Are you interested in maternal health as a student or as a professional?

To mark IWD in Sydney, on 8 March the University of Sydney and Médecins Sans Frontières Australia are co-hosting a 90-minute forum on addressing the challenges of maternal health in resource-poor settings.

Four speakers, midwives and obstetrician-gynaecologists, will present on critical issues in countries including Ethiopia, Nigeria and Papua New Guinea, and the intensification of efforts to improve mortality and morbidity rates for birthing women in settings like these. 

Doors open at 17:30 for tea and coffee.
Presentations will commence at 18:00 interspersed with time for Q&A.

Click for program details or to register.

Date: Wednesday, 21 March

Time: 7.30pm

Venue:

The Nursing Education Centre,
The Alfred,
Level 2, South Block,
Commercial Road,
Prahran

What was the reason for your visit to Lebanon?

In 1976, Médecins Sans Frontières carried out its first wartime mission in Lebanon and became a professional medical emergency organisation. This year, having recently celebrated our 40th anniversary, we feel it is essential to share our principles of financial and medical independence, impartiality and neutrality. We believe it is important to talk publicly about these principles – as we did in December at the Beirut launch of an Arabic-language book entitled In the Eyes of Others: Perceptions of Humanitarian Action and of Médecins Sans Frontières. My visit to Lebanon was an opportunity to restate – to the authorities and to people in the region – Médecins Sans Frontières’ readiness and commitment to provide independent, neutral and impartial healthcare in situations where humanitarian needs exist.

Why is Médecins Sans Frontières working in Lebanon?

Following the 2006 war [between Israel and Hezbollah], once the immediate response to the crisis had taken place, Médecins Sans Frontières made the worrying discovery that there was little mental healthcare on offer.

Médecins Sans Frontières has put in place several mental health programmes for Palestinians and Lebanese living in and around the two largest refugee camps in Lebanon: Burj el-Barajneh in Beirut and Ein el-Hilweh in Saida. Over the past three years, more than 2,200 patients have benefited from free psychological care, provided through a multidisciplinary, community-based approach. In total, more than 15,500 free-of-charge psychological and psychiatric consultations have taken place.  

Why did Médecins Sans Frontières decide to start working in north Lebanon?

Recently, with thousands of Syrians – many of whom have physical wounds –fleeing the violence in their country and seeking refuge in Lebanon, we dispatched medical teams to evaluate their health status. This resulted in our setting up a new health programme in Wadi Khaled, in the north of Lebanon, in November 2011. We have been working in Lebanon for three years, and were therefore in a position to monitor closely the health situation for Syrians arriving in the country.

The support we are providing today is limited. Our first approach was to provide stocks of emergency supplies to health centres near the border with Syria. Besides mental health services, Médecins Sans Frontières is increasing its capacity in the area to respond to any further and significant influx of people from Syria by reinforcing epidemiological surveillance, vaccinations, chronic disease management and emergency medical equipment, while assessing further medical needs. The presence of an independent international medical organisation such as Médecins Sans Frontières also provides a guarantee of neutrality to those arriving from Syria.  

What is the humanitarian situation in northern Lebanon?

Most of the Syrians who fled their own country in need of medical care had to leave all their belongings behind. Even if the situation remains relatively stable in Lebanon, it is difficult to predict what will happen in Syria. As an emergency medical humanitarian organisation, we need to be prepared in case of a massive influx of people to the area. Our purpose is to guarantee medical care in the case of large numbers of wounded Syrians arriving fleeing violence.

What is the humanitarian and medical situation in Syria?

It is very hard for us to have a precise picture of the humanitarian and medical situation today in Syria and the magnitude of the needs to which we could respond. Based on our experience in Libya and Bahrain, and on stories from patients and doctors in Syria, the likely pattern is that the wounded cannot be treated in the public hospitals managed by government authorities where they may be especially vulnerable. Today the Syrian population is faced with enormous difficulties in accessing necessary levels of emergency medical care. It is essential that all parties demonstrate their respect for basic medical ethics, for the impartiality of medical facilities, for the day-to-day work of doctors and nurses, and for the safety of patients.

Médecins Sans Frontières remains committed to respond to the humanitarian needs in Syria and provide the required assistance to the Syrian population if and when access is finally granted. Médecins Sans Frontières remains very concerned that victims of the conflict may not be able to access medical care, and reiterates the right of Syrians to flee violence in search of refuge and medical assistance.

The family lives in Mayondo village, around 60 kilometres north of Kismayo, in an area that has been heavily affected by the ongoing crisis in Somalia. Two of Khalif’s brothers recently died because of complications arising from measles, and Khalif and his sister were also suffering the same disease. When one of Abshiro’s brothers, who lives in Kismayo, heard the bad news about his nephews deaths and illness, he hurried to Mayando to bring the two remaining sick kids to Médecins Sans Frontières’ therapeutic feeding centre for malnourished children in Kismayo.

Date: Wednesday 18th April

Time: 6.30pm

Venue:

Ernest and Marion Davis Library

Auckland City Hospital,
2 Park Rd,
Grafton,
Auckland

Map:

Date: Thursday, 12th April

Time: 6.30pm

Venue:

St David's Seminar Room

University of Otago,
364 Leith Walk,
Dunedin

27 January 2012 – Detainees in the Libyan city of Misrata are being tortured and denied urgent medical care, leading the international medical humanitarian organisation Médecins Sans Frontières to suspend its operations in detention centres in Misrata, Médecins Sans Frontières announced today.

Médecins Sans Frontières teams began working in Misrata’s detention centres in August 2011, to treat war-wounded detainees. Since then, the organisation’s doctors were increasingly confronted with patients who suffered injuries caused by torture during interrogation sessions. The interrogations were held outside the detention centres. In total, Médecins Sans Frontières treated 115 people who had torture-related wounds and reported all the cases to the relevant authorities in Misrata. Since January, several of the patients returned to interrogation centres have even been tortured again.

“Some officials have sought to exploit and obstruct our medical work,” said Médecins Sans Frontières General Director Christopher Stokes. “Patients were brought to us in the middle of interrogation for medical care, in order to make them fit for further interrogation. This is unacceptable. Our role is to provide medical care to war casualties and sick detainees, not to repeatedly treat the same patients between torture sessions.”

Médecins Sans Frontières medical teams were also asked to treat patients inside the interrogation centres, which was categorically refused by the organisation.

The most alarming case occurred on 3 January, when Médecins Sans Frontières doctors treated a group of 14 detainees returning from an interrogation centre located outside the detention facilities. Despite previous demands from Médecins Sans Frontières for the immediate end of torture, nine of the 14 detainees suffered numerous injuries and displayed obvious signs of torture.

The Médecins Sans Frontières team informed the National Army Security Service—the agency responsible for interrogations—that a number of patients needed to be transferred to hospitals for urgent and specialised care. All but one of the detainees were again deprived of essential medical care and were subjected to renewed interrogations and torture outside the detention centres.

After meeting with various authorities, Médecins Sans Frontières sent an official letter on 9 January to the Misrata Military Council, the Misrata Security Committee, the National Army Security Service, and the Misrata Local Civil Council, again demanding an immediate stop to any form of ill treatment of detainees.

“No concrete action has been taken,” said Stokes. “Instead, our team received four new torture cases. We have therefore come to the decision to suspend our medical activities in the detention centres.”

Médecins Sans Frontières has been present in Misrata since April 2011, in the midst of the Libyan conflict. Since August 2011, Médecins Sans Frontières has worked in Misrata’s detention centres, treating war wounded, performing surgeries, and providing orthopaedic follow-up care to people who had suffered bone fractures. The organisation’s medical teams have carried out 2,600 consultations, including 311 for violent trauma.

Médecins Sans Frontières will continue its mental health support activities in schools and health facilities in Misrata, as well as its assistance to 3,000 African migrants, refugees and internally displaced persons in and around Tripoli.

Médecins Sans Frontières is an international humanitarian medical organisation that has worked in Libya since 25 February 2011. To ensure the independence of its medical work, Médecins Sans Frontières relies solely on private donations to finance its activities in Libya and does not accept any funding from governments, donor agencies, or military or political groups.

For more information, please contact Sally McMillan on +61 447 482 379 or email sally.mcmillan@sydney.msf.org

Our village was one of the first to be attacked.  Three women, including me, ran with our children – my own 3 year old daughter and two of their boys 10 and 11 years old. We could only carry water with us for the children, no food, no clothes, nothing.

We ran and tried to hide in the high grass when we heard them approaching. But they heard my child crying so they found us three women and the three children. They abducted my child and slit the throats of the two boys in front of us. They told us three women to run – we ran 10m and they started shooting.

The other two women were killed right away. I was shot in the leg so I fell down. They came over to me and shot me in the head to make sure I was dead and left me there for dead. But the bullet just went through my cheek so I survived. I crawled to the river to take water and stayed there alone for seven days in much pain. I didn’t know where my family was or what had happened to my daughter, my only child.

On the eighth day I couldn’t stay there alone anymore so I used a stick to get up and walked for two hours until I came across neighbours who cared for me for 7 days. They told me that my mother was missing. Then they left me to inform my family where I was. I was alone again for two days. I crawled again to the river to take water. Then my husband’s brother found me and carried me for three days to Lekwongole. I couldn’t walk, I was so tired and it was very painful.

Then Médecins Sans Frontières returned to Lekwongole and drove me to Pibor. I found out the next day that my mother was not just missing, she was dead. I felt so lonely. My mother is dead yes but at least if my child was still with me I would be okay. But I’m not okay, I don’t even know what happened to my child.

From my family 10 people have been killed, four women and six men.  From my husband’s family 8 people have been killed.  They also abducted my sister’s son, who is 6 years old. It is very painful because my whole family has been killed. My only child has been taken – I feel so alone and it’s very painful.

For the future if I get something to work with then I will but only God knows. People are just stuck here with nothing now.

My name is Karel Janssens, I’m the field coordinator for Médecins Sans Frontières (MSF) in Pibor.

Here in Pibor county, MSF is providing healthcare in three health structures, three clinics, one in Pibor town, one in Lekwongole, and one in Gumruk. And those three facilities together provide the only access to healthcare for the 160,000 people who are living in Pibor county.

Our team here in Pibor was evacuated on 23 December when we knew about an imminent attack on Lekwongole and Pibor, and on Christmas Day Lekwongole was attacked and a couple of days later Pibor was attacked as well.

On 7 January the MSF team returned to Pibor and started medical activities again. I myself a couple of days later went to Lekwongole, that was 13 January, and found our clinic in the middle of Lekwongole town completely burnt out, the walls and the roof are still there, but all the rest of the clinic has been burnt, thrown out of the clinic, it’s a total mess. And Lekwongole town is a ghost town, it’s completely burnt to the ground, not a single tukul, not a single hut that is still standing. Stray dogs, some birds, some individuals wandering through that sinister landscape.

We decided to go back basically three days ago with a medical team, and so for the past three days we have been doing medical consultations for the people that are remaining around Lekwongole, because the people don’t dare yet to go back to Lekwongole town, to stay there, also because there is nothing anymore left, but also because they are just afraid of other attacks. People come from the surrounding bush for some food that they hope to get at the airstrip, and also now, since the three days that we are back there, for medical consultations.

One of our major constraints on restarting our activities is the fact that our South Sudanese staff is as much affected by the violence as the rest of the community here – we still miss 27 staff.

Three weeks after the attacks we still see patients with gunshot wounds, wounds people got by fleeing from the violence. But also a lot of malaria cases – almost half of the patients that we see have malaria. We see diarrhoea, respiratory infections, and of course that comes from the fact that people have been scattered in the bush, fleeing from the violence, and sleeping outdoors, not having mosquito nets, and so we see the consequences of that.

This was a major attack, here in Pibor County. I was myself on the road leading south of here, three days ago, and half of the villages that I saw were burnt out.

At the same time we have to say that this is not the first time that such an attack happens in Jonglei State. Last year we have had several attacks, here in Pibor County, but also in Pieri, an area north of Pibor. The teams there have had the same problems here, with the hospital being ransacked, evacuation, many wounded, many women and children being between the wounded. This is not the first time; this is a recurrent problem all over Jonglei State.

Since this interview was recorded, two of Médecins Sans Frontières’ missing staff have been located; 25 others remain unaccounted for.

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Many were injured in the bush, where thousands have remained, afraid to come out of hiding. Médecins Sans Frontières medical teams are now treating serious wound infections, some several weeks old. Since re-launching emergency medical activities in Pibor on 7th January Médecins Sans Frontières has treated 47 patients with gunshot wounds – 16 women and 8 children. A further 43 patients have so far been treated for stab wounds, beatings or wounds sustained while fleeing in the bush.

In the wake of the Pibor attack, Médecins Sans Frontières learned on 16th January the tragic news that Allan Rumchar, a Médecins Sans Frontières watchman, and his wife had been killed. Of 156 locally recruited staff, 25 are still unaccounted for, three weeks after the attack, and we remain extremely concerned for them.

The violence in Pibor is not isolated. After an 11th January attack on the village of Wek in northern Jonglei State, Médecins Sans Frontières evacuated by air 13 patients, the majority women and children, who needed urgent surgery to Médecins Sans Frontières’ hospital in Nasir. This follows an August 2011 attack on the town of Pieri and surrounding villages, during which scores of villagers were killed.  In the past six months, 185 seriously wounded patients have sought care from Médecins Sans Frontières teams in Lankien, Pieri and Yuai. “We are seeing a cycle of attacks and reprisals throughout this area of northern Jonglei,” said Médecins Sans Frontières Head of Mission Jose Hulsenbek. “For the civilians in this part of South Sudan, the fear of having to flee their homes or being killed is very real.”

“For the civilians in this part of South Sudan, the fear of having to flee their homes or being killed is very real.”

One recurring characteristic of the attacks in Jonglei is their extreme violence. One woman treated for a gunshot wound by Médecins Sans Frontières in Pibor said she had fled into the bush with her husband, children and 15 other family members. After running for eleven hours, they were found by a group of men who shot at them. “We scattered. They shot me in my thigh and my baby who was hanging on my back. I tried to hide in the high grass but they found me because my baby was crying. They started beating my daughter until she kept quiet. They left us behind thinking we were dead.” Her son was also treated by Médecins Sans Frontières for a bullet wound to the chest that remarkably left him alive.

“We scattered. They shot me in my thigh and my baby who was hanging on my back. I tried to hide in the high grass but they found me because my baby was crying. They started beating my daughter until she kept quiet. They left us behind thinking we were dead.”

Médecins Sans Frontières is extremely concerned for the health and well-being of civilians forced to flee, either from fighting or from fear of an attack. These people hide out in the bush, with no or minimal shelter, limited access to food and even more chance of becoming ill. They return, often to find only ashes where their home used to be.

Lekwongole, a village north of Pibor town where Médecins Sans Frontières runs a clinic, scarcely exists now, and all that remains of the Médecins Sans Frontières clinic is the concrete floor and walls.  Karel Janssens, Médecins Sans Frontières Project Coordinator, says “The people explained to me that during the day they dare to come out of hiding in search for food or to seek medical care, which Médecins Sans Frontières restarted on January 18th. But at night they return to their hiding places in the bush where they are at risk of contracting malaria or respiratory infections.” In Pibor, approximately half the consultations since 7th January have been for malaria, as people remain exposed when sleeping in the bush.

A deeply worrisome pattern is emerging, where people and their scarce resources are deliberately targeted by all the armed groups in this inter-communal violence. Hospitals, health clinics, water sources – these have become targets for armed groups on all sides, suggesting a tactic of depriving people of their basic life essentials just when they will need them most, after fleeing into the bush. Of greatest concern for Colette Gadenne, Médecins Sans Frontières Operations Coordinator for South Sudan, is the targeting of civilians themselves: “After these attacks many women and children are coming to us shot, stabbed, beaten. They try to keep safe by hiding in the bush, but it seems that even running away is not enough”.

“After these attacks many women and children are coming to us shot, stabbed, beaten. They try to keep safe by hiding in the bush, but it seems that even running away is not enough”

In a December 2009 report ,‘Facing up to Reality: Health crisis deepens as violence escalates in Southern Sudan’, Médecins Sans Frontières documented the escalation of inter-communal violence in Jonglei and Upper Nile States, and its increasing impact on civilian populations. Médecins Sans Frontières treated 392 patients wounded by violence that year, and estimated that 86,000 people were displaced. The situation has not improved. In the past six months, Médecins Sans Frontières has treated more than 250 patients wounded in violence in Jonglei State, the majority women and children.

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Médecins Sans Frontières has been working in South Sudan since 1983, currently in more than a dozen projects covering eight states.  The medical humanitarian organisation runs its own medical facilities or supports Ministry of Health facilities in six locations in Jonglei State, providing basic healthcare, therapeutic nutrition, kala azar and tuberculosis treatment, serving a total population of some 285,000 people. In 2011 the Médecins Sans Frontières medical facilities in Lekwongole, Pibor and Pieri were targeted and either destroyed or ransacked during inter-communal violence. Médecins Sans Frontières condemns the targeting of unarmed civilians and of medical assets by any group carrying weapons.