The evaluation looks at the process for managing MSF-OCP's construction/rehabilitation projects since 2012. The main problems identified are not related to the process itself, but the way it is put into application. The main users pointed out the long delays (periods of indicision) as being the biggest difficulty, followed by budget/cost issues (cost/m² estimates) , and the quality of constructions (techniques, materials, etc). One of the root causes of delays relates to unclear/incomplete definition of roles and responsibilities = actions to take.

Medical Innovations in Humanitarian Situations. The work of Médecins Sans Frontières

Through a series of case studies, the authors reflect on how medical aid workers dealt with the incongruity of practicing conventional evidence-based medicine in contexts that require unconventional approaches.

History of MSF’s interactions with investigations and judicial proceedings: Legal or humanitarian testimony?

The document analyses and describes the different initiatives, experiences and positions that MSF has had with regard to international investigations and judicial proceedings.

MSF and protection: pending or closed?

To address protection, however, is to address the question of our responsibility and role when confronted with violence, in the context of healthcare. Has this question been settled once and for all within MSF? In order to provide elements for a reply, the study looks at the practices and discourse, both past and present, employed by MSF (headquarters, field teams, individuals) when faced with situations of violence affecting either the population in general, or the people we assist. It analyses our discourse on responsibility - discourse which has inevitably evolved with the changes in our work environment, particularly states' international actions. The study also tries to identify the constancies within our practices. Three case studies are presented in the appendices.

Humanitarian Medicine

Humanitarian medicine is intended for marginalized people, hit by a crisis or deprived of access to medical care. It is made up of a wide range of practices with few obvious connections between them. Some of them rely on specific know-how, built up through borrowing and innovation primarily over the last three decades, whilst others reflect a different way of using the knowledge we already have. This study helps us understand how the specificity of humanitarian medicine stems from real-life situations, more than from the medical act in itself.

Disabilities and medicine. A survey of the Amman Surgical Reconstruction Project 2012

This survey investigates patients’ coping mechanisms and their dependence on medical institutions both from the patients’ standpoint and from that of MSF’s project teams.

This report provides an analysis of the perception of antibiotics and antibiotic use in a district hospital in Kabul. The major findings will help to answer the following questions: how do patients, caretakers, doctors and pharmacists perceive antibiotics and antibiotic use? What do they know about medication in general and antibiotics specifically? For which illnesses do they take them and how do they use them? How do they recognise access to health care? Why do they come to Ahmad Shah Baba hospital? How do they perceive this health care facility and how do they see health personnel and their performance? What is the antibiotic seeking behaviour like? Who and what influences a decision? And how is antibiotic resistance driven?

Is humanitarian water safe to drink?

A series of failures was the starting point for this analysis. Several outbreaks of hepatitis E, transmitted via the water supply, occurred in refugee and IDP sites in the Sahel (Sudan in 2004, and Chad in 2007) and in central Africa (Central African Republic in 2002, and Uganda in 2007). MSF was responsible for all or part of the water supply, as well as medical care. These outbreaks are a reminder that significant infectious risks persists even after we implement our usual procedures.

The Ebola Workshop in Dakar, held over 3 days in June 2015, brought together experienced Ebola field people and HQ staff from diverse specialties and all MSF sections to reflect on lessons learned so far and make recommendations in the areas of outreach response, patient care, human resources and strategy. Participants placed a high value on intersectional approaches within MSF, and on strong engagement with key external organizations in preparing flexible, adapted, more effective responses to future outbreaks of Ebola or other mass epidemics. 

The MSF heavy metal poisoning project in Zamfara state has faced persistent challenges specifically in Abare village. The main research question was if there are ´specific cultural reasons for the (…) challenges in Abare, and if yes, (how) can we address them in the coming year, in order to achieve better results (discharge from program as per protocol) for the children in the program?” 3 The three problems the anthropologist was asked to focus on: - Why do patients ´default´?

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