Friends, at any given time, great numbers of people are on the move. It would be wonderful if they were all visiting family or conducting business or taking a holiday—if their journeys were their choice, that is. But we know that’s not the case.
This past year, 2013, provided numerous reminders of just how often people are forced from their homes and homelands by circumstances—armed men, natural disasters, repression, privation, and more—beyond their control. In places such as Central African Republic, South Sudan, and Syria, we saw millions take flight in the face of conflict and violence. In the Philippines, a typhoon destroyed whole towns and cities, sending their former occupants looking for shelter or neighbors with houses still intact. In other countries, it was the search for economic survival that drove people, or the need to access services they were being denied.
As an emergency medical organization, Doctors Without Borders/Médecins Sans Frontières (MSF) knows from experience that we have to be ready to respond to these sorts of situations, and we have to be ready for the particular set of needs that arise among refugees and those displaced within their own countries. Being uprooted from one’s home is traumatic enough by itself, but due to the often-grueling nature of the journey to the next point and the conditions that await there, the risk of injury, disease, malnutrition, and trauma also rises. We know that vaccinations and chronic disease care get interrupted, at great cost. We know that women and children require special attention and that physical and psychological burdens increase over time—it gets harder, not easier—for those unable to return home.
To put it simply, people are on the move, so we have to stay on the move as well. In practice, this means mobilizing staff and resources and getting them where they have to be. It means negotiating access to the populations in need and remaining constantly aware of the dynamics on the ground, so we can be as efficient as possible while keeping our personnel and our patients as safe as can be. It can mean crossing frontlines or borders or rivers and mountains to reach them.
In this year’s annual report, we are highlighting populations that were on the move en masse in 2013, along with MSF’s responses in these situations. Case studies look into specific contexts more closely, while our facts and figures, our financial case study, and our roster of US-based staff who left for missions last year all show the perpetually active and necessarily responsive nature of our work.
The challenges inherent in these efforts were underscored yet again in 2013. While we were able to celebrate the release of our colleagues Montserrat Serra and Blanca Thiebault from captivity in Somalia, we also had colleagues who went missing in Democratic Republic of Congo and others abducted in Syria, as well as numerous security incidents. Furthermore, we were forced to close our programs in Somalia after nearly two decades due to deteriorating security conditions and our realization that local communities and leaders would not or could not provide the bulwark against various threats that we rely on to operate in conflict situations.
But we can fairly say that we accomplished a great deal. MSF’s US office sent 400 people to various field missions around the world, a very significant contribution to the overall work of the organization. Our teams carried out more than 9 million consultations and 77,346 surgeries, while also assisting more than 180,000 births (a full run down of the year in numbers can be found on pages 14 and 15). Our advocacy teams and Access Campaign also fought diligently to help remove barriers that prevent patients from getting the medications they need and to push the international community to uphold its responsibilities to populations in crisis.
Many are involved in this work, and we were deeply saddened by the loss of two people integral to the founding and development of MSF-USA, Garrick Utley and Dr. Richard Rockefeller. We are forever grateful for their assistance and counsel, and thank them,as we thank all of those who help us deliver emergency care to people who need it most, wherever they may be.
Deane Marchbein, President, MSF-USA Board of Directors
Sophie Delaunay, Executive Director, MSF-USA