Access to basic healthcare and advanced medical procedures can be limited in many developing countries around the world. Especially when catastrophes strike, doctors and paramedical staff in these areas may be inadequate or non-existent at all. Responding to the call is Médecins Sans Frontières/Doctors Without Borders (MSF), an independent global movement on a mission to provide emergency medical assistance to those who need it most.
With teams in more than 60 countries, Doctors Without Borders works in conflict zones after natural disasters, during epidemics and armed conflict, or settings where long-term care is needed. According to Dr. Michael Basco, an obstetrician-gynecologist and pharmaceutical professional based in Dallas, the work done by MSF is lifesaving, especially since they focus on fast response and medical treatment to anyone regardless of gender, religion, or political convictions. Some of the medical issues addressed by MSF are cholera, Ebola, HIV/AIDS, malaria, malnutrition, maternal health, mental health, meningitis, sexual violence, tuberculosis, vaccination, and yellow fever.
As a medical professional, Dr. Basco commends how prepared and thorough Doctors Without Borders is when it comes to providing emergency medical help. Aside from the prompt availability of volunteers, MSF has pre-packaged disaster kits, a complete surgical theater, an obstetrics kit, and an inflatable hospital – all of which are ready to go at a moment’s notice. Doctors Without Borders also has logistic centers and warehouses around the world where they house and test equipment, communication paraphernalia, power supplies, vehicles, shelter kits, and water-processing facilities.
Nevertheless, Dr. Michael Basco says there are many challenges that Doctors Without Borders encounter despite having secure systems in place. Some of them are shared below:
Access to Medicines
According to Dr. Basco, doctors and paramedical personnel in Doctors Without Borders are sometimes unable to treat patients because medicines are highly priced or are no longer produced. As such, they actively campaign through a few initiatives such as the MSF Access Campaign, Drugs for Neglected Diseases Initiative (DNDi), and field research. Through these, they can push price cuts to medicines, vaccines, and diagnostic tests. The organization also works to direct medical research to urgently needed drugs, tests, and vaccines. Furthermore, research on neglected diseases such as tuberculosis, malaria, and sleeping sickness are made possible to bring these ignored maladies to the light.
Barriers to Vaccination
According to the MSF website, vaccination saves 2-3 million lives each year – but 1.5 million more could be saved through the implementation of global vaccination coverage. Dr. Michael Basco says some barriers hinder children who live in low-source countries from getting vaccines.
- Vaccines are expensive: As new vaccines were added to immunization programs, they became more expensive through the years. Low-income families struggle to put food on the table, and vaccinating the children may not be a priority for most. MSF recognizes this problem and continuously works to access vaccines for the lowest price possible. In their campaign “A Fair Shot,” they were able to successfully drop the price of the pneumonia vaccine from $75 to $3.05 per dose for their vaccination campaigns in humanitarian emergencies.
- Many children live in conflict areas or remote places: For many developing countries, having paramedical staff distribute and inject vaccines in communities requires substantial costs that they cannot afford. In areas where health care systems are disordered, children often have nowhere to get their routine vaccinations.
- Vaccines are temperature-sensitive: Another hurdle to vaccine coverage is that nearly all vaccines require refrigeration. Storing vaccines in a “cold chain” during shipping and until used is challenging in impoverished settings.
Provision for Mental Health
Dr. Michael Basco says that mental health is an extremely important aspect that is not overlooked by Doctors Without Borders. For more than 20 years, MSF paramedical teams have worked in areas that are stricken by disasters or armed conflict, leaving people in shock and despair. Many have lost their family members, some may be victims of sexual violence, and others may be experiencing trauma. Through counseling services, MSF listens to these people’s stories and helps them cope. However, setting up mental health care programs in emergency situations can be complicated, especially when violence and conflict are still ongoing. Furthermore, treating mental health conditions may require long-term visits, which, given the unstable situation, is difficult to guarantee.
Challenges in Maternal Health
As an obstetrician-gynecologist, Dr. Michael Basco recognizes the importance of medical assistance during birth. In conflicted areas, however, many women are forced to give birth without any medical help, increasing complications, and maternal death. Some serious complications in delivery include reproductive tract infections, eclampsia, postpartum hemorrhage, and other infectious diseases.
The emergency obstetric care program by Doctors Without Borders helps address the crucial “three delays” during birth: delay in deciding to seek care, delay in reaching a health facility, and delay in receiving appropriate treatment at the facility. During times when health services are dismantled in disaster-stricken areas, emergency obstetrical needs are among the major needs that require attention by paramedical staff.
Dr. Michael Basco believes that MSF is one of the most important medicinal organizations in the world and has been a major factor in improving the quality of life of millions annually around the globe.