MSF Response to COVID-19 pandemic

Last updated: 27 November 2020
We started our first activities in our response to the COVID-19 pandemic in January 2020. As the new coronavirus spread, touching virtually every country in the world, we adapted or scaled up our ongoing activities and started new activities in many countries over the course of the first six months of 2020. We committed substantial resources to developing dedicated COVID-19 projects, maintaining essential healthcare in our existing programmes, and accompanying ministries of health in preparing and/or facing the pandemic. This support was often in the form of training in infection prevention and control, health promotion and organisation of healthcare services.
Most COVID-19-related activities have been integrated in our regular projects, although we are maintaining some COVID-19-focused projects and some interventions are re-opening in Europe. What we are doing so is very much dependent on the context: the local epidemiological situation, the local health needs, and our own resources.
It is still difficult to provide a global narrative on our operations, as the pandemic is affecting every country in the world with different consequences in different places. Therefore, our approach can also be very different from country to country, or even from project to project.

Video: MSF response around the world

Hong Kong
Since the end of January, when the first COVID-19 infections arrived in HK, MSF team has conducted 39 health education and mental health workshops. We have targeted groups who are less likely to have access to important medical information, such as the street cleaners, foreign domestic helpers, visually impaired people, the homeless, refugees and asylum seekers, and those who are more vulnerable to developing severe disease if they are infected, such as the elderly. Apart from sharing up-to-date, evidence-based medical information, we also listen and answer the many questions that the outbreak has generated.
For 3 months from June 2020, MSF worked with ImpactHK, a local NGO that supports the homeless in HK and one of the few that has continued its services during the outbreak. Apart from distributing food, drinking water and hygiene kits, such as masks and hand sanitizers to homeless people on the streets of Tsim Sha Tsui district every Tuesday and Thursday night, our caseworkers also followed up on individuals’ needs. For the 3-month period, the team has conducted 51 free medical consultations and arranged temporary shelter for 35 vulnerable individuals. In Septmeber 2020, the homeless project was handed over to “ImpactHK”.
MSF team has now refocussed its attention towards mental health awareness. We are now delivering the 16-hour Community Care Training Program to community leaders of foreign domestic workers. The training aims to empower community leaders to better support their community members and understand their own boundaries. The syllabus of the programme includes mental well-being concepts, listening skills and psychological first aid.
MSF's response team in Herat has set up a COVID-19 centre to support the Ministry of Public Health's facility in Shaydayee. The team continues to run a COVID-19 triage unit at the Herat Regional Hospital - with about 10,000 patients screened weekly.
In Lashkar Gah, MSF is providing technical support for the management of the COVID-19 facility set up in Malika Suraya Hospital.
In Kandahar, our team is supporting and training the staff in provincial Tuberculosis(TB) and MSF's Drug-Resistance Tuberculosis (DRTB) centres.
In Kunduz, our team donated IPC materials and organised IPC training for the regional hospital and COVID-dedicated facilities.
Over the last months, the project in Khost has been working to adapt to the "new normal", while restarting family planning activities. Since early November, we have PCR testing capacity onsite with a GenXpert machine to make rapid antigen testing available soon.
MSF has created isolation wards in all our medical facilities in Cox's Bazar and is preparing two dedicated treatment centres.
Our teams are treating many COVID-19 patients, as well as monitoring patients with suspected COVID-19. We continue working with Bangladeshi authorities, WHO and other health actors to limit the spread of the virus. We are also carrying out health promotion activities in the camps.
In Kamrangirchar urban slum, MSF is focusing resources on providing reproductive health, and sexual and gender-based violence services in our leading clinic, as well as health promotion for COVID-19. MSF is also supporting the local health facilities with IPC training.
MSF's team in Patna, Bihar is providing health promotion, mental health, and psychological first aid activities to healthcare workers in local healthcare facilities across the state.
In Mumbai, MSF continues to scale up COVID-19 training to staff at its existing projects, while carrying out COVID-19 screening of DRTB and HIV patients at its clinic, endTB clinical trial site and a co-managed national TB programme.
MSF is also supporting the treatment of people with moderate cases of COVID-19 through high flow oxygen machines in a 1,100-bed government healthcare facility.
We are carrying out health promotion in the slum, distributing cloth masks and soap for handwashing to at-high-risk vulnerable groups as well as WASH and disinfection activities in 20 community toilets at a hotspot slum in the M-East ward of Mumbai.
MSF teams have continued their workshops, training and health education sessions related to COVID-19 for community health workers and assisted communities in Banten and Jakarta provinces. As of October 2020, the MSF team in Banten conducted two training sessions on IPC and contact tracing; and a total of 10,400 health promotion sessions with 68,000 participants. In Jakarta, MSF completed 70 health education sessions and three training of trainers sessions. We also added a psychosocial component focused on health care workers and cadres.
MSF is supporting regional health authorities in Batken and Chuy oblasts (provinces) in providing home-based care for moderate and mild COVID-19 patients to prevent overwhelming the hospitals.
Our teams are also supporting health centres in Kadamjay raion district to reinforce COVID-19 preparedness measures while offering technical advice, providing logistics assistance, supporting health promotion initiatives, and assisting in epidemiological surveillance through data collection.
MSF also collaborated with the Ministry of Education to distribute locally sourced reusable masks to over 5,000 children and organise a webinar for primary school teachers to raise awareness about COVID-19.
In Penang, we are providing health education in different languages, including Rohingya and Burmese, and translations in hospitals. We have started a COVID-19 health promotion campaign for Rohingya refugees via an online Rohingya news network. We are also advocating for the Malaysian government to cease targeting migrants and refugees in immigration raids, which risks further spread of COVID-19 in detention centres. 
The MSF in Myanmar Facebook page started an awareness and engagement campaign, focussing on the dissemination of COVID-19 prevention and health promotion messages.
In Balochistan, MSF continues to support Killa Abdullah District Hospital Isolation Ward with IPC, waste management, provision of PPE for medical and paramedical staff as well as water and electric supply.
In Karachi, MSF started digital health promotion activities within Machar Colony Community to debunk myths and raise awareness.
MSF provided PPE to district health authorities in Karachi and Timergara and continue extensive COVID-19 awareness-raising activities.
In Manila, Philippines, the team supports health workers who carry out contact tracing and COVID-19 prevention activities at community level. In three different health facilities providing care for COVID-19 patients, the team helps build tents for triage, seeks to improve IPC and provides PPE for the health workers. Since early July, MSF teams have distributed quarantine kits – including hygiene materials – to more than 1,300 COVID-19 patients and their close contacts.
In June, we started supporting the COVID-19 ward and the hospital laboratory at San Lazaro hospital, in Manila, with human resources, PPE, biomed equipment and pharmacy services in anticipation of an increase in cases. The MSF medical team started providing patient care on the COVID-19 ward in July. Following the decrease of admissions in the COVID-19 ward, we ended the collaboration with the San Lazaro hospital at the end of October 2020.
In Marawi, the team monitors COVID-19 surveillance and contact tracing in Marawi City and supports health promotion in one quarantine facility.
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We prioritise the continuity of quality care for essential services for children and adults with TB, in collaboration with the Ministry of Health and Social Protection of the Population (MoHSPP) via existing MSF programmes focused on diagnosis, treatment and contact tracing.
Our team assessed the Republican Centre TB dispensary in Dushanbe, with the objective of setting up a new triage approach to decrease risk of transmission of COVID-19 between patient and staff. The proposal, a first of its kind in the country, was approved by the NTP.
We developed a patient questionnaire to help with triage, built outdoor waiting area and improved the patient flow in the dispensary.
We continue to support IPC measures across the primary healthcare system, while also training staff in COVID-19 treatment facilities on IPC measures.
MSF also coordinates with the MoH for the treatment of patients co-infected with COVID-19 and TB. Standard operating procedures approved by MoH were developed and distributed to all medical facilities.
In Bagdad, where 30 per cent of the country's reported COVID-19 cases come from, MSF is supporting Al-Kindy hospital, which receives large numbers of severe and critical COVID-19 patients. Our teams help in the respiratory care unit (RCU), providing bedside training for staff, including ventilation use, drug use, and techniques adapted for the treatment of COVID-19. We expanded our service from a 24-bed ward to a 36-bed ward (including 11 ICU beds) inside the facility to treat more COVID-19 patients
In Mosul, MSF's post-operative care centre surgical activities were restarted, and a new operating theatre was opened.
MSF is also helping local health facilities in Erbil and Dohuk by providing technical and logistic support, and training for their staff on IPC.
In the Laylan camp (Kirkuk governorate), MSF mobilised a 20-bed caravan isolation and treatment facility and continues to implement triage measures for any suspected COVID-19 patients.
Our teams also distributed reusable cloth masks and raised awareness about prevention measures. MSF also carried out a digital health awareness campaign on COVID-19, targeting the areas of Mosul and Sinuni.
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MSF opened a dedicated 30-bed COVID-19 treatment centre, in collaboration with the Jordanian MoH, UNHCR and others, in Zaatari refugee camp.
MSF provides medical care and psychosocial support to symptomatic COVID-19 patient, and our teams also carry out health promotion activities.
In a 'transition area' of the camp, MSF teams carry out daily screenings for asymptomatic COVID-19 patients as well as transferring patients in need of medical attention to our COVID- 19 treatment centre.
In Amman, we have opened a dedicated 40-bed COVID-19 treatment centre which provides inpatient care for moderate COVID-19, following a request from the MoH.
In the Bekaa Valley, MSF is supporting the Elias Hraoui Governmental Hospital in Zahle with the triage and screening of children. MSF's hospital in Bar Elias continues treating COVID-19 patients.
In Siblin, MSF is working with UNRWA (the UN organisation for refugees from Palestine) in a training centre that was turned into an isolation site.
MSF's Medical Response Teams (MRT) and project-based Rapid Response Teams (part of the UN-led multi-sectoral emergency scheme) continues to support the Ministry of Public Health in its COVID-19 testing strategy across Lebanon.
MSF also provides health promotion and training guidance to organisations, groups of healthcare providers as well as non-medical frontline workers.
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In Libya, we continue to support the MoH in the Tripoli COVID-19 testing site as well as providing COVID-19-related training to medical and healthcare staff. We also continue to reinforce IPC and prevention measures in detention centres (in Tripoli, Zliten, Zintan).
In Gaza, MSF teams are supporting healthcare workers treating COVID-19 patients in the European Hospital as well as providing oxygen concentrators and providing training on oxygen management, patient support, and intensive care.
MSF also helped with the definition of COVID-19 treatment protocols as well as hygiene management, while continuing IPC support in the Indonesian Hospital and other healthcare centres in the north of the Gaza strip. We also conduct similar activities in Al-Awda hospital.
In the West Bank, MSF teams adapted their activities to continue providing psychological support by phone to the population in need.
In the Hebron district, the team launched a hotline service to provide remote counselling in support to some of the people most affected by the COVID-19 outbreak, such as patients and their families and the medical personnel.
The team is also distributing hygiene kits to affected households and carrying out health promotion and mental health promotion activities in the community.
MSF is also supporting the Hebron local health system by providing technical advice and hands-on training to hospital staff on personal protective equipment, infectious waste, cleaning processes, oxygen therapy and bedside training in Dura hospitals, as well as in Alia and Al Muhtaseb hospital.
As part of the COVID-19 humanitarian task force, which is chaired by the local health authorities, MSF is contributing to the coordination of the COVID-19 response. MSF is working alongside the Kurdish Red Crescent to provide medical care at the COVID-19 hospital in Washokani. Patients discharged from care are supported with hygiene materials, health education, and identifying vulnerable people within their household.
MSF increased its support in Raqqa city with a focus on protecting healthcare workers, improving IPC in primary and secondary healthcare facilities. They helped enhance triage and care for suspect patients requiring inpatient care while they await test results, and sharing all lessons learnt from our Washokani response with Raqqa health organisations.
Across the Al Hot Camp, our teams continue to follow up with those who have been identified as particularly vulnerable to developing severe symptoms if they contract COVID-19.
In the northwest, MSF is providing care for patients with moderate and severe symptoms in Idlib National Hospital's 30-bed COVID-19 treatment centre. We are also opening an additional isolation and treatment centre in the region. In the northwest Syria camps that MSF works in, our teams are spreading awareness messages about COVID-19 and distributing hygiene kits to the families.
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In Aden, MSF is supporting a 22-bed hospital with provisions of PPE, and training for medical staff on managing triage for suspected COVID-19 cases and on IPC measures.
In Khamer (Amran Governorate), we continue our COVID-19 treatment unit, while in Haydan (Saada Governate), we downsized due to the decreased number of admissions.
In Lahj governorate, MSF teams provide training to medical teams in Yafa'a district, on managing triage, isolation and referrals of COVID-19 patients.
In Abyan governorate, MSF is training the COVID-19 centre health staff, on triage, diagnosis, medico-therapy, physiotherapy and ICU care of critical cases.
In Abs Hospital and Al-Ghomouri Hospital in Hajja governorate, MSF continues screening activities, as well as referrals for suspected COVID-19 cases. In Hajja city, MSF supports referrals from Al-Ghomouri Hospital to Al-Rahadi isolation centre.
As of end of October, a little more than 37,000 deaths linked to COVID-19 were recorded in Africa, in comparison the continent recorded 380,000 deaths due to malaria in 2018.
In Sahel, it was confirmed that the peak of the malaria season struck intensely and for longer this year, in particular because the rains started earlier and were heavier compared to previous years.
In many countries of the Sub-Saharan region, national prevention programmes were impacted by restriction put in place to deal with the COVID-19 pandemic. Mass activities such as mosquito net distribution or seasonal prevention campaign were slowed down.
Burkina Faso
MSF is following up the epidemiological situation throughout the country, as concerns remain high with the number of displaced people in the northern, North-central and eastern parts of the country. We have adapted triage and IPC measures in the health facilities we support, set up isolation units and trained staff in prevention and case management.
Since the early stages of the outbreak, MSF has implemented numerous initiatives in its projects and provided support to the national response in the central, far-north, northwest and southwest regions. Our teams run training for healthcare staff in IPC measures in our projects, and also in the commercial capital Douala.
In Yaoundé, the country's COVID-19 epicentre, MSF treated patients with moderate symptoms at Djoungolo hospital as well as rehabilitated the hospital and built four new buildings. MSF and Epicentre supported the MoH in the evaluation of rapid diagnostic tests. We also launched community activities in the district of Cité Verte, one of the three most affected places in the central region.
In the northwest region, MSF set up isolation and treatment wards in Bamenda, and in the southwest region, MSF refurbished and equipped a 20-bed capacity isolation unit in Buea regional hospital. Besides, continued support in terms of oxygen and other logistics equipment, a 38-bed capacity isolation unit was also constructed at Tiko District Hospital.
In Kumba, a 16-bed isolation unit was constructed at the Presbyterian General Hospital. In both regions, health promotion was strengthened at the community level.
In the far north, MSF set up a triage and isolation circuit for alert cases in nine health centres in the city of Maroua and constructed an eight-bed isolation ward in the district hospital of Mora.
Democratic Republic of Congo (DRC)
Across all our projects in DRC, our teams are working on awareness-raising and health promotion as well as implementing preventive measures, such as providing masks and handwashing stations, setting up triage and isolation areas, as well as contact tracing.
MSF's support of COVID-19 prevention and care continues in the capital with four health structures in the Limete health zone.
In North Kivu, our activities in Goma and Rutshuru have been adapted to ensure continuity of care for victims of medical emergencies, sexual violence, malnutrition and HIV.
In South Kivu, in Baraka we are remotely supporting a 20-bed treatment facility (equipped with oxygen) and remain ready to support the MoH in Bukavu, as well as continuing to support the COVID-19 committee with technical and surveillance support.
We are supporting the MoH by assisting with IPC and triage at health facilities and as part of a technical advisory group to the MoH, implementing adjusted models of care for patients living with HIV, TB and NCD to reduce their risk of infection. A mobile MSF team is providing home-based care for COVID-19 patients, and teams are doing health education in the communities daily.
In Gambella region, in two camps for South Sudanese refugees (Kule and Tierkidi), MSF has set up a 20-bed COVID-19 isolation centre and another one with a capacity of 10 beds. In Gambella town, a team provides support to the COVID-19 triage and temporary isolation centre in Gambella Hospital.
In Addis Ababa, MSF is providing mental health support to more than 5,000 migrants who returned mainly from Saudi Arabia, Kuwait and Lebanon and are placed in three COVID-19 quarantine centres in the capital.
MSF is supporting the MoH medical and non-medical staff who work in the quarantine centres by training them on migrants' mental health needs.
Our teams support the regional health authorities in our different project locations in Amhara and Somali Region in their isolation and treatment centres and with health education. We have also been working on preparedness in all our projects putting in place preventive and hygiene measures.
In the coastal city of Mombasa, MSF is gearing up to train the MoH staff working in two new facilities currently being set up by the county's Department of Health. Training will focus on IPC, case management and support in health promotion and other community engagement where needed.
In the city of Homa Bay, MSF is setting up a COVID-19 high dependency unit (HDU) within the county's referral hospital, to manage moderate to severe cases of COVID-19. Some of these patients come from the adult inpatient wards MSF already support as part of our regular activities. The HDU is in addition to our ongoing support of COVID-19 screening and suspect case management at the referral hospital.
MSF is carrying out ongoing awareness activities on prevention measures in communities in and around Monrovia.
In Neno, Dedza and Nsanje districts, MSF's Female Sex Worker (FSW) project provides COVID-19 information and measures to prevent COVID-19 transmission among FSWs and in the community. Community sensitisation with FSW-adapted health messages on COVID-19 has been conducted, as well as installation of handwashing points in critical areas. MSF also provided IPC and technical and direct assistance to ensure effective COVID-19 patient flow at health facilities.
MSF's Zalewa Health Centre continues to screen patients for COVID-19 symptoms.
MSF's Advance HIV Disease (AHD) project provides direct daily support of the COVID-19 patient flow at Nsanje District Hospital(NDH), including screening and triage, health promotion and IPC measures. MSF continues to provide technical support to the MOH-run 19-bed IPD COVID-19 case management isolation ward at NDH.
In Maputo, MSF is supporting the main COVID-19 referral hospital, Polana Caniço. In Pemba, we helped local health authorities to install two isolation centres, 18 de Outubro (30 beds) and Decimo Congresso (100 beds) and we are providing health promotion in two IDP centres in Metuge.
In Beira, we assisted in the installation of two isolation centres, 24 de Julho (100 beds) and Marazul (33 beds). We provided support for the follow up of HIV patients with COVID-19 at the emergency isolation unit of the main hospital.
We are also providing help in patient flow and triage of suspected COVID-19 patients in four health centres. Furthermore, MSF is part of the Mozambican Government COVID-19 coordination meetings and technical groups, which provides advice for the shaping of the response in the country and facilitating access to updated evidence for the latest COVID-19 protocols.
In Zinder, MSF's awareness-raising and IPC activities in support to the health structures are being handed over to the district authorities. COVID-19 remains active in Niamez and Agadez. MSF continues epidemiological surveillance and community awareness in the towns of Niamey, Zinder, Diffa, Tillabéry and Agadez.
MSF continues to support health promotion and provide local authorities, hospitals and healthcare centres with technical support, staff training and IPC in all our projects. In Borno state, we support the MoH COVID-19 isolation centre in the state capital, Maiduguri, with training on IPC and managing the laundry.
Our teams have also prepared four beds in Gwoza and Pulka, should isolation facilities be needed. In Ebonyi state, we are supporting the MoH and Nigerian CDC with testing while also supporting a 25-bed MoH facility with treatment for COVID-19.
Together with the local authorities, we are conducting community awareness campaign on COVID-19 reaching 370 settlements. We are also supporting communities with health promotion and installed water points and distributed soap and hygiene products to displaced communities in Benue and Zamfara.
In Kano state, we are supporting primary healthcare and have carried out more than 10,000 consultations in two primary healthcare centres. We monitor conditions that could make patients more vulnerable to COVID-19, including hypertension, heart disease, diabetes, and respiratory diseases. In October, close to 65 per cent of all consultations were for malaria.
In Dakar, we support activities in Guediawaye district (a northern suburb of Dakar Region), with a particular focus on community surveillance support or analysis, community engagement, improving IPC standards, continuity of care and, since the change of the national strategy, on home-based care for simple COVID-19 cases. We are also continuing our work at the Hospital of Dalal Jamm, where we support case-management of moderate and severe cases.
Sierra Leone 
MSF is part of the case management and surveillance pillars at the national Emergency Operations Centre (EOC) and district level EOCs in Kenema, Tonkolili and Bombali Districts.
An MSF epidemiologist continues to work with the MoH and Sanitation on surveillance and testing strategies.
Since July, we have worked with community health workers (CHW) from the Thompson Bay wharf area in Freetown, characterised by informal settlements and with a lot of overcrowding, delivering COVID-19 prevention messages across the whole area, as well as providing small hygiene kit of soap and buckets with a tap, a bucket and masks to families most in need.
We have installed handwashing stations with soap, in strategic places and carried out health promotion.
On the outskirts of Freetown, we refurbished a government building into a 120-bed centre for COVID-19 patients and provided PPE training for around 140 workers. The Lassa fever isolation unit in the Kenema government hospital has been renovated into a COVID-19 treatment centre with an initial capacity of 25 beds.
Somalia and Somaliland
In Somaliland, we train members of the MoH's Rapid Response Teams on prevention of COVID-19. Due to IPC measures put in place to prevent the spread of the infection, regular programmes, such as routine immunisations and nutrition programmes, are affected.
South Africa
All MSF activities have resumed, even though the national state of disaster period is ongoing.
International travel via land borders remains stalled pending the finalisation of agreements with neighbouring states.
Any international air travel passenger from a country listed as having a high COVID-19 infection and transmission rate can, as yet, only travel to South Africa for business reasons.
As of mid-October, South Africa had reached nearly 700,000 confirmed COVID-19 cases, with over 18,000 COVID-19 related deaths.
South Sudan
MSF continues to support the MoH in the Juba Teaching Hospital with water and sanitation measures, donations and IPC training. We are also continuing to support the National Public Health Laboratory (NPHL) – the primary testing facility in the country. MSF is also advocating with the MoH for increased testing capacity in other areas, as 99 per cent of testing capacity in the NPHL is currently for travel screening purposes.
Outside of Juba, country-wide there are 23 facilities with the capacity to conduct COVID-19 testing; three are in MSF facilities in Bentiu and Malakal Protection of Civilian sites (PoC), and we plan to have testing capacities in one other MSF facility in Lankien.
In all projects across the country, we continue to isolate and treat patients with suspected or confirmed COVID-19 and also continue to support and implement preventive measures, including screening and reinforcing IPC, awareness-raising and health promotion, and training.
We are supporting four leading public hospitals in Khartoum to strengthen their screening and triage system and the isolation areas. MSF teams are supporting with training, reinforcement of infection prevention and control (IPC) measures, weekly donations of PPE.
We are also supporting the MoH in managing isolation centres in East Darfur and South Kordofan states.
MSF is the sole healthcare provider in Nduta refugee camp, which hosts some 70,000 Burundian refugees.
More than 250 MSF staff have been trained on COVID-19 preparedness and response measures to respond to a potential outbreak, and our teams continue to organise simulation exercises to maintain rapid response capacity.
We continue to have triage structures in the four health posts, including 100 beds in the main hospital.
Our community health educators in Nduta camp regularly raise awareness and educate the community on hygiene and best health practices.
We also continue with temperature screening at the triage of the main camp gate and maintain handwashing points.
MSF teams have helped with logistics and hygiene measures in three MoH isolation units in Arua and Kasese. We are raising awareness among the communities and distribute masks to patients and staff in MSF-supported health structures, as well as protective equipment to medical staff working with COVID-19 patients.
In Adjumani district, an MSF team intervened to improve living conditions in a transit centre used to quarantine and test refugees, where conditions were deplorable.
Zimbabwe's COVID-19 cases are slowly increasing, although the overall number of cases has remained relatively low. MSF operations stay on high alert to provide support in the event of the situation changing, especially now with eased restrictions on travel (in-country and across borders).
Our WASH team continues to support community activities for COVID-19 prevention, such as mask and soap distribution, access to water, health promotion and awareness-raising.
In Harare, we are supporting IPC, epidemiological surveillance, contact tracing and laboratory activities as well as screening, sample collection and safe transport of people testing positive for COVID-19.
In Beitbridge, MSF is providing support for COVID-19 screening, sample collection for testing and delivering non-COVID-19 healthcare services and health promotion.
MSF has relaunched activities in nursing homes in Belgium, as the second wave of the pandemic is hitting nursing homes hard. Our mobile teams are working in the three regions of the country, focussing on accompanying nursing homes in carrying out medical or clinical care activities for the residents (a new area of work for these structures). Our teams are also carrying out mental health sessions for nursing home staff.
An MSF outreach team is providing medical support to homeless and vulnerable people with confirmed or suspected cases of COVID-19, in the capital Brussels. The team is also providing testing and follow-up of patients. It is part of an 'Outreach Support Team' working in partnership with other NGOs, which provides HP, IPC support, contact follow-up and testing with priority given to people living in non-approved structures, such as squats.
MSF also rented out a hotel to provide accommodation to facilitate the follow-up of suspected or confirmed cases. This structure doubles up both as an accommodation and a health structure in the centre of Brussels.
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Czech Republic
MSF started a small project in nursing homes in the Czech Republic, in partnership with the Ministry of Labour and Social Affairs.
In the first-ever intervention in the country, two small MSF mobile teams are providing assessments and training on IPC measures in nursing homes. Working in facilities in the regions
of Plzensky, South Moravian, Zlinsky and Central Bohemian, all located outside the country's capital, Prague, the teams have visited almost 40 nursing homes in the first three weeks.
Our teams are providing training either onsite or through a Czech version of a website developed for their similar intervention earlier this year -
MSF is setting up teams of doctors, nurses and psychologists to reduce the burden on the most vulnerable nursing homes and strengthen the provision of medical care, in addition to our mental health support programme for nursing homes.
Mobile clinics providing general medical care as well as COVID-19 screening, testing and orientation for people living on the streets and precarious settings in Paris are about to resume up to 5 days a week and will be located nearby food distributions.
In Athens, we collaborate with the 3rd Clinic of Internal Medicine of Athens University (NKUA-EKPA) by providing psychological support to frontline health workers, COVID-19 patients and their relatives.
We also provided PPE to vulnerable social groups, including elderly, refugees, homeless, victims of gender-based violence, detainees, people with mental health problems as well as to the airlifting department of the National Emergency Aid Center.
In Rome, we have been tasked by local health authorities to manage contact tracing and isolation for COVID-19 clusters in 10 buildings housing squats and one informal settlement, where migrants, refugees, and some Italian nationals live.
Due to the increase of COVID-19 cases, our team refocused our operational strategy by giving more importance to "response preparedness" rather than prevention.
In collaboration with the residents of the spaces where we are responding, we have promoted the creation of hygiene and health surveillance committees that can monitor the presence of suspected COVID-19 cases, alert the authorities and act quickly to isolate suspect cases and disinfect any contaminated space.
In the city of Palmero, in Sicily, where the outbreak is growing exponentially, MSF continues its activities in several centres hosting migrants. The local health authorities and other institutions continue to call for our collaboration.
An MSF team is working in four reception centres in the province of Palermo, which has been in quarantine after one person tested positive for COVID-19.
MSF has been distributing parcels and hygiene kits to multidrug-resistant and extremely drug-resistant TB patients undergoing treatment in the northern region of Arkhangelsk. During the distribution, health education was conducted by MoH nurses using materials on TB and COVID-19 developed by MSF.
We continue health prevention activities, including distributing leaflets on how to use face masks, distributed to all patients visiting the Arkhangelsk TB dispensary.
MSF has partnered with two community-based NGOs in Moscow and St Petersburg to support vulnerable people. MSF distributed PPE with health information materials on COVID-19, TB and HIV. MSF is also developing training on TB/HIV co-infection, COVID-19, basic counselling and person-centred approaches for these organisations.
MSF is supporting the MoH in responding to COVID-19 in Donetsk and Zhytomyr regions.
In Mariinka raion district (Donetsk region), MSF provides home-based care for patients with mild symptoms through two mobile teams, to prevent healthcare facilities from being overwhelmed.
In Krasnohorivka hospital, MSF is supporting health authorities in establishing an isolation ward for patients with moderate symptoms by providing 22 oxygen points, technical support to reinforce triage and patient screening, conducting refresher training for health workers on treatment and infection prevention and control (IPC). In Donetsk and Zhytomyr regions, MSF is also providing psychological support through telephone hotlines for health workers, COVID-19 patients and their relatives.
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In São Paulo, MSF collaborated with MoH to provide palliative care to patients at the Tide Setubal hospital.
In the Amazonias state, MSF has an exploration team to evaluate the situation in more remote areas after a recent rise in cases that indicated a second wave of the disease.
In the state of Mato Grosso do Sul, our team in Amambaí has been conducting IPC training while waiting for an authorisation from federal authorities to work in indigenous territories.
MSF is focussing on IPC measures and medical training in six COVID-19 centres covering five municipalities. MSF is also donating PPE and medicines.
MSF is working with health authorities in Norte de Santander and Tumaco to support the local response.
We are participating in outpatient triage and supporting the area for patients with respiratory symptoms at the Tibú hospital, as well as following up on patients with chronic diseases. We are also maintaining sexual and reproductive health activities with Venezuelan and Colombian populations without access to healthcare.
In Tumaco we are providing medical and mental health activities in the two public hospitals in the city, with a focus on our efforts on promotion and prevention activities in towns, villages and neighbourhoods through different community strategies and the media.
In Norte de Santander, we provided urgent mental health support to families of massacre victims, while in the Pacific region of Nariño mobile health teams travelled deep into conflict zones to bring medical assistance to villagers isolated by ongoing violence between armed groups.
We have deployed a small technical team, the Flying COVID-19 Team, which has been supporting local hospitals in Atlantico, one of the regions most affected by COVID-19. The team's work is supporting Erasmo Meoz Hospital in Cúcuta in rapid assessment, technical training, mental health care for health staff, and donations of medicines and supplies to help health facilities keep COVID-19 services safe at the peak of the outbreak.
El Salvador 
MSF strengthened its ambulances services in areas that are difficult to reach due to violence, to alleviate the workload of the emergency system, dedicated to the transport of COVID-19 patients.
MSF continues mobile clinics in communities of San Salvador and Soyapango affected by violence. We resumed health promotion activities with community leaders and health committees. After the reopening of the health units, we have facilitated the access of MoH personnel to the communities of San Salvador and Soyapango to carry out child vaccination campaigns.
During the COVID-19 emergency, we worked on mental health care in isolation centres dedicated exclusively to deported people (from Mexico and the United States).
MSF donated PPE to institutions and counterparts as well as hygiene supplies to communities in San Salvador and Soyapango.
In Tegucigalpa, MSF started medical activities in an adapted centre for severe COVID-19 patients to help the metropolitan health system to keep the hospitals from being overwhelmed.
MSF has set up a mental health phone line for survivors of violence and sexual violence, and the psychologists have recorded an increase in mental health consultations. MSF manages a health centre in a neighbourhood on the outskirts of Tegucigalpa, which is still functional and prepared to detect COVID-19 cases.
MSF continues to assess and implement IPC measures in any migrant shelters where more than 200 people are isolating throughout Nuevo Laredo as well as working with local
health authorities to provide an adequate COVID-19 response to migrant groups. Primary healthcare and psychosocial support are provided to the shelter's residents, staff and also to members of the surrounding communities. MSF is monitoring the constant flow of Mexicans repatriated by US authorities and deported non-Mexican migrants.
In Coatzacoalcos, MSF teams resumed our mobile clinic project, where a doctor, nurse, psychologist and social worker assist migrants in shelters.
MSF provided healthcare to migrants in Tierra Blanca and Oluta y Higueras, to evaluate the number of migrants crossing on these areas.
In Tenosique City (Tabasco), along the southern border, MSF continues to offer comprehensive primary healthcare (medical and psychological support) to migrants at the La 72 shelter and outside of the shelter.
In Mexico City, CAI, a specialised centre run by MSF for victims of extreme violence and torture, continues to welcome new patients referred by our partners in Mexico City and throughout Mexico. Besides, the patients who were already being cared for by the project before the COVID-19 isolation.
MSF assessed and implemented IPC measures and psychosocial care in 15 migrant shelters of Mexico City and another in Mexico State.
A multidisciplinary COVID-19 intervention team (health promoter, psychologist, logistician, WATSAN and IPC manager) has been formed to provide technical support, training and advocacy in decision-making on COVID-19 prevention and control in migrant shelters along the Mexican migration route. This team will also provide psychosocial support to migrants and staff with suspected or confirmed (or in contact) with COVID-19. These visits to shelters begun in the south of the country in shelters in Oaxaca, Ixtepec, Tuxtepec in Oaxaca state, as well as in Tapachula and Comalapa municipalities in Chiapas.
In Guerrero, the team resumed its activities in the mobile clinics in communities affected by situations of violence and with difficulties in accessing health services, in the Central, North, Costa Grande and Tierra Caliente regions.
A hotline and WhatsApp number was set up for MSF psychologists to provide psychological care remotely to migrants and refugees across the country, and people isolated by violence in Guerrero.
MSF's response plan includes assisting with medical supplies and staff recruitment, as well as strengthening triage, diagnosis, treatment, infection control and peri-hospital system services in the projects in Amazonas, Anzoátegui, Bolívar, Sucre, Táchira and the Caracas.
In Caracas, COVID-19 activities will be carried out in Pérez de León II Hospital in Petare (Miranda), where teams rehabilitated the infrastructure, adapted the patient flow, established IPC measures and trained staff to receive COVID-19 patients for
hospitalisation and ICU care. MSF is also supporting with staff recruitment, treatment and peri-hospital system services in Vargas Hospital of Caracas.
Whether we’ll be able to make similar offers to other countries will depend on the nature of the pandemic but also on our capacity to send staff.