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In this issue of the Medical Independent, we have published a feature on the work of Médecins Sans Frontières (MSF) and the Covid-19 crisis. The focus of MSF’s work is to provide medical assistance to people affected by conflict, epidemics and disaster. The unprecedented scale of the current pandemic has seen the MSF initiate a truly global response.
In Europe and the US, which are currently the epicentres of the pandemic, MSF’s response has focused on improving care for the most vulnerable and at-risk, such as older people in care homes, homeless people and migrants living in precarious circumstances where mortality rates have been high. In our feature, Specialist Registrar in Public Health Dr Laura Heavey told Bette Browne that in Ireland, MSF has assisted a frontline medical organisation to provide care and rapid testing for vulnerable groups, such as the homeless population.
In most countries where MSF has programmes, such as in Colombia, Iraq, and Nigeria, the organisation has opened dedicated wards inside hospitals and health structures to help separate Covid-19 patients from non-Covid-19 patients and to extend the hospitals’ capacity to provide care.
Lockdowns have been a central part of the international response to Covid-19. However, for people dependent on daily activities for their survival, such as day labourers and those living in precarious or overcrowded settings, self-isolation and lockdowns are not realistic, according to MSF.
In some places, hundreds of thousands, sometimes even millions, of people live in such conditions, without any social safety net.
MSF teams are running health promotion activities so that people understand the steps they can take to reduce the chances of contracting Covid-19 and to stop the further spread of the novel coronavirus.
Where possible, MSF is distributing soap and setting-up water points so people can regularly wash their hands. These measures, and additional assistance, such as the provision of reusable cloth masks, are even more crucial for people at risk of developing serious complications, including older people and those with other diseases, such as diabetes, hypertension, cancer, HIV/AIDS or tuberculosis.
One concern with the Covid-19 pandemic is the impact it has had on programmes dedicated to fighting these diseases. Dr Heavey said MSF has already had to put some of its programmes on hold, such as its paediatric surgical programme in Monrovia, Liberia. This has been suspended due to the lack of flights and travel restrictions. Hiring crucially-needed international specialists has been made much more difficult because of the pandemic.
A priority for MSF is to keep essential services running during the current crisis in countries with fragile health systems.
“Faced with suddenly having to treat huge numbers of new patients, countries with already fragile health systems, that have fewer health staff and weaker infrastructures, can quickly collapse under the pressure and the impact can be disastrous,” according to MSF.
“If medical care were to falter, then common childhood killers like measles, malaria and diarrhoea would go untreated. Other essential services we provide, such as sexual and reproductive care, emergency room services, maternity and surgical wards, and treatment of patients who have HIV or TB, would go unmet. This would have a terrible impact on the people we serve and would surely increase the number of deaths in the community.”
The devastating global impact of the Covid-19 pandemic has underlined the value of the essential services provided by organisations such as MSF, which need to be supported now more than ever.
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