Opinion by Brice de le Vingne, head, MSF emergency desk
One year ago, on 11 March 2020, the World Health Organization declared the outbreak of COVID-19 a pandemic. At Doctors Without Borders/Médecins Sans Frontières (MSF) – where providing medical care during epidemics and pandemics is at the core of what we do – we faced dual challenges. We needed to find a way to respond to outbreaks of this new disease, while keeping our regular medical programmes running and reacting to new emergencies, such as the conflict in Ethiopia and the Ebola outbreaks in Democratic Republic of Congo and Guinea.
In January 2020, MSF’s first COVID-19 project opened in Hong Kong, focusing on health education for vulnerable people, such as the elderly and the socio-economically disadvantaged. By March, what was now a pandemic was spreading like wildfire across Europe, and MSF launched projects in some of the most severely affected countries, including Belgium, Spain and Italy.
We provided support to hospitals, sending in medical teams experienced in outbreaks of infectious diseases. We also did what we could to train our colleagues in how to keep themselves safe, knowing how exposed health staff can be during outbreaks.
Increasingly, we turned our attention to elderly people in nursing care homes, whose age and living environment made them extremely vulnerable to the new coronavirus. From March onwards, as the pandemic continued to spread around the world, MSF followed in its tracks, opening new projects and adapting existing ones, as we always do during epidemics, but this time on a global scale.
But it was not just the scale that was different. At the first sign of other epidemics, such as cholera or yellow fever, we increase the size of our teams in the area, send in our experts and deliver tons of additional supplies. But as the new coronavirus tightened its grip in more and more countries, many governments closed their borders. Moving medical staff and supplies to where they were needed became very challenging.
But the differences are only superficial. At its heart, our response to COVID-19 has been no different from our other medical projects. We focus on those places where the highest numbers of people are falling sick and dying, and we look for the most vulnerable people.
BRICE DE LE VINGNE, MSF HEAD OF EMERGENCIES
“Our response to COVID-19 has been no different from our other medical projects. We focus on those places where the highest numbers of people are falling sick and dying, and we look for the most vulnerable people.”
During the pandemic, this approach has seen us setting up medical projects in places where we rarely work, such as the United States and in several countries in Europe. It has seen us helping groups of people we don’t often help, such as residents of nursing care homes. But our medical reasoning has not changed. And a lot of the people we have assisted are not new to MSF: refugees and people on the move, people in rural areas with poor access to healthcare, neglected communities in cities…
In trying to help the people most in need, we have initiated a wide range of activities over the past 14 months, depending on what forms of support were most useful to local health systems. We have organised large numbers of training sessions for frontline health staff, both in well-equipped hospitals in wealthy places and in very basic facilities. We supported them with infection prevention and control and disinfection, triage of patients, staff and patient flow.
We have cared for patients: the mildly sick, the severely sick and the dying. In some places we’ve supported intensive care wards, in other places we ran them. We have distributed masks and taught people how to employ simple preventive measures to keep themselves safe, such as keeping a distance and washing their hands. We reached millions of people with these messages on social media. And we have provided many, many sessions of mental healthcare, mainly for staff on the frontline of the pandemic.
Having ourselves worked on the frontline of epidemics, we know first-hand how demanding, how exhausting and how stressful this work can be. Many of the health staff who have worked so tirelessly over the past year had little or no previous experience of outbreaks of infectious diseases.
None had experience of COVID-19. Faced with a new and unknown disease, lacking the tools to treat patients, scared of being infected at work and passing the infection on to loved ones at home – this pandemic has been an enormous emotional burden for frontline health staff. We must take care of the people who take care of us.
One year after its official declaration, the pandemic has not faded. Safe and effective vaccines now exist, but for the vast majority of people they are not yet available – and may not be for a long time. Often, the people who fall through the cracks in the system when it comes to preventive measures and access to healthcare, are the very same people who will again fall through the cracks for vaccination. Dedicated to help the most vulnerable, it looks as if our role in this pandemic is not over yet.
