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International Activity Report 2018 the Médecins Sans Frontières Charter

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International Activity Report 2018 the Médecins Sans Frontières Charter INTERNATIONAL ACTIVITY REPORT 2018 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 2018. Staffing figures represent the total full-time equivalent employees per country across the 12 months, for the purposes of comparisons. 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. 100. 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. This activity report serves as a performance report and was produced in accordance with the recommendations of Swiss GAAP FER/RPC 21 on accounting for charitable non-profit organisations. CONTENTS MSF PROGRAMMES FOREWORD THE YEAR AROUND THE IN REVIEW WORLD 2 4 5 OVERVIEW OF GAZA: OVERWHELMED THE BROKEN ACTIVITIES BY GUNSHOT WOUNDS AMERICAN DREAM 8 10 14 THE ROHINGYA: NO COUNTRY DRUG-RESISTANT ACTIVITIES BY COUNTRY TO CALL HOME TUBERCULOSIS: FROM HOPELESSNESS TO HEALING 16 18 20 FACTS AND GLOSSARY OF CONTACT MSF FIGURES DISEASES AND ACTIVITIES 92 96 100 International Activity Report 2018 1 MSF PROGRAMMES AROUND THE WORLD MSF PROGRAMMES AROUND THE WORLD BELARUS BELGIUM UKRAINE BOSNIA- FRANCE HERZEGOVINA SERBIA UZBEKISTAN ITALY GEORGIA ARMENIA GREECE TURKEY SYRIA LEBANON AFGHANISTAN IRAQ IRAN PALESTINE JORDAN PAKISTAN LIBYA EGYPT MEXICO MAURITANIA MALI HAITI NIGER HONDURAS CHAD SUDAN YEMEN EL SALVADOR NICARAGUA GUINEA-BISSAU BURKINA GUINEA FASO NIGERIA CÔTE VENEZUELA SIERRA LEONE CENTRAL ETHIOPIA D’IVOIRE SOUTH AFRICAN LIBERIA SUDAN REPUBLIC COLOMBIA CAMEROON SOMALIA UGANDA KENYA DEMOCRATIC REPUBLIC OF BURUNDI CONGO TANZANIA ANGOLA MALAWI ZAMBIA ZIMBABWE MOZAMBIQUE ESWATINI SOUTH AFRICA 2 Médecins Sans Frontières 21 ANGOLA 56 LIBYA 21 ARMENIA 57 LIBERIA 22 AFGHANISTAN 57 MAURITANIA 24 BALKANS 58 MALAWI 25 BANGLADESH 59 MALAYSIA 26 BELARUS 60 MEXICO 26 BELGIUM 62 MALI 27 BURKINA 63 MOZAMBIQUE FASO 64 MYANMAR 27 BURUNDI 65 NAURU 28 CAMEROON 65 NICARAGUA 29 CAMBODIA 66 NIGER 29 CÔTE D’IVOIRE 68 NIGERIA 30 CENTRAL 70 PAKISTAN AFRICAN 71 PAPUA NEW REPUBLIC RUSSIAN GUINEA FEDERATION 32 CHAD 72 PALESTINE 33 COLOMBIA 74 PHILIPPINES 34 DEMOCRATIC 74 RUSSIAN REPUBLIC FEDERATION OF CONGO 75 SEARCH 38 EGYPT AND RESCUE KYRGYZSTAN 38 EL SALVADOR OPERATIONS TAJIKISTAN 39 ESWATINI1 76 SIERRA LEONE AFGHANISTAN 39 FRANCE 77 SOMALIA 40 ETHIOPIA 78 SOUTH PAKISTAN 42 GREECE AFRICA BANGLADESH 79 SUDAN INDIA 43 GEORGIA MYANMAR 43 GUINEA 80 SOUTH SUDAN THAILAND 44 GUINEA- BISSAU 82 SYRIA CAMBODIA PHILIPPINES 44 HONDURAS 84 TAJIKISTAN 45 HAITI 84 TANZANIA MALAYSIA 46 INDIA 85 THAILAND INDONESIA NAURU 48 INDONESIA 85 TURKEY 48 IRAN 86 UGANDA PAPUA NEW GUINEA 49 ITALY 87 UKRAINE 49 KYRGYZSTAN 87 UZBEKISTAN 50 IRAQ 88 YEMEN 52 JORDAN 90 VENEZUELA 53 LEBANON 90 ZAMBIA 54 KENYA 91 ZIMBABWE Countries in which MSF only carried out assessments or small-scale cross-border activities in 2018 do not feature on this map. 1Formerly Swaziland FOREWORD With tens of millions of people on the move around the world and millions more trapped in conflict, amid political forces that – deliberately or otherwise – block access to lifesaving aid, the scale of violence and suffering inflicted on civilians in 2018 remained appalling. In 2018, Médecins Sans Frontières (MSF) was confronted with patients and their communities to define the most suitable models a barrage of cynical attacks and toxic narratives aimed at of care remains a priority for us all. This is the only way we will criminalising migrants and those showing solidarity towards them, become truly accountable to the people we assist and remain fit undermining humanitarian action, international law and the very for purpose in years to come. principles of humanity and solidarity. The most emblematic and brazen of these attacks put an end to the Aquarius’ search and We cannot talk about being accountable and ‘people-centred’ rescue operations on the Mediterranean Sea, condemning ever without also mentioning our efforts to tackle abuse and more men, women and children to drown along the world’s inappropriate behaviour within MSF and provide support to the deadliest migration route. Whatever the reasons for leaving their victims. Grievance channels have been improved and we have seen countries of origin – whether they are fleeing violence, poverty, an increase in the number of cases reported as a result, but given the insecurity or the effects of climate change – people on the move size and scope of our organisation, we know there must be more. have a right to protection and access to medical care, just as do We must therefore do more – to improve our systems, to make them those who choose to stay or are unable to leave. more widely accessible, and to ensure they are trusted and used by all our staff and patients, their caregivers and their communities. Whether it fits the political agenda or not, we will continue to offer all people in distress the most appropriate, effective medical Our social mission determines that our teams work in difficult, assistance we can. Our teams conduct independent evaluations stressful situations, often in horrific circumstances, to provide to determine medical needs and what relief we can bring, in lifesaving medical assistance to people who would otherwise be consultation first and foremost with the people we seek to assist. As without. We are immensely grateful to our tens of thousands of you will see in this report on our activities, community engagement staff in the field who spend their day-to-day lives assisting others. and patient-centred models of care are already integral to many of None of this work would be possible without the support of our our projects, but understanding how we can better work with our 6.3 million donors. Thank you for your ongoing belief in our work. Dr Joanne Liu Christopher Lockyear INTERNATIONAL PRESIDENT SECRETARY GENERAL 4 Médecins Sans Frontières A health worker waits to receive a new unconfirmed Ebola patient at the MSF-supported Ebola treatment centre in Bunia, Democratic Republic of Congo, November 2018. © John Wessels THE YEAR IN REVIEW By Dr Marc Biot, Dr Isabelle Defourny, Marcel Langenbach, Kenneth Lavelle, Bertrand Perrochet and Teresa Sancristoval, Directors of Operations In 2018, Médecins Sans Frontières (MSF) teams provided medical and humanitarian assistance to people facing extreme hardship in over 70 countries. From treating war-wounded ever closer to frontlines in Yemen, to responding to epidemic outbreaks such as cholera in Niger, or providing assistance to people fleeing violence in the Central African Republic, emergency response continued to be a core part of our work. As 2018 drew to a close, the Democratic seeking treatment. By the end of the year, the siege blocked incoming aid, medical staff had Republic of Congo (DRC) was in the midst of epidemic in North Kivu and Ituri provinces few medical supplies to work with. By the its second Ebola outbreak of the year, and its had claimed more than 360 lives and in some end of the offensive, 19 of the 20 hospitals biggest ever. MSF was part of the response, areas was still not under control. and clinics we supported were destroyed or led by the Ministry of Health. Although rapid abandoned, leaving civilians with few options and well-resourced, with teams having access Seeking care in war zones to seek medical help. to a promising new vaccine and several new Early in the year, Syrian civilians and medical The war in Yemen, which has left the country staff were caught in the violence in Idlib, in drugs with the potential to better protect and its healthcare system in ruins, entered and treat people, the response, and those the northwest, and in East Ghouta, near the its fourth year. The Saudi- and Emirati-led managing it, failed to adapt to people’s capital Damascus. In East Ghouta, the barrage coalition continued to target civilian areas with priorities, and to gain the trust of the was relentless in February and March, with airstrikes and bombings, including our new community. This lack of trust in the health waves of dead and injured arriving at MSF- cholera treatment centre in Abs. The war is services meant people delayed or avoided supported hospitals and health posts. As the taking a heavy toll on people, who often must continued overleaf International Activity Report 2018 5 THE YEAR IN REVIEW Displaced families in Pulka town queue for relief items after having been driven from their homes by the conflict between non-state © Igor Barbero/MSF armed groups and the army in northeast Nigeria, May 2018.
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