Conflict

 

Angola, 9 September 1999. MSF/Hans-Juergen Burkard

In war zones, MSF does not take sides. We provide medical care based on needs alone, and work hard to try and reach the people who need help most. If warring parties see aid organisations as being on one side of a conflict, we are less likely to gain access to those in need and more likely to be attacked.

One of the ways in which we are able to demonstrate our independence to warring parties is to ensure that all our funding for work in conflicts comes from private individuals – we do not accept government grants.

People caught up in armed conflict may be subject to harassment, displacement, violent attacks, rape or murder. In such situations comprehensive medical and humanitarian support is vital, but health services are often scarce.

When hospitals and clinics are destroyed or overwhelmed, MSF provides healthcare and support. Teams set up operating theatres, clinics, public hygiene assistance, nutrition programmes, epidemic control and mental health services to people displaced by fighting or living in conflict zones.

Immediate response

Conflicts, be they international wars or internal disputes, can have many consequences.

Fear of violence or persecution uproots entire communities and, for those who stay, many are often left without access to medical care. 

Conflicts normally lead to a rise in trauma injuries, but also lead to problems for people needing normal medical care, such as for complications with pregnancy or chronic diseases such as diabetes. 

Psychological distress and mental illnesses also generally rise. Sexual violence is sadly all too common in conflicts too.

We try to fill these gaps with highly experienced doctors, nurses and logisticians who provide specialised medical care and logistical support.

Intense violence

During times of intense violence, our teams often have to work with a great deal of flexibility. In 2011, with ongoing violence engulfing medical facilities in Misrata, Libya, an MSF team had to find a way to safely and quickly evacuate a large number of severely wounded patients from the city.

The team chartered a fast passenger ferry, stripping it of its seats so that plastic sheeting and mattresses could be laid and IV lines set up. “The violence caused an influx of wounded people and it was fortunate we could be there and get them onboard,” said Helmy Mekaoui, an MSF doctor who coordinated the medical evacuation.

Despite the rough seas, the boat safely arrived in Tunisia the following day with 20 ambulances waiting to take the 71 patients to hospital.

MSF logistician, Annas Alamudi, said: “As far as I’m concerned, it was a successful operation and I’m glad we could help. There were sick people who needed to get out, and we got them out. Job done.”

Highly experienced staff

Working in a warzone can be an extremely frightening, stressful and disturbing experience. Because of this, we only allow highly trained and experienced staff who have volunteered themselves to work in such situations.

Paul McMaster, a British surgeon who has worked extensively with MSF, still finds high security missions challenging.

After returning from a mission in Syria where he treated the wounded in an operating theatre set up in a cave, he said: “I've worked in many difficult places with MSF – war zones like Sri Lanka, Ivory Coast and Somalia – but while in those countries it was dangerous on the ground, in Syria the danger always comes from the air.

“It’s a much more oppressive type of danger, having a helicopter hovering in the sky above you.”

Security

Although we accept that it is impossible to exclude our staff from every form of risk, we do our utmost to manage them through our strict security measures.

Before starting a new project, and throughout its run, we are continually assessing risks. Each field mission has specific and detailed safety regulations in place, outlining strategies and specific security measures and responsibilities.

Among these regulations, MSF holds a strict ‘no-weapons’ policy in all of our clinics, vehicles and health centres. For the safety of our staff and patients, it is crucial that no armed people are in our hospitals. Naturally we will treat fighters who need medical help, whatever side they are on, but they and their colleagues must leave their weapons outside. The presence of anyone who is armed heightens the chances of our facility becoming a target of violence.

Sort by:

Updates
On Wednesday 13 June, forces loyal to President Hadi, backed by the Saudi and Emirati-led...
Updates
Article
More than half of Idlib’s population of roughly two million people are displaced. MSF has been...
Crisis Update
Hundreds of thousands of people remain heavily dependent on humanitarian aid for survival. Any...
Press release
"Our request is to provide medical assistance... our actions are based on the needs of patients...
Gallery
Since December 2017 the international coalition led by Saudi Arabia and the United Arab Emirates...
Article
"The people of the Central African Republic seem very much trapped in an endless cycle of...
Article
"Lots of the patients were in a state of shock. They hadn’t expected such a level of violence."
Statement
"The Israeli army must stop its disproportionate use of force against Palestinians protestors."
Press release
“Some of the patients were suffering from head trauma. Others had shrapnel wounds in their legs...
Statement
A team working for MSF were victims of a violent armed robbery on Tuesday 24 April.
Article
Michael Shek is an MSF nurse from Dumfries, Scotland. He worked in MSF’s trauma stabilisation unit...
Press release
“Half of the more than 500 patients we have admitted in our clinics have injuries where the bullet...
Article
“Given the violence that people have lived through, many would be expected to experience post-...
Testimony
More than two decades since the 1994 genocide, Rwandan fieldworkers tell us about the experiences...
Testimony
Sébastien Jagla, MSF project coordinator in the north of Democratic Republic of Congo, describes...

Pages