From the President
and the Executive Director

© P.K. Lee / MSF
Association members and staff of MSF-Hong Kong show solidarity with the team in Kunduz, Afghanistan, and call for independent investigation on the MSF hospital attack by US airstrikes

Dear Friends,
In October 2015, the Médecins Sans Frontières (MSF) Kunduz Trauma Centre in Afghanistan was targeted by US airstrikes. 14 staff, 24 patients and four patient caretakers were killed. One million people in northeastern Afghanistan remain deprived of lifesaving surgical care.

MSF was able to work in Kunduz through negotiated agreements with all parties to the conflict that they would respect the neutrality of the medical facility. An independent and impartial inquiry into the facts and circumstances of the attack is needed, as we cannot rely only on the US internal military investigations. Aerial bombardments of hospitals cannot simply be dismissed as “mistakes”.

Meanwhile, medical care in Syria has also become the target of deliberate and indiscriminate violence. Throughout 2015, 94 aerial and shelling attacks hit 63 MSF-supported facilities, of which 12 were completely destroyed; 81 MSF-supported medical staff were killed or wounded. In Yemen, airstrikes conducted by the Saudi- led coalition destroyed an MSF-supported hospital in October, leaving 200,000 people without access to medical assistance. The repercussions of attacks on health facilities continue long after the initial impact: civilians cannot receive essential medical care when they need it most, and some regard visits to hospitals as riskier than not seeking assistance at all.

Conflict and violence have forced hundreds of thousands of people to flee, but the global responsibility for hosting refugees is largely shouldered by countries bordering conflict zones. Lebanon is struggling to cope with the 1.5 million refugees from Syria, while Jordan has registered 600,000 Syrian refugees. In the Lake Chad region in western Africa, 2.5 million people in Cameroon, Chad, Niger and Nigeria sought shelter and protection following attacks by Boko Haram. MSF works in all these countries that rarely make the headlines.

This year, one million people fled to Europe. Among them, half came from Syria. At least 3,771 people died while attempting the dangerous sea crossing. MSF conducted search and rescue operations at sea and provided assistance at Europe’s entry points and along the “migration route”.

The humanitarian crisis that has unfolded on the borders of the European Union (EU) is largely policy-driven – the EU fails to put in place effective and humane responses, but rather concentrates on deterrence measures aimed at stemming the flow of refugees and migrants arriving on its soil. World leaders turn their backs, although in some cases they themselves are contributing to the suffering. Four of the five permanent members of the UN Security Council are involved in bombing Syrian civilians.

With no end to the war in sight, the numbers will only continue to grow. The EU has externalised its border management to Turkey, handing over billions of euros in return for a clampdown on Syrians attempting the crossing. The end result of border closures from Europe all the way back to Syria is that civilians are being trapped in one of the most brutal wars of our times.

In Southeast Asia, MSF closely monitors the migration routes, and engages local actors in Indonesia, Malaysia and Thailand to explore ways to care for people who risk their lives to escape persecution and unacceptable hardship. In Indonesia and Malaysia, small scale projects giving direct medical support to migrants have begun.

Towards the end of 2015, the Ebola outbreak was declared over in Sierra Leone and Guinea, but new cases have since been reported. Many survivors still suffer from physical and mental problems. Public health systems in West Africa have been devastated. Routine vaccine campaigns have fallen by the wayside. Reinstating healthcare and re-establishing people’s trust in it is crucial, but this is complicated by a lack of trained medical personnel.

Ebola is not the only disease threatening populations. Outbreaks of measles, meningitis and cholera are common in places where people are forced to live in unsanitary conditions, or where routine vaccinations are interrupted. In 2015, the MSF Access Campaign launched its “A Fair Shot” campaign in a bid to lower the prices of vaccines, particularly for pneumococcal disease.

Malaria is also a major challenge, with artemisinin-resistant strains of the disease being identified in Cambodia. If the resistant parasites spread, they would pose a huge public health threat. MSF has opened a project striving to contribute to the elimination of resistant malaria locally.

It is essential to act ahead of epidemics, not at the tail end. R&D must ensure that diagnostics, vaccines and treatments are effective, accessible and affordable, and adapted to the communities and contexts most in need. Safety studies and ethical frameworks should be conducted and developed during inter-epidemic phases, which would allow fast-track use of experimental drugs and vaccines during an outbreak and efficiency trials to be conducted as an epidemic peaks.

Out of the spotlight, MSF treats patients with HIV, tuberculosis (TB) and malnutrition, offers specialist care to mothers and children, and conducts vaccination campaigns and surgeries in nearly 70 countries worldwide. We thank our supporters wholeheartedly for making our work possible.

Dr. Liu Chen-kun President, MSF-Hong Kong

Rémi Carrier Executive Director, MSF-Hong Kong