Last updated: 26 June 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 are running 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 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. We have expanded activities in São Paulo and are now treating people with mild COVID-19 at two isolation centres for vulnerable patients (homeless people, drug users and the elderly).
Screening and health promotion activities with the homeless have also started in Rio de Janeiro. We are also conducting street activities with homeless and vulnerable people.
In Manaus, in the country’s north, an MSF team is training local health professionals on infection and prevention control. We are also working at the public hospital 28 de Agosto, providing treatment to people in 12 ICU beds and 36 beds for moderate and severe cases of COVID-19. We are also running an isolation centre for migrant Venezuelan indigenous people with suspected COVID-19.
In Amazonias state, teams are working in the remote towns of São Gabriel da Cachoeira and Tefé, several hours by plane from Manaus. In Tefe we are treating people with moderate and severe COVID-19 cases at the town’s main hospital. In São Gabriel da Cachoeira, we are referring critical COVID-19 patients to Manaus and treating people with mild cases at a local medical centre.
In Boa Vista, in Roraima state, MSF staff are working in a COVID-dedicated field hospital, providing medical care. 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.
United States
In the United States, MSF has been partnering with local service organisations in New York to improve infection prevention and control (IPC) measures in facilities serving the homeless and housing insecure. Teams have been donating over 80 handwashing stations to key locations, including soup kitchens and supportive housing facilities in New York. MSF teams have opened shower trailers in Manhattan to give people who are currently homeless or housing insecure a place to bathe while public restrooms and facilities are closed due to COVID-19.
In Michigan, in the country’s northeast, staff and residents of nursing homes have been hit hard, accounting for a significant proportion of cases and deaths in the state. Our team is coordinating with the Michigan Department of Health and Human Services and the Detroit Health Department to quickly identify which nursing homes are in need of infection prevention and control measures. MSF teams offers three sets of activities to help protect residents and staff: assessments and general guidance to improve infection prevention and control practices, technical on-site support and training, and mental health workshops to address the high level of stress and grief that the frontline staff face every day.
In southwestern USA, especially in the states of New Mexico and Arizona, an MSF team is working with local officials, healthcare workers from the Navajo Nation and Pueblo peoples, and organisations that directly address needs related to COVID-19 in Native American communities. We are focusing on providing infection prevention and control technical guidance to healthcare facilities and communities, including to prisons and communal living facilities, such as nursing homes. We are also actively engaged with community leaders to increase access to health promotion and practical education.
MSF teams are on the ground assessing local needs and our capacity to offer support to organisations and health care providers serving vulnerable groups in Puerto Rico. MSF is distributing essential supplies, such as masks, face shields and hygiene kits to healthcare facilities and vulnerable groups of people on the island. We are also providing training on IPC measures to help essential workers, patients and others stay safe.
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.
Closed projects. In Immokalee, Florida, where approximately 15,000-20,0000 migrant farmworkers have been working during the pandemic with minimal access to healthcare and testing, we worked closely with Coalition of Immokalee Workers (CIW), the Department of Health and local organisations and healthcare providers. MSF ran a public health education campaign and mobile ‘virtual’ clinics, which provided COVID-19 testing and remote medical consultations for COVID-19 and other health issues. The clinics have been handed over to the Department of Health who will continue this work.
Africa
Mali
In Bamako, Mali’s capital, MSF is supporting the management of a COVID-19 unit within the grounds of Point G hospital, where we run our oncology programme. The unit includes a triage and isolation area, and a ward, where we are working to increase the capacity to up to 100 beds. We have renovated and improved the hospital’s oxygen distribution network. MSF is providing 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. 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. Cloth masks are also being produced and distributed to contacts of contacts in the community.
In the centre (Niono, Tenenkou, Ansongo, Douentza, Koro), south (Koutiala) and north (Kidal and Ansongo) of the country, our teams are conducting health promotion activities with local people, are training local staff and have established handwashing points at the referral hospital in Niono and surrounding health centres.
In Tominian, near the border with Burkina Faso, we have 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.
Cameroon
In Yaoundé, we have started receiving and treating patients with moderate COVID-19 in Djoungolo health centre, where we increased the capacity in building four rooms with 20 beds. Our teams have also improved IPC measures, triage, and staff and patient flow in the General hospital and we set up a systematic triage service at Jamot hospital.
MSF teams are setting up a 20-bed isolation ward in Buea regional hospital, western Cameroon, to treat people with the new coronavirus. Our staff are providing training for IPC measures and providing treatment to people with suspected or confirmed COVID-19 disease. We are also providing health promotion to local people on hygiene measures.
MSF is providing support to Bamenda Regional hospital – the referral centre for COVID-19 cases in northwest Cameroon – where our teams are training hospital staff on IPC measures and have installed a pre-screening tent at the entrance. We have also trained staff at the general hospital in Douala, Cameroon’s second-most affected city, and at two other hospitals in the area.
Teams are providing psychosocial support in Vitib, with the presence of two psychologists recruited by MSF. Two other psychologists have also been recruited to support Ivorian citizens repatriated from neighbouring countries and contact cases who are followed by the medical authorities.
Middle East and North Africa
Iraq
In Iraq, our teams are supporting Baghdad’s Ibn Al-Khatib hospital with improving infection prevention and control measures and providing training on PPE. Also in Baghdad, MSF has sent specialist ICU staff who have started providing on-the-job clinical coaching support in Al-Kindy hospital, another facility dedicated to treating COVID-19 patients in the city.
In Mosul, MSF has equipped a 50-room building in the MoH-run Al-Salam hospital complex to isolate patients. Another hospital located in the same complex, Al-Shifaa, was rebuilt by MSF in 2019 and is now being used as the main COVID-19 referral point for patients in Ninewa province. We are supporting Al-Shifaa by setting up 62 beds to treat people with mild and moderate cases; MSF is working in cooperation with local health authorities to treat the patients.
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.
Triage has started in Laylan IDP camp (Kirkuk province) and in Abbasi, Hawija province. MSF staff in Hawija are also undertaking disease surveillance, and are building two COVID-19 mobile hospitals, in caravans, with 10-bed capacity in each, to treat mild coronavirus cases.
Lebanon
In Zahle, central Lebanon, where MSF runs a paediatric ward in the Elias Hraoui Governmental hospital – now a COVID-19 referral hospital – our teams are supporting the hospital staff by setting up a COVIID-19 emergency room in tents outside the premises, and managing triage and screening of adults and children. We are also treating people suspected of having COVID-19 in the inpatient ward and the paediatric intensive care unit.
We have trained hospital staff in Hermel, Saida and Tripoli including on IPC measures, and have provided hospitals in these areas with logistical support.
MSF also launched a new pilot programme, consisting of training and assisting families in South Beirut and the Bekaa Valley with the practice of shielding. Shielding is a voluntary process that can provide additional protection to people at higher risk of contracting COVID-19, such as the elderly or people living with chronic diseases.
Meanwhile, a massive awareness campaign targeting frontline workers also took place in these two areas. MSF health promotion teams targeted people who are in daily contact with the community (such as taxi drivers, internal security forces, food distributors and waiters) to IPC measures, to avoid potential transmission of the virus when they do their work.
Closed projects
At the end of May, we launched a quick response unit in the Ras Al-Nabaa and Basta neighbourhoods in Beirut to support vulnerable people, where 70 people confirmed to have COVID-19 had been previously identified. MSF provided information to suspected and confirmed COVID-19 patients on their health condition, and also general health awareness sessions and mental health support. Over the course of 10 days, our teams took more than 200 swab samples of suspected cases in the Basta area for testing.
Asia
Hong Kong
In Hong Kong, where the outbreak is winding down and restrictions are being relaxed, we have shifted our focus to providing mental health support – via a website with tips and face-to-face sessions – for people caused by prolonged exposure to uncertainty.
Papua New Guinea
In Papua New Guinea staff in health facilities have received training on infection prevention control, and our teams have undertaken screening and triage of people with potential cases of COVID-19 in 22 provinces. Our teams have also set up a large facility for treating COVID-19 patients in the capital, Port Moresby.
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.
Europe
Italy
In Italy, which had been an epicentre of the pandemic, our teams continue to work in Rome, where we are undertaking health promotion and medical care through a clinic at Selam Palace, a building hosting more than 500 refugees, mostly coming from the Horn of Africa.
These activities have been expanded, reaching a network of informal settlements and reception centres for migrants in the southeastern suburbs of the city, in cooperation with health authorities and Médecins du Monde, and to home care services to protect fragile and marginalised communities from COVID-19, both Italians and foreigners. The dedicated phone helpline that has been set up to serve these communities are being staffed by doctors and intercultural mediators, who provide counselling, supports community health needs and helps identify and provide treatment advice for people with COVID-19.
In the Lombardy, Piedmont and Liguria regions, MSF teams are working in prisons, to protect detainees, prison and police officers. The MSF team includes doctors, nurses and hygiene experts, who are covering all measures to contain the spread of the virus and protect people inside the prisons. We have designed procedures which will identify suspected cases among new detainees, verify their diagnosis and identify the contacts of confirmed cases.
In Catania, on the island of Sicily, we are supporting the epidemiological surveillance service that is identifying and recording new cases, and tracing people’s contacts.
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.
Belgium
In Belgium, our teams are winding down their COVID-19 activities, with most projects 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.