Alert is a quarterly magazine published by Doctors Without Borders/Médecins Sans Frontières (MSF-USA) that features compelling stories and photography from our work in the field. Below is an excerpt from MSF-USA Board President John P. Lawrence's introduction to the Spring 2018 issue (Vol 19. No. 1).
As I write this letter, we are confronting massive humanitarian emergencies on all sides. MSF has scaled up its response to help hundreds of thousands of Rohingya refugees in Bangladesh. We are calling for lifesaving medical aid to Syria’s besieged eastern Ghouta—where 15 health facilities supported by Doctors Without Borders/Médecins Sans Frontières (MSF) were hit by bombing and shelling during an escalation in late February. We continue to provide urgently needed medical care to people suffering the consequences of the war and blockade in Yemen. We offer essential health services to people in Central African Republic, one of the world’s most underreported conflicts.
In the context of so much upheaval, humanitarian aid organizations must constantly adapt and seek new ways to meet growing needs. This issue of Alert looks at how innovation—defined as a new idea, method, or device—drives our work to deliver high-quality medical care to patients around the world.
MSF is well known for providing essential medical care in austere settings, but it may be surprising to some that we are also engaged in pioneering medical research and innovation. In fact, conditions in the field frequently require new and creative approaches in order to treat our patients effectively.
One of the first innovative developments in MSF’s history was the use of standardized kits for medical equipment and supplies to enable the quick and consistent delivery of health services in the field. The larger scale adoption of this principle led to the creation of Logistique in 1986, MSF’s first satellite entity.
In 1987, as the volume of MSF’s clinical work and experience was becoming more substantial, we established Epicentre, our epidemiological research center. This development has made MSF uniquely poised to conduct medical research and analysis of the needs in crisis situations. Last year MSF published the results of a clinical trial initiated by Epicentre in Niger demonstrating that a new, heat-stable vaccine against rotavirus could help prevent large numbers of children from dying of severe diarrhea—a potential game-changer.
Many of the diseases we treat are largely ignored by a system of medical research and development that invests little in diseases that affect the world’s poorest people. In 2003, MSF cofounded the Drugs for Neglected Diseases initiative, an independent nonprofit drug research and development foundation that is expanding treatment options.
Within MSF-USA, one of our most exciting avenues for innovation is adapting the use of ultrasound to meet the needs of our field projects. Ultrasound has tremendous potential as a mainstay diagnostic tool because it can be housed in a unit that is both durable and portable. Additionally, ultrasound images can be transmitted remotely, allowing for secondary reading of studies by practitioners anywhere in the world. In South Sudan, we are launching a training program to use point-of-care ultrasound (POCUS) to assist with the diagnosis of common pulmonary diseases, among other conditions.
Beginning in January 2018, I had the privilege of working in a pediatric hospital in Monrovia, Liberia, for almost six weeks. During this time, our clinical team introduced the use of ultrasound in diagnosing pediatric surgical patients. Utilizing ultrasound, we confirmed that a child was suffering from an abdominal emergency known as intussusception, a telescoping of the intestine inside of itself. Another child was found to have a large abscess inside his liver. We performed successful surgeries on both children.
The pediatric program in Liberia represents another innovation arm of MSF’s activities, namely the introduction of more formal training and education within the scope of our work. Since the end of the Ebola epidemic in Liberia in 2015, we have provided training for nursing personnel in pediatrics at the Bardnesville Junction Hospital (BJH) in Monrovia. The intent is to expand the educational emphasis in pediatric anesthesia and perioperative care to nursing students as well as surgical residents within Liberian training programs—helping to strengthen the capacity of care providers in this region in the future.
We hope you enjoy reading about some of the many ways that MSF is testing new ground to bring the best medical care possible to those who need it most. Thank you for encouraging us to push forward.
John P. Lawrence, MD, President, MSF-USA Board of Directors