Last updated: 5 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 a general overview of our activities and key concerns, click here; to read detailed information on our activities per country, scroll down to the list below.
(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.
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, where we provide outbreak monitoring and manage dedicated phone line with a doctor and an intercultural mediator providing counselling and assistance.
In the Lombardy, Piedmont and Liguria regions, MSF teams are working in prisons, to protect detainees, prison and police officers.
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.
France
In France, we are helping to detect people with, and provide care for, coronavirus COVID-19 among the most vulnerable populations in Paris and the surrounding region. Activities include mobile consultations and screening of vulnerable people, and support with diagnosis, isolation and patient care, in shelters.
MSF teams are working in some of these Paris shelters to evaluate their health and identify potential COVID-19 cases. Our teams are also working with homeless people living on the streets, evaluating people via a mobile clinic for COVID-19 and other illnesses. MSF teams in Marseille, in the south of France, are using mobile clinics to reach people living in extremely precarious situations, away from healthcare centres, and often without health insurance coverage.
We are providing support to nursing homes: teams are working in care homes across Paris and the suburbs, providing medical and psychological care assistance to residents, and psychosocial and IPC support to staff. Since the beginning of activities, we’ve reached over 30 nursing homes, and more than 2,000 elderly residents.
Closed projects
We had been running two COVID centres for homeless and migrant people infected with the new coronavirus – where they could self-isolate and where our teams provided some medical assistance – in Châtenay-Malabry and in Aulnay-sous-Bois, in Paris’s southwestern and northwestern suburbs, respectively. Both centres are now closed.
We had also been providing support to hospitals, including setting up inflatable tents to temporarily increase the ICU capacity at the hospital in Reims, east of Paris. In addition, 5 nurses, 5 assistant nurses, and 2 doctors had been in charge of managing a 10-bed care ward at Henri-Mondor hospital in Créteil, in Paris’s southeastern suburbs, to increase capacity treating patients with severe COVID-19 who were well enough to leave intensive care, but still required inpatient medical care. With the diminished number of people with COVID-19 in France, we have now ended our support to both hospitals.
In Marseille between mid-April and 31 May, we had conducted nearly 1,000 COVID-19 tests in support of two health centres in the city’s impoverished neighbourhoods. We have now handed over these activities.
A team from MSF Switzerland had crossed the border to assist nursing homes, providing advice on IPC and medical awareness to staff, in the French département of Haute-Savoie, southeast of Geneva, but this activity has now ended.
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.
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 40 isolation beds and 30 beds for treating people with mild and moderate cases; MSF will work in cooperation with local health authorities to treat the patients.
In Erbil, MSF has also been helping local health facilities by providing technical support, logistic 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.
On 23 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.
Cambodia
Staff in health facilities in three provinces in Cambodia – Pailin, Bantey Meanchey and Oddar Meanchey – have received training and technical support. MSF has also contributed to the development on national treatment protocols.
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.
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.
Americas
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.
MSF has also distributed 1,000 mobile phones to vulnerable New Yorkers who lack the essential technology needed to contact emergency and support services, including telemedicine providers. We’re also supporting New York City authorities in developing a webinar training on IPC practices.
In Immokalee, Florida, where approximately 15,000-20,0000 migrant farm workers have continued to work during the pandemic with minimal access to healthcare and testing, we are working closely with Coalition of Immokalee Workers (CIW), the Department of Health and local organisations and healthcare providers. MSF is running a public health education campaign and mobile ‘virtual’ clinics, which provide COVID-19 testing and remote medical consultations for COVID-19 and other health issues.
In southwestern USA, especially in New Mexico and the Navajo Nation, an MSF team is working with local officials, healthcare providers 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.
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.