MSF has projects in the region -- in Hong Kong, Philippines, Indonesia, Malaysia, Cambodia, Myanmar, Thailand -- during the past decades. Some projects, such as in mainland China, were handed over in 2014. These projects varied depending on the medical and humanitarian needs of the people throughout the years. Some projects were in response to the aftermath of major natural disasters; addressing Hepatitis C, HIV, and Tuberculosis; on sexual reproductive healthcare, and others.
MSF started working in Hong Kong in 1988 during the height of an influx of Vietnamese boat people. For 10 years, we provided medical services in refugee camps in Sham Shui Po, Tuen Mun and Pillar Point, and detention camps in Whitehead, High Island, Chi Ma Wan and many other sites, in conjunction with UNHCR, the Hong Kong Government and other NGOs.
We ran outpatient clinics with medical referral services, offered antenatal care and extended programmes of immunisation, and launched psychological support programmes. We gave health education, which focused on the prevention of HIV/AIDS and other sexually transmitted diseases and conducted a harm reduction needle exchange programme for heroin addicts.
Opposing the forced repatriation of the Vietnamese boat people, MSF asked to be present during such operations and acted, from 1994 onwards, as an independent monitor to report any human rights abuses. We stayed in the camps until most of the Vietnamese boat people were properly resettled or repatriated, in early 1998.
During the SARS outbreak in Hong Kong in 2003, MSF set up an information, education and communication programme at the peak of the epidemic and mobilised more than 100 medical and nursing students and local medical doctors to bring SARS prevention messages to public housing estates and ethnic minority communities.
Amid the COVID-19 outbreak in the city, an MSF emergency team has been mobilized to respond to the outbreak here since late January 2020. Our team has been reaching out to vulnerable groups in the society and has conducted 39 health education and mental health workshops. We focused on 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. A mental health website was created for the general public, offering tips and tools to help cope with these stresses and worries due to prolonged exposure to uncertainty.
In June 2020, as Hong Kong faced the third wave of COVID-19 infections, some of the public facilities and local services have been suspended which affected the homeless particularly. Our emergency team worked with Impact HK, a local NGO that supports the homeless and one of the few that has continued its services during the COVID-19 outbreak. Over a period of three months, the team has conducted 51 medical consultations and has arranged temporary shelter for 35 vulnerable individuals. The teams also visited the homeless in Tsim Sha Tsui every Tuesday and Thursday nights. Apart from distributing food, drinking water and hygiene kits, our caseworkers also followed up on individuals' needs.
In September 2020, the homeless project was handed over to ImpactHK. The team has now refocused its attention towards mental health awareness and psychosocial support. We are now delivering the Community Care Training Programme to the community leaders of foreign domestic helpers which aims to empower them to better support their peers and understand their own boundaries. The syllabus of the programme includes mental health concepts, listening skills and psychological first aid.
Médecins Sans Frontières (MSF) hds projects in China from 1988 to 2014. Initially to provide emergency assistance to people affected by natural disasters. In the decade that followed, we responded to over 20 floods, earthquakes, snow-storms and typhoons around the country – bringing help to tens of millions of beneficiaries.
In 2008, MSF provided tents, relief items, medical care and psychological support to victims of the Sichuan earthquake. After that, MSF also sent teams to assist people affected by floods, landslide in rural areas in Guangxi, Sichuan, Guizhou and Yunnan.
In response to COVID-19, we donated 3.5 tonnes of personal protective equipment to the Wuhan Jinyintan hospital in Hubei province, China, the epicentre of the COVID-19 outbreak in February 2020. We also provided remote training of trainers to local actors for them to capacitate local health promotors in serving vulnerable communities.
Medical care for vulnerable people
In the mid 1990s, China's own capacity in disaster response, management, and emergency-preparedness as well as the availability and quality of relief supplies in China improved significantly. MSF thus shifted its focus to vulnerable communities. Between 1991 and 2002, MSF ran a Kashin-Beck research and treatment project in the Tibet Autonomous Region, helping to ease the pain of sufferers of this debilitating joint disease. In Guangxi Zhuang Autonomous Region and the provinces of Qinghai and Yunnan, we trained village doctors, built hospitals, supported health structures and offered basic health care to people living in remote areas. In Shaanxi province, we provided social support and medical care to street children from 1997 to 2006.
Responding to infectious diseases
In the late 1990s, MSF had fought to tackle infectious diseases in China. Awareness programmes for HIV/AIDS and tuberculosis were launched in the provinces of Yunnan and Sichuan in 1999. In 2003, we helped control the spread of the Severe Acute Respiratory Syndrome (SARS) epidemic in the Hebei province, and started giving free comprehensive care and treatment to HIV-positive people in Xiangfan, Hubei province and Nanning, Guangxi Zhuang Autonomous Region, in collaboration with Chinese health authorities. The projects in Hubei and Guangxi have been handed over to the local government in 2008 and 2010 respectively.
Water supply and sanitation assistance
Between 1995 and 2002, MSF carried out a number of water and sanitation projects to supply clean drinking water and raise hygiene awareness for tens of thousands of people. We constructed wells, installed water pumps and conducted hygiene education in Guangxi Zhuang Autonomous Region, Yunnan province and the Xinjiang Uighur Autonomous Region.
MSF started working in Malaysia in 2004 to improve access to medical and mental health services for refugee and asylum seeker communities in and around Kuala Lumpur who often have no official status and face difficulties in accessing healthcare.
In 2006, MSF opened three mobile clinics, working in close collaboration with local partners, and carried out 8,159 medical consultations. The clinics offered primary healthcare, mental health consultations and referrals. MSF also organised community health education, psychosocial and mental health training for NGOs, community groups and volunteers from refugee and asylum seeker communities.
After building up the capacity of local partners through training and direct support of clinical services, MSF handed the project over to local partners in April 2007, to continue the medical and mental health work.
In 2015, MSF started providing primary health care to marginalised people in Penang through mobile clinics. In Oct 2018, MSF opened a fixed clinic to further improve the provision of healthcare to the migrant communities. MSF also provided medical and mental healthcare in 5 of the protection shelters for survivors of trafficking under the Ministry of Women, Family and Community Development, which closed in 2019.
During the COVID-19 pandemic, we increased support to the national Ministry of Health and district authorities for contact tracing and testing. In Penang, we are providing COVID-19 health education in different languages, including Rohingya and Burmese, and translations support to patients referred to hospitals. We have started a COVID-19 health promotion campaign for Rohingya refugees via R-Vision, 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.
MSF started its medical operations in Indonesia in 1995, following a massive earthquake in Jambi Province, Central Sumatra. Since then, MSF provided medical treatment services in many other provinces across the country until its end of programme in 2009.
In 2015, MSF collaborated with the Crisis Centre of the Ministry of Health (MoH) and the Aceh government in responding to Rohingya refugees. MSF delivered mental health support and psychosocial activities for the refugees. In 2016 up to February 2017, MSF mobilised medical response for those affected by the earthquake in Aceh. MSF also delivered psychosocial education and psychological first aid training to the health staff and cadres in health clinics.
The current focus of MSF in Indonesia is adolescent reproductive health, as covered by the Memorandum of Understanding inked between MSF and the Department of Family Health, an agency of the Indonesian Ministry of Health.
In 2017 until 2018, MSF and the Jakarta Province Health Agency conducted trainings on reproductive health to teachers and students of elementary schools in Kepulauan Seribu (Thousand Islands). Also starting 2017, MSF has been conducting trainings for methanol poisoning in three cities; Jakarta, Yogyakarta, and Surabaya. In 2018, MSF started the implementation of a youth health programme in the sub-districts of Labuan and Carita, in Banten Province.
Also in 2018, MSF mobilised emergency medical response for those affected by the triple disasters of earthquake, tsunami and liquefaction in Central Sulawesi; and the tsunami that hit Sunda Strait which affected Banten and Lampung provinces. MSF covered Pandeglang District as the organisation has presence in the area due to the adolescent health project in Banten Province.
With the surge of COVID-19 infections in Indonesia, MSF teams have conducted 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 has been responding to crises in the Philippines since 1984. MSF has conducted operations in 11 different regions within the country, including the Autonomous Region in Muslim Mindanao (ARMM), which is now part of the Bangsamoro Autonomous Region in Muslim Mindanao.
Initially focusing on the needs of disaster victims and displaced people due to typhoons, floods, eruptions and droughts, MSF increased its response areas in 1989 to include tuberculosis, and in 1995 to include STI and HIV/AIDS prevention. In addition, MSF offered comprehensive health services for urban street children for more than a decade.
MSF provided repeated humanitarian assistance and medical care to families affected by armed conflicts in Mindanao from 1997 through 2009. We also carried out humanitarian support to Filipinos affected by massive floods and several strong typhoons in 2011 and 2012.
The Philippines experienced its worst year of disasters in recent history in 2013. MSF responded by launching one of its largest humanitarian responses that year in multiple areas devastated by typhoon Haiyan (locally known as typhoon Yolanda). This included trauma care; restoring basic medical services and facilities; providing shelter, reconstruction kits, water and sanitation facilities; and offering psychosocial support to children and adults. The same year, MSF also provided medical donations in response to the Zamboanga crisis.
In 2016, MSF started supporting a local organisation, Likhaan Center for Women’s Health, and is in close collaboration with the Department of Health in providing reproductive health services in Tondo slums; including cervical cancer prevention, screening, and treatment. In 2017, we undertook a vaccination campaign against human papillomavirus, responsible for cervical cancer, reaching 24,000 girls aged between nine and 13 in three districts in the City of Manila.
MSF has been responding to the displacements in the aftermath of the 2017 Marawi siege. Our field teams provided psychological first aid to more than 11,500 people displaced by the Marawi siege and are currently supporting primary healthcare and mental health services for internally displaced people and returnees.
In 2020, the team supported health workers who carry out contact tracing and COVID-19 prevention activities at community level in Manila. In three different health facilities providing care for COVID-19 patients, the team helped build tents for triage, sought 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 2020, 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 City, the team monitored COVID-19 surveillance and contact tracing and supports health promotion in one quarantine facility.