Surviving conflict

Around one-quarter of the medical assistance provided by Doctors Without Borders/Médecins Sans Frontières (MSF) is for people caught in armed conflict. At risk of indiscriminate attacks as well as targeted violence, many civilians living through wars are faced with a wrenching choice: flee their homes or try to survive under siege. Conflict disrupts every aspect of daily life, jeopardizing access to even the most basic needs, like food and medical care.

In conﬂict zones around the world, MSF provides lifesaving medical care based on needs alone. In countries convulsed by ﬁghting—from Yemen to Syria to South Sudan and many more—our teams treat both the direct consequences of war and provide basic medical services when national health systems have collapsed. We set up operating theaters and clinics, run nutrition programs, ﬁght disease outbreaks, and provide medical and mental health care for victims of sexual violence, among other essential services.

Daily life in Saada city — Two boys stand outside a park and several shops that were bombed in an airstrike near the old city of Saada, Yemen. MSF has been working in Saada governorate since 2015. The region has borne the brunt of airstrikes carried out by the Saudi and Emirati-led coalition (SELC), targeted by almost a quarter of all recorded air raids in Yemen since March 2015.

In Yemen, where more than four years of war have caused tens of thousands of deaths and left the country’s health system in ruins, MSF teams have treated more than 100,000 people for injuries related to the conﬂict. We’ve also provided hundreds of thousands of outpatient consultations and supported many health facilities with supplies, including assistance to provide salaries for public health staff, many of whom have not been paid by the government since the war began in 2015.

Emergency North East Syria: Fleeing and Seeking Refuge - Displaced Population — The Qados family takes shelter from the extreme heat in the shade of a truck on the outskirts of Tal Tamer, northeastern Syria. They ﬂed their home in Ras Al Ain in Hasakah province amid bombardment by the Turkish military in October, leaving with very few belongings.

MSF is the largest provider of health care in Central African Republic (CAR), a country shattered by the civil war that began in 2013. Though a peace agreement went into effect in early 2019, the situation remains fragile, and violence and lawlessness are still common. Across CAR, many people do not have access to basic health care. Our teams provide medical services including vaccinations for preventable diseases, testing for malaria and malnutrition, sexual and reproductive health care, and trauma surgery in health facilities throughout the country.

CAR Boguila Patient Story — At the MSF clinic in Boguila, Central African Republic (CAR), a doctor examines 10-month-old Ketira, who is suffering from a lung infection. MSF is the largest health care provider in CAR, a country fractured by violent conﬂict and lawlessness.

In Nigeria, conﬂict continues to simmer across the northeast even as insecurity and violence have escalated in other regions. Violence by criminal armed groups in the northwestern state of Zamfara has caused tens of thousands of people to ﬂee their villages. With farms abandoned, a nutrition crisis looms. In the town of Anka, where many displaced people have gathered, MSF runs a pediatric ward at the general hospital, providing treatment for malnutrition, malaria, and other ailments.

Zamfara: Anka General Hospital — Nigeria is facing an upsurge of violent conﬂict. Since 2018, Zamfara state has seen a drastic deterioration in security, with armed criminals carrying out frequent attacks on villages. The violence has forced thousands of people to ﬂee their homes. At Anka general hospital, MSF runs a 135-bed pediatric ward, mainly treating children suffering from malaria or malnutrition.

Conﬂict also forces extremely difficult decisions. In Syria, a country devastated by more than eight years of civil war, MSF was forced to evacuate international staff and suspend most activities in the northeast in October amid heightened insecurity following the US withdrawal from the region and launch of Turkish military operations. We are continuing our work in other parts of Syria. MSF reiterates its call on all parties to the conﬂict to provide humanitarian organizations with safe access to civilians in this time of urgent need. We are also stepping up medical and mental health care for people who have ﬂed to neighboring areas in Iraq.

Zamfara: Paediatric Ward — Patients rest in the inpatient department at Anka general hospital in Nigeria’s Zamfara state.

Zamfara: IDP - Rahamu Story — Children of displaced families gather at the old construction site—that was once meant to become the New Emir's Palace of Anka—where they now live.

Surviving conflict

2019: The year in photos

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Surviving conflict

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2019: The year in photos

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