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MSF ACTIVITY REPO MSF ACTIVITY R T 06 | 07 Médecins Sans Frontières (MSF) was founded in Today MSF is an international medical- 1971 by a small group of doctors and journalists humanitarian movement with branch offices in who believed that all people should have access 19 countries. In 2006, over 27,000 MSF doctors, to emergency relief. MSF was one of the first nurses, other medical professionals, logistical MSF ACTIVITY nongovernmental organisations to provide experts, water and sanitation engineers and urgently needed medical assistance and to administrators provided medical aid in over 60 publicly bear witness to the plight of the people countries. | it helps. REPORT 06 07 MSF International Office 78 Rue de Lausanne, Case Postale 116, CH-1211 Geneva 21, Switzerland T (+41-22) 8498 400, F (+41-22) 8498 404, E [email protected], www.msf.org THE MEDECINS SANS FRONTIERES CHARTER ABOUT THIS BOOK Country text and sidebar material written by Médecins Sans Frontières is a private international Sylviane Bachy, Claude Briade, Gloria Chan, Petrana Ford, Jean-Marc Jacobs, association. The association is made up mainly of doctors Anthony Jacopucci, Alois Hug, Frida Lagerholm, James Lorenz, Laura and health sector workers and is also open to all other McCullagh, Anna-Karin Modin, Alessandra Oglino, Susan Sandars, Natalia professions which might help in achieving its aims. All of Sheletova, Veronique Terrasse, Bas Tielens, Elena Torta, Erwin van ’t Land its members agree to honour the following principles: Special thanks to Médecins Sans Frontières provides assistance to populations Laure Bonnevie, Natacha Buhler, Tobias Buhrer, Christophe Fournier, Tory in distress, to victims of natural or man-made disasters and Godsal, Michael Goldfarb, Myriam Henkins, Cathy Hewison, Eva Kongs, Jordi to victims of armed conflict. They do so irrespective of race, Passola, Barry Sandland, Miriam Schlick, Emmanuel Tronc, and all the field, religion, creed or political convictions. operations and communications staff who reviewed material for this report. Médecins Sans Frontières observes neutrality and Editor Caroline Veldhuis impartiality in the name of universal medical ethics and Photo Editor Bruno De Cock, Sofie Stevens the right to humanitarian assistance and claims full and Copy Editor Melissa Franco unhindered freedom in the exercise of its functions. Arabic Edition Members undertake to respect their professional code of Coordinator Mohamed Naji ethics and to maintain complete independence from all Translator Marouane El-Fakiri political, economic or religious powers. Editor Mohamed Naji As volunteers, members understand the risks and dangers French Edition of the missions they carry out and make no claim for Coordinator Hélène Ponpon themselves or their assigns for any form of compensation Translation Translate 4 U sàrl other than that which the association might be able to (Aliette Chaput, Emmanuel Pons, Philippe Delahaut) afford them. Editor Hélène Ponpon Italian Edition Coordinator Barbara Galmuzzi Translator Selig S.a.S. Editor Barbara Galmuzzi Spanish Edition Coordinator Mar Padilla Translator Pilar Petit Editor Eulalia Sanabra Graphic Design Studio Roozen, Amsterdam, The Netherlands Printing Kunstdrukkerij Mercurius, Westzaan, The Netherlands The country texts in this report provide descriptive overviews of MSF work throughout the world between July 2006 and July 2007. Staffing figures represent the total of full-time equivalent positions per country in 2006. Reasons for Intervention classify the initial event(s) triggering an MSF medical-humanitarian response as documented in the 2006 International Typology study. Country summaries are representational and, owing to space considerations, may not be entirely comprehensive. COVer PHOTO © Michael Zumstein/L’Oeil Public, Sudan 1 CONTENTS Médecins Sans Frontières 4 | 2 | MSF MISSIONS AROUND 27 | GLOssary OF DISEASES THE WORLD MSF PROJECTS AROUND Report Activity 4 | THE YEAR IN REVIEW THE WORLD Dr. Christophe Fournier, President, MSF International Council 29 | Africa 7 | OVERVIEW OF MSF 57 | Asia and the Caucasus 06 | OPERATIONS 8 | 07 71 | The Americas PHOTO Essay 77 | Europe and 8 | Reasons for Intervention the Middle East text by Emmanuel Tronc, Policy and Advocacy Coordinator, MSF International 85 | MSF COUNTry PrOGRAMME CLOSURES EssayS 86 | AUDITED FACTS AND 18 | Humanitarianism… FIGURES | in the Meantime 18 Christopher Stokes, Secretary General, 88 | CONTACT MSF MSF International 21 | What Borders for MSF Surgery? Caroline Veldhuis, International Editor 24 | Displaced in Darfur Bruno Jochum, Director of Operations, MSF Switzerland 29 | 85 | © Monica Rull 2 MSF MISSIONS AROUND THE WORLD MSF opens and closes a number of individual projects each year, responding to acute crises, handing over projects, and monitoring and remaining flexible to the changing needs of patients at any given location. Several projects may be running simultaneously in a single country as needed. BELGIUM FRANCE SWITZERLAND ITALY MOROCCO HAITI MALI NIGER CHAD GUATEMALA HONDURAS BURKINA FasO GUINEA NIGERIA SIErra IVOry CENTraL LEONE COasT AfrICAN LIBERIA REPUBLIC CamEROON COLOMBIA REPUBLIC OF ECUADOR CONGO DEMOCraTIC REPUBLIC OF CONGO PERU ANGOLA ZambIA BOLIVIA SOUTH AfrICA 3 31 | ANGOLA 64 | KYRGYZSTAN 59 | ARMENIA 64 | LAOS 60 | BANGLADESH 42 | LESOTHO 79 | BELGIUM 42 | LIBERIA 73 | BOLIVIA 43 | MALawI 32 | BURKINA FASO 44 | MALI 32 | BURUNDI 82 | MOLDOVA RUSSIAN 60 | CAMBODIA 44 | MOROCCO FEDERATION 32 | CAMEROON 45 | MOzambIQUE 34 | CENTRAL AFRICAN 65 | MYANMAR REPUBLIC 66 | NEPAL 34 | CHAD 46 | NIGER 61 | CHINA 48 | NIGERIA 73 | COLOMBIA 66 | PAKISTAN 35 | REPUBLIC OF CONGO 82 | PALESTINIAN 36 | DEMOCRATIC TERRITORIES MOLDOVA REPUBLIC OF CONGO 76 | PERU 74 | ECUADOR 82 | RUSSIAN FEDERATION UZBEKISTAN 38 | ETHIOPIA 48 | RwaNDA GEORGIA KYRGYZSTAN ARMENIA 79 | FRANCE 49 | SIERRA LEONE TURKMENISTAN 62 | GEORGIA 50 | SOMALIA 74 | GUATEMALA 51 | SOUTH AFRICA CHINA 39 | GUINEA 67 | SRI LANKA PALESTINIAN IRAN IRAQ TERRITORIES 75 | HAITI 52 | SUDAN PAKISTAN NEPAL 76 | HONDURAS 84 | SWITZERLAND 62 | INDIA 68 | THAILAND BANGLADESH 63 | INDONESIA 70 | TURKMENISTAN INDIA MYANMAR 80 | IRAN 54 | UgaNDA LAOS 80 | IRAQ 70 | UZBEKISTAN THAILAND 81 | ITALY 55 | ZAMBIA SUDAN CAMBODIA 40 | IVOry COAST 56 | ZImbabwE 40 | KENya ETHIOPIA SRI LANKA SOmaLIA UgaNDA KENya INDONESIA RwaNDA DEMOCraTIC BURUNDI REPUBLIC OF CONGO MALawI ZambIA ZImbabwE MOzambIQUE LESOTHO SOUTH AfrICA THE YEAR IN REVIEW 4 © Sven Torfinn, Sudan © SvenTorfinn, Kenya Telemans, © Dieter 5 Médecins Sans Frontières The Year in Review Activity Report Activity 06 | Medical practise does not and cannot have double stan- ready-to-use therapeutic food based on a nutrient-dense peanut- 07 dards. So as health professionals we’re constantly looking milk paste. With this we initiated an outpatient strategy, treat- to provide the most effective healthcare possible for our ing the vast majority of children affected by severe malnutrition patients. This is no easy task, and even if we’re continually in an area of Niger. We now know that the number of children we making progress, there’s still a lot to do. were able to treat increased about ten-fold and the cure rate was better than previous protocols requiring systematic hospitalisa- In 2006, MSF provided treatment for almost two million people tion and using therapeutic milk or enriched flour. We now apply with malaria. This disease is all too common in poor, tropical this strategy everywhere, from West Africa, where severe infant areas and remains responsible for large-scale loss of life, particu- malnutrition is recurrent in countries such as Niger, through to larly among young children. In March 2007, we were pleased to the displaced or refugee populations in Darfur and Chad. A lot see the launch of a new medicine combining two of the most still has to be done to extend the use of these new therapeutic effective molecules for treating this disease in one tablet. Named ASAQ, because it combines Artesunate and Amodiaquine, this new formulation is the work of the DNDi (Drugs for Neglected Diseases “We now know that the Initiative), of which MSF is one of the co-founders*. The DNDi should allow us access to another medicine in the next few number of children we were able months, this time combining Artesunate and Mefloquine – a combination required for the numerous regions where the most to treat increased about ten-fold.” serious form of the malarial parasite has been highly resistant for some years. foods; to reduce the price of the raw materials they are made At present we are treating 100,000 HIV/AIDS patients with daily with, especially milk; and to get new compositions specifically anti-retroviral therapy (ART) in over 30 countries. This is obvi- for pregnant women and those with chronic illnesses. The avail- ously insufficient given the rising needs generated by the pan- ability of such a product is bringing a potential revolution for demic. AIDS is a disease that currently necessitates lifelong nutrition in resource-poor settings. treatment. The virus’ resistance to drugs after some years is a major concern for each of our patients and presents limitations to Overcoming this hurdle in the domain of nutrition should not, us as medical practitioners attempting to treat them. We have however, mask accumulated delays in the domain of preventive already observed this complication in South Africa, where 17 medicine, and two examples particularly stand out. First, vaccina- percent of our patients require a second line
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