Médecins Sans Frontières or HEALTH SECTOR STRATEGY FOR AFRICA?

Original Link INTRODUCTION This is what happens when a temporary measure becomes a permanent solution. How did I start writing this article? I remember one day I had returned from Ottawa to Toronto and the Reprobates were bothering me as per usual. I found my spot at Rouge Hill Go Station. It was no longer very private because it had been invaded by the Reprobates and their agents. In the night season I was praying and Médecins Sans Frontières (MSF) came to mind. In the day I had heard two news items about the organization. It was one from Ethiopia and another I think from Sudan. It came clearly to my Spirit that this was another strategy for the whiteman to control Africa. Unfortunately, the nations which are involved should realize that in the long run this is a very short sighted policy. This strategy leads to a very stunted and ineffective health system and deprives your people of vital training and development. You will notice that most of the personnel used by these NGOs are from the nations involved. There are not many people from the nations involved at the local level. Those who are involved are the hewers of wood and the carriers of water. It is obvious that this short term solution cannot and I repeat cannot be a permanent one. In fact it has survived too long. The things we are reading below should not have happened and the quicker we move to have the situation regularized will be better. Africa has a lot of young people. They should be channeled properly, everyone cannot sell on the streets. There is a need for that also but we have to work to become the solution to our problems under God. We thank the Whiteman for helping us to solve the problems they have created but going forward there has to be serious policy changes so the Politicians can stop being a bait for the aid money. This article on MSF is in two parts: Part I - Administration Part II - Operations of the Mission As per usual I have underestimated the amount of information which is out there. Médecins Sans Frontières (MSF)- ADMINISTRATION Médecins Sans Frontières (MSF; pronounced [medsɛ̃ sɑ̃ fʁɔ̃tjɛʁ] (listen)), rendered in English as Doctors Without Borders, is an international humanitarian medical non-governmental organisation (NGO) of French origin best known for its projects in conflict zones and in countries affected by endemic diseases. In 2019, the group was active in 70 countries with over 35,000 personnel mostly local doctors, nurses and other medical professionals, logistical experts, water and sanitation engineers and administrators. Private donors provide about 90% of the organisation's funding, while corporate donations provide the rest, giving MSF an annual budget of approximately US$1.63 billion. Médecins Sans Frontières was founded in 1971, in the aftermath of the Biafra secession, by a small group of French doctors and journalists who sought to expand accessibility to medical care across national boundaries and irrespective of race, religion, creed or political affiliation. To that end, the organisation emphasises "independence and impartiality", and explicitly precludes political, economic, or religious factors in its decision making. For these reasons, it limits the amount of funding received from governments or intergovernmental organisations. These principles have allowed MSF to speak freely with respect to acts of war, corruption, or other hindrances to medical care or human well-being. Only once in its history, during the 1994 genocide in Rwanda, has the organisation called for military intervention. MSF's principles and operational guidelines are highlighted in its Charter, the Chantilly Principles, and the later La Mancha Agreement. Governance is addressed in Section 2 of the Rules portion of this final document. MSF has an associative structure, where operational decisions are made, largely independently, by the five operational centres (Amsterdam, Barcelona-Athens, Brussels, Geneva and Paris). Common policies on core issues are coordinated by the International Council, in which each of the 24 sections (national offices) is represented. The International Council meets in Geneva, Switzerland, where the International Office, which coordinates international activities common to the operational centres, is also based. MSF has general consultative status with the United Nations Economic and Social Council. Origin Biafra A child with kwashiorkor during the Nigerian Civil War During the Nigerian Civil War of 1967 to 1970, the Nigerian military formed a blockade around the nation's newly independent south-eastern region, Biafra. At this time, France was one of the only major countries supportive of the Biafrans (the United Kingdom, the Soviet Union and the United States sided with the Nigerian government), and the conditions within the blockade were unknown to the world. A number of French doctors volunteered with the French Red Cross to work in hospitals and feeding centres in besieged Biafra. One of the co-founders of the organisation was Bernard Kouchner, who later became a high-ranking French politician. After entering the country, the volunteers, in addition to Biafran health workers and hospitals, were subjected to attacks by the Nigerian army, and witnessed civilians being murdered and starved by the blockading forces. The doctors publicly criticised the Nigerian government and the Red Cross for their seemingly complicit behaviour. These doctors concluded that a new aid organisation was needed that would ignore political/religious boundaries and prioritise the welfare of victims. Apart from Nigeria, MSF exists in several African countries including Benin, Zambia, Uganda, Kenya, South Africa, Rwanda, Sudan, Sierra Leone, etc. Nigeria talking about generational curse, there needs to be a national repentance for this war. The blood of innocent victims is still worrying the nation. 1971 establishment The Groupe d'intervention médicale et chirurgicale en urgence ("Emergency Medical and Surgical Intervention Group") was formed in 1971 by French doctors who had worked in Biafra, to provide aid and to emphasize the importance of victims' rights. At the same time, Raymond Borel, the editor of the French medical journal TONUS, had started a group called Secours Médical Français ("French Medical Relief") in response to the 1970 Bhola cyclone, which killed at least 625,000 in East Pakistan (now Bangladesh). Borel had intended to recruit doctors to provide aid to victims of natural disasters. On 22 December 1971, the two groups of colleagues merged to form Médecins Sans Frontières. New leadership Claude Malhuret was elected as the new president of Medecins Sans Frontieres in 1977, and soon after debates began over the future of the organisation. In particular, the concept of témoignage ("witnessing"), which refers to speaking out about the suffering that one sees as opposed to remaining silent, was being opposed or played down by Malhuret and his supporters. Malhuret thought MSF should avoid criticism of the governments of countries in which they were working, while Kouchner believed that documenting and broadcasting the suffering in a country was the most effective way to solve a problem. In 1979, after four years of refugee movement from South Vietnam and the surrounding countries by foot and by boat, French intellectuals made an appeal in Le Monde for "A Boat for Vietnam", a project intended to provide medical aid to the refugees. Although the project did not receive support from the majority of MSF, some, including later Minister Bernard Kouchner, chartered a ship called L’Île de Lumière ("The Island of Light"), and, along with doctors, journalists and photographers, sailed to the South China Sea and provided some medical aid to the boat people. The splinter organisation that undertook this, Médecins du Monde, later developed the idea of humanitarian intervention as a duty, in particular on the part of Western nations such as France. In 2007 MSF clarified that for nearly 30 years MSF and Kouchner have had public disagreements on such issues as the right to intervene and the use of armed force for humanitarian reasons. Kouchner is in favour of the latter, whereas MSF stands up for an impartial humanitarian action, independent from all political, economic and religious powers. MSF development In 1982, Malhuret and Rony Brauman (who became the organisation's president in 1982) brought increased financial independence to MSF by introducing fundraising-by-mail to better collect donations. The 1980s also saw the establishment of the other operational sections from MSF-France (1971): MSF-Belgium (1980), MSF-Switzerland (1981), MSF-Holland (1984), and MSF-Spain (1986). MSF-Luxembourg was the first support section, created in 1986. The early 1990s saw the establishment of the majority of the support sections: MSF-Greece (1990), MSF-USA (1990), MSF-Canada (1991), MSF-Japan (1992), MSF-UK (1993), MSF-Italy (1993), MSF-Australia (1994), as well as Germany, Austria, Denmark, Sweden, Norway, and Hong Kong (MSF-UAE was formed later).Malhuret and Brauman were instrumental in professionalising MSF.. During the 1983–1985 famine in Ethiopia, MSF set up nutrition programmes in the country in 1984, but was expelled in 1985 after denouncing the abuse of international aid and the forced resettlements. MSF's explicit attacks on the Ethiopian government led to other NGOs criticizing their abandonment of their supposed neutrality and contributed to a series of debates in France around humanitarian ethics.This is what you call ethics of convenience. Sudan Since 1979, MSF has been providing medical humanitarian assistance in Sudan, a nation plagued by starvation and the civil war, prevalent malnutrition and one of the highest maternal mortality rates in the world. In March 2009, it is reported that MSF employed 4,590 field staff in Sudan tackling issues such as armed conflicts, epidemic diseases, health care and social exclusion. MSF's continued presence and work in Sudan is one of the organization's largest interventions. MSF provides a range of health care services including nutritional support, reproductive healthcare, Kala-Azar treatment, counselling services and surgery to the people living in Sudan. Common diseases prevalent in Sudan include tuberculosis, kala-azar also known as visceral leishmaniasis, meningitis, measles, cholera, and malaria. Kala-Azar in Sudan Kala-azar, also known as visceral leishmaniasis, has been one of the major health problems in Sudan. After the Comprehensive Peace Agreement between North and Southern Sudan on 9 January 2005, the increase in stability within the region helped further efforts in healthcare delivery. Médicins Sans Frontières tested a combination of sodium stibogluconate and paromomycin, which would reduce treatment duration (from 30 to 17 days) and cost in 2008. In March 2010, MSF set up its first Kala-Azar treatment centre in Eastern Sudan, providing free treatment for this otherwise deadly disease. If left untreated, there is a fatality rate of 99% within 1–4 months of infection. Since the treatment centre was set up, MSF has cured more than 27,000 Kala-Azar patients with a success rate of approximately 90–95%. There are plans to open an additional Kala-Azar treatment centre in Malakal, Southern Sudan to cope with the overwhelming number of patients that are seeking treatment. MSF has been providing necessary medical supplies to hospitals and training Sudanese health professionals to help them deal with Kala-Azar. MSF, Sudanese Ministry of Health and other national and international institutions are combining efforts to improve on the treatment and diagnosis of Kala-Azar. Research on its cures and vaccines are currently being conducted. By whom? In December 2010, South Sudan was hit with the worst outbreak of Kala-Azar in eight years. The number of patients seeking treatment increased eight-fold as compared to the year before. Health care infrastructure in Sudan Sudan's latest civil war began in 1983 and ended in 2005 when a peace agreement was signed between North Sudan and South Sudan. MSF medical teams were active throughout and prior to the civil war, providing emergency medical humanitarian assistance in multiple locations. The situation of poor infrastructure in the South was aggravated by the civil war and resulted in the worsening of the region's appalling health indicators. An estimated 75 percent of people in the nascent nation have no access to basic medical care and one in seven women dies during childbirth. Malnutrition and disease outbreaks are perennial concerns as well. In 2011, MSF clinic in Jonglei State, South Sudan was looted and attacked by raiders. Hundreds, including women and children were killed. Valuable items including medical equipment and drugs were lost during the raid and parts of the MSF facilities were destroyed in a fire. The incident had serious repercussions as MSF is the only primary health care provider in this part of Jonglei State. Early 1990s The early 1990s saw MSF open a number of new national sections, and at the same time, set up field missions in some of the most dangerous and distressing situations it had ever encountered. Liberia In 1990, MSF first entered Liberia to help civilians and refugees affected by the Liberian Civil War. Constant fighting throughout the 1990s and the Second Liberian Civil War have kept MSF volunteers actively providing nutrition, basic health care, and mass vaccinations, and speaking out against attacks on hospitals and feeding stations, especially in Monrovia. 1991 saw the beginning of the civil war in Somalia, during which MSF set up field missions in 1992 alongside a UN peacekeeping mission. Although the UN-aborted operations by 1993, MSF representatives continued with their relief work, running clinics and hospitals for civilians. Rwanda When the genocide in Rwanda began in April 1994, some delegates of MSF working in the country were incorporated into the International Committee of the Red Cross (ICRC) medical team for protection. Both groups succeeded in keeping all main hospitals in Rwanda's capital Kigali operational throughout the main period of the genocide. MSF, together with several other aid organisations, had to leave the country in 1995, although many MSF and ICRC volunteers worked together under the ICRC's rules of engagement, which held that neutrality was of the utmost importance. These events led to a debate within the organisation about the concept of balancing neutrality of humanitarian aid workers against their witnessing role. As a result of its Rwanda mission, the position of MSF with respect to neutrality moved closer to that of the ICRC, a remarkable development in the light of the origin of the organisation. The ICRC lost 56 and MSF lost almost one hundred of their respective local staff in Rwanda, and MSF-France, which had chosen to evacuate its team from the country (the local staff were forced to stay), denounced the murders and demanded that a French military intervention stop the genocide. MSF-France introduced the slogan "One cannot stop a genocide with doctors" to the media, and the controversial Opération Turquoise followed less than one month later. This intervention directly or indirectly resulted in movements of hundreds of thousands of Rwandan refugees to Zaire and Tanzania in what became known as the Great Lakes refugee crisis, and subsequent cholera epidemics, starvation and more mass killings in the large groups of civilians. MSF-France returned to the area and provided medical aid to refugees in Goma. At the time of the genocide, competition between the medical efforts of MSF, the ICRC, and other aid groups had reached an all-time high, but the conditions in Rwanda prompted a drastic change in the way humanitarian organisations approached aid missions. The Code of Conduct for the International Red Cross and Red Crescent Movement and NGOs in Disaster Relief Programmes was created by the ICRC in 1994 to provide a framework for humanitarian missions and MSF is a signatory of this code. The code advocates the provision of humanitarian aid only, and groups are urged not to serve any political or religious interest, or be used as a tool for foreign governments. Sierra Leone They vaccinated 3 million Nigerians against meningitis during an epidemic in 1996. Arguably, the most significant country in which MSF set up field missions in the late 1990s was Sierra Leone, which was involved in a civil war at the time. In 1998, volunteers began assisting in surgeries in Freetown to help with an increasing number of amputees, and collecting statistics on civilians (men, women and children) being attacked by large groups of men claiming to represent ECOMOG. The groups of men were travelling between villages and systematically chopping off one or both of each resident's arms, raping women, gunning down families, razing houses, and forcing survivors to leave the area. Long-term projects following the end of the civil war included psychological support and phantom limb pain management. Haiti MSF has been working in Haiti since 1991, but since President Jean-Bertrand Aristide was forced from power, the country has seen a large increase in civilian attacks and rape by armed groups. In addition to providing surgical and psychological support in existing hospitals – offering the only free surgery available in Port-au-Prince – field missions have been set up to rebuild water and waste management systems and treat survivors of major flooding caused by Hurricane Jeanne; patients with HIV/AIDS and malaria, both of which are widespread in the country, also receive better treatment and monitoring. As a result of 12 January 2010 Haiti earthquake, reports from Haiti indicated that all three of the organisation's hospitals had been severely damaged; one collapsing completely and the other two having to be abandoned.[51] Following the quake, MSF sent about nine planes loaded with medical equipment and a field hospital to help treat the victims. However, the landings of some of the planes had to be delayed due to the massive number of humanitarian and military flights coming in. MSF went through a long process of self-examination and discussion in 2005–2006. Many issues were debated, including the treatment of "nationals" as well as "fair employment" and self-criticism. Africa An MSF outpost in Darfur (2005) MSF has been active in a large number of African countries for decades, sometimes serving as the sole provider of healthcare, food, and water. Although MSF has consistently attempted to increase media coverage of the situation in Africa to increase international support, long-term field missions are still necessary. Treating and educating the public about HIV/AIDS in sub-Saharan Africa, which sees the most deaths and cases of the disease in the world, is a major task for volunteers. Of the 14.6 million people in need of antiretroviral treatment the WHO estimated that only 5.25 million people were receiving it in developing countries, and MSF continues to urge governments and companies to increase research and development into HIV/AIDS treatments to decrease cost and increase availability. Congo Although active in the Congo region of Africa since 1985, the First and Second Congo War brought increased violence and instability to the area. MSF has had to evacuate its teams from areas such as around Bunia, in the Ituri district due to extreme violence but continues to work in other areas to provide food to tens of thousands of displaced civilians, as well as treat survivors of mass rapes and widespread fighting. The treatment and possible vaccination against diseases such as cholera, measles, polio, Marburg fever, sleeping sickness, HIV/AIDS, and Bubonic plague is also important to prevent or slow down epidemics. Uganda MSF has been active in Uganda since 1980, and provided relief to civilians during the country's guerrilla war during the Second Obote Period. However, the formation of the Lord's Resistance Army saw the beginning of a long campaign of violence in northern Uganda and southern Sudan. Civilians were subjected to mass killings and rapes, torture, and abductions of children, who would later serve as sex slaves or child soldiers. Faced with more than 1.5 million people displaced from their homes, MSF set up relief programmes in internally displaced person (IDP) camps to provide clean water, food and sanitation. Diseases such as tuberculosis, measles, polio, cholera, ebola, and HIV/AIDS occur in epidemics in the country, and volunteers provide vaccinations (in the cases of measles and polio) and/or treatment to the residents. Mental health is also an important aspect of medical treatment for MSF teams in Uganda since most people refuse to leave the IDP camps for constant fear of being attacked. Côte d'Ivoire MSF first camp set up a field mission in Côte d'Ivoire in 1990, but ongoing violence and the 2002 division of the country by rebel groups and the government led to several massacres, and MSF teams have even begun to suspect that an ethnic cleansing is occurring. Mass measles vaccinations, tuberculosis treatment and the re-opening of hospitals closed by fighting are projects run by MSF, which is the only group providing aid in much of the country.[64]cx MSF has strongly promoted the use of contraception in Africa. During the Ebola outbreak in West Africa in 2014, MSF met serious medical demands largely on its own, after the organisation's early warnings were largely ignored. In 2014 MSF partnered with satellite operator SES, other NGOs Archemed, Fondation Follereau, Friendship Luxembourg and German Doctors, and the Luxembourg government in the pilot phase of SATMED, a project to use satellite broadband technology to bring eHealth and telemedicine to isolated areas of developing countries. SATMED was first deployed in Sierra Leone in support of the fight against Ebola. MSF-Burundi has aided in attending to casualties suffered in the 2019 Burundi landslides. CONCLUSION Time for change, the young people of Africa need it!