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Reasons for Intervention
At its core, the purpose of humanitarian action is to save lives, relieve acute suffering and help restore the potential of individuals who find themselves in life threatening circumstances. in each country where MSF is working, one or more of four events has taken place. this triggers a medical humanitarian response, and if required, the obligation to speak out to ensure those in need are assisted. the four events are armed conflict, endemic/epidemic disease, social violence/healthcare exclusion and natural disasters.
However, in reality life is not this simple or clear so MSF uses its previous experience and judgment to decide whether its expertise is needed. MSF also recognises the inherent limits that exist in delivering aid and, therefore, MSF does not intervene in all conflicts or respond to all natural or man made catastrophes. Our actions reflect an analysis of the potential added value we can bring, and we question the pertinence of our presence or absence in any given situation on a regular basis.
Populations affected by armed conflict require comprehensive medical and humanitarian support. These people are victims of violence, civilian populations that have been harassed and affected directly or indirectly through attacks, rapes and killings. They are weakened, subordinated, and may be forcibly displaced from their homes, looking for refuge within or outside their home countries.
In an environment of such destruction and disruption of healthcare systems, medical, surgical and psychological care is needed. Indirect effects of conflict and instability, including a collapse of general infrastructures and a ruined economy, also lead to suffering. As a result, people are excluded from essential medical care and services, and can be devastated by epidemics such as AIDS, TB, malaria, or lesser known diseases such as sleeping sickness.
MSF operations are based on medical teams working in health structures/hospitals offering medical services to cover the range of medical crises inherent to a conflict, such as malnutrition or mental health problems. When needed, MSF also constructs wells and dispenses clean drinking water and offers shelter materials.
Populations affected by natural disasters require an immediate medical humanitarian response. They find themselves in desperate conditions, having suddenly lost their homes, material goods, family members and relatives. They are highly traumatized, in need of rapid and diverse medical care and support. Access to the disaster area and the victims is usually complex and demands fast identification of multiple needs.
The poorest people are particularly affected, having precarious habitats and living conditions. MSF supplies a wide range of answers: medical support such as surgery, psychological and nutritional programs, and preventative actions addressing potential epidemic risks. These are provided in existing hospitals or through the erection of temporary buildings if needed. Provision of relief items such as blankets, tents and cooking oil may also be distributed. These operations are developed through extensive collaboration with national actors, taking into account the importance of local efforts and strategies, and the limitations of an international intervention with regards to time, quality and pertinence.
Populations affected by epidemic or endemic disease
Such populations arise in variable contexts of stability and conflict. Emergency capacity and innovative medical actions are imperative to ensure a viable response.
People who live in precarious regions, remote and/or underdeveloped areas, slums of capitals and cities, camps or shantytowns, often do not receive strong support from the local and international authorities. They are often minority groups, refugees or nomads. They are at increased risk in situations of economic and social dependency. Women and children are the most worrying categories. Exposed to infectious and communicable diseases, vulnerable during pregnancy, and traditionally less able to express their pains and concerns, women’s realities go unnoticed in many countries. The dependency of infants and children further increases their vulnerability.
MSF works in existing medical structures and also establishes new structures if needed. It responds quickly to outbreaks of disease including cholera, measles and malaria. It targets the most vulnerable to infection. In addition, it raises awareness about the risks of an epidemic through training and prevention initiatives. Collaboration with local governments and authorities is a condition for implementing activities and rapidly improving the situation. Engaging in advocacy to support medical action, as in the case of HIV/AIDS, is also crucial in identifying responsibilities, understanding political intentions and mounting effective responses.
Social violence and healthcare exclusion
Populations affected by social violence and healthcare exclusion often suffer because of who they are. They could be minority groups, ethnic groups, migrants, displaced people or refugees. They may be street kids or night commuters. They may be sex workers or simply a patient with HIV/AIDS or TB.
Living in environments where their conditions and rights are limited or non existent, they frequently do not receive adequate support from local authorities and also suffer the limits of international aid.
MSF becomes directly involved to alleviate such daily suffering with medical, psychological and social activities. Healthcare exclusion requires projects that bring attention to healthcare access and the absence of medical services. MSF’s identity includes the act of speaking out, and united with patient care is a commitment to bringing attention to the causes of suffering and the obstacles to providing effective healthcare, and raising the concerns and the realities of our patients to national and international actors.