Photo: Over the next four weeks, MSF project coordinator Will Turner and his team will mount an expedition to screen 40,000 people for sleeping sickness in remote villages of the Democratic Republic of Congo.

DRC: Through northern Congo with a fridge

Travelling along muddy rainforest tracks by motorbike and crossing swollen rivers by dugout canoe while carrying a refrigerator, a microscope and a generator is no easy task. But this is what MSF project coordinator Will Turner and his team will be doing for the next four weeks. 

Without treatment, sleeping sickess - transmitted by the tsetse fly - is always fatal.

Photo: Members of a refugee family in a makeshift tent at the Mbera camp for Malian refugees. Mauritania © Nyani Quarmyne

Stranded in the Desert

Since the start of the conflict in Mali in January 2012, hundreds of thousands of people have fled to other locations inside the country or to neighboring countries. More than 270,000 people have been displaced within Mali, according to the United Nations, while more than 170,000 refugees have fled to neighboringBurkina Faso, Mauritania, and Niger. Mauritania hosts the highest number of refugees, with some 68,000 people registered by the Office of the UN High Commissioner for Refugees (UNHCR) in camps in Mauritania.

The camps in Mauritania are located in a remote, arid region close to the border with Mali. The refugees rely completely on outside assistance and humanitarian aid for their survival, including such basic needs as food, water, shelter, and medical care.

MSF & the Treatment Action Campaign rallied in front of the Africa IP Forum in Johannesburg, South Africa. We are calling for the South African government to fix its patent law to better protect access to affordable medicines.

Kenya: Escaping death in Africa’s largest urban slum

“When I came to Kibera for the first time I felt humbled by what I saw. It was hard for me to imagine that it was possible to live in such conditions: in Kibera, an estimated 250,000 people live on a five-square-kilometre patch of land. They live in very small houses made of mud or iron sheeting. 

MSF Clinical officer, Kelly Khabala, recounts his work treating people in Kibera, Africa’s largest urban slum in the Kenyan capital of Nairobi.

Dust and smoke, stench, sewage, waste, and water shortages are common and leave their mark on people’s everyday lives. There are not enough latrines, and if you want to use a toilet, you have to pay five shillings. Some families cannot afford this, and as a result use plastic bags, which in turn are thrown along the narrow paths of the slum.

Photo: Patients wait for triage at the Damara Health Center in the Central African Republic.CAR 2013 © Chloé Cébron/MSF

MSF Expands Emergency Services in CAR While Waiting For Peace Deal To Take Hold

As the government of Central African Republic (CAR) attempts to implement a peace deal it struck with rebel groups in the country, Doctors Without Borders/Médecins Sans Frontières (MSF) is continuing to expand its emergency response to thousands of people who have been affected by the conflict. MSF is also negotiating for greater access to areas where health care staff has fled and basic medical services are no longer available.

In recent weeks, as the conflict worsened, thousands of civilians fled their homes and sought refuge in the bush, where they tried to subsist without proper shelter, safe drinking water, or access to medical services. On January 10, MSF opened an emergency project in the government-held frontline town of Damara and began providing basic health care, conducting mobile clinics, and supporting displaced people in order to prevent deaths due to common illnesses such as diarrhea, respiratory infections, and malaria, which is a chronic health care threat in CAR. Medical staff has been treating up to 100 patients per day, most of them for malaria and malnutrition.

“The Central African population already suffers from some of the worst health indicators in the world, with alarming mortality rates even in peaceful times,” says Sylvain Groulx, an MSF coordinator in CAR. “Because of the recent instability, many people have been forced to displace themselves. An added burden is the fact that many local health facilities closed when medical staff fled into the bush. The few health posts that have remained open are either running out of basic essential medicines or, worse, had their stock completely looted.”

Photo:Malian refugees wait in Fassala to be registered by Mauritanian officials and a local NGO after fleeing Mali for the border. Mauritania 2012 © Lynsey Addario/VII

Alarming Malnutrition and Mortality Among Malian Refugees in Mauritania

One year after the start of the political crisis in Mali, insecurity resulting from the military coup, the Tuareg rebellion, and the presence of armed Islamist groups in the north has displaced hundreds of thousands of people. Some 55,000 refugees are still living in difficult conditions in the Mbera camp in Mauritania. A nutrition and retrospective mortality survey by Doctors Without Borders/Médecins Sans Frontères (MSF) has revealed critical mortality and malnutrition rates. In this interview, Karl Nawezi, head of MSF’s activities in Mauritania, explains why the situation in the camp—which is located in the middle of the desert a few kilometres from the Malian border—has reached such an alarming point.

Photo:Migrants in the Gourougou are mostly young men from West Africa who say they had to leave home due to poverty and no hopes of finding a job. In Europe, they say, they have dreams of getting education and earning money to send home to their families. Morocco 2012 © Anna Surinyach

Migrants in Morocco: “We Live Like Prehistoric Men”

In northwestern Morocco, in the forests of Gourougou Mountain, several hundred African migrants are living covertly in remote makeshift camps, struggling to survive, and waiting for an opportunity to enter Europe.

They are mostly young men from West African countries who have left their homes because they had no way to make money and who have left behind family members who are reliant on them, in the hopes of sending back support.

Having gained the trust of these migrants, who hide because they are frequently targeted by the authorities, Doctors Without Borders/Médecins Sans Frontières (MSF) conducts monthly mobile medical clinics to their camps, providing primary health care, distributions, and psychological support.

Photo: Young mothers and their newborns at the Maternity service of the MSF-supported hospital in Batangafo. CAR 2012 © Chloé Cébron

As Violence Surges Anew in CAR, Families Again Flee Into The Bush

On December 20, the rebel coalition known as “Seleka, which has attacked several locations in the north of Central African Republic (CAR) in recent days, entered the town of Batangafo, where Doctors Without Borders/Médecins Sans Frontières (MSF) has been supporting the main hospital.

The previous day, after the rebels announced their intention to move towards Bouca, through the town of Batangafo, FACA—the Central African military forces—the gendarmerie, and all public authorities fled the town. Numerous civilians, scared by the threat of an attack, also left Batangafo to seek refuge into the bush. The rebels entered and took the town 24 hours later.

MSF maintains its team on the ground and is continuing its activities at the hospital, though the number of consultations dropped from 193 the day before the rebels’ advances to 38 on the day after they entered the town.

Testimonies collected by MSF’s team in Batangafo a few hours before rebels entered the town illustrate the fear pervasive among a population that has already endured more than 10 years of armed conflicts. Fleeing into the bush has become almost routine at this point, though it certainly hasn’t gotten any easier or less fraught. “I am very worried by the situation, said a 55-year-old woman named Ghislaine. “Yesterday the kids at school fled in the bush when they heard that armed troops were arriving in town. We did not know where they were. We are so scared.”

According to Enoch Nodl-ya, an MSF anesthetist nurse at Batangafo hospital, “for the last ten years the population has endured the regular presence and attacks from armed men in this region. People are scared and flee rapidly into the bush. As a consequence, many women give birth in the fields without any assistance and most sick or wounded are hesitant to receive medical assistance, scared of possible violence in the populated areas. When the violence stops, we often see patients coming in an advance stage of their diseases.”

Photo: Sleeping Sickness in South Sudan 2012 © John Stanmeyer/VII

Fatal Neglect
Sleeping Sickness: The Long Road

For centuries, sleeping sickness, or Human African Trypanosomiasis (HAT), caused havoc in isolated reaches of Africa, preying on people with no access to medical care or those unaware of the biological dangers they faced when wading into a foreign land.

Sleeping sickness is endemic in 36 African countries and around 60 million people are at risk of being infected. Spread by the bite of a tsetse fly, the disease was signaled by the onset of fever, headaches, and joint pain, followed by disorientation and profound fatigue that makes it difficult to stay awake—hence the name sleeping sickness.

Between 1986 and 2010, MSF teams in several countries screened nearly 3 million people and treated more than 51,000 for the disease. At present, MSF has sleeping sickness programs in several other African countries as well. Collectively, this experience has made clear the need not only for ongoing vigilance, but also for new and easier diagnostic tests and shorter, more adaptable treatment regimens for patients.

VII Photo’s John Stanmeyer joined one of MSF’s mobile HAT teams, which was designed to augment fixed-site screening and treatment activities in Central Africa, allowing him a firsthand look at the modern-day effort to battle this age-old scourge.

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Photo: An MSF staff member vaccinates a child for measles. DRC 2008 © Anna Surinyach

Photo: An MSF staff member vaccinates a child for measles. DRC 2008 © Anna Surinyach

GAVI Needs to Offer Lower Vaccine Prices to Humanitarian Groups

The GAVI Alliance should systematically extend the discounted vaccine prices it obtains from pharmaceutical companies to humanitarian organizations that are often well placed to reach unvaccinated children, MSF said today at the GAVI Partners Forum meeting in Tanzania. Currently, humanitarian groups such as MSF are not able to obtain vaccines at GAVI prices, and are left to negotiate access to vaccines on a cumbersome case-by-case basis.

Photo: Looted and burned houses in Pinga after fighting between armed groups caused the majority of the town’s population—together with many of MSF’s Congolese staff—to flee the area in October. DRC 2012 © MSF

Violence in North Kivu, DRC, Displaces Thousands, Forces Majority of MSF Personnel to Evacuate

Active fighting has hit the town of Pinga in the North Kivu Province of the Democratic Republic of Congo (DRC) once again, forcing 20,000 inhabitants and the majority of Congolese personnel employed by MSF to flee for the second time in six weeks.

Armed groups have clashed in the last few days, causing widespread panic and alarm in the area. Fearing for their lives, people grabbed whatever they could carry and ran into the surrounding forests. While displaced from their homes and villages, people’s access to health care is extremely limited. Some of those wounded in the fighting were brought to the MSF-run hospital 50 kilometers [about 31 miles] away in Mweso where doctors treated 24 people for violent trauma. Twelve more managed to reach the Mpeti health center 18 kilometers [about 11 miles] away from Pinga.

“What we see in Pinga is the tip of the iceberg,” said Grace Tang, MSF head of mission. “This kind of violence and mass displacement is happening throughout the province of North Kivu. We’re trying to respond as best we can in very difficult and challenging circumstances.”