6 MSF International Office Rue de Lausanne 78, Case Postale 116, CH-1211 Geneva 21, Switzerland T (+41-22) 8498 400, F (+41-22) 8498 404, E [email protected], www.msf.org MSF Activity Report 2005/0 MSF Activity Repor t July 2005 – July 20 06 Médecins Sans Frontières (MSF) was founded in 1971 by a small group of doctors and journalists who believed that all people should have access to emergency relief. MSF was one of the first nongovernmental organisations to provide urgently needed medical assistance and to publicly bear witness to the plight of the people it helps. Today MSF is an international medical humanitarian movement with branch offices in 19 countries. In 2005, over 2225 MSF volunteer doctors, nurses, other medical professionals, logistical experts, water and sanitation engineers and administrators joined approximately 25,850 locally hired staff to provide medical aid in over 70 countries. MSF was awarded the 1999 Nobel Peace Prize. The Médecins Sans Frontières Charter About this publication FEATURE WRITERS Médecins Sans Frontières is a private international association. Nathalie Borremans, Leopold Buhendwa, Dieudonné Bwirire, Fabien Dubuet, Margaret Fitzgerald, The association is made up mainly of doctors and health C. Foncha, Moses Massaquoi, Marilyn McHarg, Dalitso Minsinde, Rodrick Nalingukgwi, Fasineh Samura, Milton Tectonidis, Emmanuel Tronc sector workers and is also open to all other professions which might help in achieving its aims. COUNTRY TEXT AND SIDEBAR MATERIAL WRITTEN BY Emma Bell, Claude Briade, Lucy Clayton, Gabi Faber-Weiner, Petrana Ford, Stephan Grosserueschkamp, All of its members agree to hounor the following principles: Lisa Hayes, Jean-Marc Jacobs, Anthony Jacopucci, James Lorenz, Alessandra Oglino, Susan Sandars, Diderik van Halsema, Erwin van ‘t Land Médecins Sans Frontières provides assistance to populations SPECIAL THANKS TO in distress, to victims of natural or man-made disasters and Anne Ameye, Laure Bonnevie, Marine Buissonnière, Anouk Delafortrie, Rowan Gillies, Tory Godsal, Olivier Guillerminet, Lisa Hayes, Myriam Henkens, Florence Licci, Miquel Maldonado, Barry Sandland, to victims of armed conflict. They do so irrespective of race Miriam Schlick, Nicolas de Torrente, Emmanuel Tronc, and all the field, operations and communications religion, creed or political convictions. staff who reviewed material for this report. EDITOR Caroline Veldhuis Médecins Sans Frontières observes neutrality and impartiality PHOTO EDITORS Bruno de Cock, Sofie Stevens COPY EDITOR Melissa Franco in the name of universal medical ethics and the right to human- itarian assistance and claims full and unhindered freedom in ARABIC EDITION COORDINATOR Mohamed Naji the exercise of its functions. TRANSLATOR Brahim El-Khazrouni EDITOR Mohamed Naji Members undertake to respect their professional code of ethics FRENCH EDITION and to maintain complete independence from all political, COORDINATOR Corinne Cecilia TRANSLATOR Emmanuel Pons economic or religious powers. EDITOR Corinne Cecilia ITALIAN EDITION As volunteers, members understand the risks and dangers of COORDINATOR Barbara Galmuzzi the missions they carry out and make no claim for themselves TRANSLATOR Selig S.a.S. EDITOR Barbara Galmuzzi or their assigns for any form of compensation other than that which the association might be able to afford them. SPANISH EDITION COORDINATOR Mar Padilla TRANSLATOR Pilar Petit EDITOR Eulalia Sanabra GRAPHIC DESIGN Studio Roozen, Amsterdam, The Netherlands PRINTING Drukkerij Mercurius, Wormerveer, The Netherlands The country texts in this report provide descriptive overviews of MSF work throughout the world between July 2005 and July 2006. Staffing figures represent the total of full-time staff equivalents per country for 2005. Country summaries are representational and, owing to space considerations, may not be entirely comprehensive. COVER PHOTO Patients in the post-operation ward at the MSF Bon Marché Hospital, Bunia, Democratic Republic of Congo, May 2005. © Gary Knight (VII) 6 Contents 2005/0 MSF Missions around the World 2 The Year in Review 4 Rowan Gillies, President, MSF International Council and Marine Buissonnière, MSF Secretary General The Challenge of an Emergency in a World in Flux 7 Marilyn McHarg, General Director, MSF Canada Acute Malnutrition: A Highly Prevalent, Frequently Fatal, Imminently Treatable, Neglected Disease 10 Milton Tectonidis, MSF nutrition expert Doing More by Doing Less: Decentralising HIV/AIDS Care in Rural Malawi 13 MSF Team in Thyolo, Malawi: Fasineh Samura, Rodrick Nalingukgwi, C. Foncha, Dieudonné Bwirire, Leopold Buhendwa, Margaret Fitzgerald, Dalitso Minsinde, Moses Massaquoi, Nathalie Borremans United Nations: Deceptive Humanitarian Reforms? 16 Fabien Dubuet, UN Liaison Officer and Emmanuel Tronc, Policy and Advocacy Coordinator, MSF International Democratic Republic of Congo: Forgotten War 18 Photo Essay Medical Conditions Frequently Treated by MSF 25 MSF Projects around the World 27 Africa Asia and the Caucasus 53 The Americas 67 Europe and the Middle East 75 Project Handovers 83 Overview of MSF Operations 84 Audited Facts and Figures 85 Contact MSF 88 MSF Missions around the World POLAND P.80 BELGIUM P.76 LUXEMBOURG P.78 SWITZERLAND P.80 FRANCE P.76 ITALY P.77 LEBANON P.81 PALESTINIAN TERRITORIES P.82 MOROCCO P.42 NIGER P.44 MALI P.42 BURKINA FASO P.30 GUINEA P.37 GUINEA-BISSAU P.38 SIERRA LEONE P.46 LIBERIA P.40 GUATEMALA P.73 IVORY COAST P.38 HONDURAS P.69 BENIN P.29 HAITI P.72 NIGERIA P.44 ECUADOR P.68 CAMEROON P.32 COLOMBIA P.70 REPUBLIC OF CONGO P.34 PERU P.74 DEMOCRATIC REPUBLIC OF CONGO P.34 BOLIVIA P.68 ANGOLA P.28 SOUTH AFRICA P.50 2 MEDECINS SANS FRONTIERES ACTIVITY REPORT 2005/2006 RUSSIAN FEDERATION P.78 IRAN P.59 TURKMENISTAN P.65 ARMENIA P.54 UZBEKISTAN P.66 GEORGIA P.54 KYRGYZSTAN P.61 PAKISTAN P.63 JAPAN P.59 SOUTH KOREA P.66 CHINA P.56 CHAD P.32 LAOS P.61 SUDAN P.48 NEPAL P.62 MALAYSIA P.61 ETHIOPIA P.36 INDIA P.58 CENTRAL AFRICAN REPUBLIC P.31 SOMALIA P.47 BANGLADESH P.55 KENYA P.39 MYANMAR P.60 UGANDA P.50 THAILAND P.64 RWANDA P.45 CAMBODIA P.56 BURUNDI P.30 INDONESIA P.57 TANZANIA P.46 MALAWI P.41 MOZAMBIQUE P.43 ZAMBIA P.52 ZIMBABWE P.52 LESOTHO P.40 ACTIVITY REPORT 2005/2006 MEDECINS SANS FRONTIERES 3 The Year in Review In July 2006, amid intensifying armed conflict between Israeli Defense Forces (IDF) and Lebanese Hezbollah fighters, MSF launched an emergency intervention to help address medical-humanitarian needs. Assistance was offered on the Israeli side dealing with civilian deaths and injured from rocket attacks; however the nature of the conflict was such that there were greater needs and less available assistance in Lebanon. © Zohra Bensemra/REUTERS With a high intensity bombardment cutting demands, MSF retained its neutrality by The difficulties reaching people in need in major roads and bridges throughout the refraining from commenting on specific Lebanon are illustrative of a growing prob- country, transportation was difficult and military decisions of either side. This inde- lem of access that MSF has confronted over dangerous, compelling MSF to make public pendent and impartial approach to the pro- the past year. Despite the relative simplicity statements reminding those engaged in the vision of aid allowed us to move and assist of our mission – to provide impartial medi- conflict that they had a responsibility to in a context where almost all movement was cal-humanitarian assistance to those in allow assistance to reach civilians caught in prevented. need and prevent loss of life – our ability to the fighting. Though vociferous in such obtain access to patients can rarely be 4 MEDECINS SANS FRONTIERES ACTIVITY REPORT 2005/2006 Many of the people we help are trapped within highly charged and complex social and political contexts that create significant barriers to the provision of aid. diminishing and underfunded aid made available to them. Outside the camps, espe- cially in West and North Darfur, violence against civilians continues, accompanied by a significant increase in targeted attacks against aid workers including MSF staff, making land travel and logistical assistance close to impossible. MSF has been working in Darfur since early 2004 and intends to stay as long as we are able to be effective, although the situation is becoming increasingly precarious. Serious security incidents have forced us to reduce activities in the Jebel Marra region, despite an ongoing cholera outbreak, and we can no longer send surgical referrals by road for emergency care. This reduction in the ability to provide basic assistance is likely to have a critical impact on an already fragile health situation. Likewise in Sri Lanka, a country where we worked for many years during the conflict, seventeen aid workers from the NGO Action Contre la Faim were executed in July 2006. The perpetrators of this outrage have not been identified. With such attacks on clear- ly identified aid workers, there is a grave concern for the future of assistance in this country. MSF is struggling to get access to areas where there is no humanitarian assistance at all in this brutal civil war. An unhealthy mix Over the past year, there has been a mount- ing distrust toward aid organisations by those who have the power to grant us access. This mistrust is not always mis- placed. The practice of some nongovern- mental organisations (NGOs), private con- tractors and many governments doing ‘humanitarian’ work with a specific politi- cal aim causes confusion, and reduces the acceptance of the universal nature of An MSF convoy transporting emergency medical supplies and fuel remained stuck north of the Litani humanitarian assistance. This contributes River after an airstrike destroyed the last bridge. Four tonnes of supplies were carried by hand over 500 to a climate where groups opposed to any metres using a human chain. A tree trunk spanning the river was used as a makeshift bridge.