August 23, 1999
Relief Rushed to Turkey Earthquake Victims
Four teams from MSF are now assisting in the relief efforts for victims of last week's 7.4-magnitude earthquake in northwestern Turkey. After assessing the most urgent needs in Izmit and Adapazari, MSF has set up field hospitals and dispensaries in these cities. An additional MSF team is providing aid in the worst-hit suburbs of Istanbul. All teams consist of a combination of international aid workers and Turkish doctors. Medical supplies, surgical materials, tents, hospital tents, blankets, and materials for safe water supply and sanitation arrived in Istanbul by cargo plane. MSF has also sent in a nephrologist (kidney specialist), who has started working with a Turkish colleague and five nurses specialized in dialysis. Experience treating earthquake victims shows that kidney failure is a major cause of death among those who survive their initial injuries. In an affliction known as "crush syndrome," muscle tissue damaged after severe internal injury can release massive quantities of toxins into the bloodstream and lead to kidney failure. Left untreated, crush syndrome can be fatal. Water and sanitation also remains a serious concern. The large numbers of people still living in open areas in unhygienic conditions raises the possibility of epidemic outbreaks. MSF is providing water and sanitation support in certain affected regions and monitoring the risk of epidemics.
Health Care and Well Cleaning in Kosovo
MSF continues to provide primary medical health care, water and sanitation, and mental health care to vulnerable groups in Kosovo. Currently, MSF medical teams are conducting up to 400 consultations in Kosovo every day, through its eight mobile clinic based in Pristina, Pec, Djakovica, and Prizren. MSF has established two new field offices in Skenderaj and Vucitrn, to provide mental health, water and sanitation, and basic health care. In Gjakova, mobile clinics continue to support clinics in the town and the villages of Dol, Brizhatazin, and Rugova. A mental health program for children and adults is also being implemented in Gjakova. In Prizren, the mental health team started Monday, August 15, with an intensive training program for local counselors. Building upon their expertise, the team intends to root mental health into health services in Kosovo. Well-cleaning activities continue in Kosovo. Two water/sanitation teams based in Skenderaj and Vucitrn have outlined 32 key villages in need of well cleaning. In Gjakova, the wat/san teams have chlorinated a total of 264 wells and disinfected and additional 38. In Prizren, the wat/san team continue to clean six to eight wells a day in Neprebiste and Samodraze villages.
Therapeutic Feeding Centers Open in Angola
MSF has opened 6 therapeutic feeding centers in Malange, Angola, last week. Treating approximately 200 children each, the centers are already filled to capacity. According to operational director Wilna van Aartsen, who has just returned from Angola, the aim is to open 3 centers per week until the total reaches 12. "The entire population of Malange is liable to suffer from malnutrition unless something changes," says Van Aartsen. In addition, there is a serious risk of the famine spreading to cities such as Huambo and Kuito. The difficult security situation along roads in the region makes it practically impossible for humanitarian aid to reach people in the most affected areas. Where food and other basic necessities are available in the markets, the prices are far beyond the reach of ordinary people. Continued fighting in the region has also made it impossible for farmers to cultivate their land. Many rural people have fled to cities such as Malange, where according to Van Aartsen some 70 percent of the population are made up of displaced persons. At present, MSF has seven international staff members in Malange. MSF has also compiled a special report on the Angolan crisis entitled "Angola: An Alarming Nutritional Situation," in which it calls on the two warring parties to allow safe and unhindered access by humanitarian aid agencies to the affected regions.
Volunteers Abducted in Liberia Released
Two MSF volunteers who were reported missing in Liberia on August 11, 1999, were released last week along with 4 other international humanitarian aid workers and 10 local staff members taken at the same time. The two volunteers, Irene Martino, 34, a nurse from Italy, and Trond Heldaas, 53, a logistician from Norway, were working in Liberia to provide health care and water and sanitation to refugees from Sierra Leone. Upon arriving at the Liberia-Guinea border, the released aid workers were met by two MSF physicians and taken to Macenta in Guinea, before flying to the capital, Conakry. Once in Conakry, the two received a special debriefing from MSF staff trained to help field workers who have been involved in a critical situation deal with emotional stress. According to newly received information, the MSF volunteers were taken by an armed group when fighting broke out in the neighborhood of Kolahun in northwestern Liberia. The armed group did not take them hostage, according to this new information, but held them for their own protection. "We are delighted that our colleagues are safe and sound," said Amanda Harvey, MSF Head of Mission in Liberia. "Apparently, they have been treated correctly. However, we are still concerned about the situation of the population in the northwest region of Liberia where there is still much tension and insecurity."
HIV/AIDS/STD Assistance for Southern China
MSF, in cooperation with the health authorities of Liangshan prefecture in Sichuan province, is launching an HIV/AIDS/STD assistance project in this poor mountainous area of southwestern China inhabited mainly by the Yi minority. Since HIV testing of IV drug users began here in 1995, an increasing number of HIV carriers have been found, especially in the two remote counties of Zhaojue and Butuo. Knowledge of HIV and Sexually Transmitted Diseases (STDs) is very limited in the region and access to health care is difficult due to cost and geographical remoteness. MSF will work alongside the Public Health Bureau and local health care workers to carry out awareness-raising and prevention activities focusing on high-risk groups in the two counties. In addition, a study of the prevalence of STDs in the region is being carried out and appropriate treatment protocols will be introduced. There will be an MSF trainer based in each county, plus one MSF physician who will focus on the STD component in the counties and in the prefecture capital. From Kunming, medical coordinator Diane Rutter adds, "This is a significant moment for HIV prevention in China. The Liangshan authorities are willing and keen to explore supportive approaches, and MSF is very pleased to assist them."
Cholera Hits Afghanistan
Cholera has broken out in Afghanistan, with the first cases discovered at the end of June. "The fact of the health-care system having collapsed makes it difficult to obtain reliable figures, but we're certainly dealing with cholera," says country manager Oliver Mathieson. MSF is supporting the Infectious Diseases Ward of the Mirwais hospital in Kandahar. The team is supplying drugs to the hospital, giving technical advice, and improving the water and sanitation facilities. In collaboration with the Ministry of Health, MSF is working on an effective response for keeping the situation under control in the rural areas of Kandahar and neighboring provinces. Another team is on the way to Oruzgan province to assess whether aid is also necessary there. Cholera tends to be seasonal in Afghanistan. When water sources dry up in the summer, widespread use of open irrigation canals for domestic water increases the risk of infection and spread of the disease. The affected area is extremely large, consisting of isolated villages most of which are without proper infrastructure and communication lines, let alone public health services. "Any outreach activities to the rural populations are a big logistical challenge," says Mathieson. MSF has also set up five cholera treatment centers in Kabul, the capital, and is preparing for the possibility of an outbreak in the northern part of the country.
New Attention to Aral Sea after Discovery of Anthrax Dump
The discovery of hundreds of tons of anthrax bacteria on the island of Vozrozhdeniye in the Aral Sea which touches Uzbekistan and Kazakhstan has focused attention on the region, considered to be the most environmentally damaged in the world. MSF has a medial team in Munyak, Uzbekistan, 100 kilometers from the southern shore of the sea where some health problems may be related to environmental damage. According to a recent article in The New York Times, the material was produced as part of a top-secret biological weapons program and was dumped on the island in 1988. The quantity of dumped bacteria is enough to destroy the world's population several times over. The Soviet Union tried to render the bacteria harmless by pouring bleach over the discarded bacteria, but research has revealed that not all spores are dead. More detailed information about the past biological warfare program and the potential hazards of the bacteria on the island has yet to be released. "We're totally in the dark," says Ian Small, MSF country manager in Uzbekistan. "It's scary not to know what we're dealing with." Soviet irrigation schemes for cotton plantations begun in the 1960s have caused the Aral Sea to shrink significantly. As a result, the island of Vozrozhdeniye will become connected to the mainland in a few years, increasing the risk that local people will come into contact with the bacteria. The health condition of the population around the sea is already very poor. MSF is concentrating on combating tuberculosis in the region and carrying out research into the links between the environmental damage (such as the excessive use of pesticides on the cotton plantations, and the salt-laden winds from the exposed seabed) and the health of the population.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)