How Do They Help? Doctors Without Borders

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Medical Editing Intern. Desk Intern. The eHealth Unit promotes and advances secure, efficient, and…. Press Intern. Be the first to see new Doctors Without Borders jobs. Both groups succeeded in keeping all main hospitals in Rwanda's capital Kigali operational throughout the main period of the genocide. These events led to a debate within the organisation about the concept of balancing neutrality of humanitarian aid workers against their witnessing role.

As a result of its Rwanda mission, the position of MSF with respect to neutrality moved closer to that of the ICRC, a remarkable development in the light of the origin of the organisation. The ICRC lost 56 and MSF lost almost one hundred of their respective local staff in Rwanda, and MSF-France, which had chosen to evacuate its team from the country the local staff were forced to stay , denounced the murders and demanded that a French military intervention stop the genocide. MSF-France returned to the area and provided medical aid to refugees in Goma.

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At the time of the genocide, competition between the medical efforts of MSF, the ICRC, and other aid groups had reached an all-time high, [36] but the conditions in Rwanda prompted a drastic change in the way humanitarian organisations approached aid missions. In the late s, MSF missions were set up to treat tuberculosis and anaemia in residents of the Aral Sea area, and look after civilians affected by drug-resistant disease, famine, and epidemics of cholera and AIDS.

In , volunteers began assisting in surgeries in Freetown to help with an increasing number of amputees , and collecting statistics on civilians men, women and children being attacked by large groups of men claiming to represent ECOMOG. The groups of men were travelling between villages and systematically chopping off one or both of each resident's arms, raping women, gunning down families, razing houses, and forcing survivors to leave the area. The Campaign for Access to Essential Medicines was created in late , providing MSF with a new voice with which to bring awareness to the lack of effective treatments and vaccines available in developing countries.

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In , the organisation also spoke out about the lack of humanitarian support in Kosovo and Chechnya, having set up field missions to help civilians affected by the respective political situations. Although MSF had worked in the Kosovo region since , the onset of the Kosovo War prompted the movement of tens of thousands of refugees, and a decline in suitable living conditions. A serious crisis within MSF erupted in connection with the organisation's work in Kosovo when the Greek section of MSF was expelled from the organization.

The Greek MSF section had gained access to Serbia at the cost of accepting Serb government imposed limits on where it could go and what it could see — terms that the rest of the MSF movement had refused. A similar situation was found in Chechnya, whose civilian population was largely forced from their homes into unhealthy conditions and subjected to the violence of the Second Chechen War.

MSF has been working in Haiti since , but since President Jean-Bertrand Aristide was forced from power, the country has seen a large increase in civilian attacks and rape by armed groups. However, the landings of some of the planes had to be delayed due to the massive number of humanitarian and military flights coming in. The Kashmir Conflict in northern India resulted in a more recent MSF intervention the first field mission was set up in to help civilians displaced by fighting in Jammu and Kashmir , as well as in Manipur.

MSF went through a long process of self-examination and discussion in — Many issues were debated, including the treatment "nationals" as well as "fair employment" and self-criticism. MSF has been active in a large number of African countries for decades, sometimes serving as the sole provider of health care, food, and water.

Although MSF has consistently attempted to increase media coverage of the situation in Africa to increase international support, long-term field missions are still necessary. Of the Although active in the Congo region of Africa since , the First and Second Congo War brought increased violence and instability to the area.

MSF has had to evacuate its teams from areas such as around Bunia , in the Ituri district due to extreme violence, [57] but continues to work in other areas to provide food to tens of thousands of displaced civilians, as well as treat survivors of mass rapes and widespread fighting. MSF has been active in Uganda since , and provided relief to civilians during the country's guerrilla war during the Second Obote Period. However, the formation of the Lord's Resistance Army saw the beginning of a long campaign of violence in northern Uganda and southern Sudan.

Civilians were subjected to mass killings and rapes, torture, and abductions of children, who would later serve as sex slaves or child soldiers. Faced with more than 1. Mental health is also an important aspect of medical treatment for MSF teams in Uganda since most people refuse to leave the IDP camps for constant fear of being attacked.

MSF has strongly promoted the use of contraception in Africa. During the Ebola outbreak in West Africa in , MSF met serious medical demands largely on its own, after the organisation's early warnings were largely ignored.

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MSF first provided medical help to civilians and refugees who have escaped to camps along the Thai-Cambodian border in Due to long decades of war, a proper health care system in the country was severely lacking and MSF moved inland in to help restructure basic medical facilities. In , Cambodia was hit with a malaria epidemic. The situation of the epidemic was aggravated by a lack of qualified practitioners and poor quality control which led to a market of fake antimalarial drugs.

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Counterfeit antimalarial drugs were responsible for the deaths of at least 30 people during the epidemic. This therapy prolongs the patients' lives and is a long-term treatment. MSF also provided humanitarian aid in times of natural disaster such as a major flood in which affected up to 1. In partnership with local health authorities and other NGOs, MSF encouraged decentralized clinics and rendered localized treatments to more rural areas from In , Southern and Eastern provinces of Cambodia were hit with a cholera epidemic and MSF responded by providing medical support that were adapted for usage in the country.

Cambodia is one of 22 countries listed by WHO as having a high burden of tuberculosis. The Libyan civil war has prompted efforts by MSF to set up a hospital and mental health services to help locals affected by the conflict. The fighting created a backlog of patients that needed surgery. With parts of the country slowly returning to livable, MSF has started working with local health personnel to address the needs. The need for psychological counseling has increased and MSF has set up mental health services to address the fears and stress of people living in tents without water and electricity.

This came after attacks by EU states that stripped the vessel of its registration and produced criminal accusations against MSF. Up to then 80, people were rescued or assisted since the beginning of the mission. MSF is involved in Sri Lanka, where a 26 year civil war ended in and MSF has adapted its activities there to continue its mission. For example, it helps with physical therapy for patients with spinal cord injuries. The organisation operates eleven hospitals and health centres in Yemen and provides support to another 18 hospitals or health centres.

Before a field mission is established in a country, an MSF team visits the area to determine the nature of the humanitarian emergency, the level of safety in the area and what type of aid is needed this is called an "exploratory mission". Medical aid is the main objective of most missions, although some missions help in such areas as water purification and nutrition.

A field mission team usually consists of a small number of coordinators to head each component of a field mission, and a "head of mission. The head of mission does not necessarily have a medical background. Medical volunteers include physicians, surgeons, nurses, and various other specialists.

In addition to operating the medical and nutrition components of the field mission, these volunteers are sometimes in charge of a group of local medical staff and provide training for them. Although the medical volunteers almost always receive the most media attention when the world becomes aware of an MSF field mission, there are a number of non-medical volunteers who help keep the field mission functioning. Logisticians are responsible for providing everything that the medical component of a mission needs, ranging from security and vehicle maintenance to food and electricity supplies.

Vaccination campaigns are a major part of the medical care provided during MSF missions. Diseases such as diphtheria , measles , meningitis , tetanus , pertussis , yellow fever , polio , and cholera , all of which are uncommon in developed countries, may be prevented with vaccination. Some of these diseases, such as cholera and measles, spread rapidly in large populations living in close proximity, such as in a refugee camp, and people must be immunised by the hundreds or thousands in a short period of time.

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In most countries, MSF increases the capabilities of local hospitals by improving sanitation, providing equipment and drugs, and training local hospital staff. International staff start these clinics but MSF strives to increase the local staff's ability to run the clinics themselves through training and supervision. Since most of the areas that require field missions have been affected by a natural disaster, civil war, or endemic disease, the residents usually require psychological support as well. Although the presence of an MSF medical team may decrease stress somewhat among victims, often a team of psychologists or psychiatrists work with victims of depression, domestic violence and substance abuse.

The doctors may also train local mental health staff. Often in situations where an MSF mission is set up, there is moderate or severe malnutrition as a result of war, drought, or government economic mismanagement. Intentional starvation is also sometimes used during a war as a weapon, and MSF, in addition to providing food, brings awareness to the situation and insists on foreign government intervention.

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Infectious diseases and diarrhoea , both of which cause weight loss and weakening of a person's body especially in children , must be treated with medication and proper nutrition to prevent further infections and weight loss. A combination of the above situations, as when a civil war is fought during times of drought and infectious disease outbreaks, can create famine.

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In emergency situations where there is a lack of nutritious food, but not to the level of a true famine, protein-energy malnutrition is most common among young children. Marasmus , a form of calorie deficiency, is the most common form of childhood malnutrition and is characterised by severe wasting and often fatal weakening of the immune system. Kwashiorkor , a form of calorie and protein deficiency, is a more serious type of malnutrition in young children, and can negatively affect physical and mental development.

Both types of malnutrition can make opportunistic infections fatal. A Therapeutic Feeding Centre or Therapeutic Feeding Programme is designed to treat severe malnutrition through the gradual introduction of a special diet intended to promote weight gain after the individual has been treated for other health problems. The treatment programme is split between two phases: [99]. MSF uses foods designed specifically for treatment of severe malnutrition.

During phase 1, a type of therapeutic milk called F is fed to patients. F and Plumpy'nut are designed to quickly provide large amounts of nutrients so that patients can be treated efficiently.

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BP5 is a popular food for treating populations because it can be distributed easily and sent home with individuals, or it can be crushed and mixed with therapeutic milk for specific treatments. Dehydration , sometimes due to diarrhoea or cholera, may also be present in a population, and MSF set up rehydration centres to combat this. A special solution called Oral Rehydration Solution ORS , which contains glucose and electrolytes , is given to patients to replace fluids lost.

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