2012 was yet another difficult year for humanitarian work, with insecurity remaining one of the biggest challenges for Médecins Sans Frontières (MSF) in delivering healthcare to the places it is needed most. 

 

Good news came in July 2013 that our two colleagues, Montserrat SERRA and Blanca THIEBAUT, were finally released after being abducted by armed men from Dadaab on Kenya’s border with Somalia and held captive for 21 months. However, MSF is still facing multiple dangers in many other projects, with staff detained and threatened, medical facilities targeted and shelled, and patients blocked from accessing lifesaving care.

 

In Syria, the civil war has taken a shockingly high death toll. The unpredictable nature of the conflict is very challenging for our teams in the front line and the country’s health system is now in ruins. We have received a lot of patients with war-related injuries such as gunshot and shrapnel wounds, as well as accidental trauma and the full range of illnesses. MSF is working in 6 field hospitals in the country and providing aid to the increasing number of Syrian refugees in neighboring countries, but overall international response is still far from meeting the overwhelming needs of the population.

 

Our work is no easier in Afghanistan. In the face of the surging needs for medical care from pregnant women, MSF opened a maternity hospital in Khost in March 2012, not long before it was targeted in a bomb attack a month later. Our activities were suspended until the end of 2012, when we got assurances of support from the community to reopen the hospital.

 

In Myanmar, the inter-ethnic clashes in Rakhine drove 140,000 people away from their homes to live in makeshift camps. Many of those people, including patients with chronic diseases, were not allowed to move freely to seek medical help. What further hindered our efforts were threats, hostility and intimidation from some members of the community, who objected us to offer any help reaching people they see as enemies.

 

You may already be well aware of the refugee crisis in South Sudan as it was one of the major emergencies we responded to last year. MSF set up field hospitals, clinics and feeding centres, but as essentials like water, bulk food and shelter were inadequate for the 170,000 refugees who fled from Sudan, the medical impact of our services was constantly undermined. We must get the right balance between delivery of the more general humanitarian relief and the more specialised medical services.

 

In Asia, severe flooding in the Philippines caused catastrophic damage in early August. MSF was involved to provide basic healthcare and improve water and sanitation infrastructure. Also in the Philippines, after Typhoon Bopha devastated coastal parts of Mindanao Island last December, MSF ran mobile clinics, monitored for outbreaks of disease and supported recovery efforts. 

 

On a global level, we are increasingly alarmed at the growing resistance against tuberculosis (TB) drugs. Treatments for drug-resistant TB (DR-TB) are particularly harsh and require patients to take 20 pills every day with severe side effects. In Cambodia and other countries with high TB burden, MSF is working to improve detection of the disease, raise public awareness about TB and offer treatment. But there are still hundreds of thousands of people who urgently need better diagnostics and effective treatments, ones which are faster and less toxic.

 

Vaccination for preventable diseases is another area that clearly needs action. The number of children who have not received vaccination packages has grown from 19 million to 22.4 million in the past two years. As most vaccines must be kept refrigerated, need more than one dose, and require skilled health workers to administer them, children living in areas with poor road conditions, no electricity or insecurity find it very difficult to get vaccinated. What is urgently needed is research money flowing towards the development of vaccines that work much better in these settings.

 

But it is your ongoing and generous support for our emergency medicine that enables MSF to work efficiently and effectively for millions of patients, regardless of who or where they are. We know that we have your backing to provide assistance to those who need it most urgently. We are determined to adhere to our principles of independence, neutrality and impartiality. But we often face difficulties in divided societies, where politics complicate and obstruct the simple business of treating individual patients.  The struggle to reach those people and the successes we have when we do so are at the heart of this report. I hope you are proud to be part of that effort. 

 

Thank you very much again for your support.

 

Dr. FAN Ning

President, MSF-Hong Kong

 

Rémi CARRIER

Executive Director, MSF-Hong Kong