The Photographer by Didier Lefevre and Emmanuel Guibert

There often comes a time when the services MSF offers are no longer necessary, when, for example, an epidemic or a conflict has abated, or local organizations are able to take over the operations. There is not a rigid and specific formula for when this might occur; nor is it always an easy decision. It is a very complex process that depends on the specific project, the immediate context, the capabilities that exist on the ground, and the judgment of field and headquarters staff.

In 2009, for example, MSF handed over its HIV/AIDS programs in Cambodia to local actors. In 2010, it handed over a number of projects in Liberia, where relative stability had arrived after many years of civil war, and closed its Bon Marche hospital in the town of Bunia, in the Democratic Republic of Congo, because it was determined that the situation in the immediate area had improved and that the emergency needs were greater in other locations.

In each case, MSF does the best it can to ensure high quality continuity of care. And in many MSF projects, training of local employees is emphasized with the hope of helping developing broader skills across a given society that can be employed to deliver the necessary care after MSF has departed or handed over its programs.

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