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MSF in Cameroon, 2006/2007
Field Staff: 90
Reason for Intervention:
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Buruli Ulcer, an infection caused by mycobacterium ulcerans, is an emerging disease in several Western and Central African countries. Related to tuberculosis and leprosy, Buruli causes ulceration of the skin, primarily of the arms and legs, and destruction of underlying tissue and bone. Untreated, it may lead to permanent disability and limb amputation in those affected.
In Cameroon, this disease affects the inhabitants of several provinces situated in the Forest Equatorial Zone, with “nests” of high prevalence running alongside slow-flowing rivers. People in the Akonolinga and Ayos districts of Center Province are among the worst affected. The two towns, which are focal points in their districts, are in the heart of the Buruli Ulcer (BU) epidemic zone and less than one hour’s journey apart.
MSF has been developing the “Buruli Pavilion” in the District Hospital of Akonolinga since 2002. The Pavilion has become a reference centre for managing BU free of charge and over 500 patients have been treated since the project began. Medical care for Buruli currently includes drugs and surgery.
The means of transmission and development of BU are still unknown. The prevention, diagnosis and treatment are complicated and compounded by the widely held perception of the disease as “mystical”, resulting from a curse. There is an urgent need for affordable and rapid, non-invasive diagnostic tests to detect the disease in its early stages and newer antibiotic treatment as an alternative to the anti-tuberculosis treatment currently being used.
Treating people with HIV/AIDS MSF initiated an HIV/AIDS pilot project in 2000 and follows some 6,000 persons living with AIDS (PLWA) in its project in Nylon hospital, Douala, and more than 800 in Djoungolo hospital in Yaoundé.
MSF has concentrated on simplifying HIV/AIDS case management to help ensure care for patients in a country that now administers treatment free of charge, but suffers from severe structural limitations in the domain of medical human resources. Simplification of care should help guarantee the continuity of anti-retroviral treatment and enable MSF to begin withdrawing from Yaoundé. MSF is also working on decentralizing care for PLWA in Douala, Nylon district, to the health facility in New Bell and to the Catholic Church’s medical facilities.
Assisting refugees from Central African Republic
By July 2007, a three year long civil war in neighboring Central African Republic had led to the exodus of some 78,000 people. By July 2007 more than 26,000 had taken refuge at dozens of sites along Cameroon’s eastern border. Insufficient protection and assistance and a deterioration in the medical and nutritional situation led MSF in July to urge more humanitarian actors to provide aid. MSF itself had been distributing supplementary food rations in the East province, where 12 tonnes of food had been supplied to 2,398 recipients (children and mothers). MSF was also implementing a medical and nutritional care strategy in collaboration with Cameroon’s Ministry of Public Health for the most urgent cases.
MSF has worked in Cameroon since 2000.