In New York City, the early epicentre of the pandemic in the US, we provided showers, portable toilets, handwashing stations, hygiene kits and other essentials for people experiencing homelessness. We improved infection prevention and control measures in facilities for the homeless or housing insecure, and distributed mobile phones to help them stay connected to information about local services.

We set up mobile testing clinics in Immokalee, Florida, for migrant farmworkers, a community at high risk of contracting COVID-19. We also ran a public health education programme in partnership with a local human rights group.   

In Detroit, Michigan, and Houston, Texas, where COVID-19 devastated nursing homes and long-term care facilities, we offered support to help protect residents and staff, including assessment and guidance to improve infection prevention and control practices, and technical on-site assistance and training. We also ran mental health workshops for staff.

In Native American communities in Navajo Nation and Pueblos in the southwest ─ neglected by the federal government and lacking access to clean water, electricity and passable roads ─ MSF provided infection prevention and control training, and logistical and technical medical support in partnership with local groups.

Puerto Rico continues to grapple with the health impacts of devastating hurricanes in 2017 and experienced a series of powerful earthquakes in 2020. We began a home-based care programme for people on the island with chronic conditions unable to access health services during the pandemic. We provided COVID-19 monitoring for people isolated at home and prepared thousands of hygiene kits for those experiencing homelessness or living in remote communities.

We supported hospitals and care facilities by distributing personal protective equipment, conducting infection prevention and control training, and running health education programmes. We handed the programme over to Puerto Rico Salud, a new organisation established by several Puerto Rican MSF staff.