Last updated: 3 February 2021
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
We started our first activities in our response to the COVID-19 pandemic in January 2020. As the new coronavirus spread, touching virtually every country in the world, MSF adapted or scaled up our ongoing activities and started new activities in many countries over the course of the first six months of 2020.
We committed substantial resources to developing dedicated COVID-19 projects, maintaining essential healthcare in our existing programmes, and accompanying ministries of health in preparing and/or facing the pandemic. This support was often in the form of training in infection prevention and control, health promotion and organisation of healthcare services.
In the second half of 2020, most of this training has concluded, and the greater part of our COVID-19-specific activities have been handed over or closed. Most COVID-19-related activities have been integrated in our regular projects, although we are maintaining some COVID-19-focused projects and, with the second wave of infections in some areas, some activities are re-opening or scaling up. Where we are doing so is very much dependent on the context: the local epidemiological situation, the local health needs, and our own resources.
It is still difficult to provide a global narrative on our operations, as the pandemic is affecting every country in the world, with different consequences, in different places. Therefore, our approach can also be very different from country to country or even from project to project.
Americas
Brazil
MSF teams in Brazil are working in the hard-hit and remote Amazonas province. In Tefé, we support the local 24-bed hospital, where we have donated in oxygen cylinders and oxygen concentrators. We are also providing tests to the local people. In São Gabriel da Cachoeira, we support the local infirmary and have increased the testing capacity of the municipality.
Teams are also working in Manaus, the province’s capital, where the coronavirus has caused the local health system to collapse, making the transfer of serious patients from smaller towns impossible.
We have also worked in São Paulo, Rio de Janeiro and in the states of Mato Grosso do Sul and Roraima.
Mexico
In Tijuana, far northwestern Mexico, an MSF doctor is supervising the installation and hiring of staff at the local general hospital, so that a new hospital floor can open for additional COVID-19 patients.
In the northeast, MSF is monitoring the flow of Mexicans repatriated and non-Mexican migrants deported from the US. We are also working with the Nuevo Laredo health authorities to provide adequate COVID-19 response to migrants.
A multidisciplinary COVID-19 intervention team (health promoter, psychologist, logistician, water and sanitation expert and IPC manager) is providing technical support, training and advocacy in decision-making on COVID-19 in migrant shelters along the Mexican migration route. This team also provides psychosocial support to migrants and staff with suspected or confirmed (or in contact with) COVID-19.
MSF teams have also responded to the pandemic in Oaxaca, Chiapas, Tabasco, Veracruz, Nuevo Léon, Coahuila, Tamaulipas, and Guerrero states.
Closed countries
Throughout the Americas, MSF teams have responded to the pandemic in: Argentina, Bolivia, Canada, Colombia, Ecuador, Haiti, Honduras, Peru, the United States, and Venezuela.
Africa
Burkina Faso
MSF teams in Ouagadougou, the capital of Burkina Faso, are working in the city’s COVID-19 treatment centre, at the request of the Ministry of Health (MoH). Teams are undertaking the follow-up of outpatients and health promotion activities in the community.
In Bobo-Dioulasso, in the country’s west, a team has been sent for six weeks to support to the local health authorities. We continue to follow up epidemiological situation throughout the country, as concerns remain high with the number of displaced people in the northern, north-central and eastern parts of the country. We have adapted triage and infection prevention and control measures in the health facilities we support, set up isolation units and trained staff in prevention and case management.
MSF teams had also been responding in Fada and Dafra.
Democratic Republic of Congo
In Kinshasa, the capital of Democratic Republic of Congo (DRC), we are supporting the Cliniques Universitaires de Kinshasa (CUK) – the Kinshasa University clinics – to treat people with moderate and severe cases in the CUK’s 40-bed COVID unit.
In addition, the MSF-supported Hospital of Kinshasa, dedicated to HIV/AIDS patients, has been equipped with isolation tents for people with suspect and confirmed cases and a reference system put in place. The same approach was implemented in Kasai province, in Kananga, where MSF supports the General Hospital with triage and donations to the hospital and health centres according to their needs.
MSF teams had also responded to the pandemic in North Kivu, South Kivu and Ituri provinces.
Middle East and North Africa
Iraq
In Iraq, our teams are supporting Al-Kindi hospital in Baghdad, where we are operating a 36-bed COVID-19 ward for severe and critical patients.
In Mosul, we have opened and are operating a 16-bed COVID-19 intensive care unit in the city, where we provide care to patients with severe symptoms of the disease.
In Sinuni, we provide care to people in a four-bed unit of Sinuni General Hospital dedicated to observing and stabilising suspected COVID-19 patients.
Elsewhere in Iraq, our teams had also responded in Erbil, Dohuk and in Laylan camp.
Jordan
MSF, in collaboration with the MoH of health in Jordan, and other organisations, has opened a dedicated 30-bed COVID-19 treatment centre in Zaatari refugee camp. We treat confirmed and suspect COVID-19 patients in the treatment centre; our care includes providing psychosocial support. In a dedicated ‘transition area’ of the camp, MSF teams also carry out daily screenings for asymptomatic COVID-19 patients (confirmed cases and/or people who were close contacts of cases), transferring patients in need of medical attention to our COVID- 19 treatment centre.
We had also partly converted our reconstructive surgery hospital in Amman to a 40-bed dedicated COVID-19 treatment centre; the treatment centre has now closed and reconverted back to surgical activities.
Asia
Afghanistan
In Herat, in northwestern Afghanistan, we are continuing activities in our 32-bed COVID-19 centre in Gazer Gah. Our screening and triage activities in Herat regional hospital continue and patients are being referred to other COVID-19 centres in case they show symptoms.
In Lashkar Gah, the team is referring people with suspected COVID-19 to the main COVID-19 hospital in Helmand province, Malika Suraya hospital. We are also treating COVID-19 patients with four identified risk factors: those with tuberculosis, surgical patients, children and pregnant women. In the city’s Boost hospital, we provide care to COVID-19 patients with comorbidities in a 30-bed ward.
In Kandahar, the team is supporting the designated inpatient facilities for the treatment of DR-TB patients infected with COVID-19 in the MSF DR-TB centre.
MSF teams had responded to the pandemic in a number of areas across Afghanistan, including in Khost, and Kabul.
Bangladesh
Teams in the Rohingya refugee camp in Cox’s Bazar, southeastern Bangladesh, are treating a number of patients who are COVID-19 positive, as well as monitoring others with suspected COVID-19, in isolation wards in our facilities in Cox’s Bazar. We are also undertaking health promotion activities among those in the camp and building two dedicated COVID-19 treatment centres.
In Kamrangirchar urban slum, in Dhaka, the country’s capital, MSF is focusing on providing health promotion about COVID-19 to residents. We are also supporting the local health facilities with IPC training.
Europe
Belgium
In Belgium, MSF teams are once again supporting nursing homes in Brussels, this time during the first phase of vaccination (from 5 January). We are undertaking health promotion and awareness-raising activities, both for residents and staff. We are also training staff for the implementation of the vaccination campaign. This is the third intervention MSF is carrying out in nursing homes in Belgium.
Since November 2020, in the centre of Brussels, we have been providing shelter and medical care to homeless patients who are COVID-19 positive or are likely to be COVID-19 positive. These vulnerable people are offered the opportunity to isolate themselves, to be medically monitored and referred for appropriate care, if needed. Since the shelter’s opening at Galia Hotel, more than 100 patients have been treated by MSF teams.
An outreach team also provides support to patients who are COVID-19 positive or likely to be COVID-19 positive, who are staying in unauthorised places (e.g. squats). MSF offers screening and medical follow-up in collaboration with two other NGOs. This team also provides health promotion, infection prevention and control, contact tracing and psychological support.
In Belgium, teams had also been working – especially in nursing homes – in Flanders and Wallonia.
France
In France, MSF has set up teams of doctors, nurses and psychologists to reduce the burden on the most vulnerable nursing homes and strengthen medical care – the teams are currently working in the Provence-Alpes-Cote d’Azur and Occitanie regions, in southeast and southwest of France, respectively.
This is in addition to our mental health support programme for nursing homes launched in July, which is currently focused on the Paris region. However, the programme will also be expanded to other regions of France in the coming weeks, depending on our capacities and the most pressing needs
In the Île-de-France region and Parisian suburbs, we have resumed screening people who are homeless and living in precarious settings for COVID-19. Our teams are doing this via mobile clinics, where they also provide general medical care.
In France, MSF teams have worked extensively in previous projects across Paris and the Île-de-France region, plus in Marseille, Reims, and in the département (administrative division) of Haute-Savoie, in the country’s southeast.
*Shielding consists of creating ‘green zones’, or safe zones, where individuals more susceptible to COVID-19 are kept protected from any potential source of infection. The areas where they stay can either be inside the household or in separate locations, in the neighbourhood. During the shielding phase, these people should have minimal physical interactions with their relatives and other community members.
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.