International Activity Report 2016
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INTERNATIONAL ACTIVITY REPORT 2016 www.msf.org THE MÉDECINS SANS FRONTIÈRES CHARTER Médecins Sans Frontières is a private international association. The association is made up mainly of doctors and health sector workers, and is also open to all other professions which might help in achieving its aims. All of its members agree to honour the following principles: Médecins Sans Frontières provides assistance to populations in distress, to victims of natural or man-made disasters and to victims of armed conflict. They do so irrespective of race, religion, creed or political convictions. Médecins Sans Frontières observes neutrality and impartiality in the name of universal medical ethics and the right to humanitarian assistance, and claims full and unhindered freedom in the exercise of its functions. Members undertake to respect their professional code of ethics and to maintain complete independence from all political, economic or religious powers. As volunteers, members understand the risks and dangers of the missions they carry out and make no claim for themselves or their assigns for any form of compensation other than that which the association might be able to afford them. The country texts in this report provide descriptive overviews of MSF’s operational activities throughout the world between January and December 2016. Staffing figures represent the total full-time equivalent positions per country in 2016. Country summaries are representational and, owing to space considerations, may not be comprehensive. For more information on our activities in other languages, please visit one of the websites listed on p. 96. The place names and boundaries used in this report do not reflect any position by MSF on their legal status. Some patients’ names have been changed for reasons of confidentiality. CONTENTS MSF PROGRAMMES THE YEAR OVERVIEW OF AROUND THE WORLD IN REVIEW ACTIVITIES 2 4 8 GLOSSARY OF DESTROYING THE EXPANDING THE DISEASES AND LAST HAVENS OF RESPONSE TO NIGERIA’S ACTIVITIES HUMANITY IN WAR HUMANITARIAN CRISIS 10 14 16 SEARCH AND RESCUE VACCINATION ON AN ACTIVITIES IN THE CENTRAL UNPRECEDENTED SCALE BY COUNTRY MEDITERRANEAN 18 22 24 International Activity Report 2016 1 MSF PROGRAMMES AROUND THE WORLD MSF PROGRAMMES AROUND THE WORLD SWEDEN BELARUS UKRAINE FRANCE SERBIA ITALY GEORGIA ARMENIA GREECE TURKEY TUNISIA SYRIA LEBANON IRAQ PALESTINE JORDAN ALGERIA LIBYA EGYPT MEXICO MAURITANIA MALI HAITI NIGER HONDURAS CHAD SUDAN YEMEN GUINEA-BISSAU GUINEA NIGERIA CÔTE VENEZUELA SIERRA LEONE CENTRAL ETHIOPIA D’IVOIRE SOUTH AFRICAN LIBERIA SUDAN REPUBLIC COLOMBIA CAMEROON UGANDA KENYA ECUADOR DEMOCRATIC REPUBLIC OF BURUNDI CONGO TANZANIA ANGOLA MALAWI ZAMBIA BOLIVIA ZIMBABWE MADAGASCAR MOZAMBIQUE SWAZILAND SOUTH AFRICA 2 Médecins Sans Frontières 25 ALGERIA 60 MALAWI 25 ANGOLA 61 MALI 26 AFGHANISTAN 62 MEXICO 28 ARMENIA 62 MOZAMBIQUE 28 BANGLADESH 63 MYANMAR 29 BELARUS 64 NIGER 29 BOLIVIA 66 NIGERIA 30 BURUNDI RUSSIAN FEDERATION 68 PAKISTAN 30 CAMBODIA 70 PALESTINE 31 CAMEROON 32 CENTRAL 71 PAPUA NEW AFRICAN GUINEA REPUBLIC 71 PHILIPPINES 34 CHAD UZBEKISTAN KYRGYZSTAN 72 RUSSIAN 35 COLOMBIA FEDERATION TAJIKISTAN 35 CÔTE 72 SWEDEN IRAN AFGHANISTAN D’IVOIRE 73 SEARCH AND 36 DEMOCRATIC PAKISTAN REPUBLIC RESCUE BANGLADESH OF CONGO INDIA 74 SOUTH MYANMAR 38 ETHIOPIA AFRICA THAILAND 40 ECUADOR 75 SOUTHEAST ASIA CAMBODIA PHILIPPINES 40 EGYPT MIGRATION 41 FRANCE 76 SOUTH 41 GEORGIA MALAYSIA SUDAN 42 GREECE INDONESIA 78 SYRIA 44 GUINEA PAPUA 80 SIERRA LEONE NEW GUINEA 45 GUINEA- BISSAU 81 SUDAN 45 HONDURAS 82 SWAZILAND 46 HAITI 83 SERBIA 48 ITALY 83 TAJIKISTAN 49 IRAN 84 TANZANIA 49 KYRGYZSTAN 85 TUNISIA 50 INDIA 85 TURKEY 52 IRAQ 86 UGANDA 54 JORDAN 87 UKRAINE 55 LEBANON 87 UZBEKISTAN 56 KENYA 58 LIBERIA 88 YEMEN 58 LIBYA 90 VENEZUELA Countries in which MSF only carried out assessments 59 MADAGASCAR 90 ZAMBIA in 2016 do not feature on this map. 59 MAURITANIA 91 ZIMBABWE THE YEAR IN REVIEW Dr Joanne Liu, International President Jérôme Oberreit, Secretary General Almost one-third of Médecins Sans Frontières wounded and people with medical emergencies, managed chronic (MSF) projects in 2016 were dedicated to illnesses and responded to disease outbreaks, notably through vaccination campaigns. MSF also worked to meet other vital needs, providing assistance to populations caught such as for drinking water and essential relief items. From Lebanon in wars, such as in Yemen, South Sudan, to Tanzania, MSF teams mobilised to assist hundreds of thousands Afghanistan, Iraq, Nigeria and Syria. MSF also of people who had fled violence and conflict to other countries in provided assistance to people on the move, search of safety. fleeing repression, poverty or violence, and in In Nigeria, the armed conflict between Boko Haram and the Nigerian many cases subject to new forms of violence, military displaced an estimated 1.8 million people in Borno state alone, with many communities cut off from the rest of the country for exploitation or danger as countries closed extended periods of time due to the conflict. In June, with only limited options for safe and legal routes. Our teams access due to widespread insecurity, MSF teams discovered shocking responded to other emergencies caused by situations in villages such as Bama, where two out of 10 children epidemics and natural disasters, and provided under the age of five were at risk of death due to malnutrition. care and improved treatment for patients with Thousands of people regrouped in different villages were entirely reliant on aid. By the end of the year, the humanitarian situation had diseases such as tuberculosis (TB) and HIV. improved in areas that were still accessible. However, the widespread insecurity and military restrictions presented a significant challenge to People in conflict MSF and other humanitarian actors: the number of people in need of In many conflict zones, civilians and civilian infrastructure – including lifesaving assistance in inaccessible areas is unknown. medical facilities – came under indiscriminate or targeted attacks. Millions of people had to flee their homes, sometimes multiple The armed conflict in Nigeria took on a regional dimension in the Lake times. Our teams provided assistance to those caught in conflict and Chad Basin, expanding across borders to Cameroon, Chad and Niger, fleeing. They cared for pregnant women and newborns, treated the with direct consequences for civilian populations. The crisis aggravated 4 Médecins Sans Frontières People queue to be vaccinated against yellow fever at a school in the Zone de Santé Kikimi in Kinshasa, Democratic Republic of Congo. © Dieter Telemans an already dire situation in a region suffering from poverty, food networks inside the country, through training, technical support insecurity, recurring outbreaks of disease, and almost non-existent and donations to medical facilities. This remains an extraordinary health systems. MSF teams stepped up medical and humanitarian approach for MSF, made necessary by people’s extreme level of assistance in Chad, Cameroon and Niger for people fleeing Nigeria, as need and suffering, and our lack of direct access. The level of well as for local and displaced populations affected by the crisis. violence, and need, and lack of assistance led to sustained public communications by MSF through the testimonies of Syrian medical In South Sudan in July, intense fighting erupted between government staff we supported, particularly in east Aleppo city and in besieged and opposition forces in the capital, Juba. MSF opened clinics to areas around Damascus. provide emergency treatment for patients with gunshot wounds and injuries, as well as ongoing healthcare for conditions such as Following the closure of the border between Syria and Jordan in June, malnutrition, malaria and diarrhoea. Between August and December, around 75,000 Syrians were left stranded in the Berm/Rukban area. we intensified our response to help South Sudanese refugees as MSF teams and other aid actors were no longer able to reach the the number of people fleeing violence increased, with hundreds of population. The border closures also prevented people from seeking thousands arriving in Uganda, as well as in Ethiopia and Sudan. assistance and protection outside Syria, a situation that is emblematic of a growing, pervasive reality across war zones, particularly in Syria. In areas hit by violence, adapted solutions have had to be found. In South Sudan, to ensure continuity of care during instability for patients receiving In Yemen, indiscriminate attacks against civilians and civilian HIV antiretroviral treatment, three-month emergency patient kits were infrastructure had a devastating impact on a country that was already prepared and distributed in the event of imminent displacement. one of the poorest in the region. To address the lack of healthcare and treat the increasing number of war victims, MSF scaled up its activities, In Syria, MSF medical activities continued to be significantly making the response in Yemen our largest in the Middle East in 2016. constrained due to insecurity in opposition areas and a lack of MSF teams directly provided healthcare to patients in 12 hospitals and authorisation by the Syrian government. MSF operated six medical supported at least 18 other facilities. On 15 August, an airstrike on Abs structures in northern Syria in 2016. In inaccessible zones, such as hospital in northern Yemen killed 19 people, including an MSF staff besieged areas, our teams provided distance support to medical member, and