MSF supports to health facilities in the Middle East and north Africa

Ever since civil unrest and violence erupted in countries across north Africa and the Middle East, teams from Medecins Sans Frontieres (MSF) have been supplying and assisting hospitals and health structures where medical staff are facing increased numbers of injured people. Teams are also assisting people who are fleeing to neighbouring countries.

Although MSF continues to work tirelessly to enter Libya to tend to medical needs in the areas where there is conflict, the teams are currently unable to work on Libyan soil. Last week the teams in Benghazi saw themselves forced to leave as fighting was moving their way and travel in eastern Libya became increasingly insecure. Nine MSF staff are in Alexandria, Egypt and are delivering emergency medical supplies across the border, including dressing materials, medical kits for treating the wounded and surgical supplies. They also deliver drugs, including for chronic diseases such as diabetes, hypertension and cardiopathy, which have been identified by Libyan doctors as medical needs. Already more than 33 tons of supplies were donated.

An MSF theatre nurse worked one night in the hospital in Ajdabya and assisted in the treatment of ten wounded people and one twin birth. But such presence of MSF staff in health facilities in Libya is today not possible. Neither are assessments possible and it is very difficult for MSF to have a clear picture of the needs in the country.

MSF is also trying to enter Libya from Tunisia. But in spite of continuous efforts since 23 February, the teams have still not received authorisation to cross the border. From the western side, too, MSF has been supplying health facilities in the areas affected by conflict with medical kits and drugs. On 21 March, a shipment of two surgical kits for 150 wounded arrived in Misratah and reached the hospital.

Assisting people who flee conflict
In Tunisia, at the border with Libya, a team of 25 MSF staff provide care to people who have fled the conflict. They have set up tents at the entry point at Ras Ajdir and the Choucha transit camp, seven kilometres inland and housing 6,000 people who await either resettlement or repatriation, for giving mental health support to people who have been subjected to, or witnessed, varying degrees and forms of violence and who now face an uncertain future. Similar support is given to people in Dehiba, 150 kilometers from Ras Ajdir. In all three locations, MSF psychologists offer individual consultations and group sessions, from which to date 4,062 people have benefitted. A total of 501 refugees and migrants have had individual consultations at one of the MSF tents, while the psychologists have organised 323 group sessions so far in Choucha camp.

People are fleeing to Niger too. Between 11 and 15 March, 1,309 people arrived in Dirkou. MSF provides medical attention when they get to Agadez.

On the Italian island of Lampedusa, an MSF team of four – a doctor, nurse, logistician and cultural mediator – are assessing the health needs of migrants and provide medical care in collaboration with the local authorities. In recent weeks, around 5,400 migrants arrived here, the majority from Tunisia and in good health. But living conditions are poor; people arrive in structures that are overcrowded and where sanitation is lacking. The MSF team will distribute relief items to the migrants by the end of this week.

Activities in other countries in the Middle East where tension is high
Since the beginning of demonstrations in Yemen in January, MSF has been closely following the evolution of situation in the country. In Sana'a, Aden and Ta'izz, MSF teams are in contact with both Yemeni authorities and medical committees set up by demonstrators. In recent weeks, MSF has donated medical material and performed training to medical staff in different healthcare structures of these three locations. As for now, Ministry of Health-run hospitals, as well as field hospitals set up by demonstrators’ committees, have been able to cope with increased needs and influx of wounded people. MSF teams are ready to scale up their relief activities, if an impartial and neutral evaluation of needs reveals a need for this.

The regular medical activities of MSF in different areas of the country continue. In the north, MSF provides medical care, including surgery, to resident and displaced population in Saada governorate as well as in the neighbouring governorates of Hajjah and Amran. In the south, MSF supports the public hospital of Radfan district to cope with the needs of the population affected by unrest in Lahij governorate. MSF has also started a partnership with Yemeni Health authorities to improve the treatment and reduce the stigmatisation of HIV/AIDS in the capital city of Sana’a.

In Bahrain, MSF is in contact with a number of medical facilities and ready to assist if needed. Earlier this year, an MSF assessment team made contact with medical organisations in the country. The team visited Salmanya hospital, in the capital Manama, several times and offered support.

MSF is also following the situation in Syria where unrest started in Daraa city some days ago. Since 2009, MSF works in Damascus with a local organisation to provide free healthcare and mental health support to unregistered Iraqi refugees, migrants and vulnerable residents of the city. In Algeria an MSF exploratory team made contact with the Ministry of Health and with non-governmental organisations in early March. The aim was to assess possibilities of cooperation in case violence would erupt in the country. So far, no MSF intervention has been needed.

Previous assistance
Earlier, during the uprisings in Tunisia and Egypt, MSF already gave support to resident medical structures. In Tunisia in January, MSF donated medical equipment, including orthopaedic materials to hospitals in Kasserine and Sidi Bouzid where health staff had seen their stocks depleted during the demonstrations and were lacking medical supplies to cover the needs.

During the protests in Tahrir Square in the Egyptian capital, Cairo, MSF supplied medical materials to Egyptian doctors in two hospitals and in an improvised clinic in a mosque. The team also provided training on how to manage a high number of injured people coming in over a short period of time, and helped set up additional emergency preparedness systems.