From the Executive Director

Spring has come after winter and warms the earth. While I personally like the transition periods between seasons, they are also conducive to spread of epidemics. We know well how vaccination can help reduce outbreaks; we have it at home, seasonally, with the flu. Yet, lack of access to vaccination, insufficient vaccination coverage, can instead lead to a resurgence of preventable diseases and result in outbreaks.

This issue’s Cover Story features Diphtheria, a bacterial infection which has been eradicated from most countries over the past thirty years. Diphtheria is a preventable disease – for those who are vaccinated against it – and a potentially deadly one for those who are not and who get infected.

Since August 2017, about 700,000 Rohingya have fled to Bangladesh following targeted violence against them in Myanmar in the last half year. The overcrowded refugee camps and poor water and sanitation conditions there have become breeding grounds for the disease, among a population group who had little access to vaccination in Myanmar.  MSF teams identified the first suspected case of diphtheria three months after the Rohingya crisis unfolded – an outbreak had started: This vulnerable population, which had gone through so much trauma, was now being hit by a disease that could have been completely preventable. MSF teams have since then been treating patients and supporting vaccination campaigns.

In another part of the world, armed conflicts in Yemen started in March 2015, dragging the whole country into extreme violence and insecurity, and crushing the health system. When medical facilities can barely operate, people will not be able to get the medical care they require, including basic, essential vaccinations.  Following cholera and acute watery diarrhea outbreaks, a suspected diphtheria outbreak took hold in Yemen late last year. Here again, MSF field workers have helped treat patients and implement vaccination campaigns.

Coverage in vaccination campaigns is essential. In many instances, in some of the remote or volatile areas on our humanitarian front lines, even population data or maps can be lacking, outdated or inaccurate. To support our medical field workers, MSF has co-founded the “Missing Maps Project” and organized a number of collective mapping activities, “Mapathons”, gathering volunteers to locate buildings, pathways and water sources based on satellite pictures.  Accurate, updated maps help remarkably in the planning and implementation of many of our frontline activities, in the preparedness for future emergencies. This Mapathon endeavor is another feature in this edition of Borderline I strongly recommend.

Preparing for emergencies is an essential part of our work; Mapathon is one of the means to support our preparedness. Vaccination, on another hand, is a powerful prevention measure and we all know well the saying “prevention is better than cure”. But the outrage of preventable epidemics, when, as in Yemen and Bangladesh, patients need emergency treatment, still demand action. This is also our crucial task to bring rapid assistance to the people in need.