Hundreds of thousands of Syrian civilians have lost their lives in over 7 years of armed conflict, which began with anti-government protests before escalating into a full-scale civil war.
More than 11 million people have been forced from their homes amongst clashes between supporters of President Bashar al-Assad and those opposed to his rule - as well as jihadist militants from the so-called Islamic State.
Closed borders, appalling living conditions and limited assistance have compounded their suffering. People fleeing violence live in camps, improvised shelters or with host families.
Violence, attacks on health facilities, the absence of government authorisation and the reneging by armed groups on guarantees of safety for MSF teams have been major obstacles to a more extensive program of medical humanitarian aid in Syria.
Siege warfare has been widely used in Syria. Civilian areas have been routinely bombed and deprived of assistance.
Early on, the systematic bombing of civilian areas made it a priority to help treat the wounded. We opened surgical facilities in the north, provided supplies and training to health staff across the country, and set up cross-border trauma care in Jordan. As living conditions deteriorated in the north, we set up a surgical burns unit.
MSF was one of the only organisations to start providing medical assistance inside Raqqa, through a primary healthcare unit and a stabilisation point. Even as the violence subsided, and residents started to return home, staff saw a sharp increase in the number of patients wounded or killed by booby traps, improvised explosive devices (IEDs), mines and explosive ordnance that littered the city or deliberately left in homes, on agricultural land and along roadsides.
MSF has been present in Syria since 2009. Teams continue to provide medical and humanitarian assistance in the country but activities are severely limited by insecurity and constraints on access. Thousands of doctors, nurses, pharmacists and paramedics have been killed, kidnapped, or displaced by violence, leaving a massive gap in medical expertise and experience.
The Syrian government has not granted MSF authorisation to operate in the country despite repeated requests, and our presence in areas outside government control is minimal. Unable to obtain government permission to assist the sick and wounded, we started by supporting underground medical networks.
Our main programs are in the governorates of Aleppo, Idlib, Raqqa and Hassakeh. In addition to providing medical care, we carry out water and sanitation activities and distribute relief items.
Raqqa, the west side of the city. People are slowly returning to their homes to find in either damaged of fully destroyed. While bombs and gunfire cause death and destruction across large parts of Syria, many more people are threatened by the collapsing medical system. © Van Wessel / MSF
Syria’s once fully-functional healthcare system has been devastated as hundreds of medical facilities have been bombed, and medical staff have fled or been killed. Preventable diseases have made a resurgence as common needs go unaddressed. Syrian health staff have been forced to improvise operating theatres and work in deplorable conditions, overwhelmed by the emergencies they face.
Basic essentials such as medical supplies are restricted amid intense bombing and shelling. Unable to enter these areas, we remotely support medical facilities in besieged areas as necessary.
The consequences of interrupted treatment for chronic diseases such as high blood pressure or diabetes can lead to serious complications. Mobile clinics have increasingly become a central part of our response, to provide preventative care and basic treatment to besieged districts as well as camps in surrounding areas. Since no regular vaccinations have been administered in some areas (such as Aleppo) since 2014, MSF launched a large-scale vaccination campaign.
The bulk of our activity in Syria focuses on the health needs of people with common illnesses, pregnant women, and improving vaccination coverage to prevent childhood diseases.
Médecins Sans Frontières has been working in Afghanistan since 1980, providing emergency surgical care, responding to conflict and natural disasters, and treating people cut off from healthcare.
MSF worked in Angola from 1983 until 2007. Why were we there? Armed conflict Endemic/Epidemic disease Social violence/Healthcare exclusion
MSF worked in Argentina from 2001 until 2003. Why were we there? Providing essential medicines and supplies
Why are we there? Endemic/epidemic disease Social violence/healthcare exclusion Natural disaster
Cameroon is facing multiple and overlapping crises, including recurrent epidemics, malnutrition due to food insecurity, displacement, and conflict.
Why are we there? Armed conflict Endemic/epidemic disease Healthcare exclusion
Why are we there? Armed conflict Healthcare exclusion Natural disaster
The political, economic and military crises of 2002-2010 have taken a severe toll on the Ivorian health system.
MSF worked in Ecuador until 2007. Why were we there? Endemic/Epidemic disease Natural disaster
In France, we work with migrants and refugees, who encounter policies and practices aimed at preventing them from settling or claiming their rights.
Why are we there? Armed conflict Endemic/epidemic disease Social violence/heathcare exclusion
Haiti’s healthcare system remains precarious in the wake of natural disasters and ongoing political and economic crises. Ongoing disasters have led to Haiti becoming the poorest country in the Western Hemisphere.
Honduras has experienced years of political, economic and social instability, and has one of the highest rates of violence in the world. This has great medical, psychological and social consequences for people.
An MSF team in Hong Kong opened a project at the end of January focusing on health education for vulnerable people. Community engagement is a crucial activity of any outbreak response and in Hong Kong, this focuses on groups who are less likely to have access to important medical information, such as the socio-economically disadvantaged. The team is also targeting those who are more vulnerable to developing severe disease if they are infected, such as the elderly.
MSF worked in Indonesia between 1995 and 2009 Why were we there? Natural disaster
Jordan hosts over 700,000 refugees, according to the UNHCR, many of whom reside in camps or have settled in the country.
Although health services are being progressively restored in Liberia, important gaps persist, notably in specialised paediatric care and mental health.
Libya remains fragmented by a decade of conflict and political instability. The breakdown of law and order, the collapse of the economy, and fighting have decimated the healthcare system.
Access to medical care remains very limited in the north and centre of Mali due to a lack of medical staff and supplies and spiralling violence between armed groups.
In Mozambique we are responding to emergencies including disease outbreaks, providing care to people with advanced HIV, while also working in the conflict-ridden Cabo-Delgado province.
Why are we there? Endemic/epidemic disease Social violence/healthcare exclusion
Why are we there? Providing comprehensive emergency healthcare to people in remote regions of Pakistan is a priority, yet accessibility and security are a constraint for both Médecins Sans Frontières (MSF) and patients.
At the end of 2007, MSF ended its activities in Rwanda after 16 years in the country. MSF's work included assistance to displaced persons, war surgery, programmes for unaccompanied children and street children, support to victims traumatised by the conflict, programmes to improve access to healthcare, responding to epidemics such as malaria, cholera and tuberculosis, and projects linked to maternal and reproductive health.
Why are we there? Endemic/epidemic disease Healthcare exclusion
Why are we there? Armed conflict Endemic/epidemic disease Healthcare exclusion
Why are we there? Armed conflict Endemic/Epidemic disease Healthcare exclusion
Why are we there? Endemic/epidemic disease Social violence Healthcare exclusion
