Last updated: 19 May 2020
As COVID-19 spreads across the world, MSF is racing to respond to the pandemic in over 70 countries where we run existing programmes, whilst opening projects in new countries as they become outbreak hotspots. In many of the places where we work, there is limited capacity to respond to an influx of patients with a new disease that may require intensive care.
Our key priority is to keep our regular medical programmes running for the tens of thousands of patients and extremely vulnerable communities we support around the world. Meanwhile, MSF emergency teams are responding on multiple fronts— supporting health authorities to provide care for patients with COVID-19, protecting people who are vulnerable and at-risk conducting health education, raising awareness on mental health, and providing training for vital infection prevention and control (IPC) measures to protect patients and staff.
In Hong Kong, our team is reaching out to the vulnerable groups in the society and has conducted more than 32 face-to-face health education and mental health sessions since February. Community engagement is a crucial activity of any outbreak response and in Hong Kong, this focuses on groups who are less likely to have access to important medical information, such as the socio-economically disadvantaged. The team is also targeting those who are more vulnerable to developing severe disease if they are infected, such as the elderly.
Meanwhile, the 1 tonne donation of personal protective equipment has been received by Hong Kong St. John Ambulance on Thursday, 5 March. The shipment contains protective suits, shoe covers, face shields, goggles, N95 and surgical masks, gloves and gowns. In addition, another 11,000 pairs of gloves were also donated to the organisation. We also donated around 50,000 surgical masks to local organisations that serve people with chronic diseases and compromised immune systems such as cancer survivors/chemotherapy patients, and the elderly who are most in need of protection.
Regular activities in the Rohingya refugee camp in Cox’s Bazar are ongoing. Whereas we have adapted our outpatient clinic to isolate patients with COVID-19 symptoms. We have built dedicated COVID-19 wards and isolation rooms in our field hospitals, reaching to a 300-bed capacity, in different locations. Our teams are also carrying out health promotion activities in the camps.
All regular project activities on hepatitis C both in Phnom Penh and Battambang are currently suspended. The team has contributed to the development of national guidelines for IPC and clinical care of COVID-19 cases. Trainings of staff and technical support to health facilities in three provinces (Pailin, Bantey Meanchey, and Oddar Meanchey, all in the northwest of the country) were launched on 22 April.
Due to COVID-19, our local health authority partner suspended most adolescent health activities in Banten. We provided trainings to community leaders and has been working with them to provide health education activities for the communities of Labuan and Carita sub-districts of Banten province (including the setting up hand-washing points), as well as for students in Jakarta. We are also strengthening capacity to respond to COVID-19 in health centres in Labuan and Carita, including improving patient flow.
We issued a call to the Malaysian government to repeal a circular, obliging public health facilities to report irregular migrants, including refugees and asylum seekers. In Penang, we are providing COVID-19 health education in different languages and translations support to patients referred to hospitals. Our mobile clinics are suspended, but patients reach us through our phone hotline. Also, we donated food supplements to 100 vulnerable families.
In Timergara, the team is screening more than 1,000 people every day for symptoms of COVID-19 and undertaking consultations for suspect cases. We are running a 15-bed isolation ward and referring serious patients, including providing an ambulatory service for COVID –19 patients in most of the facilities we support across Pakistan, we have added protective COVID-19 measures and isolation areas. MSF is also conducting extensive awareness-raising activities.
Papua New Guinea
MSF has provided technical support in helping the country to develop its response, including training, being part of the group developing the response, and setting up a large facility for case management in Port Moresby.
Regular activities have been put on hold, both in Manila and Marawi. In Manila, the team supports our partner organisation Likhaan with health promotion activities. In Marawi, in the south of the country, a "mobile information drive" to pass health promotion messages to vulnerable populations has been launched, and medication, hygiene kits and leaflets about COVID-19 have been delivered to patients suffering from diabetes or hypertension.
MSF is supporting Ibn El Khateeb Hospital and health facilities in Erbil and Al-Shifaa hospital in Mosul. MSF donated beds to furnish a 50-room building in Al Salam hospital complex for the isolation of patients. MSF is also working jointly with local health authorities to facilitate the treatment of suspect cases.
Across northeast Syria, MSF takes part in the COVID-19 humanitarian task force, chaired by local health authorities. We are providing training and preparedness measures in Al Hassakeh National Hospital and in Al Hol camp. MSF continues to support various health facilities and run regular programmes in Al Hol camp. In northwest Syria, we are undergoing preparedness activities in some of the hospitals and health centres that we support and equipped our staff with the needed protective equipment. MSF supported the Idlib National Hospital with the design of a COVID-19 isolation unit, as well as through medical and logistical donations to the quarantine department. In Azaz, in Al Salamah hospital, MSF has set up a COVID-19 triage tent.
In some of the camps we intervene in, we have spread awareness messages and adapting measures to help prevent the spread of disease.
MSF is discussing with the Ministry of Health to support provision of care for patients with severe and acute symptoms. In the West Bank, MSF teams adapted the activities to continue to provide psychological support by phone to the population in need. In Hebron, MSF teams launched a dedicated hotline to support the mental health needs of people most affected by the spread of the virus.
MSF has put in place measures to keep staff and patients safe in our existing projects across 13 governorates in Yemen. Our teams are ensuring the continuation of lifesaving activities in the hospitals we work in (like Al Jambouri hospital) and is helping prepare hospitals to receive COVID-19 cases (like in Abs hospital and Sheikh Zayyed Hospital). Our teams have provided trainings and assisted the Ministry of Health in the setting up COVID-19 treatment centres and isolation units in Aden, Hajjah, Sanaa, Hodeidah, and Ibb governorates, and in Taiz City. In Abs, we are also working with communities to understand more about local perceptions and knowledge of COVID-19.
MSF teams have been training staff in the facilities we support in Bamenda, Kumba, Muyuka, Mamfe, and Widikum. In Yaounde, MSF started receiving patients with moderate symptoms of COVID-19 in the 110-bed Djoungolo health facility. Isolation and treatment wards were set up in Bamenda and Buea regional hospitals.
Democratic Republic of Congo (DRC)
In Masisi General Reference Hospital (North Kivu), a 20-bed isolation ward has been set up. In Kinshasa, support has started for St. Joseph Hospital, one of the six hospitals for COVID-19 patient care. Training of medical staff has started and MSF teams are working on the installation of a 40-bed isolation ward (tent). In Goma and Lubumbashi, MSF is preparing to support dedicated COVID-19 health facilities.
Across the seven states where MSF works in Nigeria, we are providing technical support to the Ministry of Health (MoH) and Nigeria Centre for Disease Control (NCDC) as they set up isolation centres for patients who may present symptoms of COVID-19, as well as undertaking community-based health promotion and setting up handwashing points and isolation areas in local communities and camps for internally displaced persons (IDP). In Ebonyi state, MSF is supporting the MoH and NCDC in setting up the state’s first COVID-19 testing centre. In Sokoto, we are providing trainings to the MoH and supporting the setup of a 20-bed isolation and treatment unit. Community engagement is ongoing in Anka and Benue in displaced persons’ camps.
MSF is part of the case management and surveillance pillars at the national Emergency Operations Centre (EOC). In Freetown, MSF water and sanitation and construction specialists have begun work on repurposing a government facility into a 120-bed COVID-19 treatment centre. In Kenema District, MSF has carried out an assessment at a facility at Kenema Government Hospital where MSF has been engaged to assist in opening a treatment centre for COVID-19 patients. MSF is also providing donations of IPC supplies, and handwashing stations to 42 villages in the district. In Makeni Regional Hospital, Magburaka Hospital and Hinistas Community Health Centre, MSF has set up isolation wards.
MSF is assisting the Ministry of Health in training healthcare workers on infection prevention and control measures and triage of patients showing symptoms consistent with COVID-19. In Juba, MSF teams are installing handwashing points in several locations with high concentrations of people, including around hospitals and healthcare centres, and in and around Konyo Konyo, the main market area.
MSF is the sole healthcare provider in Nduta refugee camp, which hosts 75,000 Burundian refugees, and health promotion activities are ongoing. In preparation for a COVID-19 outbreak in the camp, we built four triage or isolation areas in each of the health clinics where we work in the camp. We completed preparation for a main isolation centre with 10-bed capacity at the MSF hospital.
We are in the process of constructing an additional 50 beds and trained around 116 MSF staff for COVID-19 response.
MSF’s intervention for COVID-19 is currently focusing on nursing homes, and homeless and migrants. For nursing homes for the elderly, MSF has nine mobile teams and visited 95 nursing homes in Flanders, Brussels and Wallonia. For vulnerable groups such as homeless people and undocumented migrants, there is an isolation medical structure in Brussels.So far, they reached out to almost 3, 300 homeless and migrants.
We run projects for vulnerable populations—homeless and migrants in Paris region—with mobile clinics and aid in screening. A new hotline was set up with MSF nurses to provide advice to managers of emergency shelters and flag the most concerning situation to medical mobile teams. We also run activities in support of hospitals and health centres.
MSF supported three hospitals in the first epicentre of the outbreak, in Lombardia region, mostly through infection control activities and training. Outside the hospitals we are doing outreach activities in order to reach vulnerable communities (as nursing homes for the elderly, local organisations working with homeless and migrants) and we are supporting a program of telemedicine which is assisting people under isolation at home.
In Marche region, MSF teams increased their support within 30 retirement homes, with IPC and local staff training, to prevent cases to spread in such vulnerable locations. In Rome, an emergency intervention has been launched at Selam Palace, a building hosting more than 500 refugees, mostly coming from the Horn of Africa. Activities include MSF clinic and health promotion.
MSF’s operations in Spain is focused on elderly homes, with more than 200 supported homes since mid-March. MSF has been providing strategic support to the local health authority to flatten the curve.
MSF teams are providing nursing and logistics support at the London COVID CARE Centre, in partnership with the University College London Hospital (UCLH) Find & Treat team.
MSF has been partnering with local service organisations in New York to improve infection prevention and control measures in facilities serving the homeless and housing insecure. Teams have been donating over 80 handwashing stations in New York and opened a shower trailer in Manhattan to give people who are currently homeless a place to bathe. MSF has also distributed 1,000 mobile phones to vulnerable New Yorkers who lack the essential technology needed to contact emergency and support services.
MSF teams also offer support to organisations and health care providers serving vulnerable communities in Puerto Rico, Florida and Native American people in the country’s southwest.
Our team has also been remotely advising non-profit organisations throughout the United States working with the homeless and migrant workers on infection prevention and control measures and hospital triage set up.
In São Paulo, MSF teams are triaging patients at the Missão Belém homeless shelter, referring COVID-19 suspect cases to hospital. Teams are working with homeless people – in shelters and on the streets – youth in adolescent detention centres, and with heavy drug users providing health promotion and IPC education, and running a mobile triage clinic in the downtown area. Screening and health promotion activities with the homeless have also started in Rio de Janeiro.
In Manaus, an MSF team has started training local health professionals on infection and prevention control.
In Boa Vista, in Roraima state, the team has visited informal shelters where migrants and refugees from Venezuela have gathered, providing hygiene and physical distancing guidance to residents. The team has also assisted in expanding access to water in formal and informal shelter and has distributed hygiene kits.
MSF has also reorganised the Emergency Centre in Port-au-Prince in order to isolate and refer COVID-19 suspect cases. A separate patient/staff flow is in place, in addition to triage and five isolation beds. Our teams are carrying out health promotion activities in communities, via mass media, training of health workers and community leaders, and in health institutions.
In the South of Haiti, MSF supported two public health facilities for the set-up of triage systems, isolation beds, referral systems and training of medical staff and also doing health promotion, community awareness and prevention activities.
Whether we’ll be able to make similar offers to other countries will depend on the nature of the pandemic but also on our capacity to send staff.