Preventing and containing outbreaks

MSF nurse Persa Dimitsaki vaccinates a child during an emergency measles vaccination campaign in Moria camp on the Greek island of Lesvos

GREECE 2018 © Julia Kourafa/MSF

This article is part of the Winter 2018 issue of Alert—2018: The Year in Photos—featuring some of the most striking images and stories from our work around the world.

Over the past year, Doctors Without Borders/Médecins Sans Frontières (MSF) teams responded to manifold disease outbreaks in diverse contexts, from tackling malaria in Niger, to vaccinating refugee children in Greece against measles. In Bangladesh, where more than 800,000 Rohingya Muslim refugees have settled since fleeing targeted violence and persecution in neighboring Myanmar, our teams mobilized quickly to help contain a major outbreak of diphtheria.

MSF also responded to the largest outbreak of Ebola ever recorded in Democratic Republic of Congo (DRC), opening treatment and transit centers in the small town of Mangina, North Kivu, where the outbreak began, and in the larger city of Beni when it began to spread. The outbreak is proving especially difficult to curtail, with active conflict in the region hampering containment efforts. This area also sees a lot of transit and trade, and some communities straddle the border with Uganda to the east. It is quite common for people to travel back and forth, raising risks of transmission across the border and the possibility the virus could spread further in the region.


Help save lives

Hygienists disinfect personal protective equipment used by medical staff in an Ebola treatment center
MSF nurse dons personal protective equipment as she prepares to enter the Ebola treatment center
An MSF team member prepares to enter the high risk zone of the Ebola treatment center in Mangina, DRC.
MSF hygienist Roger prepares to enter the high-risk zone of the Ebola treatment center in Mangina. The personal protective equipment worn by health workers inside the treatment centers is hot, heavy, and makes breathing difficult, which means that they can only remain inside for a maximum of one hour.
Democratic Republic of Congo 2018 © Carl Theunis/MSF

A seasonal "peak" in malaria cases occurs annually in the Zinder region of Niger, but the 2018 season brought extremely high levels of mortality in children under five years old. In response, MSF sent 243 experienced medical staff from across Niger and around the world to ensure patients received the best possible care inside the hospital and in the community, where a team ran mobile clinics to care for children closer to home.

MSF team cares for pediatric patient in Niger
NIGER © Laurence Hoenig/MSF

In early 2018 an outbreak of diphtheria raged in the refugee camps in Cox's Bazar, where hundreds of thousands of Rohingya people settled after fleeing Myanmar, where they had extremely limited access to health care. Though diphtheria is covered by the most basic vaccine packages, the deadly childhood disease spread quickly through the camps in Bangladesh, where most children had not been immunized.

Diphtheria intervention in Cox's Bazar
An MSF doctor cares for a patient suffering from diphtheria at an MSF clinic near Cox’s Bazar, Bangladesh. “We should not be seeing cases of diphtheria anymore,” said MSF doctor Rosie Burton in January. “So when it appears it shows there has been a fundamental breakdown in vaccination programs.”
BANGLADESH 2018 © Sara Creta/MSF