MSF teams are directly responding to the COVID-19 pandemic in over 40 countries worldwide.

Our COVID-19 response focuses on three main priorities:

• supporting authorities to provide care for COVID-19 patients;
• protecting people who are vulnerable and at risk;
• and keeping essential medical services running.

Across our projects, MSF teams have been improving infection prevention and control measures to protect patients and staff, and prevent further spread of the new coronavirus. It is absolutely crucial to prevent health facilities from amplifying the pandemic or being forced to close their doors.

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.

On the ground, around the world, our emergency teams are experts at fighting epidemics. With your support, we will help beat the new coronavirus pandemic.

DONATE TO OUR COVID-19 APPEAL

Where is MSF responding?

Information as of 16 August 2021

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.

Cameroon

Activities closed. In Yaoundé, the capital of Cameroon, our teams treated patients with moderate COVID-19 in Djoungolo hospital; MSF teams had worked to increase the hospital’s capacity in building four rooms with 20 beds each, for a total capacity of 110 beds. Between late April and the end of August, 328 people had received treatment. Also in Yaoundé, our teams 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 ran community information sessions in Cité Verte, as well as follow-up home visits for moderate cases and referrals to a dedicated hospital for the most severe cases. We also supported patient tracing and epidemiological surveillance in this district.

MSF’s research and epidemiologic branch, Epicentre, carried out operational research activities on the effectiveness of screening tests, in partnership with the national emergency operations centre.

In the southwest, MSF teams set up a 20-bed isolation ward in Buea regional hospital to treat people with the new coronavirus. Our staff provided training for IPC measures and treated people with suspected or confirmed COVID-19 disease; we also supported the hospital with oxygen supplies and other logistics equipment.  In the local community, we provided health promotion to people on hygiene measures. In the same region, our teams constructed a 38-bed isolation unit at Tiko District hospital and a 16-bed isolation unit was constructed at the Presbyterian General hospital in Kumba.  

MSF teams trained hospital staff at Bamenda Regional hospital on IPC measures and installed a pre-screening tent at the entrance. We also trained staff at the general hospital in Douala, Cameroon’s second-most affected city, and at two other hospitals in the area.

Teams provided psychosocial support in Vitib, with the presence of two psychologists recruited by MSF. Two other psychologists were recruited to support Ivorian citizens repatriated from neighbouring countries and contact cases who were followed by the medical authorities.

In both Northwest and Southwest regions, we strengthened health promotion measures at community level, especially targeting people affected and displaced by violence, using community health workers and nurses, as well as radio messages. Community health workers informed their communities on COVID-19 using communication materials and tools our teams equipped them with.

In the Far North, we had set up triage and isolation circuits in nine health centres in the city of Maroua and constructed an 8-bed isolation ward in the district hospital of Mora.

Central African Republic

Activities closed. In Central African Republic, teams worked with people living with HIV in four outpatient treatment centres across Bangui, benefiting 9,000 people, on the practice of shielding.* A similar strategy, which included the distribution of soap and masks, providing food support and awareness raising sessions, was implemented in Paoua and Carnot, and targeted around 4,000 patients and their families.
Also in Bangui, our teams supported the MoH with surveillance activities, including contact tracing and sample collection. We engaged with the communities to explain what COVID-19 is and work together to promote and adapt prevention measures to their daily realities.

MSF built a COVID-19 treatment centre in Bangui, with a capacity of 24 beds, but given the low number of severe cases, the centre did not open; it remains ready to be used.

*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.

Chad

Activities closed

In Chad, MSF teams worked in Farcha hospital, in the capital, N’Djamena, where people with severe cases of COVID-19 are being cared for. We provided clinical training to the staff, reinforced lab and testing capacity, and installed an oxygen generator. With the low number of severe cases, our support was no longer needed. Also in N’Djamena, our teams supported laboratory activities at central level to draw up biosecurity procedures.

Elsewhere in N’Djamena, we provided support for surveillance, contact tracing, and home-based care for people with mild forms of the disease. We also undertook health promotion and community engagement, including with marginalised groups who have less access to health information such as nomadic people on the outskirts of the city. We strengthened IPC measures across communities, including having installed handwashing stations.
 

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.

Ethiopia

In Gambella region, Ethiopia, MSF has set up a 20-bed COVID-19 isolation centre and another one with a capacity of 10 beds in two camps for South Sudanese refugees (Kule and Tierkidi). In Gambella town, a team provides support to the COVID-19 triage and temporary isolation centre in Gambella hospital.

Since May, a team in Addis Ababa has been providing mental health support in to more than 5,000 migrants who returned mainly from Saudi Arabia, Kuwait and Lebanon, and are placed in three COVID-19 quarantine centres in the capital. MSF is supporting the MoH’s medical and non-medical staff who work in the quarantine centres by training them on migrants’ mental health needs.

Our teams support the regional health authorities in our different project locations in Amhara and Somali Region in their isolation and treatment centres and with health education.

Eswatini

In Eswatini we implement a home-based care approach, where patients with comorbidities are visited at home to ensure continuity of care. This team is being trained on critical care in preparation of the anticipated third wave.    

Guinea

Activities closed

In Guinea, MSF teams provided care for 350 COVID-19 patients with mild symptoms of the disease but who need hospitalization in the Nongo Epidemic Treatment Centre, in the capital, Conakry. We had set up this structure in 2015 as part of our response to the Ebola epidemic, before handing it over to the authorities, and in April 2020, we had rehabilitated the structure, so it is now a 75-bed COVID-19 isolation and treatment unit with the capacity to provide oxygen therapy. Both the structure and our treatment activities were handed over in August.

Our teams also disinfected the homes of patients admitted to hospital, provided psychosocial support, and traced and followed up on patients’ contacts. In Kouroussa, Guinea, we established an 8-bed isolation ward at the Hopital Préfectoral de Kouroussa.

Guinea-Bissau

Activities closed. In Bissau, the capital of Guinea-Bissau, we provided different training at the National hospital Siamo Mendes including on the treatment of people with COVID-19, on IPC measures, water and sanitation improvement, and provided support with hygienists on waste management.

Kenya

In the coastal city of Mombasa, in eastern Kenya, MSF is training MoH staff working in two new facilities currently being set up by the county’s Department of Health. Training is focusing on infection prevention and control, treatment and support in health promotion and other community engagement where needed.

In the city of Homa Bay, in the country’s southwest, the county isolation centres are either closed or insufficiently equipped to treat people with symptoms and underlying conditions in the increasing number of patients. We are setting up a COVID-19 high dependency unit (HDU) within the county’s referral hospital, to treat people with moderate to severe cases of COVID-19. Some of these patients come from the adult inpatient wards we already support as part of our regular activities. The HDU is in addition to our ongoing support of COVID-19 screening and suspect case management at the referral hospital.

MSF teams in Kenya had also responded to COVID-19 in Embu, Nairobi, Kiambu, Dadaab and Mombasa counties.

Liberia

In Liberia, our teams are undertaking health promotion activities on prevention measures in and around Monrovia, the capital.

Malawi

In Malawi, MSF is providing staff, oxygen and technical support to Queen Elizabeth Hospital in Blantyre.

MSF has also responded in Neno, Dedza and Nsanje districts.

Mali

Across Mali, we continue to strengthen outpatient activities, such as improving dedicated COVID-19 patient flow and triage areas in health centres, medical follow up of COVID-19 positive patients at home, and raising awareness in communities.

In Timbuktu, we are supporting COVID-19 screening activities in the Centre de Santé de Référence with a five-person team.

MSF teams had also responded by treating patients in Bamako.

Mozambique

In Mozambique, we have scaled up our national response following an increase in cases. In Maputo, we set up two tents able to accommodate 16 people with moderate or severe symptoms in Mavalane Hospital. We installed GeneXpert machines to improve testing and diagnosis and provided technical support for the organisation of the new COVID-19 treatment centre and IPC training to local front-line health workers.

In Montepuez, we continue to support the local hospital, setting up pre-triage points there and in three health centres. We’re also providing training for health staff to open a COVID-19 treatment centre.

We assist the MoH in Beira with triage in two health facilities and at Central Hospital. We are also supporting the isolation centre with 20 beds and are providing IPC and treatment training to MoH front-line health workers. The capacity of health staff was also scaled up with one doctor, five nurses, six health promoters and 14 cleaners.

MSF teams in Mozambique had also responded to COVID-19 in Pemba.

Niger

COVID-19 remains active in Niamey, the capital of Niger, as well as in all other major cities of the country. MSF is supporting with logistics and human resources in Lamordé hospital in Niamey, where people with moderate cases are treated.

We are also supporting health centres in Magaria, Dungass and Tillaberi with water and sanitation activities, distributing masks, organising the triage of patients, and helping the investigation and response team. We are also treating COVID-19 patients in our facilities in Diffa and Agadez.

We continue epidemiological surveillance and community awareness.

MSF teams in Niger also worked on the COVID-19 response in Zinder, Maradi and Madarounfa.

Nigeria

In Ebonyi state, southeastern Nigeria, we are supporting the MoH and Nigerian disease control centre with testing, in the state’s first COVID-19 testing centre, and are currently supporting the re-opening of a 25-bed MoH facility in preparation for a second wave of COVID-19 in the state.

Our teams have set-up isolation units in Gwoza and Pulka where suspected and confirmed cases of COVID-19 are treated. The capacity of the unit has been reduced to five beds in each facility. In Ngala, where cases have been confirmed for the first time in mid-February, we have increased epidemiological surveillance and started to run IPC and health promotion activities.

Across Nigeria, we have responded in Ngala, Sokoto, Gwoza, Pulka, Maiduguri, Benue, and Zamfara.

Senegal

Activities closed. In Dakar, the capital of Senegal, we supported the treatment of people with moderate and severe cases of COVID-19 in the Hospital Dalal Jamm. Here we also provided training as well as support for water and sanitation activities, and simplified triage protocols.

We provided support in Guediawaye district, in Dakar’s northern suburbs. Our teams supported the MoH on community engagement, case surveillance, testing mechanisms and improving IPC measures and continuity of care.

Sierra Leone

Activities closed. In Sierra Leone, MSF was part of the national emergency preparedness task force and MSF epidemiologists provided support with contact tracing and surveillance. We provided health promotion to local people and supported improved IPC in MoH basic healthcare units.

In slum areas of Freetown, Sierra Leone’s capital, we worked with community health workers to identify the poorest families in the slum and provide them with a small hygiene kit of soap and buckets with a tap, and masks for the adults. Community health workers distributed large COVID-19 banners and also put up COVID-19 posters we donated about social distancing, how to wear a mask, and proper hand hygiene to distribute in other slum areas and key areas within Freetown.

In Kenema district, we adapted and rehabilitated a Lassa Fever isolation unit at Kenema government hospital to become a 25-bed COVID-19 treatment centre.

In Freetown, MSF water and sanitation and construction specialists repurposed a government facility into a 120-bed COVID-19 treatment centre, and carried out PPE training for around 140 workers. In Makeni Regional hospital, Magburaka hospital and Hinistas Community health centre, our teams set up isolation wards.

Somalia and Somaliland

We are providing health promotion to communities and technical advice or logistic support to set up isolation structures in some places; teams are screening people at the entrances to hospitals. In Somaliland, we are training members of the MoH rapid response teams on prevention of COVID-19.

Our teams in the country have also worked in Hargeisa, Galcayo, Las Anod and Baidoa.

South Africa

With a new local variant of the coronavirus, which saw the number of cases surge and hospitals in South Africa become overwhelmed, MSF teams returned to working in hospitals in the country starting in November. A team of 20 MSF doctors and nurses are responding in Livingstone Tertiary Hospital and Elizabeth Mamisa Chabula-Nxiweni Field Hospital, both in Port Elizabeth.

MSF medical staff are also boosting response capacity in Lenteguer Field Hospital, Western Cape province and in Ngwelezane Hospital, KwaZulu-Natal province. In KwaZulu-Natal, we are also supporting basic-level healthcare facilities, and community support activities covering health promotion and shielding* of patients.

In addition to previous projects in KwaZulu-Natal and Western Cape provinces, MSF teams had also worked in Johannesburg, and in Gauteng and North West provinces.

South Sudan

In South Sudan’s capital city, Juba, MSF teams are providing technical support to the MoH, the National Public Health Laboratory with a laboratory supervisor, and Juba Teaching hospital, with water and sanitation measures, donations and IPC training.

Outside of Juba, four MSF facilities in Agok, Bentiu, Lankien and Malakal Protection of Civilian sites run COVID-19 testing.  

In addition, in all projects across the country we continue to isolate and treat patients with suspected or confirmed COVID-19, although the numbers of confirmed patients remain low. We also continue to support and implement preventive measures, including screening and reinforcing IPC, awareness-raising and health promotion, and training.

MSF teams had previously responded to the coronavirus in Yei, Old Fangak, and in Doro refugee camp in Maban.

Sudan

In Khartoum, Sudan’s capital, we are supporting four main public hospitals to strengthen their screening and triage system and the isolation areas. The objective is to protect or reopen lifesaving services and to reinstate confidence among health workers.

We are conducting a seroprevalence survey in Omdurman, just over the Nile River from Khartoum, and are discussing with MoH to begin a home-based support system for COVID-19 patients, covering the same area.

Our teams are also supporting the MoH to manage isolation centres in East Darfur and South Kordofan states.

Tanzania

In Tanzania, our health promotion team in Nduta refugee camp, is undertaking health promotion activities, raising awareness among the community on hygiene and best health practices. MSF has built four triage/isolation areas at each of our health clinics at Nduta refugee camp, and a main isolation centre at our hospital, with a 100-bed capacity, where people suspected of having COVID-19 are referred.

Uganda

Uganda has experienced three waves of COVID-19. The most affected district remains the capital Kampala but other districts are also heavily affected such as Arua and Mbarara. The situation is very worrying in Kampala with shortages of oxygen supply and understaffed units. MSF intervenes at the level of the two structures of Entebbe and Arua with the organization and supervision of COVID-19 Treatment Units (CTUs), the provision of human resources, and the supply of oxygen and consumables (PPE and drugs).

Zimbabwe

We are supporting Parirenyatwa Hospital Isolation Centre, Zimbabwe’s main referral site for COVID-19 cases in Harare, to help them prepare for the next potential surge in COVID-19 infections. We work towards improving infection prevention and control (IPC) measures, improve patient flow and tackle shortages of PPE, essential medicines and medical supplies. Additionally, MSF has recruited and sent medical staff to support the hospital.

MSF is also supporting a second COVID-19 isolation centre, the Wilkins Hospital in Harare.

In Zimbabwe, we had also conducted activities in Beitbridge, on the border with South Africa.

Americas

Argentina

Activities Closed. In Argentina, MSF offered technical support and advice to health authorities in the provinces of Buenos Aires and Córdoba. We helped to design protocols, circuits and infection prevention and control measures in health structures, alternative treatment structures, and nursing homes. In Córdoba, we provided technical support to the province’s Emergency Operations Committee working group for enclosed structures (which includes nursing homes, haemodialysis units and prisons), and participated in training the staff.

In Buenos Aires, we collaborated with the secretariats in charge of the response to COVID-19 in the city’s vulnerable neighbourhoods on possible intervention strategies, definition of priorities, and in the trainings. Overall, MSF teams provided direct training (in-person and online) to more than 550 people who work with some of the most at-risk groups: staff from nursing homes, organisations for people with disabilities, homes for children and adolescents, and community representatives from vulnerable neighbourhoods. MSF also worked with the National Penitentiary Office, providing advice on general aspects of the disease, prevention measures in detention centres, psychosocial aspects and promotion of mental health. Activities in Argentina ended in July.

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.

Bolivia

Activities closed. A team assessed needs in the Beni region, a rural Amazonia-basin area in the northeast of Bolivia. Our activities focused on training on IPC measures and medical training in six COVID-19 centres covering five municipalities. MSF also donated PPE and medicines.

Canada

Activities closed

In Canada, we used our expertise in emergency outbreak response to provide valuable guidance to medical organisations, government agencies and remote Indigenous communities on how to prevent and manage COVID-19 outbreaks. Teams created and shared two e-briefings related to COVID-19; one on infection prevention and control (IPC) and another on adapting and developing medical facilities.

MSF facilitated experienced field staff in Canada to join other front-line organisations. MSF teams conducted several IPC assessments in shelters in Toronto for people experiencing homelessness and long-term care facilities in Montreal, providing recommendations to improve staff and residents’ overall safety. After three months of activities, all MSF COVID-19 projects in Canada had closed by 15 July.

Colombia

Activities closed. Our teams supported patients with respiratory symptoms at Tibú hospital, in Colombia’s north. In Buenaventura, we adapted and expanded our psychological care Line #335 for the early identification of potential patients with symptoms of COVID-19.

In Arauca, we provided technical advice to hospitals and mental health support to medical staff. MSF teams also engaged people on health promotion and IPC activities in towns, villages and neighbourhoods throughout the northeast, through different community strategies and the media.  

MSF worked closely with health authorities in Norte de Santander and Tumaco to support the local response. We participated in outpatient triage and supporting the area for patients with respiratory symptoms at the Tibú hospital. In Tumaco, we carried out medical and mental health activities in the two public hospitals in the city. In each of these places, we also focused a large part of our efforts on promotion and prevention activities in towns, villages and neighbourhoods through different community strategies and the media.

We deployed a small technical team, the Flying COVID Team, which supported local hospitals in Atlantico, one of the regions most affected by COVID-19. The team’s work, which was supporting Erasmo Meoz Hospital in Cúcuta, focused on rapid assessment, technical training, mental health care for health staff, and donations of medicines and supplies to help health facilities keep COVID-19 services safe at the peak of the outbreak.

Ecuador

Activities closed. In Ecuador’s capital, Quito, MSF supported health centres, in the wake of a launch of a testing campaign, in the follow-up on positive tests. We also provided training and support for IPC, health promotion and mental health to mobile teams and to health posts.

In the city’s Temporary Attention Centre, we provided palliative care and trained staff in this field; the initiative was a pioneering project for the country.

MSF teams also provided on-site support and training on IPC, mental health and health promotion in nursing homes and shelters for homeless people across the country.

In the Guayaquil region, which was the first area in Ecuador to be hit hard by COVID-19, a small team assisted health centres and nursing/care homes with infection prevention and control measures. An MSF team worked in the coastal Esmeraldas Province in the northwest. All projects in Ecuador had been handed over or ended by October.

Haiti

Activities closed. In Port-au-Prince, Haiti’s capital, MSF reorganised our Emergency Centre in the Martissant neighbourhood of Port-au-Prince to isolate and refer COVID-19 suspect cases. In city’s Drouillard area, we had converted our burns hospital to a field hospital to treat COVID-19 patients; we screened over 330 people and treated nearly 200 for COVID-19 before the centre closed at the beginning of August, and reconverted back to our burns hospital. Our teams also visited the Chancrelles hospital in Port-au-Prince’s Cité Soleil district, and supported them in implementing IPC measures, including triage and isolation.  

MSF teams carried out health promotion activities in communities all over the country, via mass media such as radio and social networks but also through training health workers and community leaders, and in health institutions.

In Haiti’s south, MSF supported several public health facilities across Port-à-Piment and Port Salut for the set-up of triage systems, isolation beds, referral systems and training of medical staff.

In Les Cayes, also in the country’s south, our team set up a triage and an isolation unit in the departmental referral hospital. Medical staff were trained on early detection of suspected cases and IPC standards. Support staff, such as hygienists and health officers, were trained in IPC standards and in the maintenance of the water and sanitation infrastructure installed by MSF. Our activities in Haiti ended in August.

Honduras

Activities closed. In Tegucigalpa, the capital of Honduras, MSF provided medical care in an adapted centre for severe COVID-19 patients, to help the metropolitan health system to keep the hospitals from overcrowding. We also provided mental health, social work and health promotion activities; all activities had come to an end by mid-October.

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.

PAEC-LAT Project

Activities closed. MSF developed the PAEC-LAT (‘Proyecto de Asesoramiento Estratégico ante el COVID-19 en Latinoamérica’, or Strategic Advisory Project for COVID-19 in Latin America) project, as a way to overcome the restrictions for face-to-face work and staff movements. We created a free online strategic and technical support service aimed at institutions and staff that are at the frontline of the pandemic in Latin America. This innovative digital solution took advantage of the possibilities of virtual visits and online trainings to reach multiple countries, regions and different audiences, including health professionals, administrative staff, cleaning staff, community agents and indigenous health teams, mainly in remote communities and areas with limited access to healthcare services.

Between May and November, PAEC-LAT responded to more than 1,500 requests from health personnel working against COVID-19 in 14 countries in the region (Mexico, Guatemala, Honduras, Nicaragua, Costa Rica, Colombia, Venezuela, Peru, Uruguay, Argentina, Chile, Ecuador, Bolivia and Puerto Rico), and conducted 130 trainings and 35 virtual visits followed by recommendations reports.

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.

United States

Activities closed. In the United States, MSF worked in key sites around the country with local authorities and partner organisations serving vulnerable communities who often lack access to healthcare. Our teams also helped residents and staff at long-term healthcare facilities reduce and stop the spread of the coronavirus. The last of our activities in the US ended on 15 October.

Our response in the US started in New York in March. During our activities, we donated over 160 handwashing stations to key locations, including soup kitchens and supportive housing facilities in the city. We 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. MSF teams opened a shower trailer in Manhattan to give people who are homeless or housing insecure a place to bathe while public restrooms and facilities are closed due to COVID-19. We also supported New York City authorities with webinar training on IPC practices.  

MSF teams worked in nursing homes across the country, including in Michigan and in Texas. In Michigan, in the country’s northeast, our team worked in nursing homes which needed assistance, including 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. Our activities in Michigan came to a close at the end of July. Starting in August, two MSF teams, comprised of nurses and a wellness specialist, worked in nursing homes across Texas. Each team conducted in-person IPC trainings and created tailored IPC action plans for both medical and non-medical staff. They also provided technical support and wellness sessions to staff and residents. Our support to facilities in Texas ended in mid-October.

On the island of Puerto Rico, MSF teams worked across the island, in and around San Juan, or travelled to remote areas in the east, west, south and the third-largest island, Vieques. Teams distributed essential supplies, such as masks, face shields and hygiene kits to healthcare facilities and vulnerable groups of people on the island. We also provided training on IPC measures. We collaborated with local partners on the island and provided primary care consultations in homes and at ‘pop-up’ clinics to people suffering from chronic health conditions who had been unable to or fearful of going to health care facilities due to COVID-19. The team also monitored the symptoms of COVID-19 patients or people who tested positive, but were asymptomatic.

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.

In southwestern USA, especially in the states of New Mexico and Arizona, an MSF team worked 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 provided infection prevention and control technical guidance to healthcare facilities and communities, including to prisons and communal living facilities, such as nursing homes.

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.

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.

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.

Cambodia

Activities closed. MSF provided staff in health facilities in three provinces in Cambodia – Pailin, Bantey Meanchey and Oddar Meanchey – with training and technical support, which included implementing triage infrastructure in six hospitals bordering Thailand. More than 300 staff members of the Ministry of Health were trained on the new guidelines and protocols concerning COVID-19, among them ambulance drivers, cleaners, laboratory technicians, doctors and nurses, on IPC measures and the treatment of people with suspected or confirmed cases of COVID-19. MSF also contributed to the development on national treatment protocols.

China

Activities closed

Hong Kong

Activities closed. One of the first activities in MSF’s global COVID-19 response was in Hong Kong, when at the end of January, we started providing face-to-face, and later virtual, health promotion sessions with vulnerable people less likely to be able to access information, such as refugees, and those on the front line, such as street cleaners.

Given the prolonged crisis and exposure to uncertainty in the city-state, which can cause stress and anxiety, our teams focused on managing people’s mental health and conducted workshops on how to manage stress and anxiety for vulnerable people. We also created a website for the general public which offers tips and tools to cope with stress and worry; https://howareyou.msf.hk/en/.

Our emergency team had been working with Impact HK, a local NGO, that has been supporting the homeless for some years. Our teams visited homeless people twice a week in various streets of Hong Kong, and distributed food, drinking water and hygiene kits; our caseworkers also followed up on individuals’ needs. Between June and when the project was handed over in mid-September, the team conducted 51 free medical consultations and arranged temporary shelter for 35 vulnerable individuals.

Our activities in Hong Kong had ended by November.

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 in Mumbai, Maharashtra

MSF restarts emergency response amid a surging second wave of COVID-19 in Mumbai in Maharashtra state.  Our teams are actively identifying cases, conducting screening and appropriate triage for infection prevention and control for TB/DR-TB patients at Shatabdi hospital and the MSF independent clinic. Patients coinfected with COVID-19 and tuberculosis are being referred for inpatient management and treatment to Sewri hospital. MSF is further providing prevention kits, counseling and phone follow-up to high risk patients, including TB/DR-TB, Diabetes melitus patients and the elderly. To ensure continuity of care, MSF continues to support four health centers in MEW.

As of Saturday, April 17, MSF started shielding, digital health promotion, water and sanitation activities in the M-East Ward (MEW) of Mumbai. Activities will be further extended to five more health facilities.

MSF is supporting two units within a Jumbo hospital in Mumbai. The divisions include two sets of tents with about 1000 intensive care unit bed capacity in each. Additional medical doctors and nurses have been recruited to strengthen the response.

MSF continues to provide medical and technical support with oxygen supplies and therapy.

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Our teams in Patna, Bihar state, eastern India, provided health promotion, mental health, and psychological first aid activities to healthcare workers in government hospitals across the state. Community health promotion and education activities are also taking place in the area.  

In Mumbai, teams provided training and are screening in TB projects. We also undertook a digital health promotion campaign through Facebook in the city’s M-East Ward, with messages focusing on COVID-19 prevention and the reduction of stigma within the community.

Indonesia

In Indonesia, MSF teams are conducting workshops and training of trainers for doctors and community health workers in Jakarta, who treat suspected COVID-19 cases and those observing home-isolation. Training sessions are on topics including IPC measures, contact tracing and health promotion.

MSF provides COVID-19 mental health and psychosocial support activities in Banten province and in Jakarta.

MSF teams in Indonesia had also responded to the pandemic in the West Java province.

Japan

Activities closed. An outbreak of COVID-19 among crew members on a cruise ship docked for repairs in Nagasaki, in western Japan, led to 149 out of 623 staff on board testing positive for the new coronavirus. MSF sent a team of one doctor and two nurses to provide onshore medical assistance. The team assessed patients and assisted with referrals to further health facilities, depending on patients’ condition and the urgency of medical care. In Suginami, a district of Tokyo, MSF teams provided epidemiological analysis, supporting local health authorities.

Kyrgyzstan

In Kyrgyzstan, we are working closely with the MoH in Chuy and Batken oblasts (provinces), where teams provide home-based care for moderate and mild COVID-19 patients to prevent hospitals from being overwhelmed.

Our teams are also supporting health centres in Kadamjay raion (district) to reinforce COVID-19 preparedness measures, while offering technical advice, providing logistics assistance, supporting health promotion initiatives, and assisting in epidemiological surveillance through data collection.

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. We have started a COVID-19 health promotion campaign for Rohingya refugees via an online Rohingya news network. We’re also providing health kits and hygiene items, such as soap, to people in immigration detention centres.

Nepal

Activities closed. In Nepal, MSF staff operated a 24/7 mental health telephone hotline in Nepali, an extension of the same service our teams operated in India.

Pakistan

In Balochistan province, northern Pakistan, MSF staff are facilitating COVID-19 sample deliveries to Quetta. In Karachi, we are undertaking digital health promotion activities within Machar Colony Community to debunk myths and raise awareness.

We are also conducting extensive awareness-raising activities on ways for people to protect themselves and prevent spreading the virus, and we have added protective COVID-19 measures and isolation areas in most of the facilities we support across Pakistan.

Across Pakistan, MSF teams also responded in Timergara.

Papua New Guinea

Since early March, the number of confirmed infections in Papua New Guinea has tripled to 3,500. This outbreak includes a large number of healthcare workers as well as other key groups of concern, such as incarcerated people and people working in closed settings including mine sites. Around one-third of MSF staff working in the tuberculosis projects have tested positive, limiting our response capacity for the regular programme, as well as response to the outbreak of COVID-19. MSF is currently finalizing the plans to support a makeshift 43-bed COVID-19 treatment facility in Rita Flynn hospital in Port Morseby.

MSF is also supporting the Rita Flynn hospital with one lab technician and cartridges to analyse samples of PCR tests for SARS-CoV-2 infections.

Philippines

Activities closed. In Manila, capital of the Philippines, the MSF team supported our partner organisation Likhaan with health promotion activities. Teams also supported with contact tracing and COVID-19 prevention activities at the community level, plus helped to implement IPC measures in the health facilities that were caring for COVID-19 patients.

In Marawi, a “mobile information drive” to passes health promotion messages to vulnerable people and the team trained the local health teams in 60 of the 72 communities in charge of COVID-19 surveillance and contact tracing.

In Manila between early July and mid-August, MSF teams distributed ‘quarantine kits’ – including hygiene materials – to 726 COVID-19 patients and contacts.

In June, we started supporting the COVID-19 ward and the hospital laboratory at San Lazaro hospital, in Manila, with human resources, PPE, biomed equipment and pharmacy. Following a decrease in the number of cases, we ended our activities at the hospital at the end of October.

Tajikistan

In Tajikistan, we have developed a tuberculosis+COVID health education leaflet and shared the document with the health ministry to ensure accurate information is disseminated. In Dushanbe, we are working with TB patients, their families and their communities to explain how to prevent the transmission and infection of COVID-19.

At the Republican Centre TB dispensary, we are developing improved triage protocols and patient flow, and offering health promotion for people awaiting their consultation.

Uzbekistan

In Karakalpakstan, in Uzbekistan’s west, we have started a health promotion campaign aimed at TB patients on how to prevent contracting COVID-19. Additionally, we coordinate with the MoH for the treatment of patients co-infected with COVID-19 and TB.

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.

Czech Republic

Activities closed. In November, MSF started a small project in nursing homes in the Czech Republic, in partnership with the Ministry of Labour and Social Affairs. Even though the staff of these facilities was not obliged to have a formal medical education, they were on the front line of the COVID-19 response, treating one of the most vulnerable groups. In the first-ever MSF intervention in the country, two small mobile teams provided assessments and training on IPC measures in nursing homes.

Working in facilities in the regions of Plzensky, South Moravian, Zlinsky and Central Bohemian, all located outside the country’s capital, Prague, the teams visited almost 40 nursing homes in the first three weeks. Our teams provided training either on-site or through a Czech version of a website developed by MSF’s Barcelona section for their similar activities earlier this year – https://msfcovid19.org/. We also received requests to provide support from other regions as well. 

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.

Germany

Activities closed. In Germany, MSF advised organisations, volunteer groups and state institutions working with the homeless, migrants and other vulnerable groups on IPC measures, to enable them to continue their services; this support had finished by the end of June.

Until early May, an MSF team had supported the authorities in the federal state of Saxony-Anhalt in a centre for asylum seekers in the city of Halberstadt, in which hundreds of inhabitants were under quarantine, with health education activities and psychological support.

Greece

In Athens, our teams are collaborating with the 3rd Clinic of Internal Medicine of Athens University (NKUA-EKPA) by providing psychological support to frontline health workers, COVID-19 patients and their relatives.

In Greece, our teams had been responding to COVID-19 on the islands of Samos and Lesbos; the latter via a COVID-19 isolation centre in Moria refugee camp, which we were forced to close after being issued with fines and the threat of criminal charges by local authorities.

Italy

In Italy, which had been an early epicentre of the pandemic, our teams continue to work in Rome, where we are working in informal settlements and squats, where we have been tasked by local health authorities to manage contact tracing and isolation for COVID-19 clusters in 10 buildings. In these settlements, we aim to strengthen COVID-19 surveillance among marginalised urban communities – who include migrants, refugees, and some Italian nationals – through the creation of COVID community health and hygiene surveillance committees. We are training the committees on improving infection prevention and control measures in their structures and communities, and on identifying and temporarily isolating people with suspect cases, and how to alert the authorities and medical staff.

On the island of Sicily, the outbreak is growing exponentially in the city of Palermo, where we continue our activities in four centres hosting migrants and marginalised Italians. An MSF team continues to undertake health promotion and IPC activities in many official Migrant Reception Centres in the city, where there are new COVID-19 cases.

MSF teams have worked extensively in Italy, including in the Lombardy, Marche, Piedmont and Liguria regions.

Norway

Activities closed. In Norway, MSF provided strategic advice and IPC support to a hospital close to Oslo which was located in one of the main clusters of cases in the country.

The Netherlands

Activities closed. In the Netherlands, we provided mental health support to frontline workers. This included a short video with a highly experienced and well-known MSF clinical and health psychologist which had been widely shared in hospitals and nursing homes across the country.

Portugal

In Portugal, our teams are providing health promotion in areas of in Lisbon and Vale do Tejo which have a majority of people of Roma and African descent.

We also provide training on digital health promotion and provide donations of IPC materials and hygiene kits, including masks, soap, bleach, and hydroalcoholic gel.

Russia

In Russia, MSF is distributing information leaflets on TB and COVID-19 which we developed to multidrug-resistant and extensively drug-resistant TB patients in Arkhangelsk region, in the country’s north. MSF teams are distributing food and hygiene packages during the patient visits.

In addition, are partnering with two community-based NGOs in Moscow and St Petersburg to support vulnerable people, where PPE (masks, gloves and hydroalcoholic gel) have been distributed with information materials developed on COVID-19, TB and HIV. MSF is also providing training on COVID-19 for these organisations.

Spain

Activities closed. Elderly and aged care homes have been hit particularly hard in Spain, and we focused many of our activities on aged care homes. Our teams worked in more than 300 aged care homes with a wide range of activities, including supporting management teams and authorities, implementing emergency measures to separate COVID-positive or symptomatic residents from the rest, supporting disinfection, and training of staff in IPC and risk mitigation. We worked with steering committees that manage aged care homes, to help protect the elderly through patient care and infection prevention and control measures. These activities were undertaken in Madrid, the Catalonia region (including Barcelona), the Basque country, Castilla y Leon, in Andalucia, Tarragona, Palencia and Asturias.

MSF had set up two health units to support hospitals around Madrid, with a total capacity of 200 beds. The units received patients with moderate cases, helping decongest the hospitals’ emergency and intensive care services, and were run by hospital staff, while our teams are provided them with logistical and infection prevention and control advice to protect healthcare workers and patients.

MSF also advised hospitals on staff and patient flow to manage infection control in Barcelona and the Catalonia region.

All MSF COVID-19 operations in Spain had ended, closed or been handed over by 22 May.

Switzerland

In Switzerland, MSF is working in collaboration with the health authorities and charities in the cantons (states) of Geneva and Vaud and in neighbouring Haute-Savoie, France, where we are caring for vulnerable people and the elderly in nursing homes.

MSF teams in Switzerland responded to the pandemic in a number of different projects across cantons Geneva, Vaud and Jura.

Ukraine

In Ukraine, MSF is supporting the Ministry of Health to respond to COVID-19 in Donetsk and Zhytomyr regions. In Mariinka raion (district), Donetsk region, two mobile teams provide home-based care for people with mild coronavirus symptoms, in order to prevent health structures from being overwhelmed.

At Central District Hospital in Krasnogorívka, MSF is supporting health authorities in establishing an isolation ward for patients with moderate symptoms by providing 22 oxygen points, technical support to reinforce triage and patient screening, conducting refresher training for health workers on treatment and infection prevention and control (IPC). We are also undertaking screening and isolation activities, plus waste management, in four health facilities and a nursing home. Training and psychological support is also being provided to healthcare workers in Zhytomyr region.

In Donetsk and Zhytomyr regions, MSF is also providing psychological support through telephone hotlines for health workers, COVID-19 patients and their relatives.

United Kingdom

Activities closed. In the United Kingdom, our staff are provided nursing and logistics support at the London COVID CARE Centre, in partnership with the University College London Hospital Find & Treat team. The project provided rapid testing, accommodation in which to self-isolate, and medical care for homeless people with suspected or confirmed COVID-19; with the decline in new cases, MSF staff ended their support on 8 June.

Middle East and North Africa

Iran

Activities closed.

In Iran, MSF had reached an agreement with authorities to provide care for patients with COVID-19 in the city of Isfahan. We had flown over cargo, including an inflatable hospital, and staff, and were preparing to start activities, before authorities unexpectedly revoked permission.

After the Iranian Ministry of Health rescinded the approval for our intervention in Isfahan, MSF was asked to participate in the response dedicated to foreign nationals in the northeast of the country. A team went to assess the possibility of setting up our inflatable medical unit in places located between Mashhad and the Afghan border, but after discussion with local authorities, it appeared there was no location in this area where our medical unit could be sent in support of an existing medical facility, as planned in the original design of our intervention.

In early April, when it became clear that we would not launch activities to respond to the COVID-19 outbreak in Iran, the international team who had arrived to start activities left the country. In mid-June, the inflatable medical unit and the medical supplies which we had sent to Tehran for the response were shipped to Afghanistan. They are being used in Herat, in the COVID-19 treatment hospital which MSF has opened.

Regular MSF activities in Iran are continuing in South Tehran and Mashhad.

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.

Lebanon

In Lebanon, MSF, in collaboration with the Ministry of Public Health, started vaccinating elderly people and healthcare workers in nursing homes across the country. We provide the personnel to vaccinate these groups – as per MoPH priority criteria – and we are supplied with vaccines through the MoPH.

In parallel, we conduct health education sessions, which include informative messages about COVID-19 vaccination and the ways to register to get vaccinated.

In Zahle, central Lebanon, where MSF runs a paediatric ward in the Elias Hraoui Governmental hospital, our teams are supporting the hospital staff by triaging children for COVIID-19 in tents outside the premises. Those who test positive are referred to hospitals managing COVID-19 treatment. In the Bekaa Valley, the MSF hospital in Bar Elias continues treating COVID-19 patients and the hospital’s ICU beds are fully occupied.

Our Medical Response Teams (MRT), which support the Ministry of Public Health, and our Rapid Response Team (part of the UN-led multi-sectoral emergency scheme), undertake COVID-19 testing across Lebanon, taking samples for testing from people who have been contact traced or are within active clusters of infection. In addition, the teams provide guidance and support to medical teams and people with COVID-19 in isolation sites. Our project-based Rapid Response Teams have also been part of the testing campaign in their project areas, notably in Tripoli and in the Bekaa Valley.

In Siblin (south Lebanon), the training centre of the United Nations Relief and Works Agency for Palestine Refugees (UNRWA) that had been turned into an isolation site in partnership with MSF, is taking in patients with suspected or confirmed cases of COVID-19. The centre admits vulnerable people of all nationalities, who cannot home isolate due to overcrowded living conditions.  

In Lebanon, MSF teams have worked in a number of neighbourhoods across Beirut, plus in Hermel, Saida, and Tripoli, among other places.

Libya

In Libya, our COVID-19 focused activities centre on providing training on infection prevention and control measures and treatment to nurses and doctors in hospitals in Tripoli. In the city, we are also supporting the Ministry of Health in one COVID-19 testing site.

Teams are reinforcing IPC measures in detention centres in Tripoli, Zliten and Zintan, including having installed handwashing points, distributed soap and cloth masks.

Palestine

In the Gaza Strip, we continue to support the European Gaza hospital with nursing education and trainings in infection prevention and control (IPC), and physiotherapy for COVID-19 patients. Meanwhile, our health promotion teams carry out approximately 120 COVID-19 and vaccination sessions every month at four Ministry of Health (MoH) primary healthcare facilities in Gaza City and in the north of the Strip, in addition to the ongoing COVID-19 awareness campaign on Facebook.

In the West Bank, we continue to operate a hotline service to provide remote counselling as well as providing psychosocial support to healthcare workers in Dura Hospital in Hebron. Technical trainings on IPC and non-invasive ventilation support to staff in Dura and Halhul hospitals in Hebron continue. COVID-19 awareness and mental health promotion activities are also ongoing.

Syria

In northwest Syria, MSF continues to provide care for patients with moderate and severe symptoms in Idlib National Hospital’s 30-bed COVID-19 treatment centre. We are working in three recently-opened COVID-19 treatment centres in the region, with capacities of 31 beds, 34 beds in Afrin, and 28 beds in Al-Bab. In the centres, we treat patients with mild, moderate and severe symptoms, providing oxygen support to those patients who need it. In the camps where we work in northwest Syria, our teams are still spreading awareness messages about COVID-19 and distributing hygiene kits to the families.

In Syria’s northeast, MSF teams are working with the Kurdish Red Crescent in supporting the only dedicated COVID-19 hospital in northeast Syria, on the outskirts of Hassakeh city, which also has some intensive care capacity. People who are discharged from care, as well as people who are able to self-isolate at home with mild illness, are supported with hygiene materials, health education, and with identifying vulnerable people within their household. Patients are also offered self-protection advice, and their health status is reviewed at regular intervals over a one-month period; we also follow up on their household contacts. We have increased our support in Raqqa city with a focus on protecting healthcare workers, improving IPC in primary and secondary healthcare facilities, improving triage, providing and care for suspect patients requiring inpatient care while they await test results.

In Al-Hol camp, our teams have identified 1,900 people who are particularly vulnerable to COVID-19, (due to having conditions such as diabetes, hypertension, or asthma).  MSF teams are supporting them as per their individual needs.

Yemen

In response to the current COVID-19 outbreak in Yemen, we are running a 25-bed inpatient department (IPD) and are supporting a 10-bed intensive care unit (ICU) in Al-Jumhouri Hospital in Sanaa by providing oxygen therapy, other essential care and IPC measures. 

In Al Sahul Hospital in Ibb, our teams support local health authorities at the COVID-19 treatment centre in managing the 18-bed ICU and 25-bed IPD. We provide case management in the IPD, nursing care, support in provision of medications, health promotion, training on personal protection equipment use, and infection prevention and control measures.
We also support the COVID-19 isolation centre in Al-Salakhanah in Hodeidah city with a capacity of eight ICU beds and 14 IPD beds with technical support, IPC trainings and case management in IPD. The team also supports inpatient and caretaker education.

In Hajjah Governorate, Yemen, teams are working in Abs and Al-Jamhouri hospitals, where they undertake screening and refer people with suspected COVID-19 to treatment centres. We are also supporting referrals of patients from Al-Jamhouri hospital to an isolation centre at Al-Rahadi, as well as the triage area of the centre.

In Aden, MSF is supporting the 22 May hospital with donations of PPE, and training for medical staff on how to manage triage for COVID-19 suspect cases and on IPC measures.

In Khamer (Amran Governorate), our COVID-19 treatment unit, in which we treat patients with respiratory infections and suspected moderate cases of COVID-19, is still receiving some patients.

In Haydan (Saada Governate), we are treating people in a downsized COVID-19 treatment unit of just two beds, due to the decreased number of admissions.

In Yemen, MSF teams had been working in Abyan, Lahj, and Taiz governorates.

*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.

 

MSF and COVID-19

What is the new coronavirus disease?

COVID-19 (short for “coronavirus disease”) is caused by a virus discovered in early January in China. It appears to be transmitted through droplets spread by coughing.

The virus affects the respiratory system. The main symptoms include general weakness and fever; coughing; and in later stages sometimes pneumonia and difficulty breathing.

Identified by Chinese scientists, the virus is now called SARS-CoV-2 because of its similarities to the virus that causes Severe Acute Respiratory Syndrome (SARS).

The coronaviruses are a large family of viruses, most of which are harmless to humans. Four types are known to cause colds, while two other types can cause

severe lung infections (SARS and MERS – Middle East Respiratory Syndrome), similar to COVID-19.

Like all viruses, SARS-CoV-2 needs the cells of living beings to multiply. This virus seems to target cells in the lungs and possibly other cells in the respiratory system, too. 

Cells infected by the virus will produce more virus particles, which can then spread to other people, by coughing for instance.

How is MSF responding?

COVID-19 preparation

Protecting patients and healthcare workers is essential, so our medical teams are preparing for potential cases of COVID-19 in our projects.

In places where there is a higher chance of cases, this means ensuring infection control measures are in place, setting up screening at triage, isolation areas, and health education.

In most countries where MSF works, we are coordinating with the WHO and Ministries of Health to see how MSF can help in case of a high load of COVID-19 patients and are providing training on infection control for health facilities.

Pre-existing projects

On any given day we are treating hundreds of thousands of patients for a variety of illnesses. We need to ensure we can continue to provide adequate and life-saving medical care in our ongoing projects.

This is challenging because current travel restrictions are limiting our ability to move staff between different countries.

Establishing future supplies of certain key items, such as surgical masks, swabs, gloves and chemicals for diagnosis of COVID-19 is also of concern.

There is a risk of supply shortages due to lack of production of generic drugs and difficulties to import essential drugs (such as antibiotics and antiretroviral drugs) due to lockdowns, reduced production of basic products, exportation stops or repurposing/stocking of drugs and material for COVID-19.

What needs to be done?

We must do everything to prevent and delay further spreading of the virus. It is already straining some of the world’s most advanced healthcare systems. 

Access to healthcare

Preserving access to healthcare, both for COVID-19 patients as well as for any other patient, is paramount. This means ensuring that hospitals don’t become overwhelmed and that health staff can cope with the number of patients requiring intensive care and continue providing treatment to other patients who need it too.

Protecting healthcare staff

Infections of healthcare staff can happen easily in places that are overwhelmed by large numbers of patients. Places dealing with limited supplies of personal protective equipment for staff and a probable reduced workforce (as healthcare staff will also be part of confirmed cases through transmission in the community) are also at risk. 

Infected healthcare staff will further reduce the capacity to admit and treat patients. Safety for healthcare workers should be a top priority in every healthcare facility.

Ensuring trust

We know from our experience that trust in the response and in health authorities is an essential component for outbreak control. Clear, timely, measured and honest communication and guidance is needed. People need to be empowered to protect themselves.  

To ensure that the medical tools urgently needed to respond to COVID-19 are accessible, affordable, and available concerned stakeholders including governments, pharmaceutical corporations and other research organisations developing treatments, diagnostics, and vaccines should take the necessary measures to: 
 

• prevent patents and monopolies from limiting production and affordable access;
• guarantee access to repurposed drugs for patients suffering from disease;
• prioritise the availability of the medical tools for protection and treatment of frontline healthcare workers; and  
• improve transparency and coordination, making sure an evidence-based approach is put in place to continuously monitor the risk of the potential supply chain vulnerability on essential medical tools

DONATE TO OUR COVID-19 APPEAL

Disclaimer: The place names and boundaries in this map do not reflect any position by MSF on their legal status

We must do everything to prevent and delay further spreading of the virus. We know from our experience that trust in the response and health authorities is an essential component for outbreak control.

Clear, timely and honest communication and guidance is needed. People need to be empowered to protect themselves.