MSF Operational RESEARCH DAY

MSF operational RESEARCH DAY

22th June 2012 OR Day 2012: Steering committee Meinie Nicolai Bertrand Draguez Bart Janssens Rony Zachariah Tom Ellman Carol Metcalf Rafael van Den Bergh Amine Dahmane Sophie Guillaumie Göran Svedin sighted tokeepallourexperiences toourselves. up correctly andgetthempublishedshared withothers.Itwouldbeshort- of thebestcare possible,weneedsounddataon our fieldwork,writethese In order toinfluenceotheragenciesanddecision-makers toallowtheprovision care andtoolsadaptedto thecircumstances inwhichwework. Improving ouractionimplies testingandinnovatingtofindthebestpossible to constantly improve the level of care patients and victims of crises in the future. Next toourcommitmentcare forpeopleindangerwealsoengagedourselves makers. andpolicy- conditions whichare industry often neglectedbythepharmaceutical delay possibleontheonehandandother treating diseasesand togivecareof thepeople,trying inemergencysituations withintheshortest about adaptingtoolstothecircumstances inwhichweworkandtotheneeds best levelofcare andthetechnicalpossibilitiesavailable.Ourresearch isoften In thoseisolatedregions weare confronted withatensionbetweenoffering the places. position intheworld,treatingvulnerablepatientsmostisolated oftenvery clinical trialsorevencase-control studies,butwithourworkwehaveaunique Our research isnotaboutfundamentalresearch, wehardly are everinvolvedin It isanhonourtowelcomeyouourfirstOperationalResearch DayintheOCB! Dear friends,

LETTER LETTER sure from thattheylearn yoursuccessesandfailures. project toinfluenceothersinandoutsideMSF, butthatyoucantry andmake document wellwhatyouare doing,sothatyounotonlytreat thepatientsinyour fromI do hope we collectively can learn these experiences and stimulate you to flee violenceandpoverty. Howwillanaidspatientlookforcare? protocols dictate.Populationsare more andmore mobile,crossing borders to sis of tuberculosis and is it correct to treat all fevers as malaria as some national inresource-poor mortality duce maternal settings,howcanweimprove diagno Today wewilllistentofieldexperiencesindealingwithquestionsas:can re Meinie Nicolai - - Table of contents MSF OPERATIONAL RESEARCH DAY

OR Day Agenda ______2 Oral presentations Mother and child health ______4 Hospitals and surgery ______8 HIV and TB ______12 Neglected field research ______16

Posters ______20

Chairs and speakers ______25 AGENDA 2 Bangladesh? 09.00 RESEARCH DAY OPERATIONALMSF Agenda

09.15 Malaria detectioninrelation tofeveramong Plumpy Nut-Howacceptableisitformalnourished Meinie Nicolai Is Mid Upper Arm CircumferenceIs MidUpperArm (MUAC) sufficient foradmittingchildren fornutritional Mohamed Khogali Have wegotitright? malnourished children inEthiopia- Katie Harries in Africa?TheMSFexperienceBurundi. Is there awayforward toreducemortality maternal Engy Ali pregnant &lactatingwomen inaSlumsetting Chairs: FabienneRichard / SvenGudmundHinderaker Slot 1:Maternal/Childhealthandnutrition REMARKS OPENING Zubair Shams rehabilitation inanurbanslumDhaka, Bangladesh?

needs? 10.45 COFFEE 11.00 Integrating aneonatalcare packagewithina Emergency surgicalinterventionsinaconflict Making areal difference forwomenwithObstetric Are prescriptions formalariaandLowerRespiratory Isabelle Zuniga we doing? district hospitalsettinginBurundi –Howwellare Miguel Trelles Coast:whoareIvory thepatientsandwhatare their Aristide Bishinga fistulas inBurundi–aneglecteddiseaseAfrica. Marjolein DeBruycker rural SierraLeone? Tract InfectionrationalinanMSFreferral hospitalin Chairs: JeanClaudeSchmit Slot 2:HospitalsandSurgery

15.00 TEA 13.30 Outcomes andchallengesoftreating HIV, drug- Making qualitydiagnosticsavailable:Validation of MTB/RIFondiagnosisof Impact ofXpert® Model ofcare fortheprovision ofcross-border workers inMusina,SouthAfrica. antiretroviral therapyto migrantZimbabweanfarm- Joanna Ladomirska in alargeurbanslumsettingMumbai,India. resistant tuberculosis (DRTB) co-infectedpatients Laura Treviño Thyolo District,Malawi. load monitoringinadecentralizedprogramme in finger-prick driedbloodspots(DBS)forHIVviral Peter Saranchuk tuberculosis (TB)inAfrican sites. Chairs: LutLynen /AnthonyD.Harries Slot 3:HIVandTB Gilles vanCutsem

17.00 RECEPTION 16.45 CLOSING 18.00 15.15 Lassa fever–aneglecteddiseaseinAfricawho MSF Belgium AGM MSF Rony Zachariah Assessing theimpactofOR onpolicyandpractice. Is operationalresearch deliveringthegoods? Eva Deplecker Is thepackageofcare we offer adequate? Sexual violenceinpostconflictLiberia. Peter Maes a studyfrom Niger. length ofstayinnutritionrehabilitation programs: Is there arelation betweenvillagewatersupplyand Amine Dahmane MSF referral hospitalinrural SierraLeone. are thepatientsandwhat are theiroutcomesinan /PaulHunter Chairs: MarleenBoelaert OPENING OF THEMSFOCBGathering / Slot 4:NeglectedFieldResearch Bertrand Draguez Bertrand

AGENDA 3 MOTHER AND CHILD HEALTH 4 and Tropicaland Medicine. research); LondonSchoolofHygiene Paris, France(Centreforoperational against Tuberculosis andLungdisease, Dhaka, Bangladesh;InternationalUnion Médecins SansFrontières,Kamrangirchar, Brussels OperationalCentre,Luxembourg, department (Operationalresearch); Médecins SansFrontières,Medical Harries. Draguez, PascalDelchelvarie,AnthonyD. Flavio Salio,MalikAllaouna,Bertrand Vernaeve PetraAlders,JennySoderberg, Tajmary Akter, Marcel Manzi,Lieven Engy Ali,RonyZachariah,ZubairShams,

ladesh inorder toassess theacceptabilityofPlumpy’nut This studywasconducted in Bangladesh? rehabilitation ofpregnantandlactatingwomeninaslumsetting 1. Plumpy’Nut:howacceptableisitforcommunitybasednutritional CHILD HEALTH AND MOTHER Oral presentations Dhaka, Bangladesh. malnourished pregnant and lactating women living in the slumsof Urban The aim of this study was to assess the acceptability of Plumpy’nut among toconductadeeperinvestigationonacceptabilityissues. necessary thatacceptabilityissuesmightinfluenceadherence,Due toconcerns itwasfelt found itdifficulttodigest. while offering PPN,many women complainedofitstasteandsmellthatthey of themixture. However, peanutsareofthestapledietinSouthAsiaand notpart women. AsPPNwasdevelopedforAfrica,peanutsare component animportant Use TherapeuticFood(RUTF)

the – amongmalnourishedpregnant andlactating

Kamrangirchar slumsetting inDhaka,Bang ® (PPN)–aReadyto

maternal mortalityinarural districtsetting The aim of this studyisto report on the “model of care” and its impacton lance andcommunicationsystemforthetransferofcomplicated toCURGO. stetric andgynaecologycasesfrom healthcentersandii)establishinganambu ric and Gynaecology reference centre (CURGO)for referral of complicated ob MSF tackled these two challenges by: i) setting up a central Emergency Obstet graphic access. ic access to high qualityemergency obstetric care services and the lack of geo two mainchallengesthatare causaltosuchhighratesare thelackofgeograph rates areBurundi where Mortality among the highest in the world. The Maternal Since anumberofyears,MédecinsSansFrontières hasbeenworkinginrural The MSFexperiencefromruralBurundi 2. ReducinghighmaternalmortalityinAfrica:

- - - - - Hygiene and Tropical Medicine. operational research);LondonSchoolof against TB andLungDisease(centrefor Burundi, Kabezidistrict;InternationalUnion Operational Centre;MinistryofHealth, Médecins SansFrontières-Brussels Manirampa J,KabanguA,HarriesAD. Pottier R,LopezC,ChristaensB,Ndelema V,Lambert EncinasL,Goetghebuer S, R, ManziM,ReidT, Nicolai M,DePleckerE, Tayler-Smith K, Van denBerghR,Zachariah

MOTHER AND CHILD HEALTH 5 MOTHER AND CHILD HEALTH 6 Medicine. London SchoolofHygieneand Tropical Diseases (Centerforoperationalresearch). Union Against Tuberculosis andLung Ministry ofHealth,Ethiopia.International Bergen, CentreforInternationalHealth. Médecins SansFrontières,Universityof A.D Harries. L. Ayada, D.Jima,S.G.Hinderaker, K. vandenBrande,Tayler-Smith, M. Khogali.,R.Zachariah,A.Keiluhu,

bination of malaria and malnutrition adds to morbidity and mortality ofvulnerable bination ofmalariaandmalnutritionaddstomorbidity mortality Ethiopia.Thisareacenters insouthern isalsoendemic for malariaandthecom In response toanutritionalemergencyinEthiopia,MSFsetup48 Ethiopia. Havewegotitright? 3. Malariadetectioninrelationtofeveramongmalnourishedchildren association betweenmalaria andgradesofmalnutrition dren with and without fever who had Plasmodiumfalciparum malariac)the cording underroutineconditions b) theproportion of malnourishedchil The aim of this study was to determine a) the frequency of temperature re dren whodidnothavefever atthetimeofpresentation. among children withfever andthusmighthaveexcludedmalariainfectedchil malaria. TheEthiopianguidelineshoweveronlyrecommended RDTtesting MSF routinely usedrapid malariadiagnostictests(RDTs) forthedetectionof children. Inorder basedanti-malarialtreatment, torationalizeuseofArtemesinin - - - - Bangladesh. case-finding and admission into the nutritional program in a slum setting in ability of theusesuchaMUACcut-off as a single measurement tool for and accept The aimofthisstudywas to provideinformationonthesafety be athighriskofdeath. ing of SAM using MUAC alone would miss a proportion of children who might still is arealthatthecurrent concern WHOrecommendation forcommunityscreen As WHZandMUACthresholds forSAMhaveminimaldegrees ofoverlap,there ment tool nutritional programs indeveloping countriesshouldonlyusea The World Health Organization (WHO) now recommends that community based Circumferenceof MidUpperArm (MUAC)andweight(wt)forheight(ht)(WHZ). malnutrition (SAM)hadbeenclassicallybasedonsimultaneous measurements Screening andadmissionofchildren lessthan5years ofagewithsevere acute for nutritionalrehabilitationinanurbanslumDhaka,Bangladesh? 4. IsMidUpperArmCircumferencesufficientforadmittingchildren ( MUAC) forcase-detectionandadmissionofchildren withSAM. single measure

- - - Hygiene and Tropical Medicine,London. operational research);LondonSchoolof against TB andLungDisease(Centerfor program, Bangladesh;InternationalUnion operational centre;Kamrangircharnutritional Médecins SansFrontières,Brussels A D.Harries. Allaouna M,DraguezB,DelchevalerieP, Alders P, SoderbergJ,SalioF, ManziM, Shams Z,EngyA,ZachariahR,Vernaeve L,

MOTHER AND CHILD HEALTH 7 HOSPITALS AND SURGERY 8 School ofHygieneand Tropical Medicine. (Centre foroperationalresearch);London Tuberculosis andLungdisease, Paris,France Health, Burundi;InternationalUnionagainst Operational Centre,Luxembourg,Ministryof department (Operationalresearch);Brussels Médecins SansFrontières,Medical R. Zachariah,T. Reid,A.D. Harries. C,S. Goetghebeur, E.Deplecker, M.Nicolai, M. Manzi,R.Pottier, V. Bertrand Lambert, D.VanD. Bulckaert, Laeken,D.Mesia, I. Zuniga,R.Van DenBergh,B.Ndelema,

Neonatal mortality ratestooareNeonatal mortality extremely highandin2009,MSFopenedaneo Province ratesare where mortality amongthehighestinworld. maternal In Burundi,MédecinsSansFrontières hasbeen working inBujumburaRural in ruralBurundi–Howwellarewedoing? 1. Offeringaneonatalcarepackageindistricthospitalsetting SURGERY AND HOSPITALS Oral presentations neonates offeredcareinthe unit. and outcomesof in aruraldistrictsettingandb)the characteristics care The aimofthisstudyistodescribea)thefeasibility ofofferingneonatal ogy unitatdistricthospitallevelinsub-SaharanAfrica the firsttimeofneonatalcharacteristicsandoutcomes of anintegratedneonatol GO). Standardized monitoring ofdatawasintroduced and allows descriptionfor natal unitlinkedtoanexistingreferral centre forobstetricemergencies(CUR

- - - hospital outcomesofthese inpatients. in Sierra Leone, and to examine the associations of such adherence with inpatients admitted forselecteddiseasesin hospital an MSFruralreferral treatment guidelines in prescribing anti-infective medication for paediatric This aim of this study was to assess the level of adherence to standard tings inthedevelopingworld. low ratesofadherence to suchguidelineshavebeenreportedinmultipleset Use ofstandard treatment guidelinesmayposeasolutiontothischallenge,but verse drugreactions, increasing antimicrobial resistance andwastedresources. problem. of patient outcome, ad It may have serious consequences in terms Non-rational use of medicines is a widespread global wasteful and harmful rational inanMSFhospitalSierraLeone? tractinfection 2. Areprescriptionsformalariaandlowerrespiratory - - Hygiene and Tropical Medicine. research), Paris,France;LondonSchoolof and LungDisease(CenterforOperational Leone; InternationalUnionagainst TB Centre Brussels;MinistryofHealthSierra Médecins SansFrontières,OCB,Operational Kamara. R. Zachariah,CatherineCloquet,Samuel M. Allaouna,S.Satyarayanan,D.Enarson, B. Schiavetti,Y. Nzomukunda, P. Alders, A. Dahmane,M.Khogali,T. Reid, M. DeBruycker, R.Van denBergh,

HOSPITALS AND SURGERY 9 HOSPITALS AND SURGERY 10 Hygiene and Tropical Medecine. operational research),LondonSchoolof Tuberculosis andLungDisease (Centerfor of Health,InternationalUnionagainst Médecins sansFrontières,BurundiMinistry S. Goetghebuer, M. Nicolai,A.D.Harries. V. C,L.Encinas, Bertrand Lambert, R. Pottier, M.Trelles, T. Reid,E.DePlecker, A. Vandeborne, B.Christaens,G.Sinabajije, M. Manzi,W. vandenBoogaard, A. Bishinga,K.Tayler-Smith, R.Zachariah,

tively highincidence,there islimitednationalcapacityforidentifyingandman is highandestimatedtooccurin0.2-0.5%ofalldeliveries. Despitethisrela In Burundi,theincidencerateofobstetricfistula(aneglecteddiseaseinAfrica) with Obstetricfistulas–aneglecteddiseaseinAfrica 3. Makingarealdifferenceforpeople learnt andthepatientoutcomes. thelessons of interventions, package the including fistula, obstetric ing The aimofthisstudyistodocumentholistic for manag model ofcare promote medical,physical andpsychosocialrecovery yond justthetechnicalactofsurgicalrepair related toobstetricfistula. ing inGitegaprovince in Burundi,withtheaimofreducingmorbidity maternal aging obstetricfistulae.In2010,MédecinsSansFrontières (MSF)beganwork

The MSFmodelofcare for obstetricfistulagoesbe

– itutilisesaholisticapproach to - - - - - surgical morbidity burden and pattern and the profile of operated cases and theiroutcomesduringconflictintervention. operated of profile the and pattern and burden morbidity surgical the ED, the in seen cases of profile the describe to is study this of aim The cases beingseenbyMSFare non-traumacases. tion, showingthatincircumstances ofconflict,aconsiderableproportion surgical caseburden were routinely collectedoverthecourseofinterven (ED)and well as emergency stabilization units. Dataonemergency department Coast,WestIvory Africa.Thisresponse consistedofasurgicalcomponentas In 2011, MSF conducted an emergency response in the post-electoral conflict in who arethepatientsandwhattheirneeds? Coast: in2011Ivory 4. Emergencysurgicalintervention

- Operational CentreBrussels. Médecins SansFrontières, Amine Dahmane,EngyAli,RonyZachariah. Marie-Christine Ferir, RafaelVan denBergh, Miguel Trelles, RosaCrestani,

HOSPITALS AND SURGERY 11 HIV AND TB 12 South Africa. Kenya; andMédecinsSansFrontières, Mozambique; MédecinsSansFrontières, Zimbabwe; MédecinsSansFrontières, Medical Unit;MédecinsSansFrontières, Médecins SansFrontières,South African Biot, HelenBygrave,EmmanuelFajardo. Giuliani, StephenvandenBroucke, Marc WalterElkin Bermudez, Kizito,Ruggero Peter Saranchuk,MunyaradziDhodho,

OCB, namelyKenya(1),Mozambique(2),SouthAfrica (2),andZimbabwe(2). by in 2011 in seven sites supported MTB/RIF’, also known as ‘GeneXpert’) ‘Xpert This presentation willfocusontheimplementationofanewTBdiagnostic(called 1. ImpactofXpert®MTB/RIFondiagnosisTBinAfricansites TB HIV AND Oral presentations tion of‘smear-negative’TBanddrug-resistant(DR-TB). tation ofthisnewtest,andearlyoutcomes,including the impact ondetec This presentation will describe thebackground, challenges with implemen - - prick blood,andDBSofvenous blood. finger- of DBS standard), (the plasma in measured load viral compare to This presentation will report on the results of a recent field validation study load. dressed byusingdriedblood spots(DBS)insteadofplasmatomeasure viral specimenstothedistrictlaboratory.porting Thesechallengescouldbead strained byhavinginsufficientclinicalstaff todrawblood,anddifficultyintrans At peripheralclinics,thefeasibilityofimplementingviral loadmonitoringiscon menting viral load monitoring among patients on ART in Thyolo District, Malawi. viral loadisthebestindicatoroftreatment failure. MSFisassistingwithimple Among HIV-infected patientsonantiretroviral therapy(ART), anelevatedplasma programme inThyoloDistrict,Malawi dried bloodspots(DBS)forHIVviralloadmonitoringinadecentralised 2. Makingqualitydiagnosticsavailable:Validation offinger-prick

- - - - Malawi MinistryofHealth. Thyolo DistrictHealthOffice; AIDSUnit, Sans Frontières,South African MedicalUnit; Médecins SansFrontières,Malawi; Zengani Chirwa. Fajardo, Tom Ellman,ReubenMwenda, Pieter Pannus,Carol Metcalf,Emmanuel Laura Treviño, IsabellaPanunzi,

HIV AND TB 13 HIV AND TB 14 Médecins SansFrontières,India. Homa Mansoor, HannaKaskinen. Joanna Ladomirska,Petros Isaakidis,

2006. In2007theprojectproviding started treatment toHIV/DR-TBco-infected most neglected and most medically complicated HIV patientsin India since The MumbaiHIVproject hasbeenproviding care andtreatment tosomeofthe in alargeurbanslumsettingMumbai,India 3. OutcomesandchallengesoftreatingHIV-DRTB co-infectedpatients to date. outcomes on information include will and programme influential but small This presentationwill highlight and challengesofthis the achievements collaborationwiththenationalTBandAIDSprogrammes).cal journals, tional conferences andmeetings, abstractpresentations, publicationsinmedi ties were fullyintegrated into theprogramme (presence inregional andinterna city andhasbeengainingvisibility, especially afteroperationalresearch activi Mumbai only 4years later. Theclinic is an established centre of excellence in the patients; treatment fordrug-resistant TBbecameavailableinthepublicsector

- - - tion onoutcomestodate. to provide to ART servicescross-border migrants,and will include informa This presentation will focus on the model of care that has been developed tween SouthAfricaandZimbabwe. ART andhealthservicerecords formulations oneithersideoftheborder be continuity ofcare formigrants takingART, andtocontendwithdifferences in of severalmonths,theproject hashadtodeviseinnovativestrategiesensure Zimbabwean seasonalmigrants,whosometimesreturn to Zimbabweforperiods workersare Asmostofthefarm munity byamobileclinicwhichvisitssixfarms. ing, assessmentofeligibilityforART, andART initiation,are doneinthecom ing decentralisedantiretroviral therapy(ART)workers.HIVtest servicestofarm around of2010,the projectprovid Musinasince2007. Inthelastquarter started border withZimbabwe, has beenprovidinghealthcare primary inthearea The Musinaproject, locatedinLimpopoProvince, South Africa,adjacenttothe to migrantZimbabweanfarm-workersinMusina,SouthAfrica 4. Modelofcarefortheprovisioncross-borderantiretroviraltherapy

- - - - - South Africa. Medical Unit;LimpopoDepartmentofHealth, Médecins SansFrontières,South African Médecins SansFrontières,South Africa; Sirwali. Hilderbrand, Robert Lynne Wilkinson,Carol Metcalf,Katherine Helen Bygrave,ChristineMwongera, Gilles vanCutsem,Tambudzai Matambo,

HIV AND TB 15 NEGLECTED FIELD RESEARCH 16 Medicine, London. London SchoolofHygieneand Tropical middle incomecountries–TheUnion,Paris; Centre forOperationalresearchinlowand Center forHealth(CRP-Santé),Luxembourg; Laboratory ofRetrovirology;PublicResearch Centre HospitalierdeLuxembourgand National ServiceforInfectiousDiseases, International Health,UniversityofBergen; and Sanitation–SierraLeone:Centerfor Operational Centre;MinistryofHealth Médecins SansFrontières,Brussels Vic Arendt, Jean-ClaudeSchmit,ADHarries. Stevens, DrA.P. Koroma, SvenHinderaker, Michel Van Herp,Richard Souya,Samual Nzomukunda, MalikAllouna,PetraAlders, Rafael Van denBergh,Tony Reid,Yvonne Amine Dahmane,RonyZachariah,

(Nigeria, SierraLeone,GuineaandLiberia). Africa what has become known as the Lassa fever belt in countries in western Lassa feverisanacuteviralinfectioncausedbythevirus,endemicin and whataretheiroutcomesinaruralhospitalSierraLeone 1. Lassafever–aneglecteddiseaseinAfrica-whoarethepatients RESEARCH FIELD NEGLECTED Oral presentations of thecurrentdiagnosticalgorithms. hospital in anMSFreferral in Bo,SierraLeoneandtoaddresstheweakness outcomes of children and women with suspected or confirmed Lassa fever The aim of this study was to describe the characteristics, management and ity rateof50%. Lassa feverhavebeendiagnosedintheGRChospitalwith anoverallcasefatal sporadic outbreaks ofLassa fever. SinceAugust2011,atotalof84cases Gondama ReferralCentre –GRC)inBodistrictSierraLeone,whichfaces Médecins SansFrontières levelreferral runsa200bedsecondary hospital(the

- feeding programinNiger. community watersupplyandthelength of staychildrenin a therapeutic The aim of this study was to examine the relationship between adequacyof may significantlydelayweightgaininfeedingprogrammes. ever, infectionsacquired inthehomesetting,includingwater-borne diseases, recognized factorinachievinggoodprogramme asanimportant results. How dren. Therationaleofthis approach isthatthehomeenvironment isincreasingly therapeuticfeedingformoderateandsevereambulatory malnutritioninchil has beenanincreasing move awayfrom therapeutic(inpatient)centres towards In theSahelregion ofAfrica,where MSFisfacedwith famineanddroughts, there of stayinnutritionprogramsNiger? 2. Istherearelationbetweenvillagewatersupplyandlength

- - Anglia. School ofMedicine–UniversityEast – OperationalCentreBarcelona,Norwich Centre Brussels,MédecinsSansFrontières Médecins SansFrontières–Operational Delchevalerie P., Van denBerghR.,Reid T. Maes P., DorionC.,HunterP., Roure C.,

NEGLECTED FIELD RESEARCH 17 NEGLECTED FIELD RESEARCH 18 Health andSocialWelfare, Monrovia,Liberia. Frontieres, Monrovia,Liberia;Ministryof Centre, Luxembourg;MedecinsSans reproductive health),BrusselsOperational ment (OperationalResearchandsexual Médecins SanSFrontières,Medicaldepart Charlyn Davis-Worzi. Goetghebuer, HelgaRitter, LukeBawo, Pieter Van Wolvelaer, Tatiana Gil,Stephan Hinderaker, Marcel Manzi,EvaDePlecker, Katie Tayler-Smith, RonyZachariah,Sven - ecdotal reportssuggestthatunusuallyhighratesofsexual violencehavecontin violence (SV)were suffered bycivilians.Despitetheendofwarin2003, an During the14yearsofcivilconflictinLiberia,unprecedented levelsofsexual Is thepackageofcareweofferadequate? 3. SexualviolenceinpostconflictLiberia. needs. c) how the current approach could be better adapted to meet survivors’ and the pattern of SV, b) the medical consequences and management, and of SVsurvivors The aimofthisstudywastodescribea)thecharacteristics care tohundreds ofsurvivorssexualviolenceinthecountry’s capital,Monrovia. Since 2003,MédecinsSansFrontières (MSF)hasbeenoffering comprehensive ued, especiallyagainstwomenandchildren.

- - search anddeterminethe outputs ofoperationalresearch. The aim of this study is to apply the proposed measures to MSF-OCB re and isbeneficialtocommunities sess thesuccessforoperationalresearch sothatORimproves healthsystems ure ifoperationalresearch wasdeliveringtheexpectedgoodsandhowtoas and diseaseburden high. Inarecentweproposed Lancetarticle howtomeas es isineffective andwasteful, especiallyinsettingswhere resources are scarce which finallydoesnottangiblyproduce outputsandaffect policiesandpractic so-called implementationgapor“know-do”gap.Useof resources forresearch between whatweknowfrom research andwhattodowiththatknowledge– the Operational research inlow-incomecountrieshas akeyrole infillingthegap Assessing theimpactofORonpolicyandpractice 4. Isoperationalresearchdeliveringthegoods?

- - - - college, London. Malaria, Geneva, Switzerland,Imperial Kenya; GlobalFund toFightHIV/TBand Tuberculosis researchandcontrol,Nairobi, Kenya andMedicalResearch Institute, Stockholm, Sweden;MinistryofHealth, Global Health(IHCAR),Karolinska institute, USA; DepartmentofPublicHealth, Divisionof Division of Tuberculosis Elimination, Atlanta, HIV, Viral Hepatitis,STD,and TB Prevention Control andPrevention,NationalCenterfor Antwerp, Belgium;CentersforDisease Medicine, DepartmentofMicrobiology, Brussels, Belgium;Instituteof Tropical Institute ofBiotechnology,Flemish interaction, Department ofMolecularandCellular Operational Research,Paris,France; Tuberculosis andLungDisease, Centrefor Unit on AIDS; InternationalUnionagainst Virus ResearchInstituteUganda land; MedicalResearchCouncil/Uganda Access toMedicinesUnit,Geneva,Switzer Luxembourg; MédecinsSanSFrontières, Operations researchunit;MSF-Luxembourg, Centre Brussels,Medicaldepartment, Médecins SanSFrontières,Operational DA, HarriesA.D. J, Chakaya.AtunR,Lienhardt C,Enarson Reid T, Castro KG,DraguezB,Von Schreeb Maher D,BissellK,Van denBoogard W, Zachariah R,Van denBerghR,Ford N,

NEGLECTED FIELD RESEARCH 19 POSTERS 20 van denBroucke, SandraSimons,Charlotte Elton Mbofana,EmmanuelFajardo, Steven Tubes inBuheraDistrict,Zimbabwe stored inBDVacutainer® CD4Stabilization 2. StabilityofCD4levelsinbloodspecimens Campaign, Cape Town, South Africa Town,TreatmentCape South Africa;Action Provincial GovernmentoftheWestern Cape, Frontières, Khayelitsha,South Africa; Town, South Africa; MédecinsSans Frontières, South African MedicalUnit,Cape Cape Town, South Africa; MédecinsSans South Africa; MédecinsSansFrontières, and Research,UniversityofCape Town, Centre forInfectiousDiseaseEpidemiology Mathee, Vuyiseka Dubula,Andrew Boulle Nompumelelo Mantangana,Shaheed Hildebrand, MichaelSchomaker, Cutsem, EricGoemaere, Katherine Gillesvan Miguel ÁngelLuque-Fernández, antiretroviral therapy to reinforcelong-termretentionincareon 1. Patientadherenceclubs:Anewmodelofcare RESEARCH DAY OPERATIONALMSF Posters Misheck Kuhudzayi van Vyve, Carol Metcalf,HelenBygrave, Welfare, BuheraDistrict,Zimbabwe Zimbabwe, MinistryofHealthandChild Africa; MédecinsSansFrontières,Harare, African MedicalUnit,Cape Town, South Zimbabwe; MédecinsSansFrontières,South Médecins sansFrontières,Murambinda, Johnny Daniels, Gilles vanCutsem Virginia McDermid, Azevedo, Cheryl Jennifer Hughes,HelenCox, community impact in Khayelitsha:Improvedcasedetection and 4. Decentralisedtreatmentfordrug-resistant TB Ministry ofHealth, Thyolo District,Malawi Médecins SansFrontières, Thyolo, Malawi; Richard Chidakwani Rumours Lumala,KingsleyMbewa, Andrew Mtilatila,GeorgeKhanyizira, IsabellaPanunzi, Rebecca M.Coulborn, response despiteavailabilityofviralloadtesting Malawi: Delaysinidentification,evaluation,and therapy amongHIV-positive patientsinThyolo, 3. Suspectedfailuretofirst-lineantiretroviral

Gilles vanCutsem, DanielaGarone David Coetzee,NompumeleloMantangana, Peter Saranchuk,Virginia deAzevedo, Rebecca Welfare, GabrielaPatten, Khayelitsha, SouthAfrica carein integration atprimary service 6. Identifyingandovercomingbarriers toTB/HIV Frontières, Khayelitsha,South Africa Melbourne, Australia; MédecinsSans Burnett Institute,MonashUniversity, Andiswa Vazi, JenniferHughes Helen Cox,BusisiweBeko,JohnnyDaniels, treatment duration Khayelitsha: riskfactorsandimpactoflong 5. Defaultfromdrug-resistantTBtreatmentin Health, Cape Town, South Africa Africa; CityofCape Town Departmentof University ofCape Town, Cape Town, South Sans Frontières,Cape Town South Africa; University, Melbourne, Australia; Médecins South Africa; BurnettInstitute,Monash Médecins SansFrontières,Khayelitsha,

Mozambique; CentersforDisease Control Belgium; MédecinsSansFrontières, Maputo, Médecins SansFrontières,Brussels, Ministry ofHealth, Tete, Mozambique; Ministry ofHealth,Maputo,Mozambique; TomJoseph Lara,KebbaJobarteh, Decroo Jacob Maikere,Bermudez-Aza, ElkinHernan Aleny Couto,BaltazarCandrinho,Marc Biot, Mozambique community adherencesupportgroupsin operational experiencetonationalroll-outof 8. ExpertpatientsandAIDS:Fromfield Maputo, Mozambique Mozambique; MédecinsSansFrontières, Mozambique; MinistryofHealth, Tete, Médecins SansFrontières, Tete, BTelferD Remartinez, S Dezembro, HMiro, CdasDores, LCumba, T Decroo, VMondlane,NDosSantos, children inruralTete, Mozambique and retentionamongHIV-positive dependent 7. CommunityART groupssupportART access Western Cape,Cape Town, South Africa South Africa; ProvincialGovernmentofthe University ofCape Town, Cape Town, of Health,Cape Town, South Africa; South Africa; CityofCape Town Department Médecins SansFrontières,Khayelitsha, Médecins Sans Frontières, Médecins Tete, Mozambique and Prevention, Maputo, Mozambique;

Epidemiology andMedicalStatisticsUnit, Medical ResearchCentreMumbai,India; Australia; PDHindujaNationalHospitaland South Africa; MonashUniversity, Melbourne, Médecins SansFrontières,Cape Town, Médecins SansFrontières,Mumbai,India; Giovanni Sotgiu,ChiaraMontaldo,Tony Reid Khan, EsdrasDaSilva,ZarirUdwadia, Ladomirska, PeterSaranchuk,Samsuddin Homa Mansoor, HelenCox,Joanna Petros Isaakidis,BhanumatiVarghese, second lineanti-TBtreatmentinMumbai,India infected patientsreceivingantiretroviraland 9. AdverseeventsamongHIV/MDR-TBco- Frontières, Cape Town, South Africa African MedicalUnit,MédecinsSans Ministry ofHealth, Thyolo, Malawi;South Médecins SansFrontières, Thyolo, Malawi; C Metcalf S Matewere, LTriviño Duran,PSaranchuck, E Diggle,BIsake,GKhanyizira,Goba, in ThyoloDistrict,Malawi 10. DecentralisationofTBdiagnostics Brussels, Belgium Frontières, OperationalResearchUnit, University ofSassari,Italy;MédecinsSans Department ofBiomedicalSciences,

Switzerland Frontières, Access Campaign, Geneva, Office, Thyolo,Malawi;MédecinsSans Belgium; MinistryofHealth,District Health Unit, MédecinsSansFrontières,Brussels, Town,Analysis and South Africa;Advocacy Netherlands; UniversityofCape Town, Cape Research, VUUniversity, Amsterdam, EMGO InstituteforHealthandCare Médecins SansFrontières, Thyolo, Malawi; J Shea S Scheffer, AAkkeson,NJemu,Ford, T Van denAkker, MBemelmans,EDiggle, in ThyoloDistrict,Malawi duringscaling-upofARTservices andPMTCT and outcomesofgeneralreproductivehealth 12. Constructiveintegration:Changesinuptake Thyolo, Malawi Virginia, Virginia, USA;MinistryofHealth, Department ofRadiology, Universityof Netherlands; The Network, Amsterdam, Médecins SansFrontièresDiagnostic Médecins SansFrontières, Thyolo, Malawi; Lumala, CaraSKosack,MichaelMurowa Saskia Spijker, WilliamEBrant,Rumours IsabellaPanunzi, Rebecca MCoulborn, tuberculosis inThyoloDistrictHospital,Malawi 11. Teleradiology improvesdiagnosisof

POSTERS 21 POSTERS 22 Street, London,UK. Hygiene and Tropical Medicine,Keppel Disease, Paris,France,LondonSchool of Union Against Tuberculosis andLung centre (Operationsdepartment), International MSF PakistanMission,BrusselsOperational Operational centre(OperationalResearch), Médecins SansFrontières,Brussels Catherine Van overloop. Maikéré, MicheleTwomey, RonyZachariah, Estelle Spoel,Jean-PaulJemmy, Jacob Mohammed Dalwai,KatieTayler-Smith, in anEmergencyRoomTimergara,Pakistan 14. Implementationofa“Triage Scoresystem” Disease. Union Against Tuberculosis andLung centre (Operationsdepartment),International MSF DRCMission,BrusselsOperational Operational centre(OperationalResearch), Médecins SansFrontières,Brussels Draguez B,Van HerpM. L,GrummensT,C Bertrand,Echinas Meinie Nicolai,MarcelV, Manzi,Lambert Rony Zachariah,Tony Reid, KhogaliM, of Congo(DRC) MSF experienceinLubutu,DemocraticRepublic 13. ReducinghighmortalityinruralAfrica:

Bangladesh; InternationalUnionagainst Sans Frontiéres,Kamrangirchar, Dhaka, Operational Centre,Luxembourg,Medecins department (Operationalresearch);Brussels Médecins SansFrontières,Medical Harries. Draguez, PascalDelchelvarie,Anthony. D. Flavio Salio,MalikAllaouna,Bertrand Vernaeve PetraAlders,JennySoderberg, Tajmary Akter, Marcel Manzi,Lieven Engy Ali,RonyZachariah,ZubairShams, slum settinginBangladesh malnutrition inpregnantwomenanurban 15. Plumpynutacceptabilityforsevere Guir’el Hospital(Médecins SansFrontieres), Operational centre (Operationsdepartment), Kenya,Medecins sansFrontieres, Brussels Somalia Missioncoordination,Nairobi, Operational centre(OperationalResearch), Médecins SansFrontières,Brussels Draguez.B, Stokes.C,Reid.T, HarriesA.D Amin.H (,MichalskiD,Oberreit. J, Abdulrahaman.F, Abdulrahman.O,BseisoJ, Ibrahim.A, Said.I,Hassan.A, Marcel.M, Maalim.A,Ali.E.,JemmyJ.P, Zachariah.R, Bienvenue.B,Ayada.L, without borders”inconflicttornSomalia 16. Telemedicine –practicing“medicine School ofHygieneand Tropical Medicine. (Centre foroperationalresearch);London Tuberculosis andLungdisease, Paris,France

MSF- Luxembourg, Luxembourg. Centre Brussels,Operationsresearch unit Médecins SansFrontières,Operational F,Giandonato S,Loots G,MaesP Coloni F,Van DenBerghR,Sittaro experience in anemergencysetting–theHaiti field 18. BiodegradablePlasticbagexcretadisposal Bergen, Norway, Universityof Auckland. Research, Paris,France;),Universityof and LungDisease,CentreforOperational International Unionagainst Tuberculosis Luxembourg; MedecinssansFrontieres; Operations researchunit;MSF-Luxembourg, Centre Brussels,Medicaldepartment, Médecins SansFrontières,Operational A, HarriesA.D. Draguez B,v, AmineDahmane,EnarsonD. Tayler-Smith, Manzi M,KizitoW, KhogaliM, S. Srinath,K.BisselVan denBerghR,K. Zachariah R,ReidT, Sven GHinderakar, and addedvalue research training–theapproach,outputs 17. Anewinnovativemodelofoperational Tropical Medicine,KeppelStreet,London,UK France, LondonSchoolofHygieneand Tuberculosis andLungDisease,Paris, Research, InternationalUnion Against Galgadud, Somalia.,CentreforOperational

Hygiene andTropical Medecine. operational research), LondonSchoolof Tuberculosis andLungDisease(Centerfor Unionagainst of Health,International Médecins sansFrontières, BurundiMinistry S. Goetghebuer, M. Nicolai,A.D.Harries. V. C,L.Encinas, Bertrand Lambert, R. Pottier, M.Trelles, T. Reid, E.DePlecker, A. Vandeborne, B.Christaens, G.Sinabajije, M. Manzi,W. vandenBoogaard, A. Bishinga,K.Tayler-Smith, R.Zachariah, Obstetric fistulas–aneglecteddiseaseinAfrica 20. Makingarealdifferenceforpeoplewith Hygiene and Tropical medicine,London operational research);Londonschoolof Against TB andLungDisease(Centerfor program, Bangladesh;InternationalUnion Operational centre;Kamrangircharnutritional Médecins SansFrontières,Brussels Delchevalerie P, AD.Harries. Salio F, ManziMAllaounaM,DraguezB, Lieven Vernaeve, AldersP, SoderbergJ, Zubair Shams,AliEngy, RZachariah, Bangladesh? rehabilitation inanurbanslumDhaka, for admittingchildrennutritional 19. IsMidUpperArmCircumferencesufficient

performance inahighHIVprevalencesetting, team basedincentivesystemonstaff 22. STAR Awards- Theeffectsofanon-monetary Sans Frontières,Stockholm,Sweden. Advocacy Unit,Brussels,Belgium;Médecins DRC; MédecinsSansFrontières Analysis & Médecins SansFrontières,OCBKinshasa, Van Dethier. Overloop,Thierry Catherine Mit Philips,KerstinAkerfeldt, Corine Benazeh,MamadyCamara, gap inDemocraticRepublicofCongo(DRC). shortfall causesawidening,deadlytreatment 21. RationingHIVtreatmentinreallife:Funding Belgium. Advocacy Unit,OCB,Brussels, Médecins sansFrontières, Analysis & of Tropical Medicine, Antwerp, Belgium; Health Office,Blantyre,Malawi;Institute Mission, Blantyre,Malawi; Thyolo District Médecins sansFrontièresOCBMalawi Mwagomba. Beatrice Mit Philips,KatharinaHermann, Nabila SaddiqTayub, MariëlleBemelmans, Malawi

Belgium. MSF Analysis and Advocacy Unit, Brussels, consultant, MSF-OCBKinshasa, DRC, MSF-OCB Lubutu,DRC,Independent Catherine Vanoverloop, MitPhilips Guillaume Jouquet,Frederique Ponsar, intheDistrictHospitalofLubutu. health services data, collectedduringpost-conflictrestartof district hospitalinDRC:basedonreallifecost 25. Simulationofrunningcostneedsforarural Advocacy Unit,Brussels,Belgium. Médecins SansFrontières, Analysis & Mit Philips,FrédériquePonsar, SecoGerard supported healthservices. linked totheremovalofuserfeeswithinMSF governmental organisation:Processandissues policy changewithinaninternationalnon- 24. Lessonslearnedfromanorganization-wide Advocacy Unit,Brussels,Belgium. Médecins SansFrontières, Analysis & Médecins SansFrontières,Kinshasa,DRC; Ponsar. MitPhilips,FrederiqueDominique Lambert, standards? planning andresourceallocation:alackof outpatient andinpatientactivitiesinDRCfor 23. Thequestionofadequateutilizationratesfor

POSTERS 23 POSTERS 24 Research, VUUniversityMedical Centre, EMGO InstituteforHealthandCare Access Campaign,Geneva,Switzerland; South Africa; Médecins SansFrontières, Médecins SansFrontières,Cape-Town, of Tropical Medicine(ITM), Antwerp, Belgium; Ministry ofHealth,Lilongwe,Malawi; Institute Office, MinistryofHealth, Thyolo,Malawi; Advocacy, Brussels,Belgium;DistrictHealth Médecins SansFrontières,HealthPolicy& Médecins SansFrontières, Thyolo, Malawi; C. Metcalf,N.Ford, T. vandenAkker. M.Philips, Diggle, D.Namate,K.Hermann, M. Bemelmans,A.Likaka,Akesson,E. AIDS-programming inThyolodistrict,Malawi 27. HealthsystemstrengtheningthroughHIV/ Campaign forEssentialMedicines,New York. Sweden; MédecinsSansFrontières, Access Médecins SansFrontières,Stockholm, Médecins SansFrontières,Blantyre,Malawi; Sans Frontières,Harare,Zimbabwe; Advocacy Unit,Brussels,Belgium;Médecins Médecins SansFrontières, Analysis and SharonannKerstin Akerfeldt, Lynch. Woods, FasilTeseira, Viñoles, Mari-Carmen Marielle Bemelmans,MitPhilips,Shelagh due tofundingshortfall implementation ofWHOtreatmentguidelines 26. Countriesforcedtodelayedorrationed Amsterdam, Netherlands.

treatment inseveralAfricancountries international fundingcommitmentsforHIV 29. Consequencesofbacktrackingon Belgium. Médecins SansFrontieres,Brussels, Seco Gerard, MitPhilips,MichelVan Herp Frédérique Ponsar, GuillaumeJouquet, health centrelevelinMali. for childrenunderfiveandpregnantwomenat underabolitionofallfees and malariaservices scale gainsthroughincreaseduptakeofgeneral 28. Costperpatientanalysisshowseconomyof Frontières New York, UnitedStates. Stockholm, Swede;MédecinsSans Médecins SansFrontières,ProgrammeUnit, Essential Medicines,Geneva,Switzerland; Sans Frontières,Campaignfor Access to Advocacy Unit,Brussels,Belgium;Médecins Médecins SansFrontières, Analysis and E.MacLean. K. Akerfeldt, M. Philips,S.Rens,Lynch, R. Leray,

Advocacy Unit,Brussels,Belgium. Médecins SansFrontières, Analysis and Sans Frontières,Brussels,Belgium; Democratic RepublicoftheCongo;Médecins Médecins SansFrontières,Kinshasa, Sylvaine Lonlas-Mayele,MitPhilips. Marie-EveBurny,Sophie Duterme, support inDRC. with coverageobjectivesandhealthsystems interpretation differences,conflictingpriorities outbreaks inpost-conflictcontexts: 30. ObstaclestoadequateresponsesMeasles

for projects Coast. inRDCandthenIvory 2002 until2004,hewasMedical Coordinator Angola, SouthSudanandAfghanistan. From as adoctorandthenFieldCoordinator in East Timor, and continuedgaining experience working with MSF as a practitioner in started doctor from LouvainCatholic University. He Bertrand Draguez Brussels inOctober2010. gium andofMSF’s operationaldirectorate in until shewaselectedpresident ofMSFBel director ofoperationsintheBrusselsoffice Belgian association.In2004,Meiniebecame tinued asshebecameaboard memberofthe and 2003,butherinvolvementwithMSFcon reproductive healthandAIDSbetween2002 coordinate thenationalnetworkonsexualand dan. MeiniereturnedtotheNetherlands go, Ethiopia,Rwanda,SomaliaandSouthSu Angola, theDemocraticRepublicofCon since gainedadecadeoffieldexperiencein as asupervising nurse inLiberia. She has Meinie Nicolai CHAIRS Chairs andspeakers he istheMedical Director oftheOCB. Rwanda, Burundi, DRC and CAR. Since 2008, He becameMedical Polyvalentformissionsin

first worked with MSF in 1992,

graduatedasamedical - - - - with for HealthinLuxembourg,which Retrovirology embourg. He tional serviceforinfectiousdiseasesinLux specialized in Jean- and tropical medicine.Hespentover20years in theUnitedKingdom ininfectiousdiseases He isaphysician andaregistered specialist and Tropical MedicineintheUK. professor attheLondonSchoolofHygiene and LungDiseaseinFrance anhonorary UnionagainstTuberculosisthe International Anthony DavidHarries Luxembourg association. Since 2012,heisthePresident oftheMSF and authored more the populationof in Luxembourg He also Jean-Claude became dren the earlydiagnosis

theoperationalresearch unitat over 200

born toHIVpositivemothers born Claude

participated inpublichealthstudies participated

is presentations atconferences at the

Schmit

infectious diseases at the na than 80scientificpublications in thefieldof in charge of the

chronic

of HIVinfection Public Research Center theCEO isamedicaldoctor isSeniorAdvisorat

drug users

viral infectionsin

of the Laboratory of Laboratory collaborated . In2007,

with chil . MSF He Center

has

. on - - - . of the Journal ofWaterof theJournal andHealth.Hismain committeesand isaneditor expert ternational fessor Huntersits onseveralnationalandin and NorwichUniversityHospital.ProNorfolk consultant medicalmicrobiologist withinthe College ofPhysicians.Heisalso honorary of theFacultyPublicHealth of theRoyal 1999 healsobecameaMember (now Fellow) thologists in1985andaFellow in1995.In coming aMemberoftheRoyalCollege ofPa on tospecializeinmedicalmicrobiology, be from Manchester University in 1979 and went tice since2001.Hegraduatedinmedicine School ofMedicine,HealthPolicyandPrac Protection attheUniversityofEastAnglia Paul Hunter to hiscurrent position. ofHealth.In2008,hereturnedto UK Ministry tional AdvisorinHIVcare andtreatment inthe lawi Tuberculosis Control Programme andNa school inBlantyre, NationalAdvisortotheMa Professor ofMedicineatthenewmedical secutively ConsultantPhysician,Foundation moving toMalawiin1986where hewascon Nigeriain1983and inNorth-east starting living andworkinginsub-SaharanAfrica, hasbeenProfessor ofHealth ------

CHAIRS 25 POSTERS 26 table accessto qualityC-sectioninAfrica. co. ShehasjustcompletedherPhD onequi health in Weston maternal Africa and Moroc 2013), assessing the impact of fee exemption the newFP7-EUproject FEMHealth(2011- barriers toobstetriccare. Sheisinvolvedin ed thewriting of amonograph on financial Ouagadougou, BurkinaFaso.Shecoordinat l’Accès auxSoinsObstétricauxd’Urgence)in UASOU (AméliorationdelaQualitéet ity ofcare. Shecoordinated theproject AQ health,accesstohealthcareternal andqual Antwerp in1999.Herfieldof research isma Health oftheInstituteTropical Medicinein of Public Lanka). She joinedthe Department Burkina Faso,Kenya,Liberia,Somalia,Sri 5 yearsindevelopingcountries(Afghanistan, ence asclinicalmidwife,afieldexperienceof public health(MSc).Shehas10years’experi who specializedintropical medicineand Fabienne Richard books. erature, sixbooksandover20chaptersin 180 peer-reviewed inthescientificlit articles nam. Professor Hunterhaspublishedover RicoandSaudiArabiaVietrica, Puerto ongoing studiesinHungary, Spain,SouthAf Hehashadrecentfood orwaterborne. and infectious diseases,especiallythosethatare research interests are intheepidemiologyof pert midwifeandisinvolved inFGMresearchpert She isafemale genital mutilation (FGM) ex isaregistered midwife ------overseas unit,responsible forHIVresearch team attheITMinAntwerp,asheadof 1999-2002, andin2003shejoinedtheHIV She workedfortheITMinCambodiafrom at theUniversityofAntwerp(ITM). Medicine she became a specialist in Internal Belgium inChad,SudanandGuinea.In1997 Between 1986and1992sheworkedforMSF 1985 from theCatholicUniversityofLeuven. Lut Lynen of HealthinBelgium. and clinical guidelines writing for the Ministry tières (MSF) from 1986onwards andjoined ologist who worked with Médecins Sans Fron Marleen Boelart eases &HIV/AIDS. ber 2011theheadofUnitInfectious Dis ofClinicalSciences,andinNovem partment In July2011shebecamethehead ofthede guidelines. tions andtheauthorofMSFAIDScare development groupInfec onOpportunistic tions. SheisamemberoftheWHOguideline Infec HIV co-infectionsandOpportunistic care inresource-limited settings,inparticular sicians in the field. Her fieldof interest is AIDS serviceforHIV phy medicine distantsupport Antiretroviral Therapy(SCART) andtheTele oped andcoordinatedCourseon theShort projects abroad. During this time she devel graduated as a medical doctor in is a public health epidemi ------and since2012as aprofessor. associateprofessorat theCIHaspart-time courses since2009.Since2010he isworking pneumonia programme. HefacilitatesOR consultant forTBprogrammes andachild and supervisor, with theUnionasa andpartly at theCIH as a researcher,ing partly lecturer this research in2004.Since2000heiswork rural area inTanzania, andfinishedaPhDwith a studyonoutcomesofpregnancies inthis versity inNorway, and aftersometimestarted Health (CIH) at BergenUni for International collaboratingwiththeCentretime hestarted Lutheran HospitalinTanzania. Duringthis worked asaphysicianfor6yearsinHaydom from MedicalschoolinBergen1988.He Sven Gudmund Hinderaker Nepal. Democratic RepublicofCongo,andonein grams for institutional collaboration, one in the Disease Control. Shecoordinates twopro courses ofITMandisdirector oftheMPHin epidemiology andbiostatisticsinvarious bednets forkala-azarcontrol. Shelectures treatment andtheefficacyofimpregnated benefit ofrapiddiagnosticsforkala-azar ness. Sheevaluatedamongotherstheclinical es, mainlyleishmaniasisandsleepingsick trates oncontrol oftropical infectiousdiseas werp, Belgiumin1994.Herresearch concen the InstituteofTropical Medicine(ITM)inAnt

is graduated ------provements indiagnosisoftuberculosis (TB) im focus ofhisworkhasbeento support serve asaTB-HIVtechnicaladvisor. Amajor South African Medical Unit (SAMU) in 2010 to Lesotho andChina),before joiningOCB’s HIV-TB projects inAfrica(DRC,SouthAfrica, Canada foranumberofyears.He workedin joined MSFin2002afterdoingclinicalwork Peter Saranchuk and holdsaPhDinoperationalresearch. scientific publicationsinoperational research He hasauthored andco-authored over130 al level. the scienceofoperationalresearch onaglob tributed considerablytodevelopandpromote erational research intheOCB.Healsocon of operationalresearch inMSF, and headsop He isoneofthepioneersdevelopment ence inconflictanddevelopingcontexts. working withMSFandgainedlargeexperi health.Hestarted Medicine andInternational graduate qualificationsinPediatrics, Tropical Rony Zachariah SPEAKERS Chairs andspeakers TB (DRTB). in peopleliving with HIV, plusdrug-resistant

is aMedicaldoctorwithpost isamedicaldoctor. He

- - - - - responses inthecountry. in severalemergency She hasalsotaken part drug-resistant TB(DRTB) project inMumbai. flict zone,inMon,Nagaland; and anHIV/ tal foraneglectedpopulationin apost-con ics inaconflictzoneChhattisgarh; ahospi in India,coordinating 3projects: mobileclin Medical Coordinator ofMSFBrussels’mission Chad, andPeru.Since2009she has beenthe Cost,Darfur,Indonesia, Ivory SouthSudan, emergency interventions)inBurundi,Angola, health care, nutrition,vaccination,HIV, and projects andsecondary (includingprimary Since joiningMSF, shehasworkedindiverse She hasbeenworkingforMSFsince1999. Focal Pointofthemission’s Thyoloproject for sion inMalawi,afterservingastheMedical of MedicalCoordinator ofMSFBrussels’mis since 2006.Sherecently tookuptheposition Relations. ShehasbeenworkingforMSF medical doctorwithaMastersinInternational Laura Treviño Duran Joanna Ladomirska in Zambia,UgandaandLesotho. two years. She has previously done missions

, registered nurse,isa is aregistered nurse. - - - - desh. emedicine inSomaliaandnutrition inBangla tional research studies onmalariainMali,tel research. opera Shehas beensupporting Mobile Implementation Officer for operational 2011, she has been working with MSF as a Public Health attheUniversity of Leeds.Since cian inEgypt.SheobtainedherMasters Engy Ali health inequities. child mortality, as well as advocacy to reduce and andmorbiditymaternal mortality ic strategiestoreduce TBandHIVrelated operational research, ofpragmat particularly ject. Hisinterests includeimplementationand in SouthAfrica,mostlytheKhayelitshapro Sudan, Angola,Mozambique,andsince2003 been working with MSF since 1998,inSouth medical doctorandepidemiologist, he has Research at the University of Cape Town. A tre forInfectiousDiseaseEpidemiologyand Researchan Honorary AssociateattheCen tor forMSFinSouthAfricaandLesotho Gilles Van Cutsem trainedasanintensivecare physi istheMedicalCoordina ------

SPEAKERS 27 SPEAKERS 28 ment for nutrition and primary healthcarement fornutrition andprimary in tional research and medicaldatamanage responsible fortheimplementationofopera Bangladesh, inearly2011,where heismainly nutritional project inKamrangirchar slum, Tropical Medicine. HejoinedtheMSF-OCB course attheLondonSchoolof Hygiene and health. He completed the epidemiology lish adiseasesurveillancesystemofurban toestab tothelocalgovernment cal support desh. Asahealthadvisorheprovided techni survey in divisional urban areas in Bangla supervisorforthebaseline as thesupportive DevelopmentCooperation(GIZ), with German in publichealth.HejoinedHIV/AIDSproject Zubair Shams sition. anddocumentation po ing inanORsupport have nowbeenwiththeunitsince2008,work tional Research (OR)UnitinBrussels,and Countries. Thereafter IjoinedtheMSFOpera take aMastersinPublicHealthforDeveloping and assuchIreturnedtoLondonunder healthanddevelopment est ininternational tion oftheParalysed.Thisprompted myinter with anNGOcalledCentre fortheRehabilita some timeinBangladeshworkingasaphysio National HealthServiceinLondon,Ispent working asahospitalphysiotherapistinthe Katherine Harries Luxembourg. MSF-Union operational research coursein the project. Heiscurrently completing the has a post graduation degree

Following six years of ------pharmacy attheUniversityofLeuven(1998- pharmacy Marjolein de Bruycker ric advisorforMSFOCBsinceJune2011. and Kenya.Shehasbeenworkingaspediat Central AfricanRepublic,Haiti,Zimbabwe, the Democratic Republic of Congo, Niger, the hood programs inmultiple counties, including Implementing Officer, child she supported bique. From 2009-20011,asPediatricMobile activities across severalprojects inMozam quently, shecoordinated pediatricHIV/AIDS Coast. Subse 2005 as a Pediatrician in Ivory Isabelle Zuniga –Union ORcourse inKenya. project in Burundi.Heisenrolled intheMSF currently workingintheMSFobstetricfistula Aristide Bishinga of rationalusedrugs. policiesandthepromotionof pharmaceutical intheoperationalimplementation ers support providingoperational pharmacist, amongoth May 2010sheisbasedinBrusselsworkingas inBrussels.Since the MedicalDepartment Sudan,andRDC,currentlycist inNorth works forMSFOCB,firstasmissionpharma different Since2007,Marjolein NGOpartners. to viding technicalandmanagerialsupport proKenya/South Sudanasfieldpharmacist, SansFrontièresworked forPharmaciens in Tropical MedicineinAntwerp(2004).Shehas 2003) andTropical MedicineattheInstituteof

started workingwithMSFin started

is amedicaldoctor. Heis , pharmacist, studied pharmacist, ------is aqualifiedagricultural engineerholdingan South-east Asia and SubSaharanAfrica.He 1991 in a variety of projects in Europe, Russia, Peter Maes tive healthatOCB. currently is advisorfor sexual andreproduc sexual andseproductive and healthsupport Haiti. From 2010-2011shehasworkedas pia, Papua(Indonesia),Zimbabwe, RDC,and MSF in2004,asamidwifeRwanda,Ethio working for Medicine inAntwerp.Shestarted grammes, PrinceLeopoldInstituteofTropical and Management of Reproductive Health Pro CourseonPlanning ished theInternational Eva dePlecker coordinator forsurgicalactivitiesinOCB. Burundi, andin2008hewasappointedasthe different missions: South Sudan, DR Congo, began to volunteer with MSF. He has been in werp InstituteofTropical Medicine.In2006he ished aMastercourseinPublicHealthatAnt des (cityofHuancavelica).In2002hefin Referral HospitalinthePeruviancentralAn esthesia, hewasappointedasDirector ofa siologist. AfterobtainingaPhDdegree inan til 1997,andworkedinPeruasaMDanesthe cialization inAnesthesiaandReanimationun practitioner inahealthcentre. Hedidaspe medical socialservicefirst,laterasageneral workinginPeruwiththe cine) andstarted Ukraine in1990(OdessaUniversityofMedi Miguel Trelles

has been working with MSF since finishedmedicalschoolin

is amidwife.In2008,shefin ------training course inParis, and hasfacilitated the pleted theUnion-MSFoperational research MSF OCBinEthiopia.Hesuccessfully com two yearsworkingasanepidemiologist for the SierraLeonemission.Hespent thelast MSF inMarch 2009asanepidemiologistin Mohammed Khogali Kenya is enrolled intheMSF–UnionORcourse erational research unit,asProgram officer. He ofLuxor,Since 2011,heispart theOCBop Cambodia, BurkinaFaso,China,andUkraine. head of mission in several countries including worked asadoctor, medicalcoordinator and and joinedMSFin2003.Upto2010,he gium. He worked asaphysician in Belgium medicine andemergencyinBel Amine Dahmane, working group ofMSF. leader ofthewater, hygieneandsanitation He is since 2006 the medical department. giene and sanitation unit in the MSF-OCB and iscurrently coordinator ofthewater, hy He hasbeenmemberoftheemergencypool management. mechanics, vectorcontrol, epidemiologyand trainingonsculpture,education withcertified engineering. Overtheyearshecompletedhis additional mastersdegree inwaterresources September 2011. appointed asan operational research fellowin course inLuxembourg andinKenya.Hewas .

MD, graduatedintropical , MD, MPH-DC, joined - - - -

SPEAKERS 29 NOTES 30 RESEARCH DAY OPERATIONALMSF Notes NOTES 31 NOTES 32 MSF operational centre Brussels MSF OCB Luxor Operational research MSF OCB South African Medical Unit (SAMU) Rue Dupré 94 and documentation unit 49 Jorissen Street - 3rd Floor Orion Building Brussels 1090 MSF Luxembourg P.O Box 32117 Braamfontein Belgium Rue de Gasperich 68 2017 Johannesburg www.msf-azg.be L-1617 Luxembourg www.msf.org.za Luxembourg www.msf.lu All presentations and posters will be available on the Luxor webpage: www.msf.lu/luxor