While much of the world’s attention is on battling the COVID-19 pandemic, which has now reached many countries in Africa, measles continues to silently kill large numbers of mostly children in the Democratic Republic of Congo (DRC), Central African Republic (CAR) and Chad. DRC – which has also been fighting an Ebola epidemic – declared a measles outbreak in June 2019. Chad’s measles outbreak has been raging for two years, since May 2018. CAR declared its measles outbreak in January this year.

Together, the outbreaks have infected hundreds of thousands of children and killed thousands more. Some kids die at home, never having reached proper medical care, or having been seen only by a traditional healer.

MSF teams around the world are responding to the COVID-19 pandemic, in both countries where we've previously worked, and those we haven't had to work in before. Here are our teams at work in pictures.

MSF teams are racing to respond to the COVID-19 pandemic in the more than 70 countries in which we run programmes, while opening projects in new countries as they become pandemic hotspots.

In Spain, MSF is setting up two temporary hospitals around Madrid to decongest other hospitals and are providing infection prevention and control advice to protect healthcare workers and patients. We are specifically working with steering committees that manage aged care homes, to help protect the elderly.

Since the so-called EU-Turkey deal in March 2016, migrants and refugees previously in transit through the Greek islands have been trapped there for an indeterminate time in overcrowded, unsafe and unhygienic conditions, without access to basic services, adequate shelter or information on their legal status.

Civilian areas have been routinely bombed and deprived of assistance, and access to healthcare remains extremely poor in many areas. We operate in Syria where we can, but ongoing insecurity and access constraints – the Syrian government has not granted MSF authorisation to operate in the country – severely limit our activities and hamper our ability to provide humanitarian assistance that matches the scale of the needs.

In Darvazeh Ghar district, MSF runs a clinic offering a comprehensive package of medical services designed for high-risk patients who suffer from stigma and/or need more help to follow their treatment. 

Services include counselling and support from peer workers, psychosocial aid, medical and mental health consultations, ante- and postnatal care, family planning and treatment for sexually transmitted infections.  Patients can also be tested for communicable diseases such as HIV, tuberculosis and hepatitis C.

Together with a number of other organisations, we set up a ‘humanitarian hub’ at the Gare du Nord, near Maximilian Park, in Brussels. Here, our psychologists offer counselling and mental health support as part of a complete package of services for migrants and refugees in transit.

We also offer mental health screening, counselling and psychoeducation to migrants and refugees in three reception centres and a number of individual housing projects in Charleroi and Roeselare.

Cultural briefings and recreational activities are organised to reinforce social networks, and people with symptoms of severe mental health problems are referred to specialist care as appropriate.

We provide mental healthcare across multiple reception centres in Sicily’s Trapani province, where a team of cultural mediators and psychologists screen asylum seekers for psychological vulnerabilities and provide care to those in need.

For migrants in transit along Italy's borders with France, Switzerland, and Slovenia, we provide medical care, shelter, psychological care, food and other essential items.

In Rome, in collaboration with Italian NGOs Medici Contro la Tortura (Doctors against Torture) and Association for Law Studies on Migration (ASGI), we run a rehabilitation centre for torture survivors.

Survivors are treated using a range of approaches, including medical and psychological care, and physiotherapy.

MSF has been working to respond to the coronavirus COVID-19 pandemic recently declared in Côte d'Ivoire. While Côte d'Ivoire is now registering 80 cases (as of 26 March, according to WHO) of COVID-19 and has not yet reached the stage of local transmission, the Ivorian authorities have quickly taken measures to restrict movement, as have most neighbouring countries.

Deir Hassan camp in Idlib province, northwestern Syria, is one of the many camps to which hundreds of thousands of displaced families fled, to escape the military offensive by Syrian government forces with their Russian allies between December 2019 and early March 2020. Deir Hassan camp hosts more than 164,000 people in settlements scattered over the hills and, as is the case across northwest Syria, it lacks basic services. It is now also threatened by the potential spread of COVID-19.

MSF is stepping up our response to the coronavirus COVID-19 pandemic by starting medical, logistical and strategic support activities in Spain. We will be leveraging our experience and expertise in managing epidemics in fragile contexts, in working in the country.

COVID-19 is a contagious new coronavirus and much remains to be understood. Unlike influenza, there is no known pre-immunity, no vaccine, no specific treatment and everyone is presumed to be susceptible.   
 
MSF is very concerned how the COVID-19 pandemic will affect people in countries with already fragile health systems. On any given day, our staff treats tens of thousands of patients for a variety of illnesses in our medical programmes around the world. In many areas where we work, there are few medical organisations in a position to respond to an overload of patients.

How are you supposed to wash your hands regularly if you have no running water or soap? How can you implement ‘social distancing’ if you live in a slum or a refugee camp? How are you supposed to stop crossing borders if you are fleeing from war? How are those with pre-existing health conditions going to take extra precautions if they already can’t afford or access the treatment they need? Everyone is affected by the COVID-19 pandemic, but the impact may be felt by some more than others.

One week ago, MSF started to support the COVID-19 pandemic response at Codogno hospital, where the first Italian case was detected, in the region of Lombardy, northern Italy. Half of the 100 beds in this hospital are currently dedicated to patients receiving care for COVID-19. The MSF team, made up of doctors, nurses and hygiene experts, works every day with hospital staff, including healthcare workers and cleaning teams, to support them. One of the key aims of our team is to protect hospital staff from being infected with the virus.