Witnessing 2020: The year in photos

MSF health promoter Dayana Tabbarah and MSF nurse Hala Hussein in the streets of Beirut's Burj al-Barajneh camp.
Lebanon 2020 © Diego Ibarra Sánchez
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Doctors Without Borders/Médecins Sans Frontières (MSF) teams around the world have witnessed a year like no other as they confront the extraordinary challenges of a pandemic while keeping other essential health services running. This special collection of photographs features some of the most striking scenes from our response to COVID-19—from reaching out to vulnerable groups in Hong Kong, to helping prevent the spread of infection in nursing homes in Europe and the United States, to caring for indigenous communities in Brazil’s Amazon rainforest. We see the acute humanitarian needs overshadowed by the coronavirus crisis, in countries affected by war, natural disasters, and other epidemics. In this photo essay, we also witness survival and strength during a tumultuous year.

Responding to COVID-19 around the world

Hong Kong 2020 © Shuk Lim Cheung/MSF

May Chan (in red), who works as a street cleaner in Hong Kong, attends a health promotion session run by MSF in February. She learns about infection prevention and control measures to keep herself and others safe from the new coronavirus.

Yemen 2020 © Majd Aljunaid/MSF

Workers at the Al-Sahul COVID-19 treatment center in Ibb governorate, Yemen, carry an oxygen cylinder to the intensive care unit. Patients with moderate to severe symptoms of COVID-19 need about six oxygen cylinders a day—and maintaining adequate supplies in this war-torn country is a major challenge.

Brazil 2020 © Diego Baravelli/MSF

A mobile medical team sets off to reach patients living in the Lake Mirini region of the Amazon rainforest in Brazil. They travel by boat to bring primary health services to the town of Tefé, and take smaller boats along the way to provide medical consultations to people living in more isolated areas. 

2020 Year in Photos: COVID-19 Global Response Slideshow

A volunteer from a local aid organization takes care of precious personal protective equipment at an MSF-supported COVID-19 treatment center for refugees and migrants in Brussels. Belgium 2020 © Kristof Vadino
A fireman disinfects a resident’s room at a care home for the elderly in El Royo, Spain. In April, MSF sounded the alarm about the impact of COVID-19 in long-term care facilities across Europe. “Too many people have been dying alone, frightened, and in a terrible state,” said MSF doctor Ximena di Lollo. Spain 2020 © Olmo Calvo/MSF
An MSF medic wears personal protective equipment to examine a young patient at the pediatric clinic outside Moria refugee camp on the island of Lesbos. Greece 2020 © Anna Pantelia/MSF
Lebanon 2020 © Diego Ibarra Sánchez
A nurse on the MSF team talks with a boy at a mobile clinic in a camp for displaced people in northwestern Syria. The child has brought in a young family member for a medical consultation. Syria 2020 © Omar Haj Kadour/MSF
In northwestern Syria, a doctor checks the temperature of a patient at the entrance of a dedicated space to screen potential COVID-19 patients. People with symptoms are held for observation and sent to a nearby hospital supported by MSF. Syria 2020 © Omar Haj Kadour/MSF
An MSF team visits a camp for refugees and migrants in Matamoros, Mexico—just across the border from Brownsville, Texas—to talk to families about how to prevent the spread of COVID-19. Harsh migration policies have left many vulnerable people stranded and exposed during the pandemic. Mexico 2020 © MSF
A tailor in a sewing workshop makes cloth masks commissioned by MSF for COVID-19 prevention activities in Bamako. Mali 2020 © Lamine Keita/MSF
In June, MSF set up this 60-bed field hospital in Khayelitsha, South Africa, to treat patients with moderate to severe cases of COVID-19. This project helped support the Khayelitsha district hospital, which was struggling to cope with the pressures during a peak period of transmission in the Western Cape. South Africa 2020 © MSF/Rowan Pybus
MSF staff organize a COVID-19 health information session in Aydarken, Kyrgyzstan. Rural and remote regions here strive to put infection prevention measures in place and to guarantee essential medical services, especially for people with chronic ailments who require long-term care. Kyrgyzstan 2020 © MSF/Rowan Pybus
Ghanem Qaid Nasser, a 60-year-old resident of Ibb governorate, was admitted for severe COVID-19 symptoms at the MSF-supported Al-Sahul treatment center. "It started with a high fever, coughing, and dizziness. And I couldn't breathe. For eight days I was on the brink of death,” Ghanem said. After two weeks of treatment, his condition improved. The medical team gave him a warm farewell—which is the custom for all patients who get discharged from the center. Yemen 2020 © Majd Aljunaid/MSF
Mohammed Hashim was MSF's first patient at the new 32-bed COVID-19 treatment center in Herat, Afghanistan, when it opened in June. The center serves patients in need of oxygen therapy and was set up to relieve the pressure on other facilities in the area. Afghanistan 2020 © Laura McAndrew/MSF
A young man in the inpatient ward at the MSF-run COVID-19 facility in Mosul, Iraq, seems to be feeling better. Teams provide patients with treatment, health education, and mental health support. By July, the facility had received over 700 patients. Iraq 2020 © Manhal Alkallak/MSF
Nurse Mayra Leandro works with a health worker from the Special Indigenous Health District of Mato Grosso do Sul attending to patients in Lagoinha village in the Amazon region of Brazil. They test this woman’s blood sugar levels, as many indigenous people here are living with diabetes. Brazil 2020 © Diego Baravelli/MSF
MSF community health educator Ganpat reaches out to individuals living in the densely crowded M-East ward of Mumbai, India. He provides hygiene kits and information about how to prevent the spread of COVID-19. People living in this area are at high risk of infectious diseases due to cramped spaces and poor sanitation services. India 2020 © Abhinav Chatterjee/MSF
MSF psychologist Anderson Beltrame reconnects with Miraida Guevara in Boa Vista, Brazil, several months after their last counseling session. Miraida left her home and six children in Venezuela in search of steady work in Brazil. MSF provides mental health support to help migrants and refugees navigate an uncertain future ahead. Brazil 2020 © Diego Baravelli/MSF
A patient visits with her family from a safe distance at the MSF-run COVID-19 center in Matamoros, on the Mexico-US border. Amid a surge of cases in Mexico this summer, MSF ran COVID-19 treatment centers in Matamoros, Reynosa, and Tijuana—treating over 200 patients with severe symptoms. Mexico 2020 © Arlette Blanco /MSF

Facing the pandemic in the United States

United States 2020 © Spencer Platt

A visitor to the MSF shower trailer in midtown Manhattan waits for a stall to become available. Earlier this year, MSF partnered with local organizations to operate two relief stations in New York City, offering free access to hygiene facilities for people who were homeless or housing insecure—and therefore exposed to greater risks during the pandemic.

United States 2020 © Gabriella N. Báez/MSF

MSF physician Dr. Jonathan Caldera evaluates a patient while MSF nurse Omar Martinez takes her blood pressure reading during an in-home medical consultation in the community Buen Consejo in Rio Piedras, Puerto Rico. MSF’s home-based care model was designed to reach people from the most marginalized and isolated communities. 

United States 2020 © Ali Lapetina/MSF

A staff member at Advantage Living Center in Roseville, Michigan, volunteers to demonstrate safe personal protective equipment practices during an MSF training on infection prevention and control. Essential workers in nursing homes and long-term care facilities, including environmental services staff, work in close proximity to residents and play a critical role in preventing the spread of COVID-19. 

2020 Year in Photos: US COVID-19 Response

Adelia Patterson, wellness and life enrichment director at Focused Care at Beechnut long-term care facility in Houston, Texas, plays the ukulele for a resident singing along. “I think mental health support is very much needed in this field,” says Adelia. “Especially at times like that, because we're just caregivers at heart. We don't take the time to care for ourselves.” United States 2020 © Christopher Lee
A resident visits with a family member for her birthday at Focused Care at Beechnut, a long-term care facility in Houston, Texas. Because of COVID-19, visitors must stand outside and communicate by phone with the residents. United States 2020 © Christopher Lee
Perry McAfee, MSF health and wellness officer, leads a training session for nursing home staff at Focused Care at Beechnut, a long-term nursing care facility in Houston, Texas. "COVID has had a really huge effect on the personal life and work life of those individuals who work in nursing facilities,” says Perry. “Many of them have to work long hours—12-, 16-hour shifts, multiple days in a row. That has a huge effect on their wellbeing.” United States 2020 © Christopher Lee
Staff at Advantage Living Center in Wayne, Michigan, pose for a group portrait in their “nerd day” outfits. Long-term care facility staff face anxiety and grief in their day-to-day reality, especially after losing colleagues and residents to COVID-19. Nevertheless, they work hard to boost the morale of their residents, organizing activities like door-to-door karaoke down the hallways, and themed outfit days to make residents smile. United States 2020 © Ali Lapetina/MSF
“Heroes Work Here!” reads a sign outside Advantage Living Center in Roseville, Michigan, a skilled nursing facility where MSF provided COVID-19 health education, infection control trainings, and mental health and wellness support. As of November, deaths of patients and staff in long-term care facilities accounted for 40 percent of all COVID-19 deaths in the US. United States 2020 © Ali Lapetina/MSF
An MSF team member assembles water jugs for handwashing stations to be donated to soup kitchens and supportive housing facilities in New York City. United States 2020 © Michelle Mays/MSF
COVID testing
Members of the MSF team pose with other medics at a mobile COVID-19 testing clinic in Immokalee, Florida. The free clinics were designed to be easily accessible to migrant farmworkers and other essential workers by offering services within the community, during evening hours, and with staff who speak English, Spanish, and Haitian Creole. United States 2020 © Taimy Alvarez/MSF
MSF nurse and health promotion manager Sarah Kuech (left) and MSF health promoter Maria Plata (right) wave to residents of Immokalee while spreading the word about free clinics in the area. They also answer questions from local residents, and provide health education to reduce misinformation and stigma around COVID-19. United States 2020 © Taimy Alvarez/MSF
At a mobile testing clinic supported by MSF in Immokalee, Florida, a nurse for the Collier County Department of Health gives a free COVID-19 test to an area resident. Working with local partners and targeting communities at risk, MSF helped administer 465 COVID-19 tests over six weeks. As of June 2, 36 percent of those test results came back positive—compared to a state positivity rate of 5.6 percent. United States 2020 © Taimy Alvarez/MSF
A view of the COVID-19 isolation ward inside the Gallup Indian Medical Center (GIMC) serving the Navajo Nation in New Mexico. MSF worked with community leaders and health care workers in the Navajo Nation to strengthen infection prevention and control measures in May and June, when the per capita infection rate here was higher than in any single US state. United States 2020 © Jake Pitts/MSF
Artists with Colectivo Moriviví in San Juan pose in front of a street mural they created in partnership with MSF to spread health promotion messages. The vivid pieces feature uplifting messages like, "Let's cancel plans, not humanity" and “Distancing is physical, not social.” United States 2020 © Gabriella N. Báez/MSF
MSF nurse Rolando Betancourt (left) and physician Dr. Jonathan Caldera (right) provide a medical consultation outdoors to a patient in Arecibo, Puerto Rico, where we partnered with a community-based organization to provide mobile medical services. In October, MSF handed over its medical activities to Puerto Rico Salud, a new local organization created by Betancourt and other members of our Puerto Rican team. United States 2020 © Gabriella N. Báez/MSF

Forgotten emergencies 


Cameroon 2020 © Albert Masias/MSF

At St. Mary Hospital in Bamenda, Cameroon, MSF surgeons care for a patient who had been attacked on the road by armed men. He was tortured and shot five times. Intensifying conflict across the northwestern region of the country has left many people in urgent need of medical care.

Afghanistan 2020 © Waseem Muhammadi/MSF

MSF nurse Marzia and nurse assistant Nasrin perform CPR on a baby in critical condition at the inpatient therapeutic feeding center of Herat regional hospital in Afghanistan. Persistent violence, distance, and cost remain significant barriers for people struggling to access health care. 

Central Mediterranean Sea 2020 © Thomas Lohnes

Earlier this year, MSF partnered with Sea-Watch to resume search and rescue operations in the Central Mediterranean Sea. On August 29, the Sea-Watch 4 assisted the only other search and rescue boat in the area—a ship called Louise Michel funded by the artist Banksy—taking on an additional 152 people. In September, Italian authorities detained the ship in the port of Palermo, effectively blocking further lifesaving activities.

2020 Year in Photos: Forgotten Emergencies Slideshow

An MSF team delivers measles vaccines by motorbike from Lisala to Boso Manzi, Mongala province, a remote area in northern Democratic Republic of Congo hit hard by the epidemic. In May, MSF reported that the measles emergency was being overshadowed by the international response to the Ebola outbreak in the east of the country. At that time, more than 6,200 people had died of measles—nearly three times the death toll from Ebola. Democratic Republic of Congo 2020 © Caroline Thirion/MSF
Mothers bring their children to a measles vaccination campaign carried out by MSF in the Boso Manzi health zone, in Mongala, Democratic Republic of Congo. As of May, our teams had vaccinated more than 260,000 children against measles, while caring for more than 17,500 who had the disease. Democratic Republic of Congo 2020 © Caroline Thirion/MSF
Medical staff provide care to a patient inside the MSF-supported Bolomba Ebola treatment center in Équateur province, Democratic Republic of Congo, where the country’s eleventh epidemic was recorded this year. The Ebola epidemic was declared over on November 18, thanks in part to a new vaccine, new treatment options, and a more community-centered approach. Democratic Republic of Congo 2020 © Franck Ngonga/MSF
In February—just weeks before this photograph was taken—Felix and his family were attacked by armed men amid the spiraling conflict in northwestern Cameroon. An assailant cut off his left hand with a knife. “I lay bleeding on the ground for two hours before my sister dared to come back for me,” said Felix, age 23. “We hid in the forest for two weeks.” He was eventually brought to an MSF-supported hospital, where he was treated for his physical wounds as well as for psychological trauma. Cameroon 2020 © Albert Masias/MSF
MSF teams distribute essential household items to displaced families living in Silmangué, Burkina Faso. The world´s fastest-growing humanitarian crisis is unfolding in this country, where escalating violence has forced more than one million people to flee their homes. Burkina Faso 2020 © Noelie Sawadogo/MSF
The outpatient department at MSF’s Tabarre trauma hospital receives about 80 patients per day. More than half of the patients are victims of chronic violence. According to Roussena Rouzard, outpatient department head nurse with MSF, “Orthopedic patients have a long rehabilitation process. Due to the security situation in the city and the country. we have patients who don’t come to their follow-up appointments for up to two months. Some people come from the countryside which makes it challenging for them to reach Tabarre.” Haiti 2020 © Guillaume Binet/MYOP
Ariha district in Idlib, Syria, became a ghost town as civilians fled indiscriminate attacks by the Bashar al-Assad regime and its supporters earlier this year. On a single day, February 25, three hospitals supported by MSF received 185 wounded patients, including children. Cristian Reynders, MSF project coordinator for northwestern Syria, spoke out about the extreme pressure on local medics: “Now picture this…. You are a doctor. You are already not equipped. Your hospital is not in good shape. And now you have tens of people—wounded, bleeding, with limbs falling off.… And you are responding to this, knowing that maybe the next bomb will be for you.” Syria 2020 © Muhammed Said/Anadolu Agency via Getty Images
In March, MSF distributed essential items, including blankets and hygiene kits, at a camp for internally displaced people in Idlib governate, in Syria. MSF also distributed more than 300 tons of heating materials to people living in 21 camps and settlements across the region. A military offensive by the Syrian government and its allies uprooted almost a million people in the Idlib region between December 2019 and March 2020. Syria 2020 © MSF
Nurse Raida treats a patient at MSF's Mother and Child Hospital in Taiz, Houban, in Yemen. “I didn’t choose this profession, but it was when I started practicing the actual duties of a nurse that I fell in love with my work,” says Raida. Nurses and midwives at the hospital work tirelessly to care for the patients, even while dealing with their own challenges enduring the prolonged war. Yemen 2020 © Maya Abu Ata/MSF
On May 12, armed men launched a horrific attack on MSF’s maternity ward in Kabul’s Dasht-e-Barchi hospital. Among those killed were 15 mothers and an MSF midwife, Maryam Noorzad. The attackers also killed two young children and six other individuals who happened to be present at the time. More than 100 people found shelter in the safe rooms of the facility, including one woman who gave birth to a healthy baby amid the terror attack. Afghanistan 2020 © Frederic Bonnot/MSF
Three-year-old Samar receives wound care at an MSF medical point in Beirut, Lebanon, following a massive explosion that tore through the port area on August 4. Samar and her father were just leaving their building when the blast went off. The child suffered facial injuries and burns. Lebanon 2020 © Mohamad Cheblak/MSF
After the deadly explosion in Beirut this August, MSF teams carried out door-to-door visits in Karantina—a crowded neighborhood that was once a quarantine area for immigrants and refugees arriving by sea. We provided wound care and mental health care for people affected by the disaster, as well as continuity of care for people with chronic diseases. Lebanon 2020 © Mohamad Cheblak/MSF
Fidèle Marc Hounnouvi, an MSF psychologist from Benin, speaks with patients living with HIV in the general medical ward at the Centre Hospitalier Universitaire Communautaire in Central African Republic. “I’m here to work with the patients who are tired, repress their feelings, or lose the energy to fight to survive,” he says. “The sessions can help to reinforce adherence to treatment.” Central African Republic 2020 © Adrienne Surprenant/Collectif
The MSF Goyalmara Mother and Child hospital is a specialized facility in Cox’s Bazar district, now home to nearly 900,000 Rohingya refugees forced to flee Myanmar. Staff have created a mural featuring the footprints of babies discharged after treatment at the hospital. Three years after the Rohingya exodus, MSF teams manage 10 hospitals and primary health centers here in the world’s largest refugee settlement. Bangladesh 2020 © Hasnat Sohan/MSF
This mural features the footprints of babies that are discharge after treatment in the MSF Goyalmara Mother and Child hospital is a specialized facility in Cox’s Bazar district, now home to nearly 900,000 Rohingya refugees forced to flee Myanmar. Bangladesh 2020 © Hasnat Sohan/MSF
In September, a series of fires destroyed Moria refugee camp on the island of Lesbos, leaving some 12,000 people with no safe place to stay in the middle of a COVID-19 outbreak. MSF continues to provide medical and mental health care to tens of thousands of refugees and asylum seekers trapped on the Greek islands. We are calling on European leaders to evacuate vulnerable people and end harmful migration policies. Greece 2020 © MSF
Refugees and asylum seekers leave Moria camp on the Greek island of Lesbos, the day after a fire destroyed most of it. “Our teams saw the fire spread across Moria and rage all night long. The whole place was engulfed in flames, we saw an exodus of people from a burning hell with no direction,” says Marco Sandrone, MSF field coordinator in Lesbos.“Children were scared, and parents are in shock." According to Aurelie Ponthieu, MSF Humanitarian Advisor on Displacement, “The years-long orchestration of human suffering and violence produced by European and Greek migration policies are to blame for the fire.” Greece 2020 © Enri Canaj / Magnum Photos for MSF
A young Syrian boy who lives at the Vathy refugee camp on the island of Samos is learning how to swim. At the camp, 4,314 people live in and around a site built for just 648, mostly in makeshift tents without access to showers and proper sanitation. According to Lindsay, MSF psychiatrist on the island, "The protracted containment in poor living conditions and ongoing uncertainty regarding asylum claims contribute to exacerbate mental health difficulties among residents of the camp, many who have already experienced traumatic events in their country of origin or during their journey to Greece.” Safe and stable living conditions are a necessary part of the recovery process. Greece 2020 © Enri Canaj / Magnum Photos for MSF
Mouliom Souleman and his family were taken aboard a search and rescue ship run by MSF in partnership with Sea-Watch on August 23. Originally from Cameroon, Souleman fled Libya in search of safety in Europe. Souleman wrote that on the day of the rescue, “I found a smile again. That is after more than three years of torture, forced labor, sleepless nights…. Libya for me is hell on earth.” Central Mediterranean Sea 2020© Chris Grodotzki/Sea-Watch.org
In Coatzacoalcos, Veracruz, our teams distribute water bottles and hygiene kits to migrants and refugees. We also provide medical and psychological care to people all along the migration route through Mexico. Increasingly harsh migration policies imposed by the United States and Mexico have left many migrants and refugees stranded in makeshift settlements and overcrowded shelters. People on the move face threats to their health and safety, now exacerbated by COVID-19. Mexico 2020 © Léo Coulongeat/Hans Lucas
Lurvy Elisa Ramírez, is a Honduran woman who was hit by the train when she was fleeing from the National Guard and suffered the amputation of her legs. The Mexican authorities denied her assistance. After several sessions with the MSF psychologist, Lurvy is more optimistic about her future. "I feel calmer. I know that I no longer have my legs, but I'll have my prosthetics. I'll restart the processing of my papers and I hope they will grant me refuge because I will be killed if I return to Honduras." Mexico 2020 © Léo Coulongeat/Hans Lucas
The Hamadayet border crossing, where refugees from Ethiopia cross the river into Sudan. New arrivals bring whatever belongings they can carry with them; some have their livestock, others left with nothing. The displacement of more than 40,000 Ethiopian refugees to Sudan began when Ethiopia’s prime minister responded to the attack of a military base by ordering military action against the Tigray People’s Liberation Front (TPLF) in northern Ethiopia. The escalating conflict is quickly becoming a humanitarian emergency where tens of thousands are already in need of physical and mental health care, as well as clean drinking water and proper sanitation. Ethiopia 2020 © Jason Rizzo/MSF
This year’s floods in the Greater Pibor Administrative Area are happening against the backdrop of multiple emergencies including COVID-19, increased violence and fighting, a growing economic crisis, and high levels of food insecurity. The needs for medical care are increasing with a sharp rise in malaria cases and fears of outbreaks of other diseases. South Sudan 2020 © Tetiana Gaviuk/MSF
An MSF mobile clinic provides medical consultations to the people of Lukurunyarg in the Greater Pibor Administrative Area after flooding made the roads impassable. “This year, water reached places that weren’t flooded last year,” says Nyabuok Lony Ruot, the relative of a patient at the MSF hospital in Old Fangak town. “All the crops are in the water. We came to the hospital by canoe.” In some places, the high waters make walking for medical care impossible and most people cannot afford to pay for a canoe, so MSF is using its boat as an ambulance. South Sudan 2020 © Tetiana Gaviuk/MSF
Hurricanes Eta and Iota have left Honduras in a catastrophic situation. MSF is providing medical care (including family planning) and mental health care, alongside health promotion and disease prevention activities with a focus on community shelters and people living on the streets. Priorities include distributing non-food items, COVID-19 protection and prevention equipment, and clean water in Choloma and the surrounding areas in Cortés department. Honduras 2020 © Deiby Yanes/MSF