Dear Friends, 
 
It is sad to describe 2014 as a year of abandonment. The largest Ebola outbreak in history struck West Africa, but many sufferers were left to die on their own, stripped of their dignity.  As the war in Syria entered its fourth year, desperate people found themselves being forgotten, unable to escape to safety. Médecins Sans Frontières (MSF) had to stretch beyond its limits and work in simultaneous emergency situations across the globe.
 
  • MSF works in approximately 63 countries worldwide. The named countries on the map are highlighted in this report. The map and place names used do not reflect any position by MSF on their legal status.
 
When the Ebola outbreak was officially declared in Guinea in March, no one could have foreseen the extent of the suffering that would ensue. By the end of 2014, the disease had claimed almost 8,000 lives, including 13 MSF colleagues. The number of cases began to decline but the epidemic is not yet behind us.
 
Confronted with the reality that at least 50 percent of the patients would die and that no treatments exist, MSF staff, including 23 deployed by MSF-Hong Kong, worked with the fear of contracting Ebola themselves in 2014. At times, there were not enough medical staff to safely care for the sheer number of patients. Impossible compromises like turning people away at the gates had to be made. 
 
There is no doubt that the cross-border geographical spread of this epidemic was unprecedented, and the number of experienced experts was limited. Nevertheless, the main problem of failing the sick was that there was not enough political will to combat the disease. It was not until months too late that the World Health Organization (WHO) declared the outbreak “a public health emergency of international concern”.  But even then, the aid provided was insufficient. MSF appealed to the United Nations member states for more help, including the deployment of civilian and military assets with expertise in biohazard containment. 
 
In Syria, millions of people were left abandoned to their fate too, as humanitarian organisations were prevented from accessing those in need. In January 2014, five MSF staff members were taken hostage by the Islamic State (IS) in northern Syria, despite agreements with local commanders that we would be allowed to work unhindered. We were relieved that our colleagues were released eventually, but the abduction forced us to withdraw from IS-controlled areas. Furthermore, we still do not have the permission to work in government-controlled areas. Struggling to provide substantial direct medical assistance to civilians, MSF supports networks of dedicated Syrian medics who often work in extremely hazardous conditions. This support, while valuable, falls far short of meeting the massive needs inside Syria. 
 
Over the course of the year nearly two million people fled their homes in search of safety. Many Syrians travelled to Lebanon and Jordan while others went to Iraq, which itself experienced an upsurge in violence. Shelling, air strikes and fighting again obstructed the delivery of essential medical and humanitarian aid. 
 
  • Dr. Akin Chan from Hong Kong examines a patient in a hospital in Gogrial, South Sudan. Photo source: Akin Chan
 
Once again, this year MSF has to face with difficult circumstances when our employees, healthcare facilities and patients are threatened or attacked. In Central African Republic where MSF doubled its medical assistance in 2014, 19 people, including three MSF national staff members, were killed during an armed robbery in an MSF hospital in Boguila. On several occasions armed groups entered hospitals. MSF staff had to physically protect patients, shielding them from attack. This lack of respect for the medical mission also occurred in South Sudan. Patients were shot in their beds, wards were burned to the ground, medical equipment was looted, and, in one case, an entire hospital – in Leer – was completely destroyed. The immediate consequence is that countless people are being denied lifesaving assistance. 
 
When the conflict reignited between Israel and Palestine in mid-2014, MSF supported a local hospital with a full surgical team and emergency medical equipment, and donated emergency stocks to the central pharmacy. Conflict also affected Ukraine, resulting in medical supply lines severely disrupted or completely cut. In response, MSF dramatically increased its support by providing enough supplies to treat over 13,000 wounded patients on both sides of the frontline. 
 
Other than Ebola, MSF continued to tackle tuberculosis (TB) and HIV/AIDS, looking at ways of improving treatment protocols and models of care by supporting community adherence clubs and expanding viral load testing for instance. 
 
The Ebola crisis highlighted global failures in the humanitarian aid and health systems, which had been present for years but had never been so evident. What struck MSF most strongly, however, were the lack of global leadership and the reticence of those in power to engage in the response. We were vocal about this, but ultimately MSF is a patient-focused organisation. Our role is to save patients’ lives, focusing primarily on individuals who are most in need but not on overhauling global systems. We could not work in this way without our supporters and our teams around the world. We want to take this opportunity to thank you all.
 
Dr. Liu Chen-kun 
President, MSF-Hong Kong 
 
Rémi Carrier 
Executive Director, MSF-Hong Kong 
 

 

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