an international team in 2008. Iraq 2009 © Khalil Sayyad

Increased Mental Health Care Needed in Iraq

“Many Iraqis have been pushed to their absolute limit,” said Helen O’Neill, MSF’s head of mission in Iraq. “Mentally exhausted by their experiences, many people struggle to understand what is happening to them. The feelings of isolation and hopelessness are compounded by the taboo associated with mental health issues and the lack of mental health care services that people can turn to for help,” she said.

Since 2009, MSF and the IMoH have introduced psychological counseling services in two hospitals in Baghdad and one in Fallujah. The programs focus on non-pharmaceutical approaches to address anxiety and depressive disorders commonly experienced by people exposed to violence and uncertainty. There are plans to replicate this counseling model across the country, with the IMoH starting programs in Kut, Karbala, and Sulaymaniyah hospitals.

It’s just after midnight in Rutshuru. Tomorrow morning Dr. F, the French anesthetist who arrived here with me, and I leave for Goma. Unfortunately the schedule worked out with me on-call at the hospital and I missed tonight’s farewell party. This morning we had a fairly typical day in the OR, doing 12 procedures between 8am and 1pm including performing a skin graft, placing a traction pin in a patient with a fractured femur, draining a few abscesses, debriding a few wounds plus a handful of dressing changes including two children under the age of three with 2nd degree scald burns over roughly 30% of their bodies plus an eight-month-old who had her foot amputated for an infection two days earlier. I also admitted a 16 year old girl from the ER with chronic osteomyelitis [bone infection] who will need a fairly large operation in the next week or so to remove infected dead bone from her tibia. Chronic osteomyelitis in children is rare in the US but fairly common here in the DRC.
David blogs about his busy last day and says farewell to the Democratic Republic of Congo, for now. Send David some thank you notes and comments or questions below his blog.
Finding a much broader perspectiveA world of opportunities within Doctors Without Borders In an interview with Today’s Hospitalist, MSF Dr. Navneet Bhullar talks about how working with MSF has made her more tolerant. “It’s given me a broader perspective, and things don’t upset me like they did before,” Dr. Bhullar says.

Finding a much broader perspective
A world of opportunities within Doctors Without Borders

In an interview with Today’s Hospitalist, MSF Dr. Navneet Bhullar talks about how working with MSF has made her more tolerant.

“It’s given me a broader perspective, and things don’t upset me like they did before,” Dr. Bhullar says.