The latest violence that erupted in South Sudan's Leer county earlier this month has resulted in the deaths of dozens of civilians, including a Doctors Without Borders (MSF) staff member. Indiscriminate attacks by armed groups also continue to deny people access to vital medical services, exacerbating an already dire humanitarian situation, as many continue to be trapped in an endless cycle of violence and displacement following the civil war in 2013-2018.
Peter Mathor Tap had been working with MSF in Leer since 2007, initially as a senior department supervisor at the former MSF hospital, which was destroyed twice during the civil war, once in 2014 and once in 2015, and more recently as a provider of nursing care in one. from MSF's community health care facilities (CBHCs). During the fighting on April 10, Peter was shot dead while off duty. As a child, Peter had polio, which left him disabled and forced him to use a cane. This affected Peter's ability to flee when armed assailants arrived in the area where he lived. He is the second MSF staff member to be killed in Leer since December 2021.
“We are shocked and deeply saddened by the tragic death of our colleague Peter,” said Federica Franco, MSF head of mission in South Sudan. "We strongly condemn the indiscriminate violence carried out by armed groups that have killed and injured many innocent civilians in Leer, including the most vulnerable, such as children, the elderly and people with disabilities."
The MSF clinic in Leer has remained one of the few fully functioning health care facilities in the entire county, and the only facility providing advanced emergency care. Since the latest fighting began on 4 April, the MSF clinic in the city of Leer has treated more than 30 people with gunshot wounds, as well as other trauma victims, including survivors of sexual violence.
Initial assessments of the recent violence report large-scale destruction, especially in Adok, Pilleny, Thonyor and Touchria, where scores of people were killed, houses were burned and property looted. As a result, thousands of people have been forcibly displaced, including MSF staff. The displaced are too scared to go home. As many of them have lost all their belongings, they have little to return to. Many people have sought refuge in the swamps, where they are at risk of deadly water-borne diseases such as cholera and diarrhoea, as well as malaria.
"They [the attackers] they were shooting, and everyone ran into the swamp area because we were running for our lives,” said Nyadeng*, an elderly resident of Adok. “People died, including mothers and young children. When we left, we found that the area was burned, the goats and cattle were taken, and looted [property].”
Of the six CBHC facilities that MSF operates in Leer County, three are no longer functional, as one facility was partially destroyed and two others were looted during these latest attacks. Despite this, MSF continues to ensure that people can access much-needed medical care. MSF has also started running mobile clinics in the main places of displacement.
“The level of atrocities witnessed, the persistent fear of being attacked and the widespread destruction of medical facilities are seriously affecting access to health care, as people are reluctant to travel to seek treatment,” Franco said. “Thousands of people who have been displaced urgently need humanitarian aid and medical care. We call on all armed groups to respect international humanitarian law and immediately stop attacking civilians and health facilities."
MSF has suspended all medical activities in the southwestern region of Cameroon. The suspension comes as we work to secure the release of four of our colleagues, who have been unjustly detained since December 2021 and January 2022. MSF remains open to dialogue with the authorities and urges the immediate release of all our imprisoned staff members.
Médecins Sans Frontières (MSF) officially announces the suspension of our humanitarian activities in the southwestern region of Cameroon, three months after the arrest of four members of our staff in connection with our medical work. Since their arrest, there has still been no significant progress in their cases to secure their release. Therefore, MSF decided to suspend our medical activities in the Southwest region from March 29, to work exclusively on ensuring the safe release of our colleagues.
On 27 December 2021, two MSF staff members were arrested after the ambulance carrying a gunshot wounded patient in need of urgent care was stopped at the Nguti checkpoint (southwest region, Cameroon). Despite the fact that our team followed the humanitarian notification procedures agreed upon with the authorities, our colleagues were arrested and are still in prison in Buea, in the investigation phase. They are being investigated for complicity with secessionism simply for fulfilling their medical duties.
In the following weeks, two other MSF colleagues and collaborators were also detained by the gendarmerie (armed police). They are receiving legal advice and MSF is in constant communication with them and their families.
“We find ourselves in an untenable position… our activities are required… [yet] those who provide medical support are at risk of persecution for doing their job,” said SYLVAIN GROULX, MSF PROGRAM OPERATIONS MANAGER IN CENTRAL AFRICA.
Parallel to the legal procedures, MSF representatives engaged with Cameroonian authorities and other stakeholders at different levels to provide information and clarity on our medical activities and procedures. This compromise was intended to facilitate their release, but did not lead to significant progress in their cases. In February, in a report on the arrests commissioned by the Defense Ministry, an independent Cameroonian organization concluded that MSF and our colleagues should be exonerated of any wrongdoing. The report said that we were acting in accordance with our humanitarian principles and therefore our colleagues should be released immediately.
“We are in an untenable position,” says Sylvain Groulx, MSF Program Operations Manager in Central Africa. “On the one hand, our activities are required and, on the other hand, those who provide medical support risk being persecuted for doing their job.”
“In order to fulfill our duty towards our patients, we need the basic preconditions that allow us to carry out our activities in a safe and secure environment,” says Groulx. "MSF remains available to continue the dialogue with the authorities to resolve this problem as soon as possible, so that we can resume our medical-humanitarian activities."
As an international medical organization, MSF provides impartial medical support to all patients in need, in accordance with medical ethics and international humanitarian law.
“In order to guarantee access to medical care and essential humanitarian aid while ensuring maximum security for our teams and patients, in Cameroon, as in other parts of the world, our teams are in contact with all the armed groups involved, both state and non-state,” he says. Groulx. "This can in no way be seen as a lack of impartiality or an act of collusion with any of the parties to the ongoing violence in the Anglophone regions."
Siphephelosethu Ntjangase is a 21-year-old college student from Hluti village in the Shiselweni region who is suffering from drug-resistant pulmonary tuberculosis (DR-TB). In October 2021, before his checkup, he noticed that he was losing weight, sweating at night, and had a persistent cough that had lasted for over a year. From the first test, the diagnosis was inconclusive, forcing him to opt for a second opinion, and it was then that he tested positive for tuberculosis (TB). Siphephelosethu was immediately isolated at Pigg's Peak Government Hospital to avoid infecting others and then referred to Nhlangano Health Center for treatment. Nhlangano Health Center is the national designated center for TB treatment.
“ At first I was scared because I'm not sick and taking the daily medication didn't do me any good. I told people who had been around me to get tested and luckily no one tested positive for TB."
Siphephelosethu had been taking his medicine religiously until civil unrest in the country in 2021 forced him to suspend treatment for a time as he was unable to access hospital.
“At least when I started taking the treatment, the effects weren't as bad as I had imagined when I was diagnosed. I began to gain weight and feel like myself again, with dizziness and nausea being my only side effects. The nurse gave me pills to take thirty minutes before taking the medicine and this has helped me a lot”
Previously, treatment of multidrug-resistant TB (MDR-TB) required a course of second-line drugs that included injectables for at least 24 months and up to 36 months, supported by counseling and monitoring for adverse events. Although these regimens were effective, some patients experienced serious side effects, including hearing loss, kidney and liver damage, primarily due to the injectables. The longer duration of treatment also contributed to a large number of losses to follow-up. The World Health Organization then recommended that countries abandon non-injectable regimens, adopt all oral MDRTB treatments, shorter regimens, and seek innovative approaches that include adherence facilitators to support patients.
'At first, I thought I would die, but I am happy that I did not experience any stigma either from my family or from the community. My aunt even attended a family treatment support workshop where she educated herself about TB and then enlightened other family members. The nurses also came to my house for the same thing,” Siphephelosethu said.
Dr. Takudzwanashe Gwitima of Médecins Sans Frontières (MSF) says that the shorter regimen Siphephelosethu is on is the preferred option for most patients who only use it for nine to 12 months and has fewer side effects.
“Initially, patients would come in for daily injections for eight months plus tablets and tablets for the rest of the year. They would experience serious side effects such as hearing loss which in some cases would lead to deafness, kidney problems and a lot of pain due to daily injections. It used to be very traumatic for me to inject children on a daily basis and seeing them cry was not a good feeling. At least now the mother can crush the medicine and give it to the baby to take.”- Dr. Gwitima
In Eswatini, most patients adhere to oral short course therapy (OSCT) as it is tolerable with fewer side effects. This is evident as the MDR-TB treatment success rate improved from 74% in 2018 to 79% in 2021. A figure that is higher than the global treatment success rate of 59% according to the World Report on tuberculosis in 2021. Loss to follow-up improved from 6% to less than 2% and even in the context of adherence to COVID-19 appeared to be improving. In addition, given the long duration of MDRTB treatment, as well as the safety precautions that TB patients must take, including isolation (often including loss of income), the WHO recommended that food baskets be provided to them for protect them from socioeconomic impacts.
Multidrug-resistant TB is a concern in Eswatini, accounting for around 10% of diagnosed cases. Multidrug-resistant TB (DR-TB) is more difficult to treat than drug-sensitive TB. In 2020, the new WHO DR-TB guidelines were published and Eswatini quickly adopted the guideline and revised the DR-TB guidelines in 2019, which recommended the use of all oral regimens. The same year (2019), Eswatini, with the support of MSF, developed a protocol for the implementation of a shorter oral regimen in 2020.
Unfortunately, due to the COVID 19 pandemic, the implementation was delayed by a year. A shorter oral regimen was subsequently implemented in two of the four regions under operational investigation. After 3 months of implementation, there was an evaluation by the consultants of the WHO Green Light Regional Committee, and they recommended expansion to the entire country and this was done in two months with the support of the partners of the Emergency Plan. President's Program for AIDS Relief (PEPFAR).
Going forward, the country will continue to expand the use of all short oral regimens and train nurses to initiate these treatments so that they are accessible in more health facilities to further improve patient outcomes and impact. These are efforts to guarantee Universal Health Coverage, leaving no one behind.
The French medical charity Médecins Sans Frontières (MSF) said on Thursday that five employees who were kidnapped more than a month ago in troubled northern Cameroon have been freed in neighboring Nigeria.
The five, who were arrested on February 24 in Fotokol, a border area that frequently suffers from jihadist attacks, have been transferred to a "safe place", MSF told AFP, without giving further details.
"We are pleased to have our colleagues back safe and sound," MSF Executive Director Stephen Cornish said in an email to AFP.
The five are made up of three humanitarian workers of Chadian, Senegalese and Franco-Ivorian nationality, and two Cameroonian security guards.
They were captured by armed men who entered a building used by the charity.
Fotokol is located in the Far North region of Cameroon, a strip of land that lies between Nigeria to the west and Chad to the east.
It touches the swampy lands of the Lake Chad region, where Boko Haram jihadists and militants from the rival province of the Islamic State of West Africa (ISWAP) are known for their attacks on troops and civilians.
In September 2019, six Cameroonian soldiers were killed near Fotokol by suspected members of Boko Haram.
Last August, 26 Chadians were killed in the swamps across the border.
But a local Cameroonian official, speaking after the kidnapping of the five, warned that the identity of the kidnappers was not clear.
“We don't know if it was a simple robbery gone wrong. A safe was opened,” she said.
The violence in the Lake Chad area began with the rise of Boko Haram in Nigeria in 2009.
Since then, more than 36,000 people have been killed, most of them in Nigeria, and three million have fled their homes, according to UN figures.
Eighty percent of those over the age of 50 in Uganda's Kasese district have now received two doses of the COVID-19 vaccine thanks to a Ministry of Health vaccination campaign supported by Doctors Without Borders/Médecins Sans Frontières (MSF) teams. ). A total of 252,000 people across the province were vaccinated between December 2021 and February 2022. In addition, more than 3,000 clinically vulnerable people with comorbidities were vaccinated at the Arua hospital.
In May 2021, MSF teams launched an emergency response to COVID-19 in the places in Uganda where they were already working after a large number of infections and deaths caused by the Delta variant. Initially, they focused on setting up treatment centers, organizing logistics (including oxygen supply management), training health personnel in infection prevention and control, and providing care for patients in the southwestern Kasese district, Arua in the northwest and the regional hospital of Entebbe, 40 km. From the capital
COVID-19 vaccines were not widely available in Uganda until the end of 2021. "In December, only 3% of the population had access to the vaccine, even though there was a high demand," says Christopher Mambula, medical adviser to MSF. "When the Ministry of Health announced that they had received many vaccines to use quickly, we decided to respond and help them finance and organize this vaccination campaign. For COVID-19 vaccines, we believe that it is necessary to be as close as possible." to the local context and tailor the response accordingly.”
The first round of vaccination took place over a week in December at 220 sites, with teams vaccinating 1,100 people from 872 villages. This was followed by another round in February to administer second doses.
"It was very challenging, particularly because the vaccines were of different brands, which had an impact on patient follow-up, especially during the time between two vaccination rounds," says Théo Wanteu, MSF head of mission. "Respecting the cold chain was also a real challenge, especially when traveling to remote and hard-to-reach villages perched on the slopes of the Rwenzor Mountains."
A total of 252,000 people in Kasese district received vaccinations, representing 80 percent of those over 50 years of age (the age group most at risk of developing complications from the disease) and 63 percent of those over the age of 50. 18 years.
Meanwhile, two vaccination sites were established at the Arua hospital, where teams vaccinated more than 3,000 patients with comorbidities, including HIV, tuberculosis and chronic diseases.
High levels of violence and a sense of impunity for parties to the conflict have forced MSF to close projects in parts of northeastern DRC; The arrest in Nizi and Bambu, Ituri province, comes four months after MSF vehicles were attacked, leaving two staff members seriously injured; The lack of guarantees from the belligerents and the lack of commitment from the authorities to investigate the incident have forced us to withdraw.
Four months after a convoy of vehicles belonging to Médecins Sans Frontières (MSF) was attacked by unidentified armed men in Ituri province, Democratic Republic of Congo (DRC), MSF has announced that it will close its projects in Nizi and Bambu due to to a lack of security guarantees from all parties to the conflict.
Two MSF staff members were seriously injured in the attack, which took place on October 28, 2021 on the road between Kobu and Bambu, in the Djugu territory of Ituri province.
Following the incident, MSF called on all parties to the conflict to condemn the attack and respect international humanitarian law and protect medical facilities, health workers, ambulances, patients and the wounded. We have also asked the authorities to launch an investigation into the incident, but this has not happened.
“We very much regret this decision as it will have dire consequences for people in acute need, but we cannot risk lives to save lives,” says OLIVIER MAIZOUÉ, MSF DRC PROGRAM MANAGER.
“We have been left with no choice but to close our projects,” said Olivier Maizoué, MSF program manager for the DRC. "The risks are simply too high and therefore it is impossible for MSF to return to those areas with confidence."
"We very much regret this decision as it will have dire consequences for people with acute needs, but we cannot risk lives to save lives," Maizoué said.
MSF will continue to provide medical and humanitarian aid in other parts of Ituri province, including Drodro and Angumu, and will continue to support local health authorities in Nizi and Bambu by donating medicines and medical supplies to cover the coming months.
“However, we are painfully aware that this one-time donation will not compensate for our departure and will negatively affect people who urgently need medical care,” Maizoué said.
An MSF staff member walks through part of a damaged IDP camp in the Nizi health zone. Djugu territory, Ituri province, Democratic Republic of the Congo, May 2020.
All parties to the conflict are supposed to provide unimpeded access for humanitarian aid to civilians in need, and to respect and protect humanitarian personnel.
Therefore, we maintain our request that the authorities carry out an investigation and call on all parties to the conflict, as well as all people in a position of influence, to work to ensure an environment that allows people to receive the help they so desperately need. need.
The October attack was not the only recent incident to affect MSF teams in Ituri province. In June 2021, the main referral hospital in the city of Boga, which was supported by MSF, was severely damaged during the fighting in the city. At least 12 people lost their lives, while several buildings, including the intensive care unit, were set on fire and the hospital's pharmacy and stock of medical supplies were looted.
"We are deeply concerned about the climate of impunity that reigns today in this part of the DRC... We know that impunity further fuels violence," says JÉROME ALIN, MSF CHIEF OF MISSION
"We are concerned about the numerous attacks and looting of health facilities, and we are deeply disturbed by the climate of impunity that reigns today in this part of the DRC," said Jérome Alin, MSF head of mission. "We know that impunity further fuels violence."
MSF teams in other areas of the DRC have witnessed similar incidents against medical and humanitarian workers. To express their concern and show solidarity with their colleagues and all those affected, MSF staff in the Democratic Republic of the Congo will organize a one-day protest on March 23, 2022. On that day, only life-saving medical activities will continue. .
The international humanitarian medical organization Médecins Sans Frontières/Médecins Sans Frontières (MSF) requests a safe place to disembark 111 survivors —including 52 minors, the youngest of whom is four months old— aboard the Geo Barents rescued from the Mediterranean Sea on days March 5 and 6.
Malta and Italy have denied MSF's requests for a safe place to disembark, despite MSF informing the authorities of the vulnerable condition and medical needs of many people on board. About 45 percent of the minors are traveling alone (many report they have relatives in Europe they are trying to reunite with), there are two pregnant women on board and a woman with a severe traumatic injury to her right leg who needs specialist care.
Many of those on board have symptoms of serious psychological distress, including flashbacks and generalized distress, anxious thoughts and trouble sleeping as a result of the trauma they experienced in Libya. The MSF teams on board are doing their best to provide medical and psychological support to all the survivors, but they urgently need to be disembarked in a safe place to receive further assistance.
Many of the survivors say they have attempted to cross the sea several times only to be intercepted by the Libyan Coast Guard and taken to detention centers where they experienced extreme violence, including sexual abuse and ill-treatment.
returned to Libya
On February 20, the Geo Barents left the Sicilian coast for the search and rescue zone. For several days, bad weather in the Mediterranean Sea discouraged most departures from the Libyan and Tunisian coasts. The first alert of a boat in distress came in the early hours of February 26. After an overnight search, the ship arrived near the last known position only to find an empty rubber dinghy. The 105 people reported to be on board were probably intercepted by the Libyan Coast Guard and returned to Libya.
Another alert was received from the Alarm Phone, a service to help people in distress at sea, in the early hours of March 5. Fortunately, the weather conditions were good. The Geo Barents immediately changed course and spotted a crowded rubber boat adrift with 80 people on board. After almost ten hours at sea, all the survivors, who said they had left the Libyan coast the night before, were rescued and brought safely aboard the Geo Barents. After spending so many hours sitting in seawater laced with fuel, seven people were treated for fuel burns.
“The most difficult rescue”
A second rescue took place on the night of March 6 during strong winds and waves. After six hours of searching for the boat, the Geo Barents finally reached a very unstable and endangered fiberglass boat with 31 terrified people on board.
“It was the most difficult rescue I have done since I started doing search and rescue in 2017,” said Javier Filgueira Guimerá, one of MSF's search and rescue technicians. “The boat was already taking on water when we found it at 12am in the dark. While we were still getting people into our fast rescue boats, the fiberglass boat capsized. They were all thrown into the cold water, including a pregnant woman. It was a life or death situation, but we were able to rescue all 31 people."
All survivors were taken to safety on the Geo Barents, many suffering from fuel poisoning and symptoms of hypothermia.
“We spent almost 30 hours at sea,” said Aman*, a shipwreck survivor from Eritrea. “We were stressed, scared, people got sick, we had a pregnant woman and we didn't know what to do. The boat capsized and people began to drown. It was frightening."
"This time, we were able to rescue everyone on that sinking boat, but what if we had arrived a few hours later?" "Another silent tragedy would have occurred at sea and more lives would have been lost as a result of European governments withdrawing from search and rescue operations in the central Mediterranean," said Caroline Willemen, MSF project coordinator in the Geo Barents. . states invest in policies of deterrence and militarization of borders, people drown in the sea”.
*The name has been changed.
The United Nations and aid organisations have condemned Russia’s attack on a maternity hospital in the Ukrainian city of Mariupol.UN Secretary-General Antonio Guterres called the attack “horrific” in a tweet.“Civilians are paying the highest price for a war that has nothing to do with them.“This senseless violence must stop, end the bloodshed now,’’ he asserted.Doctors Without Borders (MSF) said it could not confirm “this was a targeted attack’’ but that its staff said “houses and hospitals have been damaged during the fighting over the past days’’.“With active shelling, gunfights and aerial bombardment in Ohio Mariupol ongoing, seeking health care have become increasingly hard.“Especially for expecting mothers and elderly people who are limited in their movements,’’ MSF Emergency Manager, Kate White, said in a statement.“I am horrified by the reported attack today on a maternity hospital in Mariupol, an attack which left young children and women in labour buried beneath the rubble of destroyed buildings,’’ said Catherine Russell, UNICEF Executive Director.“We do not yet know the number of casualties but fear the worst.’’17 pregnant women and employees were injured in the bombing, according to Pavlo Kyrylenko, the head of the Donetsk Oblast military administration. (dpa/NAN)
Aisha, wife of President Muhammadu Buhari, praised Médecins sans Frontières (MSF) (Doctors Without Borders) for their humanitarian efforts in Abuja on Monday.
MSF is an international humanitarian medical non-governmental organization of French origin best known for its projects in conflict zones and affected countries.
Aisha especially praised MSF for its efforts to meet the medical needs of vulnerable people in Nigeria.
He spoke through the Principal Special Assistant to the President for Women's Affairs and Administration, Dr Rukayyatu Gorin, when an MSF delegation led by Country Representative Dr Simba Tirima visited the State House.
Dr. Gorin received the MSF delegation on behalf of Aisha Buhari.
He noted that MSF and Aisha's NGO, the Aisha Buhari Foundation (ABF), had much in common, especially in providing medical assistance to internally displaced persons (IDPs).
He particularly appreciated MSF's commitment to providing medical support to victims of the conflicts in the states of Borno, Zamfara, Katsina and other parts of the country.
Gorin said that ABF had supported victims of the insurgency in the northeast and also victims of natural disasters, especially in establishing maternity clinics in some states.
“We have carried out many humanitarian interventions through the Aisha Buhari Foundation and the Future Assured Program; we have dedicated ourselves to addressing the plight of women and children,'' she said.
He expressed the wish to strengthen the partnership between the two NGOs to address the medical and humanitarian needs of vulnerable people, especially women and children.
Earlier, Tirima said that the MSF delegation visited Government House to acquaint Aisha Buhari with her various humanitarian interventions in hard-to-reach areas of Nigeria.
Tirima said that MSF has been in Nigeria since 1996, providing humanitarian support to victims of natural disasters.
According to him, the organization currently operates in 10 states across the country, providing employment to 3,000 thousand Nigerians in different sectors.
In his remarks, the Senior Special Assistant to the President for Public Affairs and Strategy, Malam Sani Zoro, expressed his optimism that the meeting would provide a platform to consolidate various agreements with other international NGOs.
“We are at a point where the Aisha Buhari Foundation and Future Assured are building on the various partnerships they have with other international NGOs,” Zoro said.
On February 28, unidentified armed men attacked seven Médecins Sans Frontières (MSF) staff on the road outside Yei, robbing them and burning two MSF vehicles, forcing the aid organization to suspend operations in areas outside the city. On the same day, armed men attacked a World Food Program truck convoy between Gadiang and Bor in Jonglei state. The convoy was escorted by UN peacekeepers and one peacekeeper was shot and wounded during the attack.
These attacks are the latest in a wave of attacks against humanitarian workers and aid operations in South Sudan.
On 10 February, an MSF nurse and at least 20 other civilians were killed and several others injured in Agok town when fighting broke out between the communities of Twic, Warrap State and Abyei Administrative Area. The fighting displaced at least 70,000 civilians to the city of Abyei and forced aid groups to suspend their operations.
On the same day, a humanitarian worker in MirMir, Unity State, was killed in crossfire during clashes between factions of the Sudan People's Liberation Army in Opposition and militias affiliated with government forces. Two days later, a humanitarian agency vehicle on its way to a health center was attacked and three health workers were seriously injured.
At least 130 aid workers, mostly South Sudanese, have been killed on duty since the war broke out in 2013. Attacks on unarmed people and aid workers are totally reprehensible, violate international law and may amount to war crimes. They impede humanitarian work and threaten the lives of thousands of South Sudanese who depend on humanitarian assistance. At least 8.9 million people are estimated to be in need of humanitarian support this year.
The prevalence of attacks suggests that the 2018 peace agreement between warring factions has not yet achieved the desired stability and respect for rights that was hoped for. It also points to the need for the unity government to prioritize the provision of basic social services and end its over-reliance on humanitarian aid.
South Sudanese authorities must work with humanitarian organizations to identify measures to help ensure the safety of humanitarian workers, and all armed factions must scrupulously adhere to their obligations to respect and protect humanitarian personnel and assets. The authorities must launch transparent, thorough and credible investigations into the attacks and ensure that all those responsible are held accountable.