Focus on one of the world's most climate-vulnerable countries
Niger is one of the most climate-vulnerable countries in the world. Our team in Magaria have observed that the “malaria season” appears to be changing, possibly linked with changing rainfall patterns, as this impacts the mosquitoes that spread malaria. Patients and community members are telling us the rains have changed over recent years, starting later and ending earlier this year, bringing heavy rains and floods. This year, the “meningitis season” lasted longer than previous years.
Meningitis spreads more during the dry and hot season and then usually slows down when the first rains come. The rains started late this year and meningitis took longer to go away. In the area, people depend on agriculture to survive and the changing rains impact the local food production. These changes result in less crop yield, and the decreased availability of food impacts people’s health and increases their vulnerability.
In response, we are increasing our medical activities and support to communities.
To improve access to basic health services and address needs in an area with high malaria prevalence, we have put in place a health network of community activities. The aim is to prevent medical complications in children under five in the most isolated villages. Community liaison officers screen children and provide treatment. If the child’s clinical condition requires more advanced care, the community liaison officer refers the patient to the nearest health centre, which in turn will refer the most critical cases to the district hospital. Between the start of the project in May 2019 and the end of 2020, the community liaison officers alone provided care for 158,000 children, almost 60% of whom had malaria. To date, MSF and Ministry of Health teams have trained more than 278 community liaison officers.
Democratic Republic of Congo
A "door-to-door" strategy for malaria
The DRC is one of the most climate-vulnerable countries in the world and climate change worsens existing humanitarian and health problems.
Ituri Province is plagued by conflict, displacement and recurring epidemics. In Angumu health zone, malaria is the main cause of death among children under five. In recent years teams have observed what appears to be a trend of heavy rains and have treated a high number of malaria patients.
To reduce the number of deaths, MSF concluded a 4-month long preventive mass drug administration (MDA) campaign in January 2021. More than 75,000 people received the necessary 3 rounds of preventative treatment. Based on a “door-to-door” strategy and challenged by remote locations and transport difficulties, the MDA campaign involved around 2000 persons including MSF teams, community leaders and civil society actors as well as regional MoH health workers.
At the end of this intervention, the teams observed a 67% reduction in malaria cases in some places. This leads us to believe that MDA can be a useful additional way to control malaria in complex settings.
Climate change, instability and malnutrition
More than two decades of conflict, political instability and extreme weather conditions have led to one of the world's most prolonged humanitarian crises in Somalia. Intense and frequent flooding, droughts and locust swarms have combined to disrupt food security and diminish livelihoods. This has increased competition for scarce resources, exacerbating existing tensions and affecting the most marginalised people.
The most significant impact of climate change is in the form of malnutrition among children.
If climate change continues as predicted, MSF warns that reduced food production and the reduced nutritional quality of some cereal crops may threaten to increase the risk of undernutrition, with infants often the most affected.
In response, MSF runs an anti-hunger programme in southern Somalia, which aims to prevent and treat acute malnutrition during the lean season through active surveillance, screening and outpatient treatment. In Gedo and Lower Juba regions, we launched three emergency interventions to treat severely malnourished children and address critical water shortages.
More people are on the move in search of food and water, even as the risk of COVID-19 remains and a measles outbreak continues unabated in Dhobley and Kismayu. Pastoralist communities are also affected as they have lost livestock to thirst due to water shortages. Mohamed Ahmed, MSF project coordinator in Jubaland
MSF responds to two consecutive cyclones in 2019
MSF responded to two back to back cyclones in 2019. The flooding and damage destroyed homes and caused widespread devastation, disrupting essential health services.
We scaled up our activities in response to cases of cholera that were declared in Mozambique in the weeks after the disaster; at the peak, our teams were treating around 200 cases of suspected cholera per day. We supported the Ministry of Health to vaccinate 900,000 people against the disease, set up two water treatment plants, rehabilitated 18 health centres and distributed relief items, such as soap, mosquito nets, cooking utensils, blankets, mats and buckets.
In total, we conducted nearly 11,900 outpatient consultations, primarily for malnutrition and malaria, in 25 locations. The catastrophic impact of two cyclones in such a short space of time was compounded by months of drought later in the year. Together they exacerbated the already serious food insecurity and malnutrition situation in the country.
Mozambique is a one of the most climate-vulnerable countries in the world and to ensure we can provide timely and relevant assistance, we are now preparing to start new medical activities focusing on response to vector borne disease, Neglected Tropical Diseases and preparedness for natural disaster.
Limited or no access to health care for two million people
In late 2020, when hurricanes Eta and Iota hit Central America in quick succession, more than 120 health centres in Honduras were damaged or destroyed – some simply disappearing into the mud. Two million people were left with limited or no access to care.
Yet even before the storms, the health system in Honduras had been under considerable strain. Hospitals struggled to accommodate COVID-19 patients, while a dengue outbreak driven by insecticide-resistant mosquitoes loomed as a result of poorly-implemented vector control efforts.
To address this, MSF has implemented measures to bolster health system resilience to climate-related threats in Honduras. These include vector control activities and a dengue fever surveillance system to pre-empt outbreaks, which place additional stress on the health system.
We have slept in the fields. We have endured hunger and sleepless nights. At the Coatzacoalcos shelter, they told us that it was closed. I am afraid of staying on the street because anything can happen to us. I am afraid that my son will be taken from me. I don't sleep because while my son sleeps, I keep watch. Kimberly, a Honduran woman who lost her home and possessions in the hurricanes, while migrating through Mexico with relatives
Powering healthcare with solar energy in Balochistan
In four districts of Balochistan, Pakistan, MSF supports health facilities that provide care to more than 12,000 expectant mothers and approximately 10,000 children suffering from malnutrition each year. However, frequent power cuts and rising temperatures in the summertime make it difficult to maintain a cool temperature for patients, health workers and the preservation of medicines. This is a challenge given frequent power cuts and temperatures that can reach 50 degrees Celsius in the summertime.
To address this, MSF has installed solar panel systems at the facilities it supports in Dera Murad Jamali, Chaman and Kuchlak. Supplemented by grid or generator electricity, these systems provide uninterrupted power for lighting, air conditioning and fans, and water pumping and cooling, while averting more than 50,000 kg of carbon emissions per year.
As medical practitioners, our job is not only to treat people, but to prevent future illness from occurring. We must not create problems for tomorrow while trying to solve the health problems of today. Dr. Monica Rull, MSF Medical Director