Tag Archives: MSF

‘MSF adapting to worsening conditions in Gaza Strip’

Photo courtesy of MSF

Photo courtesy of MSF

I have always looked at MSF as the canary in the coal mine of humanitarian aid.  If they say it is getting bad then other folks should start lining up.  They don’t stray far from their mandate of providing medical aid in the world’s worst situations.  Gaza did not is not on their Top Ten Humanitarian Crises even thoug they were working there full time.  Now, in light of recent events they have switched into emergency mode and is attempting to get additional medical teams into Gaza.  From their site:

More than a week after the first air strikes on Gaza Strip and following the beginning of the land incursion of Israeli forces, surgical services are overwhelmed and in need of surgeons specialised in vascular surgery in order to deal with the number of wounded. In Gaza city, the intensive care unit of Shifa referral hospital has reached the limits of its capacity. The insecurity is preventing patients needing post operative follow up and health personnel from reaching health structures.

Three MSF expatriate volunteers – a field coordinator, doctor and nurse) arrived in Gaza Strip on Wednesday, December 31, to reinforce the local teams composed of 35 health personnel.

Read on…

MSF + SMS = ‘Surgeon saves boy’s life by text’

David Nott volunteers for a month a year with the medical charity

For the last few days I have been having a spirited discussion with Janet Ginsburg of InSTEDD offshoot Trackernews over at Paul Currion’s blog humanitarian.info.  This new blog post has helped bring me back to reality.  This is what it is all about:

A British doctor volunteering in DR Congo used text message instructions from a colleague to perform a life-saving amputation on a boy.

Vascular surgeon David Nott helped the 16-year-old while working 24-hour shifts with medical charity Medecins Sans Frontieres (MSF) in Rutshuru.

The boy’s left arm had been ripped off and was badly infected and gangrenous.

Mr Nott, 52, from London, had never performed the operation but followed instructions from a colleague who had.

The surgeon, who is based at Charing Cross Hospital in west London, said: “He was dying. He had about two or three days to live when I saw him.”

Read on…

MSF’s Condition: Critical

Doctors Without Borders/Medecins Sans Frontieres (MSF) has launched a new initiative called Condition: Critical aimed at raising awareness of the situation in eastern Congo.

The site has an incredibly moving slideshow with audio from the field and an informative narration.  As a father it is hard to watch.  I used to have thicker skin when I was in the field with MSF but all that changed with the birth of my son.

Read on…

Doctors Without Borders ‘A Refugee Camp in the Heart of the City’

I recently attended the Doctors Without Borders ‘A Refugee Camp in the Heart of the City’ exhibit at the Marina in San Francisco.  It was great to catch up with people I’ve known for almost a decade and tell the field stories that cause most ordinary folks to just stare blankly at you.  The tour has matured since I first saw it back in 2000 in Santa Monica and there is a tremendous amount of interesting info.  It was great to see the equipment we used to use and stepping into a Trigano tent and sitting on the blue metal footlockers caused me to flashback to my field days.  I made it all the way through the tour with a smile on my face while listening to the thoughtful narration of an epidemiologist until I was 20ft from the exit when I turned and was stopped dead in my tracks by a poster of my friend Hawah Kamara.

Hawah was one of the finest individuals the earth has ever known.  I desperately miss her and I am struggling to keep it together as I sit here and write.  I cannot do justice to this woman with words alone.  I think somewhere deep down I live my life for Hawah and people like her.  She was all that was right about humanitarian aid work.  The last person I saw when I left on a mission and the first person I saw when I came back, she was the anchor in NY for all none medical personnel and was everyone in MSF’s best friend.

Hawah was a refugee from Liberia that worked in the MSF office in Monrovia before immigrating to the US where she handled all of us Logs and Admins passing through the NY office.  Hawah was killed in Nigeria when her plane crashed on Dec 10, 2005 during a visit to a program site along with another MSF worker.  She was an incredible woman that walked for days with her 5 year old daughter with little food and water to escape the fighting in Liberia…

I am just falling apart and I don’t think I can keep writing.  There is way too much to say.  This is one of those things in my life that I cannot shake and every time Hawah comes up my throat tightens, my eyes begin to well with tears and I try to change the subject.  I think it goes back to the time I came home from a particularly difficult mission and sat down for a debrief with Hawah and another person.  I was wound up pretty tight and unloaded all that was left from my debrief in Paris.  It was not pleasant but at the end of it Hawah looked at me and said, “You did the right thing.  You took care of your staff.  At one time I too was local staff.”

I knew what she meant and I have never forgotten those kind words.  That is the kind of thing you hear that makes all the crap you endured worth it and that makes you think you might just be cut out for another mission.  It is because of people like Hawah that the humanitarian aid industry survives.  The selfless efforts of the former local staff members that personally know the incredible impact that a humanitarian aid agency can make is what makes it all worthwhile.

Although Hawah is not here in body she is with all of us in spirit.  You can see proof of it in the eyes of former volunteers who knew her as I saw it in my friend’s watery eyes that day at the exhibit.  We miss her terribly and will keep doing what we do for people just like her.  I know she is up there watching us and cheering us on.

Please attend the exhibit to experience what we do and how we do it.  At the end you can see the photo of Hawah and others and see why we do what we do.  Here is the schedule:

MSF’s ‘A Refugee Camp in the Heart of the City’ exhibit in San Francisco October 15-19

Jeff Allen wrote to let me know that our alma mater, Doctors Without Borders, will be exhibiting ‘A Refugee Camp in the Heart of a City’ October 15-19 in San Francisco’s Little Marina Green Park.

Jeff is an MSF Logistician and software developer on sabbatical somehwere in Europe.  He pens his thoughts here.  He’s right in emphasizing that friends and family should go and see this exhibit as few have any comprehension as to what we do and how we do it.  He also encourages others to attend and so do I.  Definitely, if you are anywhere near SF in two weeks be sure to check it out.  It only gets better with time and it helps to make clear what aid workers and the beneficiaries experience.  The exhibit is mobile and will also show in LA (Oct 22-27), Santa Monica (Oct 31-Nov 2) and San Diego (Nov 6-9).

IT Next to the Beneficiaries

My friend Jeff has rescued me from my flu induced apathy by sending an excellent reality check highlighting the limits of IT in the field.  Here it is in full:

Jon writes here often about how cutting edge apps might be adapted for use by aid workers. As a tech guy myself, I love to read and dream about this kind of thing. But as a field guy, I’m unfortunately here to today to bring the dreams crashing down to reality.

The thing is, the IT life I have observed in the field, near to the beneficiaries, is not all shiny and high bandwidth. And “near the beneficiaries” is what matters. Coordination meetings with Google Earth maps projected on the wall, integrating UNOSAT imagery and placemark databases showing wells and refugee camps is the dream. But we must never forget why we are there: to work with communities to make the temporary and lasting changes necessary to let them support themselves. So that’s why the IT landscape near to the beneficiaries matters to me more than the IT context in the capital or headquarters.

Here’s a beneficiary for you: The man I’m thinking about is the data manager for a Congolese health district. He’s lucky: he lives on the eastern border of the country, close enough that the strong Ugandan economy supports his own struggling one. He’s got 30 kbit/sec Internet implemented via a serial cable plugged into a desktop mobile phone with an antenna out the window pointing across the border at Uganda. He works in a district office, so there are several computers, one of which is on his desktop, all donated by various vertical programs (the “AIDS computer”, the “Malaria computer”, etc). The WHO has supported the DR Congo strongly over the last decade, so he’s had the chance to travel 8 hours by motorcycle to the regional capital to attend classes in Microsoft Excel. He has a Yahoo email account.

During a meningitis epidemic, it’s his job to enter all the paper forms arriving by bicycle and moto from around the region into a spreadsheet setup by the WHO. It’s hard for him to get his job done… which is how I came to know him. My boss sent me over to him to try to find out why he could never give us the data we needed on time in order to make good decisions about our meningitis intervention. He explained that he can only work when the generator is on. Then he explained that sending files with Yahoo mail is slow, and doesn’t always work. Then when we looked at his computer to see why, we found evidence of several viruses making it impossible for him to open any document with “virus” in the filename. (I’d already noticed the evidence: each time our USB key came back from his office, it had a file named h.vbs on it.)

Across town in the MSF compound (a rented hotel), I was working with my own constraints. We also were dependent on the generator, since there is no electrical grid in eastern DR Congo. We had three laptops for five people, approximately the same ratio as the health office (2 desktops, 4 people putting significant time into meningitis). But because we had laptops, we could work when the generator was off. We had internet via BGAN satellite at 128 kbit/sec. It is expensive, at USD 5 per megabyte, meaning that we had a filter on our mail preventing us from receiving attachments larger than 2 megs.

The attachment limit turned out to be another problem. On the off chance that the generator, the phone, and Yahoo mail worked, and he managed to send the week’s data out to us via e-mail, we couldn’t receive it, because it was too big. We solved that problem by getting in the Landcruiser and driving across town with a USB key. Which, if you’ll recall, is how I knew that I should go over and remove his viruses.

How do we remove viruses? It’s easy, right? Update your virus scanner and scan. But an update is 12 megs, or USD 60 on satellite, and completely impossible to download on a 30 kbit/sec link from Uganda. So no update. MSF solves this problem by sending virus update CDs to the field monthly. But the viruses you catch in Africa tend to be locally written (this one was from a technical university in Nairobi). If they ever end up in the virus databases at all, they arrive late. Certainly later than my most recent update CD from Geneva. I got lucky and found instructions online for how to edit the registry and remove the virus. But I’m a programmer… who would have fixed it without me?

Keeping computers working next to the beneficiaries gets a lot harder as you pile on the constraints, doesn’t it? But it’s probably worth it, because of the benefits they can bring.

Or is it?

In Myanmar, my girlfriend worked 6 days without a computer doing mobile clinics, then came back to base on Sunday for a rest and to enter stats into the MSF spreadsheets. By necessity, she finished her stats and weekly report in an hour of work Sunday afternoon, then got on with the real business of resting up for the next week of mobile clinics. She said it was liberating to not use a computer in the field… which might be a lesson for us as well.

Here’s some tech lessons I’ve learned in the field:

  • Use POP, not webmail. Slow, unreliable, expensive connections are the enemy of web apps.
  • Don’t expect to be able to use web apps, even the ones your headquarters says you should be using.
  • Have lots of USB keys around to move documents
  • Expect viruses and struggle on regardless, there seems to be no workable answer to this. (At one Congolese internet cafe, the operator scanned USB sticks before allowing us to use them. I gave him my USB stick clean, and I got a virus back from him. Great.)
  • The simplest thing possible might work. Anything more complicated won’t.

The number one lesson: The work is worth doing, and to do it right you have to be out there, at the edge, in the mud, with the beneficiaries, in their communities. If the IT can’t keep up, leave it at home.

MSF in Bihar and KMZ file of flooding

MSF has reached the flood affected regions in Bihar state and reports back from the frontlines:

An emergency relief team from the humanitarian aid agency, Medecins Sans Frontieres (MSF) has reached the areas worst affected by the flooding in Bihar State, India. The team, including a logistician, a water-sanitation engineer and a medical doctor, are assessing the extent of the humanitarian needs in Araria and Purnea-Madhepura. The team has also brought supplies of non-food items for distribution to the affected population.

Read on…

Stefan Geens over at Ogle Earth has converted the UNOSAT PDF maps into a KMZ file for those of you interested in viewing the flooding in Bihar in Google Earth.  We covered this in an earlier post sans KMZ.  When will UNOSAT start publishing all their data in KMZ?

Read on…