MSF response to COVID-19

COVID-19 is a new viral disease that affects the respiratory system

The World Health Organization (WHO) declared COVID-19 a pandemic on 11 March 2020. More than 200 countries are now reporting cases.

As COVID-19 continues to spread, MSF teams are racing to respond to the pandemic in the more than 70 countries in which we run programmes, while opening projects in new countries as they become pandemic hotspots.

Our COVID-19 response focuses on three main priorities:

  • Supporting health authorities to provide care for patients with COVID-19 
  • Protecting people who are vulnerable and at risk 
  • Keeping essential medical services running

For comprehensive information, including how to protect yourself against the disease, please visit the World Health Organization (WHO) website on COVID-19.

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.

Where is MSF responding?

Information as of 22 June 2020

Burkina Faso

In Burkina Faso, we are providing patient support in Fada health centre, where we have also rehabilitated a 20-bed provisional treatment site at the regional health centre. We are also training MoH staff and undertaking disease surveillance and health promotion activities. In Ouagadougou, MSF teams have finished the construction of a 50-bed hospital centre for the care of COVID-19 patients, and is ready to receive patients.

MSF has started activities in Bobo-Dioulasso, in the country’s west, where the second-biggest outbreak in the country is located. We are providing care for COVID-19 patients in a dedicated facility, in collaboration with the national health authorities. We have also installed an oxygen production unit, which can provide oxygen to dozens of people, direct to their beds, at once. Teams are reinforcing other facilities’ capacities in terms of triage, isolation, protection equipment and infection prevention and control measures at the University Hospital Centre, and at the Medical Centres with Surgical Annexe of Do and Dafra.

Cameroon

In Yaoundé, we have started receiving and treating patients with moderate COVID-19 in Djoungolo health centre, where we increased the capacity in building four rooms with 20 beds. Our teams have also 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 are setting up a 20-bed isolation ward in Buea regional hospital, western Cameroon, to treat people with the new coronavirus. Our staff are providing training for IPC measures and providing treatment to people with suspected or confirmed COVID-19 disease. We are also providing health promotion to local people on hygiene measures.
 
MSF is providing support to Bamenda Regional hospital – the referral centre for COVID-19 cases in northwest Cameroon – where our teams are training hospital staff on IPC measures and have installed a pre-screening tent at the entrance. We have also trained staff at the general hospital in Douala, Cameroon’s second-most affected city, and at two other hospitals in the area.

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


Central African Republic

In Central African Republic, MSF has started to build a COVID-19 treatment centre in Bangui, which will have an initial capacity of 24 beds, with the possibility to scale up to 50. The centre will treat severe patients through oxygen therapy and offer palliative care.

Also in Bangui, our teams are supporting the MoH with surveillance activities, including contact tracing and sample collection. We continue our engagement with the communities to explain what COVID-19 is and work together to promote and adapt prevention measures to their daily realities.


Côte d’Ivoire

In Abidjan, Côte d’Ivoire, MSF and Ministry of Health teams are now treating people with moderate COVID-19 in a treatment centre at Grand Bassam, just outside the city. In Bouaké, we have trained health workers and screening at the different entry points to the city are underway. Water and sanitation activities are also being implemented.

MSF also produced 1 million cloth masks in partnership with UNIWAX and other civil society organisations. They are currently being distributed to vulnerable people in Abidjan and will continue to other sites. Our teams, through local associations, are also distributing cloth masks to patients suffering from kidney failure, as well as to diabetics and people with high blood pressure.


Democratic Republic of Congo 

In Kinshasa, DRC’s capital, our teams are supporting medical staff at St Joseph hospital and Ministry of Health staff with with treatment of people with COVID-19. A team is also installing a 40-bed isolation ward (tent).  MSF mobile teams are supporting 50 health structures in four health zones in Kinshasa to strengthen hygiene measures, equip them with masks and handwashers, and train medical staff and community relays on infection prevention and control measures in health centres and within families.

In Kinshasa and Goma, MSF has started production of tens of thousands of reusable masks. These masks were manufactured to protect patients and their carers in the structures that we support, as well as our non-medical staff.

In Masisi, North Kivu province, we’ve set up a 20-bed isolation ward at the General Reference hospital and a patient flow route at Nyabiondo Reference Health Centre.

In South Kivu province, MSF is supporting with laboratory and sample analysis. We are also establishing isolation centres in Baraka hospital, Kimbi hospital and Nyange heath centre for suspected COVID-19 patients, with 80 beds total capacity, and mental health support for patients.

In Ituri province, with the commitment of the indigenous and displaced communities, MSF is building isolation rooms for the handling of COVID-19 cases in structures where we are already present. We have also implemented infection prevention and control measures in the community health sites, health centres and hospitals we support. The teams have trained health workers in the region about COVID-19 and are strengthening the hospitals in Nizi, Drodro and Angumu with medical equipment, human resources, and are preparing the isolation and treatment structures within these hospitals.

eSwatini

We are providing support to the Eswatini ministry of health by assisting with infection prevention and control and triage at health facilities. We are also part of technical advisory groups to the ministry of health. MSF teams are conducting health education and promotion in the community.


Guinea

In Kouroussa, Guinea, an 8-bed isolation ward has been put in place at the Hopital Préfectoral de Kouroussa. MSF is caring for 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 recent weeks, we have rehabilitated the structure to bring it up to standard and increase bed capacity.

Our teams are also disinfecting the homes of patients admitted to hospital, providing psychosocial support, and tracing and following up on their contacts.


Guinea-Bissau

In Bissau, the capital of Guinea-Bissau, we have 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 have provided support with hygienists on waste management.


Kenya

MSF is part of Kenya’s National Taskforce on COVID-19. MSF is supporting several health facilities in Nairobi, Kiambu, Dadaab and Mombasa counties in conducting health awareness, case management training to staff, providing logistics support, boosting infection prevention and control measures, and triage.

At Kibera South Health Centre, in the slums of Nairobi, the team is boosting infection prevention and control, triage, screening and managing referral of people suspected of having COVID-19 to a nearby hospital.

In Dagahaley camp, in Dadaab, Kenya’s largest refugee camp, MSF has set up a 10-bed isolation unit for COVID-19 patients.

In Mombasa, we have set up isolation rooms at the Mrima health centre in Likoni subcounty, which will allow women who have COVID-19 to give birth safely.

Liberia

MSF is providing support to Liberia’s MOH COVID-19 treatment centre, improving patient flow and the quality of care for patients. Our teams completed a month-long COVID-19 hygiene awareness and soap distribution campaign in April, reaching more than 78,000 households in four of Monrovia’s most vulnerable neighbourhoods; we continue to undertake health promotion activities on prevention measures in and around Monrovia, Liberia’s capital. We are also providing technical support at the city’s Military hospital, run by the Ministry of Health, where COVID-19 patients are being treated.  


Malawi

In Malawi, MSF is working at the Nsanje District hospital, where we are reorganising and adapting the patient flow, set-up a (pre-) screening and triage tent, waiting areas, and consultation zone. We’ve also undertaken health promotion and training frontline medical staff, providing technical support.


Mali

In Bamako, Mali’s capital, MSF is supporting the management of a COVID-19 unit within the grounds of Point G hospital, where we run our oncology programme. The unit includes a triage and isolation area, and a ward, where we are working to increase the capacity to up to 100 beds. We have renovated and improved the hospital’s oxygen distribution network. MSF is providing the COVID unit with medical, nursing and hygiene control staff, some coming from our regular project in Koutiala, as well as logistical and technical support. We are also helping with IPC, staff training, and revising patient flow in two other hospitals in Bamako which are receiving COVID-19 patients. We are reinforcing the MoH’s community outreach and contact tracing activities in communities in the city. Cloth masks are also being produced and distributed to contacts of contacts in the community.

In the centre (Niono, Tenenkou, Ansongo, Douentza, Koro), south (Koutiala) and north (Kidal and Ansongo) of the country, our teams are conducting health promotion activities with local people, are training local staff and have established handwashing points at the referral hospital in Niono and surrounding health centres.

In Tominian, near the border with Burkina Faso, we have installed a tent for isolating people suspected of having COVID-19, and a handwashing point.

In Mopti, MSF implemented patient flow and provided training to staff where a case was confirmed. Training was also done for 45 medical staff from the Gao region.


Mozambique

In Mozambique, we are implementing infection prevention and control measures – including 16 new hand washing points – and triage for people with respiratory symptoms in all health facilities where we work. Our teams are also working with local authorities to improve patient flows by providing logistic and technical support for two referral hospitals in Maputo. In Pemba we helped local health authorities to install an isolation centre.


Niger

In Niamey, Niger’s capital, our teams constructed a 50-bed COVID-19 treatment centre, close to the Hôpital National Lamordé which will start receiving patients, and trained the staff on COVID-19 treatment. We are also providing health promotion to local people in both Niamey and Magaria. A response team composed of MSF and MoH staff are monitoring people with simple COVID-19 cases at home.


Nigeria

MSF teams in Nigeria are establishing isolation facilities and improving staff and patient flow. Teams are also setting up handwashing points and isolation areas, plus providing health promotion information in local communities and IDP camps. In Ngala, MSF teams are focusing efforts on the reinforcing infection prevention and control, and in Ebonyi state, we are supporting the Ministry of Health and Nigeria Centre for Disease Control in setting up the state’s first COVID-19 testing centre.


Senegal

In Dakar, the capital of Senegal, we are supporting patient treatment in the Hopital Dalal Jamm, in the northern part of Dakar, where we are providing training as well as support for water and sanitation activities, and simplified triage protocols.

We are providing advice on patient flow, IPC measures, logistics, and training at a treatment centre in Guediawaye district, in Dakar’s northern suburbs, where a recent increase of positive cases was recorded. Our teams are also supporting the MoH on community engagement, case surveillance and testing mechanisms to adapt to the pandemic.


Sierra Leone

MSF is part of the national emergency preparedness task force in Sierra Leone and MSF epidemiologists have started providing support with contact tracing and surveillance. We are providing health promotion to local people and supporting improved IPC in MoH basic healthcare units.

In Freetown, MSF water and sanitation and construction specialists have begun work on repurposing a government facility into a 120-bed COVID-19 treatment centre. In Makeni Regional hospital, Magburaka hospital and Hinistas Community health centre, our teams have set up isolation wards.

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

Somalia and Somaliland

We are providing health promotion to communities and technical advice or logistic support to set up isolation structures in some places. In Hargeisa, we have trained emergency room staff and ambulance drivers in assisting the Ministry of Health to set up a COVID-19 centre.


South Africa

In South Africa, we have sent staff from all four of our existing projects to COVID-19 responses in Gauteng, KwaZulu-Natal and Western Cape provinces. MSF staff members are assisting with physical and telephonic contact tracing, the development and dissemination of health promotion materials, and by implementing various strategies for decongesting healthcare facilities.

In Johannesburg, a mobile team conducts primary healthcare consultations and screening for COVID-19 cases in four homeless shelters, as well as links to an MSF testing and tracing team.

Teams are also developing additional COVID-19 treatment capacity for healthcare facilities in Eshowe and Mbongolwane. In Eshowe and in Rustenburg, MSF has installed triage tents and handwashing points at several hospitals and community health centres. In Khayelitsha, a 60-bed MSF field hospital started receiving COVID-19 patients on 1 June, and teams are providing treatment.


South Sudan

In South Sudan, MSF is assisting the Ministry of Health with the training of healthcare workers in infection prevention and control measures and triage for symptoms compatible with COVID-19. In the capital city, Juba, MSF teams are installing handwashing points in several locations with high concentrations of people, including around hospitals and healthcare centres. Teams are also carrying out community assessments and engagement in the city.

In Yei, MSF is supporting the management of the COVID-19 isolation facility, at the request from the Ministry of Health, given constraints in staffing and supply.

In Agok, preparations are underway for an in-patient department for COVID-19 patients, and in Old Fangak, work is continuing to set up a 10-bed COVID-19 centre.


Sudan

MSF teams across Sudan are conducting health promotion and awareness sessions with the local community. We are also providing mentoring and training on a daily basis to health workers in the health facilities we support. We also run a mobile COVID-19 unit that supports other facilities, working on early detection and prevention of the disease.

At the Omdurman Teaching hospital, the largest hospital in the country, where MSF has a team of more than 60 staff, we are working closely with the MoH in the emergency department and to prepare to cope with COVID-19. We are also supporting the MoH to set up and manage isolation centres in two towns in East Darfur and South Kordofan states (Ed Daein and Dilling).


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, where people suspected of having COVID-19 will be referred. Currently we have 10 isolation beds available, and are currently constructing another 50, with the ability to scale up to 100 beds if needed.


Zimbabwe

In Harare, the capital of Zimbabwe, we are supporting COVID-19 patient care, while our teams are also working on scaling up bed capacity to 164 beds. Our water and sanitation team is providing additional support in communities. MSF has trained over 400 healthcare workers on COVID-19 treatment, laboratory surveillance, IPC measures, water and sanitation measures in facilities, epidemic surveillance, contact tracing, data management, as well as the safe transport of people testing positive for COVID-19.

Teams are also providing support for COVID-19 screening, sample collection for testing, and providing non-COVID-19 healthcare services and health promotion to people recently returned to the country.

Argentina

In Argentina, MSF is offering technical support and advice to several health authorities such as the design of protocols, circuits and infection prevention and control measures in health structures and/or in alternative treatment structures, and in supporting the staff of homes for the elderly. In Córdoba, MSF provides specific technical support to the province’s Emergency Operations Committee working group for enclosed structures (which includes homes for the elderly, hemodialysis units and prisons), and participates in training for the staff.

Brazil

In São Paulo, Brazil, we are running medical activities at two isolation centres with a total of 140 beds, for vulnerable patients (homeless people, drug users and the elderly) with mild COVID-19. Teams are working with homeless people – in shelters and on the streets – youth in adolescent detention centres, and with heavy drug users providing health promotion and IPC education, and running a mobile triage clinic in the downtown area. We have expanded activities in São Paulo and are now treating people with mild COVID-19 at two isolation centres for vulnerable patients (homeless people, drug users and the elderly).

Screening and health promotion activities with the homeless have also started in Rio de Janeiro. We are also conducting street activities with homeless and vulnerable people. 

In Manaus, in the country’s north, an MSF team is training local health professionals on infection and prevention control. We are also working at the public hospital 28 de Agosto, providing treatment to people in 12 ICU beds and 36 beds for moderate and severe cases of COVID-19. We are also running an isolation centre for migrant Venezuelan indigenous people with suspected COVID-19.

In Amazonias state, teams are working in the remote towns of São Gabriel da Cachoeira and Tefé, several hours by plane from Manaus. In Tefe we are treating people with moderate and severe COVID-19 cases at the town’s main hospital. In São Gabriel da Cachoeira, we are referring critical COVID-19 patients to Manaus and treating people with mild cases at a local medical centre.

In Boa Vista, in Roraima state, MSF staff are working in a COVID-dedicated field hospital, providing medical care. Our team has also visited informal shelters where migrants and refugees from Venezuela have gathered, providing hygiene and physical distancing guidance to residents. We have assisted in expanding access to water in formal and informal shelter and has distributed hygiene kits.

Colombia

We are currently triaging and supporting patients with respiratory symptoms at Tibú hospital, in Colombia’s north. In Buenaventura, we have adapted and expanded our psychological care Line #335 for the early identification of potential patients with symptoms of COVID-19.

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

 

Equador

In the Guayaquil region, which was the first area in Ecuador to be hit hard by COVID-19, a small team has been assisting health centres and nursing/care homes with infection prevention and control. 

Haiti

MSF has reorganised the Emergency Centre in the Martissant neighbourhood of Port-au-Prince, Haiti’s capital, in order to isolate and refer COVID-19 suspect cases. A separate patient/staff flow is in place, in addition to triage and five isolation beds. In the city’s Drouillard area, we opened a field hospital to treat COVID-19 patients on 16 May, which has received more than 250 patients. Our teams have also visited the Chancrelles hospital in Port-au-Prince’s Cité Soleil district, in order to support them in implementing IPC measures including triage and isolation.

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

In Haiti’s south, MSF supported two public health facilities (in Port-à-Piment and Port Salut) for the set-up of triage systems, isolation beds, referral systems and training of medical staff. Teams report supply as a major stumbling block.

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


Mexico

MSF teams have established an auxiliary hospital unit in a basketball stadium in Tijuana, in the far northwestern corner of Mexico. MSF medical staff are providing treatment to non-critical COVID-19 patients, relieving the burden on local hospitals.  


United States

In the United States, MSF has been partnering with local service organisations in New York to improve infection prevention and control (IPC) measures in facilities serving the homeless and housing insecure. Teams have been donating over 80 handwashing stations to key locations, including soup kitchens and supportive housing facilities in New York. MSF teams have opened shower trailers in Manhattan to give people who are currently homeless or housing insecure a place to bathe while public restrooms and facilities are closed due to COVID-19.

In Michigan, in the country’s northeast, staff and residents of nursing homes have been hit hard, accounting for a significant proportion of cases and deaths in the state. Our team is coordinating with the Michigan Department of Health and Human Services and the Detroit Health Department to quickly identify which nursing homes are in need of infection prevention and control measures. MSF teams offers three sets of activities to help protect residents and staff: assessments and 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.

In southwestern USA, especially in the states of New Mexico and Arizona, an MSF team is working 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 are focusing on providing infection prevention and control technical guidance to healthcare facilities and communities, including to prisons and communal living facilities, such as nursing homes. We are also actively engaged with community leaders to increase access to health promotion and practical education.

MSF teams are on the ground assessing local needs and our capacity to offer support to organisations and health care providers serving vulnerable groups in Puerto Rico. MSF is distributing essential supplies, such as masks, face shields and hygiene kits to healthcare facilities and vulnerable groups of people on the island. We are also providing training on IPC measures to help essential workers, patients and others stay safe.

Our team has also been remotely advising non-profit organisations throughout the United States working with the homeless and migrant workers on infection prevention and control measures and hospital triage set up.  

Closed projects. 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.

Venezuela

In Caracas, Venezuela’s capital, MSF teams are working in Pérez de León II hospital in the Petare neighbourhood, where teams rehabilitated the infrastructure, adapted the patient flow, established IPC measures and trained staff to receive COVID-19 patients for hospitalisation and ICU care. Teams have now started receiving patients and are providing medical and logistic support.

Afghanistan

In Kabul, Afghanistan’s capital, MSF has provided infection prevention and control training, and improved patient flow and triage at the Afghanistan-Japan hospital, which is the referral hospital for COVID cases in the country. However, after the attack on our maternity hospital in the city’s Dasht-e-Barchi district in mid-May, our support to the Afghanistan-Japanese COVID-19 referral centre in Kabul has been stopped.

In the COVID-19 treatment centre in Herat, MSF is supporting the Ministry of Public Health with infection prevention and control measures. In Lashkar Gah, the team is providing technical support for the management of the COVID-19 facility set up in Malika Suraya hospital.

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.

Hong Kong

In Hong Kong, where the outbreak is winding down and restrictions are being relaxed, we have shifted our focus to providing mental health support – via a website with tips and face-to-face sessions – for people caused by prolonged exposure to uncertainty.


India
 

Our teams in Patna, Bihar state, eastern India, have converted a sports hall to set up a 100-bed field hospital for mild to moderate COVID-19 patients, to support the Nalanda Medical College hospital. MSF teams are now providing treatment to patients in the field hospital. Community health promotion and education activities are also taking place in the area.  

In Mumbai, the epicentre of the outbreak in India, teams are providing training on screening, triage, IPC measures, and testing. We are also establishing an appropriate referral mechanism for presumptive cases for treatment and isolation in 28 informal settlements in the city. MSF is supporting an existing fever clinic and scaling up capacity to treat mild to moderate cases of COVID-19 in an MoH-run hospital. Our teams are also carrying out health promotion, mask and soap distribution, and WASH activities in hotspots in the city’s in M-east ward district.  

We have opened a 24/7 mental health phone hotline in English and Hindi, with five counsellors, who have been recruited and trained by MSF.


Indonesia

In West Java, Indonesia, health promotion activities, including leaflets on disease prevention measures, and setting up hand-washing points, have been carried out. Our staff have also undertaken training sessions via webinar on IPC measures and PPE use with local doctors.


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, with a specific focus on Kadamjay raion (district) and Batken oblast (province). MSF mobile teams are supporting with contact tracing and community surveillance. Our teams will also provide training in infection prevention and control measures.  

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.

Pakistan

In Timergara, northern Pakistan, the MSF team is running a 24-bed isolation ward for people with mild and moderate cases of COVID-19, referring serious patients to university hospitals. Our teams are also screening over 1,000 people a day for symptoms of the virus and providing consultations to those who have suspected cases of the new coronavirus.  MSF is also collecting COVID-positive patients in Lower Dir district to bring them to the isolation ward by ambulance, but only under specific conditions.

In Balochistan province, MSF staff are working in the isolation ward at Killa Abdullah District hospital, hiring support staff, providing water and sanitation and logistics advice, and training to health staff.

Papua New Guinea

In Papua New Guinea staff in health facilities have received training on infection prevention control, and our teams have undertaken screening and triage of people with potential cases of COVID-19 in 22 provinces. Our teams have also set up a large facility for treating COVID-19 patients in the capital, Port Moresby.

Philippines

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

In Marawi, a “mobile information drive” to pass health promotion messages to vulnerable people has launched.

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.

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.

Belgium

In Belgium, our teams are winding down their COVID-19 activities, with most projects now closed. However, an outreach team continues its IPC and contact tracing activities in shelters for vulnerable migrants and homeless people in Brussels.

Closed projects
Mobile teams were supporting nursing homes for the elderly and reached 115 homes across Brussels, Flanders, and Wallonia. Support included psychological counselling and webinars for staff, and assessing residents for potential coronavirus cases. MSF established a 150-bed medical facility for vulnerable people, including migrants and refugees, in Brussels’ Tour & Taxis area. The facility, in which we also provided medical care for COVID-19, allowed people to isolate.

MSF teams had been supporting 10 hospitals to increase their admission capacity and on IPC measures. Support included providing technical and strategic advice, plus operating post-intensive care units.

France

Activities closed. In France, we had been helping to detect people with, and provided care for, coronavirus COVID-19 among the most vulnerable populations in Paris and the surrounding region. Activities included mobile consultations and screening of vulnerable people, and support with diagnosis, isolation and patient care, in shelters.

MSF teams worked in some of these Paris shelters to evaluate their health and identify potential COVID-19 cases. Our teams are also worked with homeless people living on the streets, evaluating people via a mobile clinic for COVID-19 and other illnesses. MSF teams in Marseille, in the south of France, used mobile clinics to reach people living in extremely precarious situations, away from healthcare centres, and often without health insurance coverage.

We provided support to nursing homes: teams worked in care homes across Paris and the suburbs, providing medical and psychological care assistance to residents, and psychosocial and IPC support to staff. We reached over 30 nursing homes, and more than 2,000 elderly residents.

We had been running two COVID centres for homeless and migrant people infected with the new coronavirus – where they could self-isolate and where our teams provided some medical assistance – in Châtenay-Malabry and in Aulnay-sous-Bois, in Paris’s southwestern and northwestern suburbs, respectively. Both centres are now closed.

We had also been providing support to hospitals, including setting up inflatable tents to temporarily increase the ICU capacity at the hospital in Reims, east of Paris. In addition, 5 nurses, 5 assistant nurses, and 2 doctors had been in charge of managing a 10-bed care ward at Henri-Mondor hospital in Créteil, in Paris’s southeastern suburbs, to increase capacity treating patients with severe COVID-19 who were well enough to leave intensive care, but still required inpatient medical care. With the diminished number of people with COVID-19 in France, we have now ended our support to both hospitals.

In Marseille between mid-April and 31 May, we had conducted nearly 1,000 COVID-19 tests in support of two health centres in the city’s impoverished neighbourhoods. We have now handed over these activities.

A team from MSF Switzerland had crossed the border to assist nursing homes, providing advice on IPC and medical awareness to staff, in the French département of Haute-Savoie, southeast of Geneva.

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.

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. Activities in Germany ended by 8 May.

Greece

MSF is providing support on the migrant hotspot islands of Samos and Lesbos in Greece, including through health promotion activities and increased water and sanitation supplies and services.

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.

Italy

In Italy, which had been an epicentre of the pandemic, our teams continue to work in Rome, where we are undertaking health promotion and medical care through a clinic at Selam Palace, a building hosting more than 500 refugees, mostly coming from the Horn of Africa.

These activities have been expanded, reaching a network of informal settlements and reception centres for migrants in the southeastern suburbs of the city, in cooperation with health authorities and Médecins du Monde, and to home care services to protect fragile and marginalised communities from COVID-19, both Italians and foreigners. The dedicated phone helpline that has been set up to serve these communities are being staffed by doctors and intercultural mediators, who provide counselling, supports community health needs and helps identify and provide treatment advice for people with COVID-19.

In the Lombardy, Piedmont and Liguria regions, MSF teams are working in prisons, to protect detainees, prison and police officers. The MSF team includes doctors, nurses and hygiene experts, who are covering all measures to contain the spread of the virus and protect people inside the prisons. We have designed procedures which will identify suspected cases among new detainees, verify their diagnosis and identify the contacts of confirmed cases.

In Catania, on the island of Sicily, we are supporting the epidemiological surveillance service that is identifying and recording new cases, and tracing people’s contacts.

Closed projects
In the Lombardy region, in the country’s north, the original epicentre of the outbreak, we supported three hospitals with infection prevention and control (IPC) measures, as well as provided care to patients. We also undertook outreach activities in order to reach vulnerable people, such as the elderly in nearly 20 nursing homes, and local organisations working with homeless and migrants. We also supported a telemedicine programme (medical assistance via video conference), which assisted people under isolation at home.

We had also been working in one of the most affected regions, the Marche region in central eastern Italy, where we are supported 30 nursing homes across several cities to prevent the virus spreading in such vulnerable locations.

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

We are providing mental health support to frontline workers. This includes a short video with a highly experienced and well-known MSF clinical and health psychologist that has been widely shared in hospitals and nursing homes across the country.

Portugal

Activities closed. MSF teams in Portugal visited nursing homes, and supported authorities and management teams to train staff and establish basic IPC measures. Our work in Portugal came to an end on 22 May.

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

Activities closed. In Geneva, where MSF’s international headquarters are located, our staff had provided logistical and sanitation support to areas where vulnerable people are living – reaching 1,300 families in the canton (administrative division) of Geneva – and provided training for staff and volunteers working with these groups. A logistician also supervised a weekly food distribution organised by different NGOs to 2,500 people.

We exchanged medical expertise with Hôpitaux Universitaires de Genève (HUG), the university teaching hospital in Geneva. MSF medical staff detached to HUG focused on patient care and managing medical teams. In partnership with HUG, our teams tested people for free based on their symptoms, and we also undertook contact tracing among vulnerable groups of people who have confirmed cases of COVID-19. We also provided recommendations to public and private mortuary services on procedures to avoid any post-mortem transmission of the disease.

In neighbouring canton Vaud, we undertook IPC and health promotion activities with staff working in structures that support vulnerable groups, such as the homeless, in Lausanne, Vevey and Yverdon-les-Bains.

All MSF activities in Switzerland came to an end by 16 May.

Ukraine

In Ukraine, MSF has expanded health promotion activities, providing people with information on how to prevent transmission of the virus. Our teams are providing psychological support to patients by phone. We have also launched a psychological support hotline in eastern Ukraine, covering Mariinka and Volnovakha raions (district), in Donetsk region, to help people living close to the contact line to cope with the additional stress of COVID-19.

Also in Mariinka, we have two mobile teams collaborating with the MoH to provide contact tracing, screening and home-based care for people with mild coronavirus symptoms, in order to prevent health structures from being overwhelmed.

We have provided infection prevention and control training – focusing on the proper use of protection equipment, infection control, and the flow of patients – at Central District hospital in Krasnogorívka. We are also undertaking screening and isolation activities, plus waste management, in four health facilities and a nursing home.

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.

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 proposed 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 deployed in support of an existing medical facility, as planned in the original design of our intervention.

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 will be used in Herat, in the COVID-19 treatment hospital which MSF is currently opening.
 
Regular MSF activities in Iran are continuing in South Tehran and Mashhad.

Iraq

In Iraq, our teams are supporting Baghdad’s Ibn Al-Khatib hospital with improving infection prevention and control measures and providing training on PPE. Also in Baghdad, MSF has sent specialist ICU staff who have started providing on-the-job clinical coaching support in Al-Kindy hospital, another facility dedicated to treating COVID-19 patients in the city.

In Mosul, MSF has equipped a 50-room building in the MoH-run Al-Salam hospital complex to isolate patients. Another hospital located in the same complex, Al-Shifaa, was rebuilt by MSF in 2019 and is now being used as the main COVID-19 referral point for patients in Ninewa province. We are supporting Al-Shifaa by setting up 40 isolation beds and 30 beds for treating people with mild and moderate cases; MSF will work in cooperation with local health authorities to treat the patients.

In Erbil, MSF has also been helping local health facilities by providing technical support, logistic support and training for their staff on infection prevention and control.

Triage has started in Laylan IDP camp (Kirkuk province) and in Abbasi, Hawija province. MSF staff in Hawija are also undertaking disease surveillance, and are building two COVID-19 mobile hospitals, in caravans, with 10-bed capacity in each, to treat mild coronavirus cases.

Lebanon

In Zahle, central Lebanon, where MSF runs a paediatric ward in the Elias Hraoui Governmental hospital – now a COVID-19 referral hospital – our teams are supporting the hospital staff by setting up a COVID-19 emergency room in tents outside the premises, and managing triage and screening of adults and children. We are also treating people suspected of having COVID-19 in the inpatient ward and the paediatric intensive care unit.  

We have trained hospital staff in Hermel, Saida and Tripoli including on IPC measures, and have provided hospitals in these areas with logistical support. 

MSF also launched a new pilot programme, consisting of training and assisting families in South Beirut and the Bekaa Valley with the practice of shielding. Shielding is a voluntary process that can provide additional protection to people at higher risk of contracting COVID-19, such as the elderly or people living with chronic diseases.

Meanwhile, a massive awareness campaign targeting frontline workers also took place in these two areas. MSF health promotion teams targeted people who are in daily contact with the community (such as taxi drivers, internal security forces, food distributors and waiters) to IPC measures, to avoid potential transmission of the virus when they do their work.

Closed projects
At the end of May, we launched a quick response unit in the Ras Al-Nabaa and Basta neighbourhoods in Beirut to support vulnerable people, where 70 people confirmed to have COVID-19 had been previously identified. MSF provided information to suspected and confirmed COVID-19 patients on their health condition, and also general health awareness sessions and mental health support. Over the course of 10 days, our teams took more than 200 swab samples of suspected cases in the Basta area for testing.

Libya

Activities closed. In Libya, our COVID-19 focused activities centred on providing training on infection control and case management to nurses and doctors in hospitals in Tripoli. Teams also provided training to medical staff in Zliten, Misrata, Khoms, Yefren and Bani Walid, and reinforced IPC measures in detention centres, including having installed handwashing points, distributed soap and cloth masks, and undertook health promotion with migrants and refugees, and detention centre guards.

Palestine

In Hebron, Palestine, the MSF team launched a hotline service to provide remote counselling in support to some of the people most affected by the COVID-19 outbreak, such as patients and their families, medical personnel and other first responders, and families of detainees. Our team is also distributing hygiene kits to remote villages and food parcels to families that need it as a result of the outbreak-related movement restrictions and loss of income.

Syria

In northeast Syria, we are providing training and preparedness measures in Al-Hassakeh National hospital and in Al-Hol camp. This includes creating a 48-bed isolation ward, introducing surveillance measures, identifying and treating people with COVID-19, and patient flow and triage processes. We are providing training on infection prevention and control measures and personal protective equipment usage training. MSF has also rehabilitated hospital wards, which are now receiving patients with COVID-19 symptoms.

In the country’s northwest, we have reviewed the triage systems and patient flow in some MSF-supported hospitals and health centres, to ensure fast detection and isolation of people suspected of having COVID-19. In Deir Hassan camp, we have engaged with internally displaced people on IPC measures via health promotion, and distributed hygiene kits, which include soap, to more than 6,800 families. MSF supported the Idlib National hospital with the design of a COVID-19 isolation unit. An MSF team also delivered a COVID-19 training to staff from other NGOs and the Department of Health. In Azaz, our team has set up a COVID-19 triage tent and distributed soap and information on IPC measures to people in the informal camps there.

Yemen

In Yemen, we have provided support to the Ministry of Health and have set up a COVID-19 isolation unit in Aden. MSF is now running the COVID-19 treatment centre at Aden’s Al-Amal hospital, and is providing medical and logistics support to Al-Ghanouria hospital in the city, following a sharp increase of suspected and confirmed cases in Aden. In Haydan and Khamer, we have set up COVID-19 treatment centres to take care of moderate cases and have begun admitting small numbers of patients with symptoms that resemble those of COVID-19.

In Hajjah Governorate, teams have been working in Abs and Al-Jambouri hospitals, including setting-up screening points in both hospitals and establishing a 11-bed capacity isolation unit in Abs hospital. We have also improved IPC measures provided training to MoH staff on COVID-19 symptoms and case definition, treatment, and IPC measures. An MSF-supported COVID-19 isolation centre is now officially part of Al-Gumhouri Hospital and is the referral hospital for COVID-19 for Hajjah governorate.

In Sana’a, we are supporting two hospitals. At Al-Kuwait hospital, we are treating people with severe cases of COVID-19 in the 15-bed intensive care unit, as well as running the large inpatient department. At Sheikh Zayyed hospital, we are providing technical expertise for screening set up, triage and infection prevention and control.

In Ibb governorate we supported local authorities to build two COVID-19 treatment centres, including at Al-Sahul COVID-19 treatment centre, which opened on 11 June and received its first patients on 1 June. Our staff is assisting in putting in place IPC measures, and assisting with technical support, triage and screening, facility management including workforce planning, and waste management. Teams also provided training on health promotion for MoH staff and private carers.

We have conducted training on, and have implemented, IPC measures, in hospitals across Hodeidah, Taiz Houban and Taiz city. Our teams have also set up an isolation unit in Al-Salakhana hospital in Hodeidah, and triage, screening and identification for potential cases at the hospital in Taiz city.

MSF and COVID-19

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.

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.

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



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