Top Ten in Photos
Unrelenting Violence Stalks Civilians Throughout Eastern DR Congo
Throughout 2009, the civilians suffered continuous violence from different armed groups in eastern Congo. Hundreds of people were killed, thousands of women, children, and, sometimes, men were raped and hundreds of thousands of people fled their homes. Guerilla warfare has replaced armed clashes in North Kivu where combatants spread terror by looting and burning houses in reprisals against the perceived support of communities to different factions. Learn more »
DRC 2009 © Martin Beaulieu
Two women in Kitchanga camp, North Kivu, Democratic Republic of Congo (DRC).
DRC 2009 © Michael Goldfarb/MSF
An MSF vehicle, part of a mobile medical clinic, sits in the village of Muheto, Masisi District, North Kivu Province, DRC. MSF operates mobile clinics throughout North Kivu to deliver basic health care to local populations, most of whom have been displaced by ongoing conflict.
DRC 2009 © Michael Goldfarb/MSF
A woman carries firewood, her child balanced on top, along a dirt road in the village of Mweso in North Kivu province, DRC.
DRC 2009 © Martin Beaulieu
A rainy day at the internally displaced persons (IDP) camp in Nianzale, North Kivu, DRC.
DRC 2009 © Michael Goldfarb/MSF
A girl stands in front of makeshift shelters at Kahe Camp, Masisi District, North Kivu province, DRC. The camp is home to over 18,000 displaced people who have fled ongoing conflict in North Kivu.
DRC 2009 © Michael Goldfarb/MSF
A man takes shelter under an umbrella at the Mweso hospital in North Kivu province, where MSF provides surgical, pediatric, obstetric, and nutrition support.
Somalis Endure Violence and Lack of Access to Health Care
In 2009, the Somali population continued to fall victim to indiscriminate violence, while severe drought plagued parts of the country. Millions of people urgently require health care, yet the enormous gap between the needs of Somalis and the humanitarian response on the ground continues to widen. Ongoing abductions and killings of international and Somali aid workers is thwarting the efforts of humanitarian organizations to respond, and the public health-care system remains in near total collapse. Learn more »
Somalia 2009 © Javier Roldan
A mother and child wait at the Jamaame hospital in southern Somalia.
Somalia 2009 © Javier Roldan
A boy hugs his father following treatment by MSF in Jamaame hospital.
Somalia 2009 © Javier Roldan
A child with malnutrition in Jamaame hospital.
Somalia 2009 © Jan Grarup /NOOR
A mother and her malnourished child sleep in an MSF feeding centre in Galcayo, central Somalia.
Somalia 2009 © Jan Grarup /NOOR
A mother holds her malnourished child in the Galcayo feeding centre, which is often packed to capacity.
Somalia 2009 © Jan Grarup /NOOR
Prolonged drought coupled with fighting and high food prices has meant many children like this are suffering from malnutrition.
Precarious Situation for People in Southern Sudan and Darfur
Medical humanitarian emergencies persisted throughout 2009 in several parts of Sudan. In addition to the ongoing crisis in Darfur, people in southern Sudan faced a deteriorating situation marked by escalating violence, disease outbreaks, and little or no access to health care. Learn more »
Kalma Camp in Darfur, Sudan 2007 © Voitek Asztabski / MSF
Humanitarian aid agencies organize the distributions of food and non-food items. People waiting in line (mostly women) are exposed to the heat of the desert, which often reaches 50 degrees Celsius (120 Fahrenheit) in the shade.
Kalma Camp in Darfur, Sudan 2007 © Voitek Asztabski / MSF
During the rainy season there are frequent sand storms (haboob). On occasion, the wall of sand is so thick that it is dark despite of the time of day. However, the weather did not interrupt this distribution line. Kalma Camp, Darfur region.
Kalma Camp in Darfur, Sudan 2007 © MSF
A moment of rest at Kalma Camp, Darfur region.
Sudan 2009 © Jan-Joseph Stok
The region around Muhajirya has been the target of violent attacks and bombing campaigns, causing 30,000 people to flee their homes. Ache Ali, a cattle herder from a village near Muhajirya, sits in distress on a donkey cart. "I lost four children. They ran away three days ago when our village, Buhera, was bombed."
Sudan 2009 © Jan-Joseph Stok
Aziza Tahir Hassim stands in the former Shegeg Karo market, located between picturesque orange sand dunes in North Darfur. The market was destroyed when a plane dropped 17 bombs on the market. People from Darfur don't know where to go anymore.
Thousands Injured during the Final Stage of Sri Lanka's Decades-long War
As fighting raged earlier this year between the Sri Lankan military and the Liberation Tigers of Tamil Eelam in northeastern Sri Lanka, tens of thousands of civilians were trapped for months in a war zone reduced to a narrow strip of jungle and beach, with no aid and limited medical care. A few months before the final phase of the country’s decades-long civil war, humanitarian aid agencies, including MSF, had to leave the areas most affected by the fighting, at the request of the government. Only the International Committee of Red Cross (ICRC) could continue some crucial medical assistance, evacuating some of the wounded to Ministry of Health hospitals. An MSF surgical team worked since February 2009 in one of these hospitals, in nearby Vavuniya. Learn more »
Sri Lanka 2009 © Anne Yzebe / MSF
A female patient presents multiple wounds at an MSF field hospital near Manic Farm. Vanni, northern Sri Lanka.
Sri Lanka 2009 © Anne Yzebe / MSF
Approximately 260,000 people have fled the conflict area of Vanni, in northern Sri Lanka. Most have settled temporarily in Vavuniya district, and are in need of urgent medical care.
Sri Lanka 2009 © Anne Yzebe / MSF
MSF nurse, Mireille, attends to a patient in the MSF field hospital near Manic Farm.
Civilians Suffer From Violence & Neglect in Pakistan
Pakistan was convulsed by intense violence throughout 2009. Conflict between the Pakistani army and armed opposition groups in the North-West Frontier Province (NWFP) and in the Federally Administered Tribal Areas (FATA) displaced more than two million people, while numerous bombings in major Pakistani cities killed hundreds and injured thousands. In the province of Balochistan, a long-running conflict continued beyond the media’s glare. Across the country, people suffer from a general lack of health care, and Pakistan features one of the highest infant and maternal mortality rates in the region. Learn more »
Pakistan 2009 © Marta Ramoneda
An MSF doctor checks a malnourished baby admitted at the MSF ward set up at the Mardan Medical Complex, Mardan.
Pakistan 2009 © Marta Ramoneda
A child is examined in the Mardan Medical Complex. Over 2 million people have been displaced since fighting began in Pakistan's North West Frontier Province.
Pakistan 2009 © Marta Ramoneda
Displaced women sit in the waiting room of the female wing at the Takht Bhai rural health centre for internally displaced people.
Pakistan 2009 © Jobi Bieber
An elderly Afghani refugee, cradles his crying granddaughter at an MSF rural health centre in Kuchlak, in Pakistan's Balochistan province.
Pakistan 2009 © Jobi Bieber
From above the size and scale of the Munda displaced people's camp, located in Lower Dir of Pakistan's North West Frontier Province is clear.
Pakistan 2009 © Jobi Bieber
An infant dozes on a stretcher in a fan-cooled tent at the MSF run cholera treatment centre at the Mardan Medical Complex.
Pakistan 2009 © Jobi Bieber
Noor Pari and her nine children walked five hours from their destroyed home to the Summer Bagh Camp, where they have lived for five months.
Politics of Aid Leaves many Afghans Cut off from Humanitarian Assistance
As the war in Afghanistan escalated in 2009, Afghan civilians endured increasing levels of violence throughout the country. The insecurity has damaged an already beleaguered health-care system, leaving only a few poorly functioning hospitals and clinics in provincial capitals. Afghans in need of any health care must now make an impossible choice: risk traveling hundreds of miles through a war zone to seek a medical care or allow a condition to worsen until it becomes life-threatening only to arrive at a health structure where services are greatly diminished. Learn more»
Afghanistan 2009 © Pascale Zintzen /MSF
An MSF staff member provides vaccination for a mother and child. Ahmed Shah Baba Hospital, eastern Kabul, Afghanistan.
Afghanistan 2009 © Pascale Zintzen /MSF
MSF staff member examines a patient at Ahmed Shah Baba Hospital. Eastern Kabul, Afghanistan.
Afghanistan 2009 © Pascale Zintzen /MSF
An MSF staff member conducts a patient consultation at Ahmed Shah Baba Hospital. Eastern Kabul, Afghanistan.
Afghanistan 2009 © Pascale Zintzen /MSF
Patients wait the Ahmed Shas Baba Hospital. Eastern Kabul, Afghanistan.
Civilians Trapped in Brutal War in Northern Yemen
Five prior unsettled wars in Yemen’s northern Saada Governorate led to a sixth in 2009, the most intense so far. The Yemeni army ratcheted up its offensive against a rebel group drawn from the dominant community in the region, and the humanitarian fallout was unprecedented. Civilians and non-military targets such as hospitals were heavily affected by fighting. Hundreds of thousands were displaced and humanitarian assistance came to a virtual halt. A malnutrition emergency was discovered among children uprooted from their homes. For the first time, a foreign neighbour, Saudi Arabia, was drawn into the conflict, further complicating the plight of civilians. Learn more»
Yemen 2009 © Arnaud Drouart / MSF
In August 2009, the "sixth war" since 2004 broke out in this region. In this context, MSF began working in Saada governorate in partnership with health-ministry staff. Mobile health clinic activities are also performed in some peripherical health units of the governorate, depending on the changing security context.
Yemen 2009 © Alain Fredaigue / MSF
Since 2004, the region of north Yemen has been in the grip of a conflict between governmental troops and the Al Houthi rebel movement, whose demands are both political, social and religious. Although several periods of extensive fighting have alternated with cease-fires and attempts at mediation, the latter have never produced a peace agreement.
Yemen 2009 © MSF
In November 2009, MSF started medical activities in Mandabah, northern Saada governorate, a few kilometres from the Saudi border. MSF provides support to local rural hospitals in Al Talh and Razeh, and has assisted about 3,000 displaced people fleeing the fighting in Baqim district. MSF teams provide access to drinkable water, and support the local Ministry of Health with donations of medical and surgical material and additional human resources.
Yemen 2009 © MSF
In Mandabah, the local Health Unit has been rehabilitated and extended in order to run outpatient consultations, hospitalizations, gyneco-obstetric care and surgery.
Woefully Inadequate Funding Undermines Gains in Childhood Malnutrition Treatment
An estimated 3.5 to 5 million children die each year from malnutrition-related causes—one death every six seconds. Yet childhood malnutrition is a medical condition that is easy to prevent with the right mix of nutritious foods and is effectively treated with therapeutic products available today. Recent years have seen great improvements in our understanding of childhood malnutrition and an international consensus has emerged around the provision of therapeutic ready-to-use foods—rich in protein, vitamins, and minerals—to treat its most severe form in children under five. So why do 55 million children continue to suffer from this devastating condition? Learn more »
Central African Republic 2009 © Jaume Codina
The already highly vulnerable population in the south-eastern region of Central African Republic (CAR) currently faces a severe nutritional emergency. Médecins Sans Frontières (MSF) teams operate four feeding centers and a number of outpatient treatment programs. Initial assessments reveal severe malnutrition rates beyond emergency thresholds, and as high as 7% in some areas.
Djibouti 2009 © Jean-François Herrera/MSF
A mother and child, during an active screening for malnutrition in the districts of PK12, PK20, Doraley and Hayable in the city of Djibouti.
Djibouti 2009 © Jean-François Herrera/MSF
Active screening for malnutrition in the districts of PK12, PK20, Doraley and Hayable in the city of Djibouti.
Democratic Republic of Congo 2009 © Michael Goldfarb/MSF
A plate of beans in a camp for internally displaced persons. Kahe Camp, Masisi District, North Kivu, Democratic Republic of Congo (DRC).
Democratic Republic of Congo 2009 © Michael Goldfarb/MSF
A severely malnourished baby waits to be examined at MSF's ambulatory feeding clinic in the village of Bishusha, North Kivu, DRC.
Funding for AIDS Treatment Stagnating Despite Millions Still in Need
In 2005, world leaders at the G8 summit in Scotland pledged support for universal AIDS treatment coverage by 2010, a promise that encouraged many African governments to launch ambitious treatment programs and that helped to expand coverage to more than 4 million people in developing countries. And now those same leaders are retreating from the pledges made, leaving governments and millions of people with HIV/AIDS at a dangerous loss. Learn more »
Uganda 2009 © Brendan Bannon
Amato Susan, 20-years old, sits with her 7-month old daughter, Atih-Bedo Brenda. Susan is HIV positive and is waiting to find out whether her daughter is also infected with the virus, following a malaria diagnosis which HIV infected children are particularly vulnerable to. "After I received the test results which said I was HIV positive, I was very angry at my husband for giving this to me. I was also scared, I knew that I had to get treatment for me and my child."
Uganda 2009 © Brendan Bannon
Children in Madi Opei. Madi Opei Internally Displaced Persons (IDP) Camp, Kitgum district, Uganda.
Uganda 2009 © Brendan Bannon
Counting co-trimoxizole antibiotic tablets in the HIV clinic. Madi Opei health centre in Madi Opei, Kitgum District, Uganda.
Uganda 2009 © Brendan Bannon
Eight-year old Opira Isaac is HIV positive. After losing his parents five years ago to AIDS, he and his four siblings now live with his grandmother, Kelemntina, in Madi Opei with her two adult sons. Kelementina lives in her tukul with the five children and her two older sons and says that she cannot care for her household like she wants to, because she is getting old and does not have much strength anymore.
Uganda 2009 © Brendan Bannon
Dr. Eamonn Vitt examines Innocent Oyem, who is being treated for malaria. Innocent's mother is HIV positive, however at the time of his malaria treatment his HIV status had not yet been determined. Madi Opei IDP Camp, Kitgum District, Uganda.
Uganda 2009 © Brendan Bannon
Amato Susan, 20-years old, and her 7-month old girl, consult with adherence counsellor, Catherine Atim. "I have many difficulties... we have very little money to buy porridge for my child. I survive on relatives helping me out sometimes and I work in the field. My husband repairs bikes by the road. Most of the time I am alone..."
Lack of R&D and Scale Up of Treatment Plagues Patients with Neglected Diseases
More than 400 million people are at risk for the neglected tropical diseases (NTDs) visceral leishmaniasis (kala azar), sleeping sickness, Chagas disease, and Buruli ulcer. The first three are among the deadliest of all the NTDs, and all four have been highlighted by the World Health Organization (WHO) as especially troublesome due to treatment and diagnostic tools that are old, ineffective, or worst, simply non-existent, and with patient populations stuck in remote or insecure areas with little or no access to health care. Even worse, research and development (R&D) of new medicines and diagnostics is woefully under funded. Unless there is a substantial increase in resources available for national control programs for active diagnosis and treatment of patients, investment in prevention initiatives, as well as dedicated R&D for new tools, victims of these will remain neglected. Learn more »
Sudan 2006 © Juan Carlos Tomasi
Human African Trypanosomiasis, or sleeping sickness, is caused by a trypanosome parasite transmitted through the tsetse fly. A person can be infected carrying the trypanosome for months before developing symptoms. When the parasite reaches the nervous system, patients develop symptoms such as neurological problems, sleep disorders and other behavioural changes that can range from confusion to madness. Without appropriate treatment, the disease is fatal.
Sudan 2006 © Juan Carlos Tomasi
Patients with sleeping sickness usually develop inflamed lymph nodes in the neck area where the parasite is hosted. Diagnosis for this disease can be done by puncturing the ganglion in order to extract a sample of lymph, and looking for the trypanosome parasite under the microscope, or it can be detected in blood tests.
Bolivia 2006 © Juan Carlos Tomasi
Millions of people in Bolivia are living with Chagas disease; an infection of the Tripanosomasis cruzi parasite, primarily transmitted by insects common in rural areas of Latin America. Chagas disease progresses slowly over many years, developing chronic symptoms such as heart disease, malformation of the intestines and associated digestive problems. Left untreated, the chronic disease is often fatal. Over 18 million people are already infected in Latin American countries.
Mali 2007 © Bruno De Cock / MSF
After having received his first dose for the treatment of malaria, R.K. has been placed under a tree, out of the sun and the burning heat. A wet cloth has been wrapped around him to cool his fever.
Mali 2007 © Bruno De Cock / MSF
Djaba Keita lives five minutes by foot from the CSCOM (health center) of Narena. However, she would not have come so quickly if she had to pay. Her son Mambi has been ill for only one day. In the past she would probably have waited until the last minute before coming for treatment. A rapid screening test confirms in 15 minutes the presence of Plasmodium Falciparum in Mambi's blood.
This is the third time he has caught malaria since he was born. At 12 months his generation has the luck to have free access to quality treatment. Once again, Djaba Keita will only have to show her prescription to the sales depot to receive the dose of CTA and paracetamol against the fever. Three days' later, Mambi will be completely cured.
Mali 2007 © Bruno De Cock / MSF
Before MSF's malaria treatment project, medicine was inaccessible to most people, costing 2,000 to 6,000 CFA; about $4 - $12 US dollars. Today, patients pay a fixed price of 200 CFA to treat malaria.
DRC 2008 © Claude Mahoudeau/MSF
MSF doctor, Delphine, examines a patient on treatment for sleeping sickness in Haut-Uélé, Democratic Republic of Congo (DRC).
Kenya 2008 © Jan Sibik
Kala azar, also known as viceral leishmaniasis, is a parasitic infection transmitted by sandfly bites which affects the functioning of internal organs. In treating kala azar, patients are accompanied by relatives who prepare water and food, help with maintaining hygiene, and provide support, strength and courage during the painful treatment.
Kenya 2008 © Jan Sibik
People in West Pokot, Kenya, can protect themselves from kala azar, by using mosquito nets. Because sandflies, which carry the leishmaniasis parasite that causes kala azar, are very small, mosquito nets must be treated with insect repellents.
Kenya 2008 © Jan Sibik
To make the life saving treatment for kala azar accessible for people, it is necessary to reduce the prices of medication and intensify the research and development of new medicines and diagnostic tools.
Bolivia 2009 © Anna Surinyach
In the outskirts of Cochabamba, Bolivia, MSF provides medical assistance to patients up to 50 years old, promoting the inclusion of adult patients in the treatment of Chagas disease. This is a step forward in the fight against Chagas; until recently, it was thought that the treatment was only effective on very young children.
Bolivia 2009 © Anna Surinyach
Chagas disease causes 15,000 deaths each year worldwide and is one of the main public health concerns in Bolivia; the country with the highest prevalence of Chagas disease. In the outskirts of Cochabamba town MSF is working in several health centres, promoting the integration of Chagas disease diagnosis and treatment into the local primary health care network.
Central African Republic 2009 © Michael Kottmeier/agenda
In Maitikoulou, northern Central African Republic (CAR), MSF found a remarkably high prevalence of sleeping sickness; a parasitic infection transmitted by the tsetse fly. MSF is the only health care provider in this rural, rebel-controlled area.