Access to basic and emergency medical care remains severely limited and ill-adapted to meet the growing needs in the country. MSF published its research which revealed that the majority of patients could not reach critical medical assistance due to insecurity, distance and cost.
In the west of Kabul, MSF opened an obstetric department in the hospital of Dasht-e-Barchi to provide free, around the clock care for pregnant women with complications and seriously ill newborns.
- An injured man is being led by a relative at the Kunduz Trauma Centre in Northern Afghanistan. © Mikhail Galustov
In response to tens of thousands of people seeking refuge from a military offensive in neighbouring Pakistan, MSF provided measles vaccination and medical consultations in a camp in Khost province from July to September. The activities were then handed over to other organisations.
MSF’s trauma centre in Kunduz expanded its intensive care unit and bed capacity. The team treated over 22,000 people and performed 6,000 surgical procedures. The Boost hospital in Helmand province which MSF supports also expanded maternity ward’s bed capacity.
Near the border with Myanmar, there are high numbers of injecting drug users with HIV, HIV–TB or HIV–hepatitis C co-infection. At the request of Aids Care China (ACC), a Chinese NGO, MSF started supporting a clinic in Jiegao, Yunnan province in 2011. Two years later, MSF began providing technical assistance to ACC to improve the clinical management of HIV/AIDS patients. This collaboration ended in April 2014 due to a number of reasons, including changes in ACC’s objectives and the fact that the health ministry started treating HIV patients suffering from hepatitis C. MSF stopped running medical projects in China this year.
For decades, undocumented Rohingya who fled violence and persecution in Myanmar have also suffered from discrimination and healthcare exclusion in Bangladesh. In the Kutupalong makeshift camp in Cox’s Bazar, MSF continued to provide basic and emergency healthcare, inpatient services and TB treatment to refugees and the host community.
In Dhaka’s slum districts of Kamrangirchar and Hazaribagh, MSF visited factories and tanneries and conducted over 4,450 outpatient consultations for workers. Teams also offered sexual and reproductive health services for adolescent girls, as well as medical and psychological assistance to victims of sexual and domestic violence.
In the remote area of Bandarban, Chittagong Hill Tracts, MSF supported the health ministry’s response to a malaria outbreak. Travelling in boats and hiking through forests, teams treated more than 2,280 people during the three-month intervention.
MSF continues to provide treatment for malaria and TB, two of the major health concerns in Cambodia.
- MSF teams distributed leaflets and introduced the Active Case Finding TB program in the market place in Tboung Khmum, Cambodia. © Matthew Smeal/MSF
Artemisinin-based medicines are currently the most effective antimalarial treatment, yet areas of artemisinin resistance have been identified. MSF undertook a baseline survey in 23 villages in Preah Vihear province, followed by active case detection and health promotion, in preparation for a project with a specific treatment protocol aiming to eliminate the drug-resistant malaria.
In addition to the comprehensive TB care provided in Kampong Cham, MSF completed the first phase of active case finding in Tboung Khmum district. All people older than 55 – a high-risk group – were screened, and 140 out of a total of 4,900 were found to have TB. Another round of active case finding began in October.
In Bihar state, MSF provides weekly outpatient treatment for severely malnourished children. The malnutrition intensive care unit, built inside Darbhanga Medical College Hospital and run by MSF, is the first of its kind in India.
- MSF treats malnutrition in Bihar, India, where MSF has been working since 2009. ©Sami Siva
To eliminate kala azar by 2015, the government adopted a single-dose first-line treatment in October. This policy change was made following sustained advocacy by MSF with data from its pilot project in Bihar.
MSF continues to focus on treating HIV and TB in Mumbai and Manipur. Apart from running HIV and TB clinics, MSF cooperated with a local NGO to offer inpatient care for HIV patients in Manipur. In Kashmir, MSF produced a TV soap opera to increase awareness and visibility of mental health issues.
A long-established project providing basic healthcare to highly vulnerable communities in 24 displaced persons camps and in isolated villages in northern and eastern Rakhine state was suspended by the authorities in February. After the resumption of activities in mid-December, MSF teams conducted over 3,400 consultations in less than a month. Not all project activities had restarted by the end of 2014.
MSF provides HIV/AIDS care in Myanmar, supplying ARVs to more than half of the 70,000 people undergoing treatment. The newly renovated clinic in Insein Township in Yangon is Myanmar’s largest of its kind, treating 10,000 HIV/TB patients. Following years of price negotiations, MSF began offering a single daily pill taken orally which replaces the injections directly into the eye to treat cytomegalovirus (CMV) retinitis – an HIV-related infection that causes blindness – in Dawei.
- An MSF doctor begins the process for CMV injection treatment in Dawei, Myanmar, before oral drug is introduced to the project. © Eddy McCall
When active fighting resumed in northern Shan and Kachin states in April, MSF operated mobile clinics to assist displaced people.
Women and children in particular suffer from the lack of access to healthcare in Pakistan. MSF continues to provide healthcare with a focus on mother and child health in the most underdeveloped province Balochistan. In eastern part of the province, MSF focuses on treating malnutrition and providing specialist care to newborns, infants and children at the district hospital in Dera Murad Jamali.
In the northwest, MSF continues to support the hospital in Timergara and Hangu, and run a 35-bed maternity hospital in Peshawar. The teams also provide medical care to displaced and vulnerable communities in parts of the tribal areas.
- An MSF nurse takes the blood pressure of a patient in Chaman, Pakistan. © Sa'adia Khan
MSF continued to support communities affected by Typhoon Haiyan. On Leyte Island, MSF closed the temporary hospitals as local services regained the capacity but a mental health programme continued. MSF also provided human resources support in maternity, neonatology and surgery at the provincial hospital in Palo, and ensured drug and medical supplies.
MSF also started rehabilitating a hospital and two facilities on Leyte and in Eastern Samar province, which would be completed in 2015. In Guiuan, Samar Island, MSF treated patients in a tent hospital until a semi-permanent structure was built. Teams facilitated patients moving into the new hospital and handed it over to the provincial health office.