An MSF clinic in Phnom Penh.
An MSF clinic in Phnom Penh.
CAMBODIA 2017 © Todd Brown
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Opening & closing projects

Doctors Without Borders/Médecins Sans Frontières (MSF) teams work in more than 60 countries around the world. While every situation we respond to is different, we’ve developed a tried-and-true response system that ensures our teams have the resources they need to get on the ground as quickly as possible and start saving lives.

When a crisis breaks, we act fast to gauge the needs, mobilizing MSF staff already in the area or sending in an emergency team. Our unparalleled logistical capacity means that we can begin treating patients almost immediately. In Haiti, for example, our staff already working in the country treated the first victim of 2010’s earthquake within five minutes. This is because we have specialized emergency supplies—from surgical kits to inflatable hospitals—ready at all times, as well as cash reserves for disaster response.

Because we are independently funded by donors like you, we do not need to wait for institutional or government funds to be released or for a crisis to make headlines. We can immediately act where and when the need is greatest.

The way we open and close projects is designed to ensure that our resources and expertise are used in the most effective way possible to save more lives—no matter where we’re operating.

Knowing where to go

There are a number of ways we learn about crises that need our attention:

  • MSF teams already working with the people affected
  • Local government
  • The international community
  • Humanitarian organizations such as the United Nations Department of Humanitarian Affairs (UNDHA)
  • Local and national NGOs

Sending in the explo & emergency response teams

Once information about a new crisis has been confirmed, we send a team of medical and logistics experts to the crisis area to carry out a quick evaluation. This “exploratory mission,” or “explo mission” is conducted either by staff already working in the area or specialists deployed from our headquarters. 

While the explo team assesses the situation and creates a proposal, our emergency teams snap into action. These teams are composed of MSF staff who have extensive field experience in key areas, such as medical care, logistics, crisis response (including conflict and natural disasters), and management. Because emergency response team-members are on stand-by 24/7, they can be deployed within hours of an emergency breaking.

Sending in specialized field project teams & supplies

The explo team’s proposal outlines the number of people affected and the broader resources required. Once it’s approved, MSF headquarters selects personnel and coordinates the delivery of specialized equipment and other resources. Thanks to our streamlined protocols, medical kits, and logistics centers, we can distribute material and equipment within hours so that our teams can hit the ground running and begin saving lives as soon as they arrive.

In some countries that are prone to crises, or where a crisis seems like it could soon occur, MSF keeps emergency supplies on standby in warehouses.

An average field project team has between four and 12 international volunteers working in collaboration with up to 200 local staff.

Field operations are managed by a country manager and a coordination team. This often includes a medical coordinator, a logistical coordinator, and a financial coordinator who are typically located in the capital city of each country where MSF works.

They oversee the project and act as liaison between MSF, local authorities, partners, and other non-governmental organizations (NGOs). They also report regularly to the Operations Departments at their headquarters.

Knowing when to close a project

MSF projects generally have a lifespan of between 18 months and three and a half years. However, there are instances in which we stay only weeks or maintain a presence, in some form, for decades.

We rely on the judgment of field and headquarters staff to help us assess when an epidemic or conflict has subsided, or when local organizations have the resources and expertise to take over operations. During many MSF projects, we train local employees in specific medical skills to ensure that patients can continue to receive the care they need once our teams have departed.

In 2009, we handed over our HIV/AIDS programs in Cambodia to local actors. After years of civil war in Liberia, relative stability was restored in 2010, making it possible for us to hand over a number of projects. We also closed our Bon Marche hospital in Bunia, Democratic Republic of Congo, after we determined that the situation in the immediate area had improved and that emergency needs were greater in other locations.