| Feature Item |
| Médecins Sans Frontières – Providing Medical Aid for All Wed 29 Dec 2004 |
"In many conflicts today, civilian life has lost a lot of its value. A greater proportion of civilians than ever get killed or injured. In these lawless environments, an MSF hospital often represents the last bastion of humanity, where civilians are cared for and protected."
Tom Day, MSF Surgeon |
Since 1971, volunteers from the aid agency Médecins Sans Frontières (MSF) have been providing emergency medical help to people in crises. MSF strives to provide assistance to those in greatest need, regardless of ethnic origin, religion or political affiliation.
To get access to, and care for, the most vulnerable, MSF must remain scrupulously independent of governments, as well as religious and economic powers. We rely on private donors for the majority of our funding. In the field, we conduct our own assessments, manage projects directly and monitor the impact of the aid we deliver. MSF insists on exercising its responsibility to speak out when we see that those we are trying to help are being abused. We campaign locally and internationally for greater respect for
humanitarian law and the right of civilians to impartial humanitarian assistance. We also campaign for fairer access to medicines and health care for the world's poorest people.
MSF is a voluntary organisation. Each year, about 2,500 doctors, nurses, logistics specialists and engineers of all nationalities leave on field assignments. They work closely with thousands of national staff.
War Surgery
In many conflict zones, MSFs intervention is vital to ensure that local hospitals remain open to all even in the most difficult circumstances. Our surgical programmes have saved many lives and limbs over the years, but they fulfil another important function. MSF UK surgeon Tom Day has worked for MSF in Bosnia and Chechnya reflects:
"In many conflicts today, civilian life has lost a lot of its value. A greater proportion of civilians than ever get killed or injured. In these lawless environments, an MSF hospital often represents the last bastion of humanity, where civilians are cared for and protected."
MSF teams in war zones maintain a stance of absolute neutrality and call upon the warring parties to respect the neutrality of hospital facilities, patients and medical personnel. MSF hospitals and clinics are neutral areas from which armed combatants are banned.
Ensuring access to health care
MSF works with local people to rebuild health systems, including hospital and community-based services that have been disrupted by war, political instability or economic disaster. A major part of this is establishing a good primary health care network by helping health authorities with staff training, treatment protocols and epidemic control.
Primary health care workers provide basic curative and preventative services. They undertake essential projects such as immunisation and mother-and-child programmes, while acting as the front-line detectors of disease outbreaks. Where communications and security are difficult, these are the health workers who will make sure that critically ill patients get to the nearest hospital for treatment. For patients needing urgent help, such as landmine victims or women in need of caesarean sections, these referral systems can literally mean the difference between life and death.
MSF also works in hospitals, providing essential services and support, such as paediatrics, surgery and general medicine. MSF volunteers bring in supplies and train national medical staff to ensure the highest possible standards of care for patients. The aim is always to hand over responsibility to the appropriate authorities once the crisis phase has passed.
It is not our aim to meet all the health needs of a given population for long periods of time. We set strict priorities to ensure that our independent aid targets the most vulnerable or those specific groups who are most likely to fall outside the mainstream relief efforts, be they internally displaced people, ethnic minorities, women, street-children or prisoners.
Infectious disease control
More people die of infectious diseases today than from any other cause. The impact and spread of these diseases is often compounded by conflict and by the lack of adequate medical facilities. MSF is often called in to help tackle epidemics.
We have a two-pronged approach to tackling infectious diseases: treating those individual people already suffering from diseases and taking preventative measures to curb the spread of these diseases. It is important to identify what the diseases are, where they came from and how they spread. MSF use specialised field kits that enable testing for many diseases to be carried out on the spot.
Different diseases require different approaches: vaccination programmes for measles and meningitis; the provision of basic hygiene and drinking water to avert cholera and dysentery outbreaks; bed nets to reduce the spread of malaria. Diseases such as tuberculosis and AIDS demand a complex combined approach of treatment, prevention and education over a long period of time.
Much of MSF's work in disease control is made more difficult by the absence of affordable modern drugs to treat tropical diseases. MSF is actively campaigning for greater research into developing new treatments for tropical diseases, and for cheap, effective medicines to be available to those people who need them. For details of MSFs Access to Medicines Campaign, click here (link to: http://www.accessmed-msf.org/)
How can you get involved?
At the heart of MSF are the national and international personnel who work with us. We constantly require fully qualified doctors, nurses, surgeons, anaesthetists, nutritionists and other medical professionals, as well as skilled support staff with experience of water-and-sanitation work, engineering, mechanics or logistics.
Most project staff are recruited locally; the overall ratio of national to international staff is ten to one. Training of national staff often forms a key component of MSFs work in the field in the post-emergency phase, with the aim of building a health care capacity able to continue long after MSFs departure. However, international volunteers learn from their local colleagues at least as much as they teach them, so cultural awareness and an open mind is a crucial component of a successful international assignment.
Working for MSF as an international volunteer is tough and demanding; living conditions can be basic, and some experiences deeply stressful – yet the rewards are unique. Noreen Walsh, a nurse and midwife who spent a year with MSF in Afghanistan explains:
"What I gave I got back 20-fold, on a personal and professional level. It was incredibly difficult, but wonderful - I learned more in one year in Afghanistan than I would have in decades at home."
Speaking out
MSF's commitment to reporting gross abuses of humanitarian law and medical ethics can be a challenging aspect of a volunteer's assignment. Field personnel may need to record and report such abuses and champion their patients' rights with the relevant authorities, even in the face of obstruction.
Getting involved: supporting MSF financially
MSFs ability to provide impartial aid and our freedom to report abuses of humanitarian law are only possible because of the regular support of concerned individuals. Private donations enable MSF to respond immediately to any emergency, often long before official funding becomes available. And, as humanitarian aid is increasingly dictated by governments' foreign policy interests, MSFs financial independence is more crucial than ever.
You can contribute towards our work in a number of ways: regular standing order, cheque, credit card or through the Charity's Aid Foundation's schemes.
To find out more about working with MSF, visit our website http://www.uk.msf.org
Nouria Brikci
Researcher
MSF (UK)
Direct: 0207 0674219
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