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Medecins Sans Frontieres [MSF] started in the early 1970’s out of the frustration of a group of French doctors who worked in desperate conditions in the Biafra War [1967–70]. Determined to create a movement to deliver humanitarian aid wherever it was needed and to speak out about the plight of victims, doctors without borders became a reality, writes Nick Adams.
Now an international medical aid agency, MSF is often the first to arrive in crisis hit areas and, in some cases, is the only aid agency to be there at all. MSF volunteers give life–saving medical assistance to people who would otherwise be denied access to even the most basic health care. In places affected by armed conflict, drought, starvation, diseases of epidemic proportions and natural disasters, you will find Medecins Sans Frontieres.
Awarded the Nobel Peace Prize in 1999, one of the organisations great strengths is its independence from any political, religious or economic powers and its freedom to work in, and speak freely about, some of the most desperate and dangerous situations across the globe, according to its own humanitarian values.
Medical activities vary with each project and range from simple curative work and mother–and–child care, to surgery, epidemic control and psycho–social care. Where circumstances allow, MSF works with local health professionals, as well as national and international authorities, to assess and treat populations in danger as effectively as possible.
Currently at work in over 70 countries, it is involved in the rehabilitation of hospitals and dispensaries, vaccination programmes and sanitation projects. MSF provides assistance in remote health care centres, slum areas and provides training for local personnel, with the objective of rebuilding health structures to acceptable levels.
MSF says it is increasingly active in areas of conflict where great numbers of people have been displaced by war and where medical facilities are inadequate.
Iraq and Afghanistan are very well–known examples of this kind of situation, but other war torn areas where the organisation is active include places like West Darfur in the Sudan and Somalia, where MSF have set–up a camp to provide emergency medical care for the tens–of–thousands who face critical humanitarian needs due to renewed fighting in the city of Mogadishu.
But the work of MSF in the field goes much further than just a response to an immediate crisis.
A good example of this can be found in Nigeria, where violence in the Niger Delta area, as a result of the struggle to gain power and control over natural recourses in the oil rich region, prompted MSF to open a trauma centre at Teme Hospital in Port Harcourt, the state capital. The trauma unit deals with gunshots, stabbings, beatings and sexual violence as well as other trauma cases like road accidents.
Since October 2005, the emergency room has admitted more than 4,500 patients, with more than 1,100 of them for violence related trauma, including 380 gunshot victims. MSF surgical teams have performed 1,700 operations for acute emergencies and the facilities for orthopaedic surgery and physiotherapy have been brought up to a high standard not usually found in such poor countries.
MSF has also established a comprehensive HIV/AIDS programme in Nigeria which provides care to over 1,500 people, while in the north of the country it responds to epidemics of measles and meningitis. MSF has worked in Nigeria since 1996, which shows how its long–term commitment to a country, in collaboration with its people, can save lives.
Because many of the areas the organisation works in are affected by long–term conflicts, aid projects can, and do, go on for decades.
Projects such as these can take MSF personnel into danger zones that present real risks to their lives. In Iraq, where MSF is mainly focused on the treatment of the war–wounded, it reports that its doctors are at risk of being murdered, precisely because they are so close to those who most need their help, and it has been forced to re–evaluate its approach to the supply of medical aid in the country.
To reach and usefully assist people in the worlds worst places demands great feats of organisation and people with varied skills. Although MSF is primarily a medical organisation, it would not be able to operate without support from technical staff, such as logisticians, building engineers and water and sanitation experts who bring their motivation, professional abilities and practical experience to their work in the field.
The organisation grew and increased in professionalism in the 1970’s in its response to decolonisation and Cold War conflicts in Africa and Asia which created massive refugee crises. Volunteers were paid for the first time and a small back–up team was established at its headquarters in Paris. Then in 1981 MSF set up its first logistics department to coordinate and channel emergency medical relief.
The success of MSF in France caught the imagination of doctors around the world and now there are support sections throughout Europe and in Australia, Canada, Hong Kong, Japan and the United States among many other countries.
The organisation is heavily involved parts of the developing world affected by diseases of epidemic proportions. Some, like HIV/AIDS, command world–wide publicity, but MSF also highlights diseases that do not have a global high profile, but do have a high death rate, and fights for better treatment and more health workers to address them; such is the case in Ethiopia.
Ethiopia has been successful in its fight against HIV/AIDS, says MSF, but it has a serious problem with a tropical disease called Kala azar, which is transmitted by parasites and affects the immune system. MSF have called for extra recourses to beat this disease which, untreated, has a mortality rate of almost 100 per cent, but with proper treatment has a cure rate of around 92 per cent.
Well–known diseases, such as, cholera, tuberculosis, malaria and HIV/AIDS command much attention from MSF, which works at grassroots level to prevent and treat these conditions in collaboration with local authorities. At present it provides treatment to over 80,000 patients with AIDS in 30 countries.
It also campaigns for more drugs to be made available to poor countries to fight these diseases and for more research into new medications. MSF points to the fact that standard treatments for TB were developed in the 1960’s, multi–drug resistant TB is a major problem and thus new drugs are badly needed to fight the disease. A similar problem exists with Malaria and with HIV/AIDS where it exists in combination with drug resistant TB.
A further restriction, according to MSF, is the global shortage of healthcare workers. In South Africa the lack of health professionals reduces the amount of people who receive HIV/AIDS treatment. And in Malawi, despite new types of health workers, demand still outstrips supply, with vacancy rates at 60 per cent for nurses in rural areas.
Not surprisingly, the medical practitioners who continue to work in such areas are stretched to breaking point and MSF can provide vital assistance.
Thousands of people volunteer to work for MSF every year and the organisation could not function without them. Whether working from a support office, or in the field, all those who give their time to MSF make a practical, real difference to others in some of the hardest environments in the world.
The scale and depth of problems the organisation contends with can only, ultimately, be resolved by concerted efforts over the long–term from people at all levels of society, particularly from those with economic and political power in their grasp, nationally and internationally.
Until this can be achieved, MSF will continue to go where angels fear–to–tread, to assist and represent people in the world's most dangerous and desperate places – truly, doctors without borders.
For further information visit the Medecins Sans Frontieres website at: www.msf.org.
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