Episode: "Nomad M.D."

PHILIPPINES | CHINA | ETHIOPIA

In this episode, Dr. Helmy Mekaoui comes down with a case of malaria. Is there a preventative malarial treatment that aid workers usually take to keep from becoming infected?

Before MSF volunteers go out into the field, they are given a briefing about the health conditions in the countries to which they are traveling. For malaria-prone countries, MSF advises volunteers about different antimalarial drugs that can help prevent malaria. The most commonly used are mefloquine and chloroquine, but neither drug is guaranteed to prevent malaria. Some volunteers opt not to take any antimalarials because of side effects or for other reasons.

In this episode, Dr. Josephine Querubin is a doctor from Manila, Philippines, working with MSF in her own country. Why is MSF in a country where qualified professionals from the area are there to take care of their own country’s needs? How does MSF determine whether to staff an area with local or international volunteers?

MSF works in any country that has healthcare needs that are not being met by the local system. Although a country may have qualified doctors, nurses, and other healthcare professionals, there may be any number of reasons – including a lack of public or financial support – why the medical needs of a certain population are not being met. For example, in this episode’s Philippines portion, MSF stepped in where local organizations and the government organizations were either unable or unwilling to provide the necessary support to an impoverished population living on a city dump. From establishing feeding centers for the malnourished, to ensuring healthcare for those who could not afford it, MSF filled in the administrative and organizational gaps that were preventing local doctors from taking care of their people’s needs.

MSF determines each mission’s staffing based on a country’s individual needs. In addition to being medically or otherwise professionally qualified for MSF’s work, local volunteers and staff members are invaluable in terms of their language ability and knowledge of their own culture. However, although MSF always works with local staff members and volunteers who are capable and willing to support a mission’s goals, each mission always has a certain number of international volunteers. One goal of the MSF expatriate volunteer is to create a link from his or her own community to a population in need. Also, MSF reinforces its status as an independent, international organization in a country through its placement of expatriate volunteers.

At the end of the episode, it is mentioned that Chinese authorities will take over MSF’s role in Southwest China. However, Nurse Kate Turner is leaving her post with the worry that when MSF is gone from the region, patients will no longer be able to obtain the medicines they need at an affordable price. How does MSF provide drugs to local populations at a price that they can afford?

Actually, MSF provides nearly all medications to local populations for free. MSF is a nonprofit organization that purchases drugs through its own funds to distribute to people who need them but cannot afford them. MSF does this cheaply either by using its own supply chains or by buying generic local brands. There are some self-supported MSF missions that purchase medications and then sell them to the public for a nominal price, however proceeds from these sales are then reinvested into the purchase of more medications in order to make them abundant and available to those in need. Providing these free or affordable medications is a constant challenge because there are many drugs unavailable at low costs, and all too often the need for these drugs outstrips MSF’s ability to provide them.

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