Last updated: 15 October 2020
Highlights of our COVID-19 response activities can be found in the interactive map below; click on a country to read brief information.
To read detailed information on our activities per country, scroll down to the list below, or click on the regions on the menu to the left.
(Note: neither map nor detailed activities list below are exhaustive of all of our COVID-19 response.)
MSF response to coronavirus disease COVID-19
It is clear that healthcare workers need support and patients need care. Given the size of this pandemic, MSF’s ability to respond on the scale required will be limited.
Americas
Brazil
In São Paulo, Brazil, we have opened an eight-bed intensive care unit at Tide Setubal hospital in the city’s east and are providing care to people from the neighbourhood and those from outside São Paulo. Our teams are also undertaking outreach for active case finding and contact tracing of those people who have been admitted to the ICU. MSF teams are also running health promotion activities in the neighbourhood’s slum districts, and are developing health promotion activities, in addition to installing handwashing points and distributing hygiene kits to residents, in partnership with local leaders.
In the state of Mato Grosso do Sul, in Brazil’s south west, we are running mobile clinics in indigenous areas near the towns of Aquidauana and Anastacio, and in the Aquidauana urban area; we are also supporting the activities at the local hospital in Aquidauana.
In Boa Vista, in Roraima state, MSF staff are working in a COVID-dedicated field hospital, providing medical care in an ICU and ward treating people with moderate and severe cases. Our team has also visited informal shelters where migrants and refugees from Venezuela have gathered, providing hygiene and physical distancing guidance to residents. We have assisted in expanding access to water in formal and informal shelter and has distributed hygiene kits.
Closed projects
In Rio de Janeiro, we undertook screening and health promotion activities with the homeless and vulnerable people.
In Manaus, in the country’s north, an MSF team trained local health professionals on infection and prevention control. We worked at the public hospital 28 de Agosto, and provided treatment to people in ICU beds and in a ward for moderate and severe cases of COVID-19. We also ran an isolation centre for migrant Venezuelan indigenous people with suspected COVID-19.
In São Paulo, MSF teams ran medical activities at two isolation centres with a total of 140 beds, for vulnerable patients (homeless people, drug users and the elderly) with mild COVID-19. Teams worked 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 ran a mobile triage clinic in the downtown area.
In Amazonias state, teams worked in the remote towns of São Gabriel da Cachoeira and Tefé, several hours by plane from Manaus. In Tefe, we provided training at the town’s main hospital and undertook epidemiological surveillance in rural villages. In São Gabriel da Cachoeira, we ran a 10-bed ward where we treated people with moderate cases of COVID-19.
Haiti
MSF has reorganised the Emergency Centre in the Martissant neighbourhood of Port-au-Prince, Haiti's capital, 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 have also visited the Chancrelles hospital in Port-au-Prince’s Cité Soleil district, in order to support them in implementing IPC measures including triage and isolation.
Our teams are carrying out health promotion activities in communities all over the country, via mass media such as radio and social networks but also through training of health workers and community leaders, and in health institutions.
Closed projects
In Port-au-Prince’s Drouillard area, we had converted our burns hospital to a field hospital to treat COVID-19 patients; we screened over 330 people and treated nearly 200 for COVID-19 before the centre closed at the beginning of August, and reconverted back to our burns hospital.
In Haiti’s south, MSF supported severa; public health facilities across Port-à-Piment and Port Salut for the set-up of triage systems, isolation beds, referral systems and training of medical staff.
In Les Cayes, also in the country’s south, our team set up a triage and an isolation unit in the departmental referral hospital. Medical staff have been trained on early detection of suspected cases and IPC standards. Support staff, such as hygienists, health officers, have been trained in IPC standards and in the maintenance of the water and sanitation infrastructure installed by MSF.
Africa
Central African Republic
In Central African Republic, teams are working with people living with HIV in four outpatient treatment centres across Bangui, benefiting 9,000 people, on the practice of shielding.
Also in Bangui, our teams are supporting the MoH with surveillance activities, including contact tracing and sample collection. We continue our engagement with the communities to explain what COVID-19 is and work together to promote and adapt prevention measures to their daily realities.
Closed projects. MSF built a COVID-19 treatment centre in Bangui, with a capacity of 24 beds, but given the low number of severe cases, the centre did not open; it remains ready to be used.
Mali
In Bamako, Mali’s capital, MSF is supporting the Hôpital du Mali, improving triage, patient and staff flows and the isolation of the COVID-19 treatment centre. We are also helping with IPC, staff training, and revising patient flow in two other hospitals in Bamako which are receiving COVID-19 patients. We are reinforcing the MoH’s community outreach and contact tracing activities in communities in the city, and in connection with these activities, MSF has set up handwashing stations and provided locally-produced cloth masks and soaps. More than 800 community health workers have been trained, 50 handwashing facilities installed, 20,000 soap and 40,000 masks were distributed.
In the centre (Ségou, Niono, Tenenkou, Ansongo, Douentza, Koro), south (Koutiala) and north (Kidal and Ansongo) of the country, our teams are strengthening hygiene and IPC measures and have set up isolation areas in the supported hospitals and health centres, and training local staff. We also support MoH activities such as case management, raising awareness among people, improving prevention and setting up isolation structures for patients. are conducting health promotion activities with local people, are and have established handwashing points at the referral hospital in Niono and surrounding health centres.
Our teams are now responding to COVID-19 in Timbuktu, where MSF is conducting home-based care, contact tracing, patients testing and IPC promotion within the community.
Closed projects
MSF supported the management of a 100-bed COVID-19 unit within the grounds of Point G hospital, in Bamako, where we run our oncology programme. The unit includes a triage and isolation area, and a ward. We renovated and improved the hospital’s oxygen distribution network. MSF provided the COVID unit with medical, nursing and hygiene control staff, some coming from our regular project in Koutiala, as well as logistical and technical support. By the time we handed over the unit exclusively to the MoH at the end of August, 436 patients had been admitted, with 270 people cured. We also engaged on COVID-19 related health promotion/sensitisation with local organisations, health workers and members of civil society organisations
In Tominian, near the border with Burkina Faso, we installed a tent for isolating people suspected of having COVID-19, and a handwashing point.
In Mopti, MSF implemented patient flow and provided training to staff where a case was confirmed. Training was also done for 45 medical staff from the Gao region.
Middle East and North Africa
Yemen
In Yemen, in Haydan and Khamer, we have set up COVID-19 treatment centres to take care of moderate cases and have begun admitting small numbers of patients with symptoms that resemble those of COVID-19.
In Hajjah Governorate, teams have been working in Abs and Al-Jamhouri hospitals, including setting-up screening points in both hospitals and establishing a 11-bed capacity isolation unit in Abs hospital. We have also improved IPC measures and provided training to MoH staff on COVID-19 symptoms and case definition, treatment, and IPC measures. MSF teams are also supporting referrals of patients from Al-Jamhouri hospital to an isolation centre at Al-Rahadi, as well as the triage area of the centre.
In Sana’a, we are supporting two hospitals. At Al-Kuwait hospital, we are treating people with severe cases of COVID-19 in the 15-bed intensive care unit, as well as running the large inpatient department.
In Ibb governorate, we support local authorities to run the Al-Sahul COVID-19 centre which has been receiving patients since June. The centre has 18 intensive care unit beds and 70 inpatient beds, and MSF is providing medication and medical supplies, including PPE. Our staff are providing coaching support to the centre’s staff, and we have put in place IPC measures, assisting with technical support, triage and screening, facility management including workforce planning, and waste management. Teams also provide training on health promotion for MoH staff and private carers.
We are conducting training on, and have implemented, IPC measures, in hospitals across Taiz Houban and Taiz city. Our teams are undertaking triage, screening and identification for potential cases at the hospital in Taiz city.
MSF teams continue to put in place all IPC measures, setting-up screening and triage, and identification for potential cases in Al-Salakhana hospital and Ad Dahi rural hospital, in Hodeidah.
Closed projects
In Aden, our treatment activities at Al-Amal hospital had been transferred to the MSF-run COVID-19 treatment centre at the city’s Al-Gamhuriah hospital; in light of the reduction of cases and admissions, our activities at Al-Gamhuriah were subsequently handed over to local authorities.
In Sana’a, MSF has handed over our activities at Sheikh Zayyed hospital to the local health authorities.
In Hodeidah, MSF teams conducted training in various districts across the governorate. In addition, our teams also assisted to set up an isolation unit in Al-Salakhana hospital and supported the isolation centre with supplies of drugs and PPE.
Iraq
In Iraq, our teams have been supporting Al-Kindi hospital in Baghdad, which is the epicentre of the pandemic in the country. MSF teams are working in the hospital’s respiratory care unit by providing training for hospital staff on treatment for COVID-19, administering ventilation and conducting disinfection procedures.
In Mosul, we have temporarily transformed our post-operative care centre into a COVID-19 facility. Our teams work in collaboration with local health authorities to provide treatment to people with mild and moderate COVID-19 cases. Over 860 patients have been admitted in the facility since the beginning of the pandemic.
In Erbil and Dohuk, MSF has been helping local health facilities in both cities by providing technical support, logistics support and training for their staff on infection prevention and control.
In Laylan camp, Kirkuk governorate, our teams are triaging people for suspected cases of the new coronavirus. We have mobilised a 20-bed isolation and treatment facility, and are providing health promotion messages to communities on IPC measures. Using digital tools, other health promotion campaigns are being run targeting people in the city of Mosul, and in the area around Sinjar.
Asia
Hong Kong
In Hong Kong, the COVID-19 outbreak has lasted since the end of January. Given the prolonged crisis and exposure to uncertainty, which can cause stress and anxiety, our teams have conducted workshops on how to manage this for vulnerable people. We have also created a website for the general public which offers tips and tools to cope with stress and worry; https://howareyou.msf.hk/en/.
As Hong Kong is currently facing its most severe local outbreak since July, MSF has extended its COVID-19 emergency response from health education activities to providing emergency shelter and basic medical consultations to the homeless people. The Hong Kong’s homeless are particularly affected by the closure of publicly accessible facilities and suspension of services by local service providers or organisations. Our emergency team is working with Impact HK, a local NGO, that has been supporting the homeless for some years already. The teams visit the homeless people twice a week in various streets of Hong Kong. Apart from distributing food, drinking water and hygiene kits, our caseworkers also follow up on individuals’ needs. Since June, the team has conducted 25 medical consultations and has arranged temporary shelter for 15 vulnerable individuals.
Malaysia
In Penang, in Malaysia’s northwest, we are providing health education in different languages for vulnerable people, including Rohingya and Burmese, and translations in hospitals. We have started a COVID-19 health promotion campaign for Rohingya refugees via an online Rohingya news network. We’re also providing health kits and hygiene items, such as soap, to people in immigration detention centres.
Europe
Italy
In Italy, which had been an epicentre of the pandemic, our teams continue to work in Rome, where we working in informal settlements and squats. In these settlements, we aim to strengthen COVID-19 surveillance among marginalised urban communities through the creation of COVID community health committees.
We are training the committees on improving infection prevention and control measures in their structures and communities, and on identifying suspect cases and how to alert the authorities and medical staff through COVID-19 kits. A dedicated phone helpline has been set up to serve these communities are being staffed by doctors and intercultural mediators, who provide counselling, and supports community health needs.
On the island of Sicily, we are providing training on IPC measures and on health promotion to civil society working in the most marginalised and vulnerable areas of Palermo.
Closed projects
In the Lombardy region, in the country’s north, the original epicentre of the outbreak, we supported three hospitals with infection prevention and control (IPC) measures, as well as provided care to patients. We also undertook outreach activities in order to reach vulnerable people, such as the elderly in nearly 20 nursing homes, and local organisations working with homeless and migrants. We also supported a telemedicine programme (medical assistance via video conference), which assisted people under isolation at home.
We had also been working in one of the most affected regions, the Marche region in central eastern Italy, where we are supported 30 nursing homes across several cities to prevent the virus spreading in such vulnerable locations.
In the Lombardy, Piedmont and Liguria regions, MSF teams had worked in 15 prisons, to protect detainees, prison and police officers. The MSF team included doctors, nurses and hygiene experts, who implemented measures to contain the spread of the virus and protect people inside the prisons. We designed procedures which will identify suspected cases among new detainees, verify their diagnosis and identify the contacts of confirmed cases.
On Sicily, our team supported epidemiological surveillance service in Catania and Enna provinces.
Belgium
In Belgium, most projects have now closed. However, an outreach team continues its IPC and contact tracing activities in shelters for vulnerable migrants and homeless people in Brussels.
Closed projects
Mobile teams were supporting nursing homes for the elderly and reached 115 homes across Brussels, Flanders, and Wallonia. Support included psychological counselling and webinars for staff, and assessing residents for potential coronavirus cases. MSF established a 150-bed medical facility for vulnerable people, including migrants and refugees, in Brussels’ Tour & Taxis area. The facility, in which we also provided medical care for COVID-19, allowed people to isolate.
MSF teams had been supporting 10 hospitals to increase their admission capacity and on IPC measures. Support included providing technical and strategic advice, plus operating post-intensive care units.
Protecting people living in precarious conditions
Of particular concern is how coronavirus COVID-19 might affect people in precarious environments, such as the homeless, refugees living in camps in Greece or Bangladesh, or conflict-affected populations in Yemen or Syria. These people live under harsh, often unhygienic and overcrowded conditions, where their access to healthcare is already compromised.
How can we ask people to protect themselves when they don’t have easy access to water? Or to stay at home and self-isolate if they rely on daily jobs to make ends meet, or share a room with 10 other people? Nonetheless, it is very important to inform people of protective measures (such as washing their hands often) and help ensure they have the means to protect themselves (including self-isolation in case of contact with a person infected with COVID-19).
If COVID-19 starts to be transmitted in fragile settings like these, it will be practically impossible to contain. Basic health screening and, ideally, decentralised testing for high-risk settings such as refugee camps (Cox’s Bazaar in Bangladesh or on the Greek islands, for example) or high-density slum dwellings (Kibera in Kenya or Khayelitsha) needs to be implemented immediately.
Keeping healthcare workers safe
Protecting healthcare workers from contracting the virus is paramount for ensuring the continuity of care for general and COVID-19-related health needs. However, global shortages of personal protective equipment (PPE) pose a great threat. Healthcare workers must have access to the equipment they need to do their jobs safely and effectively.
As research and development is underway to find effective treatment for coronavirus COVID-19, we are closely tracking the trials and evidence concerning the potential medicines in the pipeline.
Any drugs, tests and vaccines for COVID-19 should be made available to all those who need them. It is crucial that governments prepare to suspend or override patents for COVID-19 medical tools by issuing compulsory licences. Removing patents and other barriers will be essential in helping ensure that suppliers can sell tests and treatments at prices everyone can afford.
Challenges in ensuring continuous care in MSF projects
We want to ensure continuous care for all patients where we work today and prepare our medical teams to manage potential cases of COVID-19. Protecting patients and healthcare workers is essential, so our medical teams are also preparing for potential cases of coronavirus disease COVID-19 in our projects. This means ensuring infection prevention and control measures are in place, including setting up screening at triage zones, creating isolation areas, and providing health education.
Our projects are still able to continue medical activities, but ascertaining future supplies of certain key items, such as surgical masks, swabs, gloves and chemicals for diagnosis of COVID-19, is a concern. There is also a risk of supply shortages for other diseases due to a lack of production of generic drugs and difficulties to import essential drugs (such as antibiotics, antimalarial and antiretroviral drugs), caused by community lockdowns, reduced production of active pharmaceutical ingredients, and reduction in export movements.
We face additional challenges because travel restrictions linked to COVID-19 are limiting our ability to move staff between different countries. We are trying to find ways to manage this, to avoid heavily impacting projects needing specialist profiles, such as surgeons. However, international staff represent just eight per cent of our total global workforce, so most MSF projects are run by locally hired team members.