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´?

The purpose of this evaluation was to assess the functioning of the hospital set-up in Léogâne, Haiti one year after its implementation and to capture the lessons learned in order to inform other missions that attempt this type of set-up. The conclusions are based on two visits, the first at the 6-month mark and the second approximately one year following the initial implementation. In general, there is a positive attitude towards the set-up and the advantage of quick and relevant decision-making was felt in most departments at almost all levels.

This is the internal reflection report for OCAs Ebola intervention in Sierra Leone. While there are numerous workshops and reflections being organized across theMSF movement, and this OCA report may form part of the larger process, its primary function willreflect on how we as OCA responded, what we learnt, and what we need to do for possible futureepidemics. The report covers discussions around Operational Decision Making, HQ setup and field supprt, Biosafety, Cinical care in EMCs and Duty of care to our international staff.

In a short and concise way this chart flags out the main lessons identified by OCBA. Besides very practical points of Ebola response it also stressed the importance of leadership and supportive platforms. The document includes a list of new approaches to be developed and evaluated, e.g. the care for vulnerable groups, the decentralization of care etc. The lessons learned from a logistic perspective are documented in a separate report

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