MSF Fight Measles Epidemic In Malawi

FIGHTING MEASLES IN THE DEVELOPING WORLD

MSF are fighting a measles epidemic in Malawi. Click here to see how.

MEASLES

Every minute a child dies of measles. Even though a safe and effective vaccine exists, outbreaks occur in many parts of the world because routine immunisation programs are not in place or efficient. In many places Médecins Sans Frontières (MSF) teams are confronted with outbreaks and have to organise emergency immunisation campaigns, which represent a complex logistical challenge.

According to the World Health Organisation (WHO), out of the 30 million children affected by measles every year, about half a million die. Most of those deaths occur in Africa and Asia. This contrasts sharply with the Western world where measles cases have become extremely rare thanks to universal routine immunisation. This leads many people to forget that measles is a major killer.

Measles is highly contagious. Symptoms like runny nose, cough, eye infection, and rash appear about 10 to 14 days after exposure to the virus. There are different levels of severity, and deaths following measles infection are usually due to measles-related complications like diarrhoea, dehydration, and respiratory infections (pneumonia, croup). Those deaths can occur weeks after the acute disease and are not always attributed to measles. Mortality can reach 5 percent to 20 percent of measles cases. Initial health condition, access to health care, and proper treatment provision are factors influencing mortality.

2011 International Symposium on Reducing Child Mortality: Thinking outside the hospital for effective medical care

15/07/2011

In the lead-up to the 7th World Congress of the World Society for Paediatric Infectious Diseases held in Melbourne, Australia, Médecins Sans Frontières and Epicentre are hosting a one-day satellite symposium to re-think...

Category: Upcoming Events (Events), Lectures & Seminars

Médecins Sans Frontières welcomes initiative by UNICEF to make vaccine prices public

31/05/2011

Geneva, 27 May 2011— In a bid to increase transparency and stimulate competition to bring down the prices of vaccines needed in the developing world, UNICEF has decided to publish the prices it pays to vaccine manufacturers.

Category: Press releases

Zambia: Measles vaccination campaign underway to immunise 600,000 children

24/05/2011

Mansa, Zambia – Médecins Sans Frontières teams are currently working alongside the Zambian health authorities to carry out a measles vaccination campaign with a target of almost 600,000 children. Médecins Sans Frontières launched...

Category: Field news

Treating measles in a remote province of the Democratic Republic of Congo

17/05/2011

In March, the measles epidemic that has raged in the Democratic Republic of Congo (DRC) for more than six months reached the remote province of Maniema. Despite the logistical challenges, Médecins Sans Frontières teams are...

Category: Field news

Medical and humanitarian emergency continues as violence persists in Ivory Coast

27/04/2011

21 April 2011: The medical and humanitarian emergency in Ivory Coast persists as violence rages in several neighbourhoods in Abidjan, and security in the west of the country remains critically unstable, with populations hiding in...

Category: Field news

DR Congo: “Measles epidemic spiralling out of control” according to Médecins Sans Frontières

28/03/2011

Over the past six months a measles epidemic has been sweeping through the Democratic Republic of Congo (DRC). Médecins Sans Frontières is raising the alarm and calling for concerted action to halt the spread of the disease.

Category: Press releases

Visit Doctors Without Borders and fight Malaria - 

http://www.msf.org.au/rciyw/

Source: www.msf.org.au

MSF Press Release -31 March 2011

IVORY COAST: CIVILIANS MUST NOT BE TARGETED AND MUST HAVE ACCESS TO MEDICAL CARE
Ivory Coast / 01.04.11
PARIS/BRUSSELS, MARCH 31, 2011 – New outbreaks of fighting in Ivory Coast are severely restricting already-limited civilian access to medical care, the international medical humanitarian organisation Médecins Sans Frontières said today.

An advancing front line has forced thousands of residents to flee in the western region of Ivory Coast over recent days. And in the city of Abidjan, it is now extremely difficult, if not impossible, to move around within certain neighborhoods, especially with armed men looting and firing in the streets.  It has become impossible to obtain access to medical care under these conditions.

"Access to care is critical," said Dr. Mego Terzian, Médecins Sans Frontières emergency coordinator. "Civilians must not be targeted and patients must be able to obtain medical care."

Médecins Sans Frontières has been working with health authorities in Abidjan since early March, treating 450 people, among them 314 victims of violence. The teams are working at the Abobo Sud Hospital, the only health facility still functioning in the city's northern neighborhoods. On March 31, 15 patients with gunshot wounds were taken to the hospital, although ambulances stopped transporting people some time ago.

While masses of people fled Abidjan last weekend, many remain in the city, taking refuge with host families or hiding in their homes. People come to the few medical facilities still operating only as a last resort. Most health care workers have left; many of those who remain do not come to work because of the insecurity. In addition, medicines and medical supplies are lacking.

Over the last three days Médecins Sans Frontières teams have treated more than 230 wounded patients in the towns of Bangolo and Duékoué, in western Ivory Coast.

"The population is yet again suffering the consequences of fighting," said Renzo Fricke, Médecins Sans Frontières emergency coordinator. "Our teams transfer patients who need emergency surgery—for example, three women with gunshot wounds recently—but there are many other patients facing problems, ranging from severe malaria to complicated labor and deliveries. They require urgent treatment too, but the difficulty of moving from one place to another is threatening patients' lives.”

In Duékoué, a town in the west severely affected by fighting, a Médecins Sans Frontières team is treating patients and stabilizing people requiring surgery for transfer to Bangolo, 30 kilometers away, where another Médecins Sans Frontières team is working in the town’s only functioning hospital.

The Catholic mission in Duékoué is housing a camp for displaced persons, where the numbers have doubled in just a few days. Confrontations in the region have also led thousands of people to converge on the western town of Guiglo, where health needs have increased. A Médecins Sans Frontières team there treats patients to the extent it can, but insecurity makes it very difficult to evacuate wounded people to Duékoué and Bangolo.

When wounded patients streamed into hospitals in Yamoussoukro and Bouaké, in the center of Ivory Coast, a Médecins Sans Frontières team contributed medical supplies. "This illustrates a problem resulting from a general paralysis of economic life," said Fricke. "Health care facilities lack medicines and supplies."

Médecins Sans Frontières, an impartial medical humanitarian organisation, observes strict neutrality in its operations. Its activities in Ivory Coast are funded exclusively by private donors, ensuring complete independence.

Related News:
 Ivory Coast: “The Fighting Is Increasing Everywhere” - 01-04-11 15:11
 Ivory Coast: Emergency Trauma Surgery

How the Cholera Outbreak In Haiti Began... MSF

Le Monde Op-Ed: Why It's Important to Know How the Cholera Epidemic in Haiti Began

DECEMBER 23, 2010

By Dr. Marie-Pierre Allié, President, Médecins Sans Frontières in France

Two months after the cholera epidemic began in Haiti, nearly 2,000 people have died and 100,000 have become ill. Médecins Sans Frontières has treated more than 51,000 people to date. The illness surprised observers both because of its breadth and the initial speed with which it spread. It raised important questions that remain unanswered today. Basic data about the source of the illness and the daily case count are among the unknowns that need to be answered in order to understand the course of the epidemic.

The monitoring and information system established by the World Health Organization (WHO) is critical for directing the response, but it has gaps. In addition to lacking specific data on the initial type of contamination, it took nearly two months to finally obtain the figures allowing responders in the field to answer, region-by-region, the questions raised by the development of the epidemic. When did it begin in this region? What are its dynamics? Should we fear a rebound of the disease?

The U.S. Centers for Disease Control has officially refused to investigate the source of the illness. Contrary to its founding principles, the U.S. government's epidemiological investigative and monitoring agency states that "the answer to that question makes no difference in efforts to prevent the disease from spreading."

In fact, the lack of investigations and documentation leaves the field wide open to multiple theories. Briefly, there are two conflicting hypotheses as to the source of the epidemic on the island. One is based on global warming and the other points to a cholera strain imported from Asia.

Johns Hopkins University professor David Sack endorses the "green" hypothesis. He and some of his colleagues believe that rising water temperatures and increased salinity created conditions favorable to the growth of plankton that serve as hosts for cholera vibrio. According to this theory, vibrio can survive long-term in brackish, stagnant water and may thus trigger new epidemic peaks.

Harvard University microbiologist John Mekalanos, working with other researchers, offers a different explanation. Advocates of the "Nepalese" hypothesis have concluded that cholera was brought to Haiti in early October with the arrival of a contingent of U.N. blue helmets (Minustah forces), including soldiers from Kathmandu. In fact, a strain of cholera similar to the one circulating in Haiti today hit Kathmandu last summer. French professor Renaud Piarroux, of Nice University Hospital, conducted an on-site investigation for the French and Haitian governments and supports this hypothesis. He places the first cases close to the Minustah camp in Mirebalais, in the center of the country and far from water that might carry plankton.  This theory may also explain the suddenness with which cholera struck in Haiti.

These two explanatory models imply very different courses of development for an epidemic, so priority should be given to assembling an independent, multidisciplinary team that can confirm or reject one or the other. However, the United Nations' Office for the Coordination of Humanitarian Affairs (OCHA) continues to repeat that "the issue of the origin of the epidemic is actually not important." Minustah has long challenged the need for any investigation, asserting that "experts have emphasized the difficulty, if not the impossibility, of determining precisely how cholera came to Haiti."

MSF cannot support such statements. It is counter-productive to hide epidemiological data and keep investigative reports confidential. Such actions prevent us from establishing a precise diagnosis and can result in misdirected aid efforts. For example, the WHO says that the epidemic continues to worsen, basing those statements on the number of cumulative cases (which, by definition, continue to increase until the epidemic ends). However, based on its activity figures, which correspond to more than half of the number of patients, MSF notes that the number of new daily cases has stabilized over the last two weeks, with the exception of certain disease centers in the Northern Department.

The alarmist—and unconfirmed—predictions of the WHO and the U.N. Secretary-General of up to 650,000 cases serve only to increase fears. Even worse, the refusal to answer Haitians' questions about the source of the cholera reinforces a climate of distrust and suspicion toward foreigners. Confidence is critical to obtaining the population's support for and cooperation with the systems that international NGOs have established.

For these reasons, we must identify the source of the epidemic. The results of the epidemiological investigations must be published and a commission of independent experts must be appointed.

—Dr. Marie-Pierre Allié, President, Médecins Sans Frontières in France

Haiti: An Overview of MSF Operations in 2010

DECEMBER 20, 2010

Haiti 2010 © Frederic Sautereau

MSF staff at work in a makeshift operating room in Port-au-Prince, in the days after the earthquake.

BRIEFING PAPER

Download Briefing Paper: MSF in Haiti, One Year After the Earthquake [128 KB]

Executive Summary:

Doctors Without Borders/Médecins Sans Frontières (MSF) is immensely grateful to the millions of people around the world who have helped finance the organization’s massive relief effort in Haiti and for the thousands of dedicated national and international staff who mobilized in the aftermath of the January 12th earthquake.

At the time of the earthquake, MSF had been providing continuous health care in Haiti for almost 20 years. After the earthquake hit, MSF’s existing deployment of 800 field staff working in three facilities in Port-au-Prince was quickly expanded to 3,400 people working in 26 hospitals and clinics in the capital city and beyond.

During the three-month emergency phase of the earthquake response, these teams treated 165,000 people, distributed 28,000 shelters and 85,000 non-food item kits, rehabilitated 10 hospitals, and constructed four new facilities. MSF devoted a large share of its operational resources to the establishment of emergency trauma and obstetrical surgical care. MSF was the major actor in emergency surgical care among the 30 foreign field hospitals deployed during these first three months. MSF surgeons performed 5,707 major surgical procedures. The Cuban government, which sent five field hospitals, reported 3,562 major operations in the same period, and the staff on USS Comfort performed 800 operations during its 7-week mission.

By mid-December, in the midst of the ongoing cholera outbreak in Haiti, MSF had more than 4,000 Haitian workers are working alongside 315 international staff to maintain existing programs and mount the cholera emergency response. They run seven private, free-of-charge, secondary-level care hospitals and support two Ministry of Health structures in Port-au-Prince, accounting for nearly 1,000 hospital beds in the capital. These facilities provide emergency, trauma, obstetrical, pediatric, maternal, and orthopedic care services. Mental health care and treatment and counseling for victims of sexual violence are also provided by MSF. Outside the capital, MSF supports Ministry of Health hospitals in Jacmel with nearly 100 beds of patient capacity and runs a private, 120-bed container hospital in Leogane that opened in October.

From January 12 to October 31, MSF treated more than 358,000 people, performed more than 16,570 surgeries, and delivered more than 15,100 babies. MSF also uses mobile and fixed-point clinics to provide primary medical care and relief supplies to displaced persons living in various camps in Port-au-Prince and is carrying out water-and-sanitation services to displaced persons in the Cite de Soleil slum. By December 12, MSF teams had treated 62,000 cholera cases in 47 treatment centers located around the country.

Download the full report.

Tags: Haiti Earthquake 2010, Haiti, Cholera

Source: http://www.doctorswithoutborders.org/news/article.cfm?id=4926&cat=field-news

For more updates on MSF's work around the world
you can follow us on Twitter and Facebook.