Insider Update: An exclusive look into our work

MSF has been a part of my life since my childhood. Growing up in East Jerusalem in the occupied Palestinian territories, I remember seeing MSF cars with their “no weapons” signs in a place where weapons were everywhere, and violence was a fact of life.

I saw how MSF served my community and the impact of independent medical care. It inspired me, and by the time I was 10 years old, I decided that I was going to become a doctor.

I went to medical school and became an OB-GYN to work for organizations like MSF. I wanted to practice humanitarianism and stand in solidarity with women and groups affected by war, poverty, climate destruction, and epidemics. Many of these groups are simultaneously neglected and feared—much like my own.

My first assignment with MSF was in 2014, working with expectant mothers in Sierra Leone. I knew right away that I had found my community—people who cared as much as I did about providing aid to those who need it most.

Since then, I have completed five more surgical assignments in Afghanistan, Ivory Coast, Iraq, and Lebanon, where I spent more than a year. Every assignment has been deeply meaningful, but some experiences and patients stand out in my mind, like little Saabira.

I first met 12-year-old Saabira when she was rushed to our clinic in Mosul, Iraq. An airstrike on her home left only two survivors, Saabira and her father, who carried Saabira out of the wreckage. She had a 20-centimeter shrapnel injury down her back—enormous for somebody so little.

Saabira means “a patient woman,” something this sweet 12-year-old girl showed during her weekly visits. Now, she needed to get through her final appointment: Removal of the many stitches down her back.

Her father held her in his arms, trying to soothe her as she cried. The trauma team asked me to help because they thought a female face might comfort her. Whether we’re pediatricians or obstetricians, surgeons or psychiatrists, our goal is to do whatever it takes to most effectively treat our patients.

In this case, it meant singing Saabira a little song to calm her as I finished removing the stitches. She giggled as I sang, a welcome sound after her tears. I still remember her waving goodbye as she left, smiling and clutching a latex glove we’d blown into a balloon as a gift.

These are the moments that show what MSF is all about. We go where children like Saabira need us, crossing borders and battle lines, with a singular focus: Providing the highest quality medical care in the world’s most challenging contexts.

But none of this work would be possible without your compassion and generosity. Our generous donor community provides financial independence that means we can act quickly and impartially—guided by medical ethics instead of politics, funding concerns, and other potential distractions.

So far, nearly eight million people have been driven from their homes, and an estimated 25 million are in need of humanitarian assistance. This human-made catastrophe is the result of ongoing fighting between the government-led Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF).

With much of the world’s focus on the crises in Ukraine and Gaza, the fighting in Sudan—and its impact on neighboring countries like Chad—are not getting as much attention. That’s a big part of the reason I recently visited our Doctors Without Borders/Médecins Sans Frontières (MSF) teams in both countries.

During my trip, I met refugees and MSF team members who have experienced these challenges firsthand. Something I heard again and again is that medical care is incredibly difficult to come by. Between 70 and 80 percent of hospitals in conflict-affected areas are no longer functioning.

One doctor’s story

I spoke with a project coordinator who shared the story of one facility, a hospital in Zalingei, the capital of western Sudan. Militants had already looted the hospital once. When they returned, it was to remove the building’s solar panels—the only source of electricity. They arrived during a cesarean section, and the surgeon begged them to wait until the operation was done. They refused—and with the electricity gone, the patient died.

I heard stories like these from far too many people during my time in Chad—in particular, from members of the Masalit ethnic group, who have been targeted with looting, burning of homes, beatings, and sexual violence.

But I also heard stories of bravery and compassion. I met people who, despite the terror and cruelty they faced, chose to go back to Sudan.

One of those people was Dr. Khadija Ismail, a Sudanese doctor whose Masalit heritage puts her and her family in particular danger. That’s part of the reason she decided to return to Sudan after initially crossing the border into Chad. “I need to go and reach my family in Al-Junaynah,” she recalled thinking. “I need to be with them.”

Dr. Ismail’s medical training meant that when she first returned to Sudan, neighbors began showing up at the family home looking for treatment. She didn’t have the medications or equipment she needed—but with most of the hospitals in the region shut down, people had nowhere else to turn. She took her neighbors into her home and provided the best care she could.

Dr. Ismail is now serving as a medical activity manager for the same hospital in Sudan where militants stole the solar panels, helping get the facility up and running again as we repair the damage, hire staff, and restock essential supplies. This is the only hospital providing care in the whole of Central Darfur, a region with a population of more than 1.6 million. Our aim is to reopen the operating room and the maternity, emergency, and pediatric departments.

The importance of independent funding

You make projects like these possible. Your support means Khadija and so many other medical professionals have the supplies and support they need to continue providing care—even in the direst of circumstances.

While other organizations rely on designated government funding, forcing them to respond to political pressures, MSF is supported by individuals, which allows us to provide medical care based on need alone. That is why we are one of the only organizations still providing lifesaving care in Sudan.

Your generosity means we can remain independent, pragmatic, and able to work with parties on opposite sides of violent conflicts to ensure we can reach all people in need of lifesaving care.

It also means we can fulfill one of our central values: Témoignage, or “bearing witness.” We believe we have an ethical responsibility to share what we are seeing and doing wherever we work, and to speak out to prevent greater harm.

In writing to you today, I am exercising that same value of bearing witness. I hope I have been able to communicate both the urgent needs I witnessed and the confidence I have that our teams can continue to save lives.

The needs are great—as are the challenges we face in meeting it. As the rainy season sets in this month, flooding will increase the difficulty of almost every aspect of our work.

But your generosity means we can support our teams, who remain committed to providing care despite the danger they face every day.

Thank you again for supporting MSF and doctors like Khadija.

In a moment when so many humanitarian emergencies are filling the news, I want to share my recent experience with Doctors Without Borders/Médecins Sans Frontières (MSF) teams in South Sudan—where conflict, corruption, and the growing impact of climate change have plunged an already vulnerable country into crisis. I have seen firsthand the impact of your support in under-reported crises like these.

I traveled to South Sudan to better understand the growing needs of the region as a result of increased displacement of people fueled by conflict and violence and the effects of climate change.

Today, South Sudan is home to one of our largest operations with 13 projects nationwide that assist hundreds of thousands of people. MSF has been working in the region for over 40 years and we have witnessed the challenges escalate: The need is greater than ever.

Since war broke out in Sudan in April 2023, 7.8 million people have fled the violence, including half a million who crossed the border into neighboring South Sudan. Many of those fleeing conflict—up to 2,500 people a day—find refuge at a government-run transit camp in Renk, a settlement near the border. The camp—originally designed only as a temporary stopping ground with capacity for 3,000 people—is now home to more than 20,000. 

Renk has a decrepit water system with limited access to water and functioning sanitation, which combined with the influx of people in the camp, has led to a rise in disease and malnutrition. Adding to these conditions, the local hospital has limited emergency room hours to treat the many in need of medical care. Our teams are responding by working to establish a cholera treatment center to meet the growing need. We are also treating up to 90,000 liters of river water every day to help provide safe drinking water for those living at the camp.

I saw how this emergency extends beyond the border and transit camp. Further south, in a town called Old Fangak, I met a mother named Nyakena at the MSF hospital. She and her children had passed through Renk and continued on to Old Fangak, where Nyakena was now looking for help for her daughter.

The family is from Sudan and lived in the capital of Khartoum, which had once been something of a safe haven from violence in the country. When conflict broke out earlier this year between military rivals however, Khartoum became a war zone. Nyakena fled with her children in August after fighting separated her from her husband.

When the family arrived at the transit camp in Renk, Nyakena stood in line for days waiting to register for cash assistance which she never received due to the overcrowding. With nowhere else to turn, she decided to bring her young children to her mother-in-law’s home in Old Fangak—only realizing after arriving that her mother-in-law was visually impaired and needed help herself.

Since 2019, Old Fangak and the surrounding region have been semi-permanently flooded. This prolonged natural disaster has destroyed food crops, driven disease, and blocked access to many aid groups.

Among the millions affected are Nyakena, her children, and her mother-in-law. The family doesn’t have enough to eat, and every evening, when the sun sets, they are swarmed by disease- carrying mosquitos. When her daughter became severely sick, Nyakena brought her to MSF for treatment. Your generosity means she, and countless others, can get the care they need, even in the most challenging circumstances.

In Old Fangak, MSF’s facility has been rebuilt on top of raised platforms to avoid the encroaching flood water—with concrete pathways connecting different wards within the hospital. It’s another example of how climate change is making our work even more difficult and how we are adapting to the changing needs of the people we serve.

A senior official in the Ministry of Humanitarian Affairs who had lived through the region’s violent conflicts told me she feared that the climate crisis is posing an even bigger challenge. “Flood[ing] is worse than war,” she said. “In war, you can hide and hunt in the bush…when there’s water, there’s no bush to hide in.”

Despite the growing need, the South Sudanese government currently funds just 30 percent of the country’s health spending. The rest of the resources must come from outside organizations like MSF—but in recent months, these groups have shifted their focus and funding to other crises. They are overstretched, and delivering aid in South Sudan is incredibly challenging.

That is why your philanthropy is so critical. Your reliable support means MSF can act independently, choosing projects based on the areas of greatest need. That is especially critical in places like South Sudan, which don’t always make the headlines.

I know there are so many emergencies going on right now across the world. And you can rest assured that MSF teams are working around the clock to care for patients in Ukraine, Gaza, and more than 70 countries.

Your continued commitment means we can be there in places like South Sudan—and everywhere else we are needed.

Thank you again for making this work possible. I am honored by your trust in MSF and our teams.