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Physicians and Health Care Workers’ Role in Conflict Zones Challenges and Successes Babak Abbaszadeh March 27, 2010, Ottawa • What is MSF? • What is our mission? • What are MSF roles in conflict zones? • What are the challenges? • How we handle challenges? What is MSF? • International humanitarian aid organisation • Provides emergency medical relief to those who need it most • ‘First in’ and ‘last out’ • Treats most vulnerable The MSF Charter 1) Independent Independent from governments, as well as religious and economic interests 2) Impartial Provides medical assistance solely on the basis of need, irrespective of political, religious and economic affiliation 3) Neutral Doesn’t take sides 4) MSF Aid Workers Aware of the risks and dangers of the missions A brief history • 1971 – Founded by French doctors • 1980 – MSF becomes international • Operational centres throughout Europe • Sections throughout the world • 1991 – MSF Canada set up • 1999 – Winner of Nobel Peace Prize Nurses 23% logistics, Laboratory technicians 60% 1800 MSF aid workers since 1992 Medical doctors 17% MSF Canada Field workers 2007 What is our mission? •Natural disaster •Armed conflict and post conflict •Population affected by epidemic or endemic diseases •Social violence or exclusion Natural Disasters • Rapid reaction from MSF workers in region. • Emergency teams on stand-by in European centres. • Rapid deployment of medical kits. • Rapid assessments of unmet needs. • Epidemic surveillance. War • Important symbolic value • Absolute neutrality • Get job done safely, simply and fast Nutrition intervention • Surveillance and early warning • Nutritional response Establish therapeutic and blanket feeding Provision of non-food items Water sanitation Vaccination • Coordination with other organisations • Lobbying for change Displacement • Both internal and external displacement. • MSF assesses the health needs of displaced populations • Medical response if assessment highlights need. Disease management • Prevention (vaccines, bednets) • Treatment (ARVs, Anti-malaria, anti-TB…) • Health education • Counselling Challenges • Remain impartial and neutral • Reach the most vulnerable population • Provide access to essential medicine • Témoignage or Speak out • Sustainability of MSF action •Post conflict interventions Remain impartial and neutral Military vans, Afghanistan, April 2004 Who is who? MSF Team, Afghanistan, April 2004 MSF’s only protection is through the communities in which we work. We are trying even harder to educate them about our complete independence from anyone’s army. Reach the most vulnerable population Myanmar Myanmar Témoignage and speaking out •Acting and speaking out are not two inseparable elements of relief: ‘Bandages are not enough’. •How does MSF gather this information? • Gathering testimonies and stories from patients • Collecting statistical medical data • How does MSF speak out? • Encouraging local authorities • Producing press releases/conferences • Publishing materials • In extreme conditions, may withdraw its presence Access to Essential Medicines Campaign International campaign started in 1999. 3 main objectives: • Stimulating research and development for drugs and neglected diseases. • Overcoming barriers to existing medicines (patents and prices). • Lobbying to overcome trade barriers. Drug development outcome 1975-1999: 1393 new chemical entities marketed Tropical diseases: 13 Tuberculosis: 3 Trouiller et al., Lancet Vol. 1359 Jun. 2002 Access to Essential Medicines Campaign Top 5 ACHIEVEMENTS… 1) Price of AIDS drugs fallen dramatically, leading to international push to treat HIV in LDCs: - 1999 = $US 10,000 per patient/year - 2001 = $300 per patient/year 2) Continued production of sleeping sickness drugs secured 3) Put need for new TB diagnosis and treatment on international agenda 4) Established the Drugs for Neglected Disease Initiative – A new model for drug development 5) Need for effective malaria diagnosis and treatment accepted nationally and internationally www.dndi.org Summary • MSF charter is our guideline • Reaching the most vulnerable people is our goal • Educating the community and living within the population we help is our security • Implementing simple projects adapted to situation of chronic conflict is key for sustainability Thank you