The Right Care for Victims of Violence
In Greece, operational research helps give a voice to victims of violence and provide them with better care. In a center for victims of torture in Athens, a series of interviews explored how asylum seekers and refugees who are survivors of torture perceive trauma, and suggested cultural background and social conditions directly affect rehabilitation.
In the Democratic Republic of the Congo (DRC), Doris Burtscher, a medical anthropologist with MSF’s Vienna Evaluation Unit, spoke with women in Mweso, Mambasa, and Lulingu, highlighting the need for safe abortion care. “While not all women who request abortions have been victims of violence, women often lack decision-making power and autonomy regarding their sexuality,” she said.
New and Persisting Challenges in HIV and TB Care
MSF often provides care for HIV and tuberculosis (TB) patients around the world, including in Guinea and South Africa. “In our hospital in Conakry, one in three patients with advanced HIV died after admission,” said Kassi Nanan-N’Zeth, the medical coordinator in Conakry. “Our research question was to know if and how care can be improved before, during, and after hospitalization,” he added.
In South Africa, the Bending the Curves project has been piloting community-driven models of care, such as HIV testing and counselling for people living far from health centers. “We compared data from household surveys in KwaZulu-Natal, South Africa, on HIV treatment and awareness,” says Vinayak Bhardwaj, deputy head of mission in Cape Town. “Our survey data shows us how successful our community mobilization, health promotion, and treatment services really were.”
Moving from Operational Research to Policy and Practice Change
MSF also uses operational research results to drive shifts in its programs, test and validate new tools to better treat patients, or advocate for policy changes at national or global levels.
In Zimbabwe, for example, operational research has led to a more comprehensive environmental health approach and an innovative WASH toolkit to site, drill, and better manage boreholes.
In Iraq, MSF and its partner Humanity & Inclusion are piloting a tool to assess the role of rehabilitation services in trauma care, and to collect better data on how to support patients on their way back to independence in their daily lives.
Nell Eisenberg, a clinician and infectious disease specialist, worked at the diphtheria treatment center in Cox’s Bazar, Bangladesh in 2018. Diphtheria is a vaccine-preventable disease that is no longer a major cause of death for children, but has been reported to re-emerge, particularly in areas of conflict and poor vaccination coverage. “Our research on MSF’s approach in Bangladesh explored the feasibility and safety of using diphtheria antitoxin to treat diphtheria in low-resource settings,” Nell said.
In Guinea’s capital Conakry, another study focused on the reasons for children not being reached during measles mass vaccination campaigns. These interviews and discussions now help to pinpoint misconceptions and barriers limiting MSF’s vaccination approach.
To learn more about the above studies and how operational research helps MSF evaluate and improve its programs, check out the presentations from the 2019 Operational Research Day. Further information on MSF’s Operational Research Unit LuxOR and the MSF Southern Africa Medical Unit SAMU is available on their websites and Twitter accounts.