Last updated: 16 August 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.
Since the middle of 2020, this training has largely concluded. Most COVID-19-related activities have been integrated in our regular projects, although we are maintaining some COVID-19-focused projects. Over the last six months, our COVID-19-specific activities have been opened (or reopened) and closed as the second wave of infections determines the need to scale 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
With Brazil becoming the world’s COVID-19 epicentre, MSF teams keep their focus on the country’s north, where there’s a historical lack of material and human healthcare resources. In mid-March, we started activities in Rondonia’s capital, Porto Velho, with medical support and training in five emergency care units. Such facilities kept patients, from moderate to critical, for long periods, as overcrowded hospitals couldn’t accommodate them. In March, we started activities in the state’s second city, Ji-Paraná, where the local 75-bed COVID-19 facility were overcrowded, understaffed and poorly supplied.
We continue to provide mental health support for professionals from the biggest public hospital and one emergency care unit in Manaus, Amazonas.
Our teams also worked in the state of Bahia from June to August, where the teams gave trainings for health professionals in the cities of Xique-Xique, Cocos and Riachão das Neves. The trainings were focused on rapid testing, patient flux, IPC protocols and health promotion, with the objective of preparing the health system for a possible third wave of cases.
Mexico
In Mexico, the MSF team based in Tenosique has extended their COVID-19 prevention activities to a shelter in Salto de Agua (Chiapas) which is receiving 150 to 200 migrants per day. Teams in Reynosa and Matamoros are conducting health promotion activities.
MSF teams have also responded to the pandemic in Oaxaca, Chiapas, Tabasco, Veracruz, Nuevo Léon, Coahuila, Tamaulipas, and Guerrero states.
Peru
A severe second wave in Peru has led us to reopen activities. We are currently providing treatment for non-critical cases in an isolation centre in north Lima, as well as supporting the intensive care unit in nearby Huacho Hospital. We also provide community outreach to facilitate early detection of potential COVID-19 patients among people.
Venezuela
MSF is working with national authorities and hospital management at the Lídice hospital in Caracas to strengthen areas specially prepared for the care of patients with COVID-19. The plan includes rehabilitating facilities, training personnel and designing care pathways that will keep both patients and hospital staff safe.
Closed countries
Throughout the Americas, MSF teams have responded to the pandemic in: Argentina, Bolivia, Canada, Colombia, Ecuador, Haiti, Honduras, and the United States.
Africa
Côte d’Ivoire
In Côte d’Ivoire, MSF teams have restarted our telemedicine project in partnership with a local NGO following the start of a COVID-19 vaccination campaign launched in early March in Abidjan. The team is supporting this campaign by helping to diagnose illnesses that could lead to complications with COVID-19.
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, as a second wave sweeps through Baghdad, we have expanded the capacity of our COVID-19 centre in Al-Kindi hospital from 36 to 51 beds. We are treating only serious and critical cases and are constantly full, with people waiting in the emergency room for a bed to become free.
Iraq saw its highest-ever number of COVID-19 cases reported on 25 March – 6,513 – but even that number is likely to be largely underestimated. Only 386,000 doses of a vaccine have arrived in Iraq so far, a number barely sufficient to cover the country’s 216,000 doctors, nurses and paramedical staff.
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 Mosul, 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 undertaking screening and triage activities in Herat regional hospital.
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.
India
After activities in India were wound down in February, MSF teams are responding to COVID-19 once again following a massive surge in new cases. From mid-April, our teams in the M-East Ward of Mumbai have restarted shielding*, digital health promotion, and water and sanitation activities.
Meanwhile, our teams are undertaking screening and triage for tuberculosis patients at Shatabdi hospital and at the MSF independent clinic, both in Mumbai. MSF is preparing to support two units in the city, each with a 1,000-bed capacity, with medical and technical support, including with oxygen supplies. Five additional medical doctors and five nurses have been recruited to strengthen the response.
Europe
Belgium
Since 20 May, our mobile team in Belgium has been vaccinating homeless people, migrants and undocumented migrants in shelters and squats, who were previously excluded from the Belgian national vaccination system, in partnership with three other organisations and local authorities.
An outreach team provides support to people 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.
France
In France, we run mobile clinics in Paris, providing COVID-19 vaccinations, tests and referrals when needed as well as basic healthcare for homeless people and migrants. Our teams are also providing people with free vaccinations in emergency shelters, day centres and workers' hostels in the Ile-de-France region.
In France, MSF teams have worked extensively in previous projects – especially in nursing homes – across Paris and the Île-de-France region, plus in Marseille, Reims, the regions of Provence-Alpes-Cote d’Azur and Occitanie, and in the département of Haute-Savoie, in the country’s east.
*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.