Photo © Enass Abu Khalaf-Tuffaha/MSF

There are nearly 500,000 Syrian refugees in Jordan; 100,000 of whom are living in Zaatari camp in the north. Every day 1,000 more people arrive at the camp. MSF has increased its staff and activities there, including opening a pediatric hospital and an outpatient clinic for children in the last couple of months. But, like other health providers in Zaatari, MSF refers the most severe cases to Jordanian public hospitals outside the camp, which are already nearing full capacity.

Jordan is not able to deal with the rising needs as people continue to arrive. The country needs increased international aid soon or they will have to resort to drastic measures, like blocking all refugee access to the country or restricting access to public facilities. Read more: http://bit.ly/15eNkY7

Photo: Destroyed medical supplies litter the ground outside the MSF hospital in Pibor. South Sudan 2013 © Vikki Stienen/MSF

South Sudan: MSF Hospital Severely Damaged in Intentional Attack

MSF strongly condemns the deliberate damage and looting of its hospital in Pibor town, in South Sudan’s Jonglei State, which has left tens of thousands of people without access to essential medical care.

The hospital’s infrastructure was systematically damaged May 11–12 in order to render it unusable without major repairs. Therapeutic medical food and hospital beds were looted. The MSF structure is the only hospital facility for Pibor County, with the nearest alternative more than 90 miles away. The hospital’s closure leaves roughly 100,000 people cut off from health care. Many of them have fled to the bush amid conflict between the South Sudan Army (SPLA) and the David YauYau armed militia group.

“A special effort was made to destroy drug supplies by strewing them on the ground, to cut and slash the warehouse tents, to ransack the hospital wards, and even to cut electricity cables and rip them from the walls,” said Richard Veerman, MSF operations coordinator for South Sudan.

Photo: A herd of goats being driven out into the savannah to graze on the edge of the Mbera camp for Malian refugees in Mauritania. Mauritania 2013 © Nyani Quarmyne

Stranded in the Desert

The majority of the refugees in Mbera camp are pastoralists who lived nomadic or semi-nomadic lifestyles in Mali. Dependent on their livestock for a living, many of them fled with their cattles. However, 55% of the refugees interviewed left family members at home to tend to the livestock.

Photo: A doctor does his rounds in MSF’s Hepatitis E ward in Maban County’s Batil camp. South Sudan 2013 © Corinne Baker/MSF

MSF Responds To Hepatitis E Outbreak In South Sudan Refugee Camps

An epidemic of hepatitis E is escalating across refugee camps in South Sudan’s Maban County. To date, Doctors Without Borders/Médecins Sans Frontières (MSF) has treated 3,991 patients in its health facilities in the camps and has recorded 88 deaths, including 15 pregnant women.

Hepatitis E is a virus that causes liver disease and can lead to acute liver failure and death. It is particularly dangerous for pregnant women. Like cholera, the virus spreads in environments with poor sanitation and contaminated water. There is no cure, but its symptoms are treatable.

“We have been doing everything we can to care for people with hepatitis E, but there is no treatment for the disease,” says Dr. José-Luis Dvorzak, MSF Medical Coordinator in Maban County. “We suspect this outbreak is far from over, and many more people will die.”

Photo: Sudanese refugees wait in line in the outpatient department at the MSF field hospital in Jamam refugee camp. South Sudan 2012 © Paula Bronstein/Getty Images

Fear and Hope in South Sudan as Refugees Start to Cross Border Again

More than 170,000 people who fled violence in Sudan are living in refugee camps in South Sudan. Doctors Without Borders/Médecins Sans Frontières (MSF) has been assisting the refugees since November 2011, running field hospitals and providing supplies of clean drinking water and oral rehydration fluids.

Now that the floods caused by the rainy season are subsiding refugees are starting to cross the border again. In December 2012, around 370 refugees arrived at the border village of El Fuj, traveling in two groups and arriving a few days apart. This is a small number compared to last year, when 35,000 people crossed the border in the space of just three weeks. Time will tell if the numbers will increase.

While the camps in South Sudan provide relative safety, refugees living there face dire conditions. There are still shortages of clean water—at times, 40 percent of medical consultations carried out by MSF were related to diarrhea—and there are ongoing occurrences of Hepatitis E. In Batil Camp (which hosts around 35,000 refugees), mortality rates were more than double emergency thresholds in summer 2012, and more than a quarter of the children under the age of five weremalnourished. Since September 2012, conditions have improved in many areas and mortality rates have dropped, but nutrition and food security are still serious concerns.

Photo: The Domeez refugee camp in Iraq, where MSF has been treating Syrian refugees since this past May. Iraq 2012 © Fayçal Touiz/MSF

Humanitarian Response Still Insufficient For Syrians In and Out of the Country

The humanitarian situation in Syria continues to worsen as the war escalates and attacks against health facilities continue. Access to large parts of the country remains extremely difficult due to insecurity and heavy fighting, and more than two million people have been displaced. The number of Syrians seeking refuge in neighboring countries is increasing, but the humanitarian response in Lebanon and Iraq has so far been unable to meet their needs. The arrival of winter is exacerbating the difficult living conditions of Syrian refugees and the population remaining in the country

Doctors Without Borders/Médecins Sans Frontières (MSF) currently works in three field hospitals in the north of Syria. Since June, 10,000 patients have received medical attention for reasons including violence-related injuries such as gunshot wounds, shrapnel wounds, open fractures, and injuries due to explosions. More than 900 surgical procedures have been carried out. Admissions are irregular, depending on shifting frontlines and whether it is possible to refer the wounded. MSF is also providing training in mass casualty management, triage, and emergency care to Syrian health personnel who need support in the management of war-wounded patients. Specific assistance is also being provided to medical facilities, such as helping set up an emergency room and a blood bank in Aleppo area.

Several other health facilities have been set up by Syrian doctors and other medical organizations to treat the wounded in the northern region. However, general access to health services remains limited for the population, particularly for people suffering from chronic illnesses. A significant number of MSF’s patients need treatment for chronic disease or accidental trauma, or assistance during childbirth. Further support needs to be developed to meet these needs.

Photo: Family members huddle in a makeshift shelter on the outskirts of the overcrowded Dadaab refugee camps. Kenya © Robin Hammond/Panos Pictures

Kenya: Possible Influx Of New Refugees Will Worsen Already Dire Conditions In Camps

Relocating thousands of Somali refugees in Kenya to overflowing and crisis-ridden camps will threaten their own health and exacerbate already disastrous humanitarian conditions, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) warned today.

Kenyan authorities recently publicly exhorted thousands of Somali refugees living in urban areas of Kenya to uproot and move to refugee camps in Dadaab, a sprawling complex in a vast desert landscape in eastern Kenya. The camps, which together comprise the largest refugee settlement in the world, are already home to close to half a million people, well beyond their original capacity of 90,000. Squalid living conditions and insufficient assistance have been compounded by increasing insecurity in the camps over the last year.

“The assistance provided in Dadaab is already completely overstretched and cannot meet existing needs,” said Dr. Elena Velilla, MSF’s head of mission in Kenya. “In the event of an influx of new arrivals, MSF would not be able to increase its assistance or respond to a new emergency due to ongoing insecurity.”

The possible arrival of thousands of additional refugees will further deteriorate the precarious conditions, already worsened by seasonal rains and an attendant increased risk of epidemics. There are already sporadic cases of cholera and hepatitis E reported throughout the camps.

MSF, one of the main health providers in Dadaab, is operating a 200-bed hospital serving as a referral facility for the camps, but it has struggled to cope with the considerable and growing medical and humanitarian needs.

“Since the beginning of December, heavy rains have flooded the camps, and the already fragile shelter and sanitation conditions have become even more deplorable, with dramatic consequences for the population’s health,” said Velilla.

Over the last month, the number of children admitted to the MSF hospital for severe acute malnutrition has doubled, with approximately 300 children hospitalized. Most of them are also suffering from acute watery diarrhoea or severe respiratory tract infections, attributable to the poor living conditions in the camps.

Since the camps were established more than 20 years ago, emergencies have plagued Dadaab, with floods, nutritional crises, and disease outbreaks occurring regularly. According to the United Nations High Commissioner for Refugees (UNHCR), which administers the camp complex, 11 epidemic outbreaks were reported in 2012.

MSF Field Report: Decreasing Child Mortality in South Sudan
“How Did You Know We Were Here?”

The refugees wanted to know Dr. Jacoby’s story. They wanted to know where she was from, why MSF had come, and how did MSF even know they were there? 

Dr. Jacoby showed them the video that convinced her to go to Batil. It mad a major impact on them to realize that we were documenting their situation, and sharing it—“and that this information was enough to get people like me to come to Batil,” says Dr. Jacoby.

“I think that is really powerful. I think that knowing someone on the other side of the world saw what they’re up against, and cares enough to come, really helps people.”