Posts tagged Photograph

"It’s Really a Delicate Balance": An MSF Doctor in the Jamam Refugee Camp

Dr. Kirrily de Polnay is working with Doctors Without Borders in the Jamam camp in an isolated region of South Sudan, where thousands of refugees from Sudan's Blue Nile State are currently seeking sanctuary and the coming rainy season threatens to make delivering humanitarian aid even more challenging than it is now. Here, she talks about the situation in Jamam:

“We have so many cases of diarrhea and you’re trying to explain to them how to make the ORS [Oral Rehydration Solution] and they don’t have anything to make it in. Even I can find it hard to judge exactly half a sachet, and you tell them, “whatever you do you must drink water, you must drink the ORS we give you.” And they nod and say yes, but you know that they do not have enough water to really do that. They’ve only got a few liters a day. So what we are prescribing, they don’t have. And so you feel like you are trying to put a tiny plaster on a big hemorrhage.”Photo:South Sudan 2012 © Robin Meldrum/MSF
MSF doctor Kirrily de Polnay treating a child in the ‘emergency room’ of MSF’s clinic in Jamam refugee camp.

"It’s Really a Delicate Balance": An MSF Doctor in the Jamam Refugee Camp

Dr. Kirrily de Polnay is working with Doctors Without Borders in the Jamam camp in an isolated region of South Sudan, where thousands of refugees from Sudan's Blue Nile State are currently seeking sanctuary and the coming rainy season threatens to make delivering humanitarian aid even more challenging than it is now. Here, she talks about the situation in Jamam:

“We have so many cases of diarrhea and you’re trying to explain to them how to make the ORS [Oral Rehydration Solution] and they don’t have anything to make it in. Even I can find it hard to judge exactly half a sachet, and you tell them, “whatever you do you must drink water, you must drink the ORS we give you.” And they nod and say yes, but you know that they do not have enough water to really do that. They’ve only got a few liters a day. So what we are prescribing, they don’t have. And so you feel like you are trying to put a tiny plaster on a big hemorrhage.”

Photo:South Sudan 2012 © Robin Meldrum/MSF
MSF doctor Kirrily de Polnay treating a child in the ‘emergency room’ of MSF’s clinic in Jamam refugee camp.

Urgent Delivery—Maternal Death: The Avoidable Crisis


Every day, approximately 1,000 women die in childbirth or from a pregnancy-related complication. Maternal death can occur at any time in pregnancy, but delivery is by far the most dangerous time for both the mother and the baby. The vast majority of these deaths can be prevented if access to emergency obstetric care is ensured.Doctors Without Borders makes it a priority to provide lifesaving, emergency obstetric care in both acute and chronic humanitarian crises. In the organization’s emergency activities, teams strive to address the five main causes of maternal death: hemorrhage, sepsis, unsafe abortion, hypertensive disorders, and obstructed labour.

South Sudan 2011 © Avril Benoit/MSF
A mother and child at MSF’s supplementary feeding distribution in Abathok.

Urgent Delivery—Maternal Death: The Avoidable Crisis

Every day, approximately 1,000 women die in childbirth or from a pregnancy-related complication. Maternal death can occur at any time in pregnancy, but delivery is by far the most dangerous time for both the mother and the baby. The vast majority of these deaths can be prevented if access to emergency obstetric care is ensured.

Doctors Without Borders makes it a priority to provide lifesaving, emergency obstetric care in both acute and chronic humanitarian crises. In the organization’s emergency activities, teams strive to address the five main causes of maternal death: hemorrhage, sepsis, unsafe abortion, hypertensive disorders, and obstructed labour.

South Sudan 2011 © Avril Benoit/MSF A mother and child at MSF’s supplementary feeding distribution in Abathok.

Chad: Villages Organize Themselves Against Malnutrition

Mahamad Adam stands proudly in front of the store under his charge. It’s a single room between four walls of dried mud and eaves made of cut branches that provide a little shade. Inside are stocks of enriched peanut paste, a product that has proven to be effective for tackling child malnutrition.

Adam is a community health agent who spends several hours each week looking for and prescribing the precious substance to children with severe acute malnutrition in his village of Michetire and the surrounding area, some 100 kilometers [60 miles] north of N’Djamena, the capital. He is one of roughly 10 community health agents in western Chad’s Hadjer Lamis region, part of a system established by MSF in collaboration with the country’s Ministry of Health.

MSF is now trying to convince the inhabitants to directly support the community health agents who, until now, have received millet, sorghum or oil from MSF in return for their service, but no money. “To make the system sustainable, the communities must organize themselves and look after the agents,” said Ibrahim Halidou, who is in charge of external activities for MSF.Photo: Chad 2011 © Natacha Buhler 
A malnourished child and his mother sit in MSF’s intensive therapeutic feeding center (ITFC) in Massakory.

Chad: Villages Organize Themselves Against Malnutrition

Mahamad Adam stands proudly in front of the store under his charge. It’s a single room between four walls of dried mud and eaves made of cut branches that provide a little shade. Inside are stocks of enriched peanut paste, a product that has proven to be effective for tackling child malnutrition.

Adam is a community health agent who spends several hours each week looking for and prescribing the precious substance to children with severe acute malnutrition in his village of Michetire and the surrounding area, some 100 kilometers [60 miles] north of N’Djamena, the capital. He is one of roughly 10 community health agents in western Chad’s Hadjer Lamis region, part of a system established by MSF in collaboration with the country’s Ministry of Health.

MSF is now trying to convince the inhabitants to directly support the community health agents who, until now, have received millet, sorghum or oil from MSF in return for their service, but no money. “To make the system sustainable, the communities must organize themselves and look after the agents,” said Ibrahim Halidou, who is in charge of external activities for MSF.
Photo: Chad 2011 © Natacha Buhler

A malnourished child and his mother sit in MSF’s intensive therapeutic feeding center (ITFC) in Massakory.

"Now There is Nothing": Testimonies from Refugees in South Sudan

Amani, who brought her daughter Harrap to the field hospital in Jamam for treatment:

“The rainy season is coming. And the place we are living, it looks like it will be in the water. We need to find another place. I know this soil, and when the rains come this will be a swamp, this will be filled with water… This is a bad place.

My daughter has diarrhea with blood. This problem has been going on for a long time now. It first started in the middle of the fighting. So now she has been ill for a long time. When the fighting started, there was no way for us to get treatment. We were just running, running, always running, until we got here. This is the first time I have been able to get some medical care for her. MSF is the first treatment we have got.”Photo: South Sudan 2012 © Robin Meldrum
A mother with her child in the Doro refugee camp in South Sudan.

"Now There is Nothing": Testimonies from Refugees in South Sudan

Amani, who brought her daughter Harrap to the field hospital in Jamam for treatment:

“The rainy season is coming. And the place we are living, it looks like it will be in the water. We need to find another place. I know this soil, and when the rains come this will be a swamp, this will be filled with water… This is a bad place.

My daughter has diarrhea with blood. This problem has been going on for a long time now. It first started in the middle of the fighting. So now she has been ill for a long time. When the fighting started, there was no way for us to get treatment. We were just running, running, always running, until we got here. This is the first time I have been able to get some medical care for her. MSF is the first treatment we have got.”

Photo: South Sudan 2012 © Robin Meldrum
A mother with her child in the Doro refugee camp in South Sudan.

Burkina Faso: Assistance to Refugees from Mali in the North

In the wake of violent clashes between Mali’s army and Tuareg rebels, nearly 20,000 Malians have fled their country and taken refuge in northern Burkina Faso. Most of the refugees are gathered in Oudalan, Seno and Soum Provinces. Doctors Without Borders is distributing water and food and assessing basic health care needs in the Mentao camp, which is near Djibo and which is now hosting 3,000 people, up from 1,000 people three weeks ago.

“There has been a significant increase in the refugee population, and we are expecting to have 5,000 to 10,000 people in this camp in the coming weeks,” says Jean Hereu, MSF’s head of mission in Burkina Faso.

MSF is distributing 50 cubic metres of water per day in Mentao. The teams are also providing food, having initially donated five tons of rice, red beans and oil, with more to come pending the start of an emergency response by the World Food Program (WFP). In the coming days, the teams will assess the medical needs of the refugees with Burkina Faso’s Ministry of Health. Photo:Burkina Faso © 2012 MSF
MSF carried out a food distribution for Malian refugees in the Mentao camp in northern Burkina Faso.

Burkina Faso: Assistance to Refugees from Mali in the North

In the wake of violent clashes between Mali’s army and Tuareg rebels, nearly 20,000 Malians have fled their country and taken refuge in northern Burkina Faso. Most of the refugees are gathered in Oudalan, Seno and Soum Provinces. Doctors Without Borders is distributing water and food and assessing basic health care needs in the Mentao camp, which is near Djibo and which is now hosting 3,000 people, up from 1,000 people three weeks ago.

“There has been a significant increase in the refugee population, and we are expecting to have 5,000 to 10,000 people in this camp in the coming weeks,” says Jean Hereu, MSF’s head of mission in Burkina Faso.

MSF is distributing 50 cubic metres of water per day in Mentao. The teams are also providing food, having initially donated five tons of rice, red beans and oil, with more to come pending the start of an emergency response by the World Food Program (WFP). In the coming days, the teams will assess the medical needs of the refugees with Burkina Faso’s Ministry of Health.

Photo:Burkina Faso © 2012 MSF
MSF carried out a food distribution for Malian refugees in the Mentao camp in northern Burkina Faso.

Urgent Humanitarian Aid Needed For 80,000 Sudanese Refugees


Driven by fighting in Sudan’s Blue Nile State, tens of thousands of refugees now in camps across the border in South Sudan need assistance before the looming rainy season renders the area impassable.

“The refugees are left almost completely reliant on humanitarian assistance because the area has scarce water and food,” said Julien Matter, MSF emergency coordinator. “The sheer number of refugees fleeing here has grown far beyond anything anyone anticipated. Providing the bare survival essentials now, and over the coming rainy season, will be a serious challenge in such a remote place,” he said.

Newly arriving refugees speak of ongoing bombing and fighting in Sudan’s Blue Nile State. While people have sought safety in the Doro and Jamam camps, they have encountered a harsh environment where their ability to survive is stretched to the breaking point.Photo: South Sudan 2012 © Robin Meldrum/MSF
Refugees in the Jamam camp in South Sudan, after having fled fighting and bombing in Blue Nile State across the border in Sudan.

Urgent Humanitarian Aid Needed For 80,000 Sudanese Refugees

Driven by fighting in Sudan’s Blue Nile State, tens of thousands of refugees now in camps across the border in South Sudan need assistance before the looming rainy season renders the area impassable.

“The refugees are left almost completely reliant on humanitarian assistance because the area has scarce water and food,” said Julien Matter, MSF emergency coordinator. “The sheer number of refugees fleeing here has grown far beyond anything anyone anticipated. Providing the bare survival essentials now, and over the coming rainy season, will be a serious challenge in such a remote place,” he said.

Newly arriving refugees speak of ongoing bombing and fighting in Sudan’s Blue Nile State. While people have sought safety in the Doro and Jamam camps, they have encountered a harsh environment where their ability to survive is stretched to the breaking point.

Photo: South Sudan 2012 © Robin Meldrum/MSF
Refugees in the Jamam camp in South Sudan, after having fled fighting and bombing in Blue Nile State across the border in Sudan.

In honor of the one year anniversary of the earthquake and it’s results in Northeastern Japan, we’ll be posting a series of photographs from MSF’s work during the crisis in 2011.

"In addition to providing medical and psychological care, MSF teams have distributed blankets and hygiene items to people sheltering in the evacuation centers."Photo:© Giulio Di Sturco VII Mentor

In honor of the one year anniversary of the earthquake and it’s results in Northeastern Japan, we’ll be posting a series of photographs from MSF’s work during the crisis in 2011.

"In addition to providing medical and psychological care, MSF teams have distributed blankets and hygiene items to people sheltering in the evacuation centers."

Photo:© Giulio Di Sturco VII Mentor

Chad: “Prevention is the Important Issue”In December 2011, Doctors Without Borders nurse Marja Scholten coordinated a vaccination campaign in the African country of Chad. Along with a team of 300 people, she ensured that nearly 110,000 people were vaccinated against meningitis.


Meningitis, which causes inflammation of the membranes surrounding the brain, is responsible for many deaths every year. The disease is particularly prevalent in the so-called “meningitis belt,” an area in sub-Saharan Africa that includes Chad. This year we were working with the new vaccine MenAfriVac, which provides protection for far longer than other vaccines: ten years as opposed to the two or three years offered by other vaccines.This was the first time we were involved in a preventative campaign—normally we start to vaccinate once a disease has already broken out, but with meningitis A prevention is the important issue. Training was planned involving all the heads of the health centers in the area.Photo: Chad 2012 © Marja Scholten
An MSF staff member uses the new MenAfriVac vaccine to vaccinate a young girl against mengingitis A.

Chad: “Prevention is the Important Issue”

In December 2011, Doctors Without Borders nurse Marja Scholten coordinated a vaccination campaign in the African country of Chad. Along with a team of 300 people, she ensured that nearly 110,000 people were vaccinated against meningitis.

Meningitis, which causes inflammation of the membranes surrounding the brain, is responsible for many deaths every year. The disease is particularly prevalent in the so-called “meningitis belt,” an area in sub-Saharan Africa that includes Chad. This year we were working with the new vaccine MenAfriVac, which provides protection for far longer than other vaccines: ten years as opposed to the two or three years offered by other vaccines.

This was the first time we were involved in a preventative campaign—normally we start to vaccinate once a disease has already broken out, but with meningitis A prevention is the important issue. Training was planned involving all the heads of the health centers in the area.

Photo: Chad 2012 © Marja Scholten
An MSF staff member uses the new MenAfriVac vaccine to vaccinate a young girl against mengingitis A.

IN CELEBRATION OF WOMEN’S DAY TODAY:Maternal Death: The Avoidable Crisis

Every year, hundreds of thousands of women around the world die avoidable deaths during childbirth, for lack of skilled birth attendants and basic medications, the international medical humanitarian organization Doctors Without Borders said in a report released today, in advance of International Women’s Day on March 8.

The report Maternal Death: The Avoidable Crisis details how the provision of emergency obstetric care to pregnant women in acute and chronic humanitarian crises can have a direct impact and save women’s lives. It examines the circumstances for pregnant women in 12 countries where MSF works, in settings ranging from conflict areas to countries with weak health systems, including Pakistan, Somalia, South Sudan, and Haiti. The report highlights the need for emergency medical assistance, particularly when pregnancy complications occur.Photo: Haiti 2012 © Frederik Matte/MSF
A woman holds her newborn at an MSF facility in Haiti.

IN CELEBRATION OF WOMEN’S DAY TODAY:
Maternal Death: The Avoidable Crisis


Every year, hundreds of thousands of women around the world die avoidable deaths during childbirth, for lack of skilled birth attendants and basic medications, the international medical humanitarian organization Doctors Without Borders said in a report released today, in advance of International Women’s Day on March 8.

The report Maternal Death: The Avoidable Crisis details how the provision of emergency obstetric care to pregnant women in acute and chronic humanitarian crises can have a direct impact and save women’s lives. It examines the circumstances for pregnant women in 12 countries where MSF works, in settings ranging from conflict areas to countries with weak health systems, including Pakistan, Somalia, South Sudan, and Haiti. The report highlights the need for emergency medical assistance, particularly when pregnancy complications occur.

Photo: Haiti 2012 © Frederik Matte/MSF A woman holds her newborn at an MSF facility in Haiti.

Afghanistan: MSF Opens Maternity Hospital in Khost

The international medical humanitarian organization MSF has opened a new maternity hospital in eastern Khost Province in Afghanistan, which will provide pregnant women in the region with desperately needed high-quality health care.

Decades of conflict have left Afghanistan with maternal and child mortality rates among the highest in the world. Most women, especially in rural areas, must resort to giving birth without skilled assistance and in unhealthy conditions, which puts their own lives and those of their children at significant risk.

Khost is one of Afghanistan’s most volatile provinces, where national and international military forces have engaged in intense fighting with armed opposition groups in recent years. The conflict has affected the ability of women to access adequate maternal health care.Photo: Afghanistan 2011 © Peter Casaer
A child with diarrhea in the pediatric department at Boost Hospital in Helmand Province, where MSF has been working since 2009.

Afghanistan: MSF Opens Maternity Hospital in Khost

The international medical humanitarian organization MSF has opened a new maternity hospital in eastern Khost Province in Afghanistan, which will provide pregnant women in the region with desperately needed high-quality health care.

Decades of conflict have left Afghanistan with maternal and child mortality rates among the highest in the world. Most women, especially in rural areas, must resort to giving birth without skilled assistance and in unhealthy conditions, which puts their own lives and those of their children at significant risk.

Khost is one of Afghanistan’s most volatile provinces, where national and international military forces have engaged in intense fighting with armed opposition groups in recent years. The conflict has affected the ability of women to access adequate maternal health care.

Photo: Afghanistan 2011 © Peter Casaer
A child with diarrhea in the pediatric department at Boost Hospital in Helmand Province, where MSF has been working since 2009.

An MSF staff member takes a break to play with children during MSF’s emergency response to a raging measles epidemic in remote Maniema Province, Democratic Republic of Congo. Staff used canoes, motorcycles, and cars to reach the affected population at 12 sites. By May 20, 2011 MSF had treated more than 2,000 patients; 250 required hospitalization. 

Photo : 2011 © Laetitia Legrand/MSF

An MSF staff member takes a break to play with children during MSF’s emergency response to a raging measles epidemic in remote Maniema Province, Democratic Republic of Congo. Staff used canoes, motorcycles, and cars to reach the affected population at 12 sites. By May 20, 2011 MSF had treated more than 2,000 patients; 250 required hospitalization.


Photo : 2011 © Laetitia Legrand/MSF

Novartis’s Day in Court Set for March 28, Campaign to Drop the Case Continues

Hearings in the case between Swiss pharmaceutical company Novartis and the Indian government are now set to start on March 28.

The Novartis supreme court case is the final act in a six-year legal battle over India’s future capacity to produce low-cost generic medicines for its people, and for patients across developing countries.

Given the possible implications for generic production and the availability of affordable medicines from India, Doctors Without Borders —along with other treatment providers, patient groups, and affected communities—has appealed to Novartis to drop its case against India, the “pharmacy of the developing world.”

In February, MSF launched a social media campaign calling for Novartis to stop its legal attacks against India which threaten access to medicines for its patients. To participate in the Stop Novartis campaign, visit www.msfaccess.org/STOPnovartis.Photo: India 2011 © Guddu
MSF protested Novartis’s case against the Indian government outside the pharmaceutical company’s Mumbai office on World AIDS Day.

Novartis’s Day in Court Set for March 28, Campaign to Drop the Case Continues

Hearings in the case between Swiss pharmaceutical company Novartis and the Indian government are now set to start on March 28.

The Novartis supreme court case is the final act in a six-year legal battle over India’s future capacity to produce low-cost generic medicines for its people, and for patients across developing countries.

Given the possible implications for generic production and the availability of affordable medicines from India, Doctors Without Borders —along with other treatment providers, patient groups, and affected communities—has appealed to Novartis to drop its case against India, the “pharmacy of the developing world.”

In February, MSF launched a social media campaign calling for Novartis to stop its legal attacks against India which threaten access to medicines for its patients. To participate in the Stop Novartis campaign, visit www.msfaccess.org/STOPnovartis.

Photo: India 2011 © Guddu MSF protested Novartis’s case against the Indian government outside the pharmaceutical company’s Mumbai office on World AIDS Day.

Greece: Extreme Weather Conditions Cause Suffering for Migrants in Border Police Stations

The constant arrival of migrants in Greece’s Evros region, coupled with the extreme weather conditions of the past few weeks, has put pressure on the already fragile system for receiving migrants in the border police stations of Soufli, Tychero, and Feres, and in the detention center of Filakio.

“The newly arrived migrants were spending up to a day in waiting areas in freezing temperatures,” says Antonio Virgilio, head of mission for Doctors Without Borders operations in Greece.

“Migrants have already suffered harsh conditions on their journeys to cross the border,” he added. “Once in Greece, they had to wait for hours, without warm clothes to protect them from the extreme cold, and sometimes without receiving a medical check-up from Ministry of Health doctors.”

There is no heating in the waiting areas of the three Evros border police stations, and migrants are not provided with extra clothes, sleeping bags, survival blankets, or other means of keeping warm. “The reception conditions are unacceptable,” says Virgilio.

An emergency team from MSF has been responding to the migrants’ immediate needs in the three border police stations and in Filakio detention center. The team is on call 24 hours a day, conducting medical triage and providing migrants with warm clothes, sleeping bags, survival blankets, and hygiene kits. During the first four days of intervention, the MSF team assisted 125 migrants, including women and children, who arrived shivering, exhausted, and complaining of pain in their legs.Greece 2011 © MSF
A small Afghan child, one of the many newly arrived migrants in the Evros region, is detained in a border police station.

Greece: Extreme Weather Conditions Cause Suffering for Migrants in Border Police Stations

The constant arrival of migrants in Greece’s Evros region, coupled with the extreme weather conditions of the past few weeks, has put pressure on the already fragile system for receiving migrants in the border police stations of Soufli, Tychero, and Feres, and in the detention center of Filakio.

“The newly arrived migrants were spending up to a day in waiting areas in freezing temperatures,” says Antonio Virgilio, head of mission for Doctors Without Borders operations in Greece.

“Migrants have already suffered harsh conditions on their journeys to cross the border,” he added. “Once in Greece, they had to wait for hours, without warm clothes to protect them from the extreme cold, and sometimes without receiving a medical check-up from Ministry of Health doctors.”

There is no heating in the waiting areas of the three Evros border police stations, and migrants are not provided with extra clothes, sleeping bags, survival blankets, or other means of keeping warm. “The reception conditions are unacceptable,” says Virgilio.

An emergency team from MSF has been responding to the migrants’ immediate needs in the three border police stations and in Filakio detention center. The team is on call 24 hours a day, conducting medical triage and providing migrants with warm clothes, sleeping bags, survival blankets, and hygiene kits. During the first four days of intervention, the MSF team assisted 125 migrants, including women and children, who arrived shivering, exhausted, and complaining of pain in their legs.

Greece 2011 © MSF A small Afghan child, one of the many newly arrived migrants in the Evros region, is detained in a border police station.

Ethiopia: “There Is Still So Much to Improve”

In early 2011, there were some 40,000 Somali refugees in Ethiopia. By the end of 2011, that number had more than tripled, to 142,000, following a mass exodus triggered by a terrible drought that killed crops and herds in a country already wracked by 20 years of conflict. The numbers alone, however, do not tell much about the days, or even weeks, Somalis spend walking to reach and cross the border with barely any food or water. It does not reveal the dire malnutrition affecting the children in the camps, nor does it express the effort made by humanitarian agencies to fight hunger and exclusion and reduce emergency levels of child mortality. José Luis Dvorzak, an MSF doctor in Liben, reminds us that there is still much work to be done.You have worked as a doctor at different times in the past two years in the Liben camps.

I first arrived in June 2010. There were three international workers and 35 national employees. We carried out nutritional activities in the two camps, in Bokolmayo and Malkadida (40,000 refugees) and the Dolo Ado health center. The second time I arrived in September 2011, the change had been enormous: we had 50 international workers and over 800 national employees. By then, new camps had been opened, Kobe and Hillaweyn, each sheltering 25,000 new refugees that had arrived from Somalia in the worst of conditions, with very high mortality rates. At one point there had been up to 13,000 people admitted in our feeding program. In September, after months conducting a nutritional intervention, we managed to reduce mortality to levels below the emergency threshold.How would you describe the medical situation endured by the population at present?

We still have children admitted in our stabilization centers suffering from severe malnutrition complicated with other diseases such as pneumonia or diarrhea—some 45 kids (during the emergency peak this figure rose to over a constant 150) weekly. The most common pathologies amongst the population are respiratory infections, diarrhea, intestinal parasites, and skin diseases. Currently, we are also implementing mental health and epidemiological surveillance programs using community health workers.Read the rest of the interview with José Luis Dvorzak.Photo: Ethiopia 2011 © Michael Tsegaye
An MSF staff member uses a feeding tube to treat a malnourished child in Liben’s Hiloweyn camp.

Ethiopia: “There Is Still So Much to Improve”

In early 2011, there were some 40,000 Somali refugees in Ethiopia. By the end of 2011, that number had more than tripled, to 142,000, following a mass exodus triggered by a terrible drought that killed crops and herds in a country already wracked by 20 years of conflict. The numbers alone, however, do not tell much about the days, or even weeks, Somalis spend walking to reach and cross the border with barely any food or water. It does not reveal the dire malnutrition affecting the children in the camps, nor does it express the effort made by humanitarian agencies to fight hunger and exclusion and reduce emergency levels of child mortality. José Luis Dvorzak, an MSF doctor in Liben, reminds us that there is still much work to be done.

You have worked as a doctor at different times in the past two years in the Liben camps.

I first arrived in June 2010. There were three international workers and 35 national employees. We carried out nutritional activities in the two camps, in Bokolmayo and Malkadida (40,000 refugees) and the Dolo Ado health center. The second time I arrived in September 2011, the change had been enormous: we had 50 international workers and over 800 national employees. By then, new camps had been opened, Kobe and Hillaweyn, each sheltering 25,000 new refugees that had arrived from Somalia in the worst of conditions, with very high mortality rates. At one point there had been up to 13,000 people admitted in our feeding program. In September, after months conducting a nutritional intervention, we managed to reduce mortality to levels below the emergency threshold.

How would you describe the medical situation endured by the population at present?

We still have children admitted in our stabilization centers suffering from severe malnutrition complicated with other diseases such as pneumonia or diarrhea—some 45 kids (during the emergency peak this figure rose to over a constant 150) weekly. The most common pathologies amongst the population are respiratory infections, diarrhea, intestinal parasites, and skin diseases. Currently, we are also implementing mental health and epidemiological surveillance programs using community health workers.

Read the rest of the interview with José Luis Dvorzak.

Photo: Ethiopia 2011 © Michael Tsegaye
An MSF staff member uses a feeding tube to treat a malnourished child in Liben’s Hiloweyn camp.

CAR: Fighting in the North Forces Thousands to Flee Their Homes

Insecurity in the north of Central African Republic (CAR) has caused thousands of people to flee their homes.

“Villages have been violently destroyed and looted, including some health centers,” says Pablo Marco, head of mission for Doctors Without Borders/Médecins Sans Frontières (MSF) in CAR.

Since the end of January, fighting around Gondava and Ouandago, along the border with Chad, has brought instability to the region. The Chadian rebel group, the Popular Front for Recovery (FPR) is fighting against Chadian and Central African forces. Some 3,000 displaced people have arrived in the villages of Farazala, Ouandago, and Nana-Outa, in addition to the 3,000 people already sheltering in Kabo.

“During the first few days of the fighting, some of the wounded were admitted to our hospitals, including two women who had been raped, but now many more cases are being reported,” says Marco. “People [were] left with nothing but the clothes they were wearing, and they are unable to go back to their fields, so there is an urgent need for food and relief items.”Photo: CAR 2011 © Anna Surinyach
A young refugee in the Kabo camp.

CAR: Fighting in the North Forces Thousands to Flee Their Homes

Insecurity in the north of Central African Republic (CAR) has caused thousands of people to flee their homes.

“Villages have been violently destroyed and looted, including some health centers,” says Pablo Marco, head of mission for Doctors Without Borders/Médecins Sans Frontières (MSF) in CAR.

Since the end of January, fighting around Gondava and Ouandago, along the border with Chad, has brought instability to the region. The Chadian rebel group, the Popular Front for Recovery (FPR) is fighting against Chadian and Central African forces. Some 3,000 displaced people have arrived in the villages of Farazala, Ouandago, and Nana-Outa, in addition to the 3,000 people already sheltering in Kabo.

“During the first few days of the fighting, some of the wounded were admitted to our hospitals, including two women who had been raped, but now many more cases are being reported,” says Marco. “People [were] left with nothing but the clothes they were wearing, and they are unable to go back to their fields, so there is an urgent need for food and relief items.”

Photo: CAR 2011 © Anna Surinyach A young refugee in the Kabo camp.