Médecins Sans Frontières Australia acknowledges the Gadigal of the Eora nation, the traditional owners of the land on which our office is located. We recognise their ongoing custodianship of land, waters and culture. We pay our respects to Elders past and present.
Whakataukī
Nāu te rourou, nāku te rourou, ka ora ai te iwiWith your basket and my basket, the people will thrive.
This whakataukī encompasses the idea that when people work together and combine resources, we can all flourish. It was chosen by our Māori partners Deborah Harding and Tracey Poutama.
On any given day, in different corners of the globe, an MSF midwife is supporting a family to welcome their child into the world; a counsellor is providing psychological first aid for an elderly woman amid the trauma of war; there is a father bringing his daughter for vaccinations at an MSF health clinic; and there is a supporter like you, contributing their care and resources so that another human being can access the healthcare they need.
Last year brought many challenges for MSF’s people. After the horrific 7 October attacks in Israel by Hamas and the launch of Israel’s indiscriminate assault on Gaza, people in Gaza were forced to repeatedly flee as their homes, the tents and schools they sought shelter in, and hospitals serving hundreds of patients were bombed and fired upon.
Our colleagues went above and beyond to continue providing lifesaving care despite great risk to their own lives. We honour the work and lives of the more than 500 health workers killed in Gaza while providing care for patients or sheltering with their families, including our own Palestinian staff.
In 2023, Israel’s assaults on healthcare, humanitarian aid and civilians in Gaza set a new, chilling precedent of how wars are waged, as did similar attacks by warring parties in Sudan despite rarely making global news headlines. After the war in Sudan broke out in April, MSF adapted our activities to assist people affected by gunshots and stabbings, and sexual violence—including violence that was ethnically targeted— as well as alarming rates of malnutrition.
Local authorities blocked the delivery of critical medical supplies in some areas, and our teams came under attack, forcing us to temporarily suspend care in some facilities. By the end of 2023, tens of thousands of people had been killed, and more than seven million had been uprooted from their homes. Many people were struggling to obtain medical care, food and water.
MSF was joined by many of our supporters across Australia and New Zealand in condemning the horrific suffering of people in Palestine and Sudan, including 92,000 of you who have so far signed a statement of support for a ceasefire in Gaza. The wars in Sudan and Palestine continue to be a priority focus for MSF in 2024.
MSF Australia continued our work in partnership with Rohingya communities in 2023, including supporting a creative advocacy initiative with storytellers, young artists and families to share Rohingya culture and stories of survival with kyssa (traditional folktales) in our hospitals in the Cox’s Bazar camps in Bangladesh, as well as in Sydney. Jennifer visited the camps, where more than a million Rohingya people have lived for almost seven years. MSF continues to advocate with the Australian government to help find durable solutions for Rohingya communities in the Asia Pacific.
Out of a total of 138 departures of Australian and New Zealand project staff supported by our international HR team, 13 of these were to Kiribati, a small island state in the Pacific Ocean where the climate crisis is compounding complex health challenges.
MSF is not only about healthcare; it is also about solidarity. In the coming years and decades, the world will need to make important decisions about how we will show up for each other in times of war, climate-induced displacement and epidemics.
For now, it is clear that MSF’s solidarity lives in the relationships between our staff, the patients and communities we work with, and our generous network of supporters, of whom the majority are private donors; everyday people who believe in medical humanitarian aid and in reaching beyond themselves for the good of humanity.
Katrina Penney President
Jennifer Tierney Executive Director
Right: A mother at home in Jarokashan, a village in Bande-Amir in Bamyan province, Afghanistan, with her baby girl who she gave birth to at the MSF community health facility.
Without Borders (MSF) is an independent international medical humanitarian organisation that delivers emergency aid to people affected by armed conflict, epidemics, disasters and exclusion from healthcare.
We are doctors, nurses, logistics experts, administrators, epidemiologists, laboratory technicians, mental health professionals, and many others who work in accordance with MSF’s guiding principles of independence, impartiality and neutrality, and medical ethics.
2023 Key Figures
16.5 million outpatient consultations
337,000 births supported
1.9 million emergency room admissions
4.6 million routine vaccinations
493,900 individual mental health consultations
62,200 survivors of sexual violence treated
Medical highlights
In 2023, the Medical Unit’s women’s and children’s health team supported MSF’s emergency response to conflict-driven crises and infectious disease outbreaks in multiple countries, alongside ongoing work to improve quality of care in all projects.
The Sydney-based Medical Unit brings together multinational expertise in obstetrics and midwifery, paediatric and newborn care and nursing, and sexual violence care, from Sydney, Dakar, Paris and Berlin.
The women’s health team was busy throughout the year working remotely and directly in projects, including helping establish six new projects to address sexual and reproductive health (SRH) and sexual violence care for communities in, and displaced from, Sudan and North Kivu, Democratic Republic of Congo. The advisors also oversaw the successful integration of specific aspects of maternal healthcare into projects already up and running for other needs, seizing this important opportunity to expand access to essential healthcare services for women and girls.
Enhancing quality of care for women and their newborns continued to be a priority. The women’s health team supported implementation of regular maternal mortality audits and reinforced the importance of respectful maternal and newborn care practices. The advisors also collaborated on models of engagement to promote healthcare at community level, including working with women fulfilling the role of birth attendants in their communities.
Community collaboration was a key feature of the unit’s sexual violence care strategy, to address some of the barriers that survivors face in accessing care, and to improve the quality of care provided. As an example, in response to the significant increase in sexual violence in North Kivu, a community-based approach in two locations allowed 137 survivors to receive an initial bundle of care from community health workers close to their homes, and then be offered a referral to the health facility for further care.
Children remain the largest cohort of patients seeking care in MSF facilities worldwide and the child health team continued to support project teams to provide both acute and chronic care to this vulnerable group.
The advisors provided agile support to emergency epidemic responses, including those prompted by measles and cholera outbreaks in several Middle Eastern and African countries, and supported the establishment of a diphtheria treatment centre in Maiduguri, Nigeria.
In Bangladesh, the launch of humidified high-flow nasal oxygen to improve ventilation and oxygenation in children with moderate to severe respiratory distress built on the implementation achievements of “high-flow” in Yemen, as overseen by the unit’s advisors.
Meanwhile the team continued its significant contribution to the new edition of MSF’s Paediatric Guidelines, due for release in 2024.
“In Liberia, MSF’s team asked for training to help them manage children with severe epilepsy and associated health problems specifically, in our epilepsy clinics. We created a two-day developmental milestones training, held during my visit in 2023. It was innovative and necessary, and best of all, the trainers were selected from the Liberian team itself. I have rarely seen such a high level of involvement, knowledge and motivation in a team.”
Dr Inma Carreras
Paediatrician
“We continued the investment in high-flow in Yemen with a review by the initial nurse implementor of implementation since 2020, and are planning to scale up with introduction of highflow in Herat, Afghanistan, and Kenema in Sierre Leone, complemented by operational research in each project.”
Dr Nikola Morton Paediatrician
Melissa Hozjan Paediatric Nurse
“We held a sexual and reproductive health training in northwest Syria with gynaecologists and midwives from multiple locations, the first training inside Syria after many years of remote management, and after the 2023 earthquake. The participants were very eager to learn more, and to grow their skills. We focused on sexual and gender-based violence and safe abortion care and, together with the local team, developed a pathway to better care for all.”
Dr Katharina Weizsacker
Obstetrician-gynaecologist
Clémence Chbat
Midwife
Financials snapshot
Our funding largely relies on individual donations. This helps to ensure our operational independence and flexibility to respond at a moment’s notice to the most urgent crises, including those which are under-reported or neglected.
Income
In 2023, 75 per cent of our financial resources were allocated to fulfilling our social mission, which includes our medical humanitarian programs as well as advocacy and awareness raising activities. During the year, we invested in a new donor database system for greater data insights, alongside our ongoing focus on accountability mechanisms and high-quality communications with our supporters.
* Examples include single donations from our regular giving programs (e.g.: face to face, telefundraising) and community fundraising programs. ^ Examples include pro-bono donations and membership fees.
The 2023 income of MSF Australia and MSF New Zealand totalled $120.9 million. Of this, $112.4 million was generated from fundraising activities. This is a 12 per cent increase from 2022 fundraising income and represents continued generous support from the Australian and New Zealand public. Approximately 125,019 Australians and New Zealanders participated in the Field Partner program in 2023, contributing on a monthly basis, and another 68,317 Australians and New Zealanders provided occasional gifts.
Finance
Our investment policy within Australia and New Zealand remained consistent with previous years. Short-term deposits were used to maximise interest, minimise risk and ensure flexibility and accessibility of funds when required.
The generous support of our office volunteers equalled approximately $37,075 (compared to $42,389 in 2022). Additionally, the Board of Directors (except for the President, who received a partial salary) and Association members freely gave their time to MSF. The estimated total value of this time was $489,000 (compared to $501,000 in 2022). In 2023, $844,000 was spent on the Southeast and East Asia and Pacific (SEEAP) project, now known as the Asia Pacific (APAC) Project (compared to $660,000 in 2022).
Spending by region
MSF Australia and MSF New Zealand spending on our medical humanitarian programs in 2023 was distributed across the following regions.
Please access our full financial statements for 2023 at our website.
AU and NZ consolidated: msf.org.au/document/2023financial-report
Below: An MSF team unloads supplies in Rhoe camp, where around 70,000 people live in dire conditions, in Ituri province, Democratic Republic of Congo.
Our project staff
Thank you to all of the Australian and New Zealand professionals who worked operationally with MSF in 2023. This includes 116 Australians and 16 New Zealanders who departed in 2023.
This list comprises only staff recruited by MSF Australia, who also gave their consent for their name to be printed. We also wish to recognise other Australians and New Zealanders who have contributed to MSF programs worldwide but are not listed here because they joined the organisation directly overseas.
Scott Abbinga
David Adams
Eithandee Aung
Audrey Badaoui
Patrick Baffoun
Florence Bascombe
Paul Blackery
Maia Blenkinsop
Eric Boon
Rodolphe Brauner
Brigid Brown
Susan Bucknell
Lucy Butler
Ivan Cerrafon
Kathrine Charlton
Isaac Chesters
Esther Choi
Prem Chopra
Joanne Clarke
Peter Clausen
Prue Coakley
Donna Collins
Shelley Cook
Louisa Cormack
Jessica Crawford
Lindsay Croghan
Amy-Louise Curtis
Frederick Cutts
Katie Dabbs
Justin Dalby
Meg Dalmau
Natasha Davies
Tecwyn Davies
Catherine Day
Andrew Dimitri
Thienminh Dinh
Herwig Drobetz
Malaika El Amrani
Rhys Evans
Janine Evans
Catherine Flanigan
Mok Fong
Isaline Goemaere
Eileen Goersdorf
Josephine Goodyer
Sarah Graham
Megan Graham
Jane Hancock
Shelley Harris-Studdart
Anna Haskovec
Ian Hayes
Melony Heaver
Adelene Hilbig
Thomas Hing
Michael Hoey
Ann Hood
Holly Houttuin
Malcolm Hugo
Rhianon Hutcheson
Anthony Jacobson
Vivegan ‘V.v’ Jayaretnam
Arunn Jegan
Anna Jenkins
William Johnson
Jairam Kamala
Ramakrishnan
Alec Kelly
Douglas Kerr
Verity Kowal
Kirk Langley
Virginia Lee
Gloria Leung
Eloise Liddy
Siobhan Lockie
Candice Lynch
Carmen Macdonald
Paul Maclure
Lenore Maitland
Claire Manera
Adam Mangal
Alison Moebus
Brian Moller
Luke Morris
Gerard Moynihan
Scott Murcko
Allen Murphy
Khairil Musa
David Nash
Carol Nagy
Désiré Ndisabiye
Gail Page
Kristi Payten
Darren Pezzack
Sophie Phelan
Tara Pollock
Jessa Pontevedra
Narelle Raiss
Hannah Rice
Philippa Rokkas
Emma Roney
Trudy Rosenwald
Kiera Sargeant
Sunil Satyavrata
Emma Schimann
Caterina Schneider-King
Helmut Schoengen
Sophia Scrimgeour
Lisa Searle
Christian Seufert
Ben Shearman
Suzen Siew
Stella Smith
Rebecca Smith
Rachel Sun
Mauricia Taylor
Linley Taylor
Natalie Thurtle
Louise Timbs
Kaylene Tomkins
Andrew Wallace
Jared Watts
Suzel Wiegert
Priyali Wijeratne
Kelly Wilcox
Noni Winkler
Scarlett Wong
Grace Yoo
Emily Young
138 DEPARTURES OF PROFESSIONALS IN 2023 FROM AUSTRALIA AND NEW ZEALAND
34 COUNTRIES WORKED IN CONTRIBUTING TO A GLOBAL WORKFORCE OF 46 , 000 + FULL TIME STAFF
*’Paramedical’ includes all health professionals who are not doctors.
Where you helped
In 2023, MSF ran medical humanitarian projects in more than 70 countries. Our donors in Australia and New Zealand supported work in 34 of those countries, as well as in four additional international projects.
Funded by Australian and/or New Zealand donors
Funded by other MSF offices
Support in action
In this section are examples of what MSF’s people achieved together in 2023, across the eight countries that received most funding from Australian and New Zealand supporters: Palestine, Yemen, Niger, Sudan, South Sudan, Afghanistan, Bangladesh and Nigeria.
Also included are “In Focus” highlights across our emergency fund, malnutrition care, women’s health and the Climate Smart project.
Regions where MSF ran projects in 2023
Cities, towns or villages where MSF ran projects in 2023
The maps and place names used do not reflect any position by MSF on their legal status.
Below: MSF doctor Sohaib Safi stands on the site of the former Al Shuruk residential tower in Gaza City, which was demolished by an Israeli airstrike in 2021 (May 2023).
ANZ FUNDING:
$5,547,983
TOTAL FUNDING:
$38.9 MILLION
ANZ STAFF: 8
TOTAL STAFF: 374
STAFF MEMBER:
In 2023, MSF adapted our activities in Palestine to assist people injured and displaced in the bloody war waged on Gaza by Israel.
During the first three quarters of 2023, our teams delivered specialised medical services in the Gaza Strip, offering support at three hospitals and various outpatient clinics, as well as the main laboratory.
After Hamas attacked Israel and Israel launched a war on Gaza in October, the already strained healthcare system crumbled under the Israeli attacks, and hospitals in Gaza City were overwhelmed with patients and people seeking refuge. The attacks were accompanied by a complete siege of Gaza by the Israeli authorities, blocking people’s access to food, medical materials, medicines and humanitarian aid.
Finding tools for trauma
New Zealand psychologist Siobhan Lockie worked in the West Bank from May 2023 until February 2024.
MSF struggled to keep medical activities up and running. By the end of December, our teams were operational in six hospitals (Al-Awda, Al-Aqsa, European, Nasser, Rafah Indonesian and Emirati Maternity Hospital) and one general healthcare facility, Al-Shaboura clinic, mainly in the Middle Area and South of Gaza. There were only a few MSF staff still working in Al-Awda hospital in northern Gaza offering surgical and wound care, physiotherapy, outpatient consultations and mental health services.
In the West Bank, MSF maintained our mental health activities in Hebron, Nablus, Qalqilya and Tubas to provide psychological support, psychotherapy and psychiatric services to people affected by occupation-related violence. In Jenin refugee camp, we offered emergency care in Khalil Suleiman Hospital for patients injured in attacks by Israeli forces.
“There was a young father who sought mental health support with our team; he had been living in Jabalia refugee camp in Gaza with his family. He was working in Israel before the war, and like many men, in October he was prevented from returning to Gaza and became stuck in Nablus (West Bank). He was trying to get home to his children and pregnant wife.
“I gave this patient some breathing strategies to help calm his mind. I was acutely aware that this seemed like quite a limited tool to deal with what he was going through: separation from his family while they were being bombed. But he returned the following week and told me that the breathing techniques were very useful, and that he had been using them every day. He had taught them to his seven-year-old son over the phone, and his son had shown his sisters and their friends too. I was so humbled when he told me this.”
Jerusalem
Nablus
Gaza Strip West Bank
Rafah Gaza City
ANZ FUNDING:
$5,515,954
TOTAL FUNDING:
$178.9 MILLION
ANZ STAFF: 12
TOTAL STAFF: 2,768
MSF continued to support Yemen’s fragile health system, providing comprehensive medical services and responding to surging rates of malnutrition and vaccinepreventable diseases.
War and the consequent economic deterioration continue to have a severe impact on people’s health, living conditions and access to basic services. Although the large-scale conflict in Yemen generally abated in 2023, bombing of northern Yemen exacerbated an already appalling humanitarian situation.
MSF supported 17 hospitals and 18 other health facilities in 13 governorates, focusing on maternal and child health, specialist and emergency care and responding to malnutrition and outbreaks of preventable diseases such as cholera, diphtheria and measles.
We responded to a surge in malnutrition cases among children in several governorates, such as Taiz, where we started supporting the outpatient therapeutic feeding centre in Mafraq al Mocha, and in Hajjah, where we extended the capacity of the inpatient therapeutic feeding centre at Abs general hospital from 45 to 88 beds during the peak malnutrition season.
In response to a rise in measles cases in Al-Baydah, we offered treatment and conducted training sessions for healthcare providers on managing the disease in eight locations. An unprecedented surge in cases in Taiz led teams to open a 16-bed measles isolation unit inside our mother and child hospital in Taiz Houban.
SUPPORTER:
In memory of Camilla Ah Kin
Performer, actor and activist Camilla Ah Kin was known for throwing her heart and soul into every venture.
This was true in her time on stage with major theatre companies; as a much-loved face on film and TV; and in her work fighting for the rights of artists and art workers with Actor’s Equity and the Media, Entertainment and Arts Alliance (MEAA). “Ferocious is the first word that comes to mind, on stage and off. A ferocious concentration, focus, attention to detail, and commitment. Fiery, passionate, grand,” says Camilla’s lifelong friend Tim.
Camilla was a fierce advocate for those whose voices needed to be amplified, and this work that she was so passionate about will now continue through the special legacy she has left behind with MSF. Camilla’s gift in her will to MSF will make a significant contribution to our work and will help ensure we remain independent and ready to respond. MSF is grateful to honour Camilla’s memory through our work.
We thank the many generous people who left a gift to MSF in their will in 2023.
MEDECINS SANS FRONTIERES ANNUAL REPORT 2023
Aden
Ibb Taiz Abyan
Sa’ada
Dhamar Sana’a
Amran Marib Hajjah Shabwah
Hodeidah Lahj
Al Bayda
ANZ FUNDING:
$5,300,000
TOTAL FUNDING:
$74 MILLION
ANZ STAFF: 2
TOTAL STAFF: 1,729
The political crisis that unfolded in July 2023 in Niger compounded pre-existing humanitarian needs in the country.
Restrictions on access imposed on humanitarian NGOs as well as border closures severely disrupted the medical supply chain, particularly for nutrition products. However, MSF continued offering comprehensive care in hospitals and integrated health centres in Tillabéri, Maradi, Zinder, Tahoua and Diffa regions. This included maternity, paediatric and nutrition services.
We also continued to build and upgrade facilities in these regions as part of our long-term partnership with Nigerien health authorities to improve access to healthcare for people in vulnerable circumstances.
In Assamaka, several international NGOs withdrew, leaving thousands of migrants expelled from Algeria to fend for themselves in the desert of northern Niger, deprived of shelter, healthcare, protection and the basic necessities. In response, MSF distributed water and essential relief items such as hygiene and cooking kits and provided mental health support, while publicly denouncing the appalling conditions migrants were forced to live in.
A man is vaccinated for diphtheria in Zinder region as part of an MSF campaign to reduce illness and death from the infectious disease.
After a brutal war erupted in Sudan in 2023, MSF quickly adapted activities to respond, despite security and administrative challenges.
On 15 April 2023, intense, unexpected fighting broke out between the Sudanese Armed Forces and the paramilitary Rapid Support Forces (RSF) in Sudan’s capital, Khartoum. The violence spread nationwide, leading to tens of thousands of casualties and uprooting millions of people from their homes.
MSF had been expanding medical activities across 11 states of Sudan since 2019, amid a volatile transition after the ousting of former president, Omar al-Bashir. There were already large groups of displaced people throughout pockets of the country, as well as refugees from neighbouring countries.
In the first 48 hours of the fighting in April, the MSFsupported South hospital in El Fasher, North Darfur, received 136 wounded patients. Patients had to be treated on the floors and in the corridors due to the lack of space, in what was originally just a small maternity facility with no surgical capacity.
Over the following weeks, we transformed it into a hospital with an operating theatre and emergency room, with the capacity to respond to masscasualty events.
In Khartoum, where the war began, fierce street fighting, shelling and airstrikes took place. Most hospitals in the city quickly ceased to function, and the facilities that were able to remain open were rapidly overwhelmed. MSF teams in Khartoum continued to support by donating medical supplies to hospitals and making assessments. In early May, we brought in a full surgical team to Bashair Teaching Hospital. By June, we were fully operational in the Turkish Hospital, originally a small maternity and paediatric facility with no surgical capacity that we converted into a facility capable of responding to masscasualty events.
In other states, our work included support for mother and child health, and responses to measles and malnutrition in camps for displaced people.
We provided medical consultations in existing health facilities and via mobile clinics, and adapted activities in an effort to meet the needs of people who were displaced several times by the fighting.
Al-Gedaref
Kassala
Central Darfur West Darfur Blue Nile Al Jazirah White Nile South Darfur
North Darfur Khartoum
South Sudan
ANZ FUNDING:
$4,352,941
TOTAL FUNDING:
$175.8 MILLION
ANZ STAFF: 8
TOTAL STAFF: 3,773
In 2023, MSF provided care to people affected by violence, displacement, disease outbreaks and natural disasters.
MSF’s program in South Sudan continued to be one of our largest worldwide, stretching across seven states and two administrative areas and reaching over a million people. We delivered a broad range of basic and specialised health services to remote communities, refugees and people displaced by violence, through both fixed and mobile clinics, as well as through community-based programs.
After war broke out in neighbouring Sudan in April, more than 600,000 people fled into South Sudan. Our teams set up mobile clinics around transit centres in Renk, a town on the Sudanese border.
We also established a measles isolation unit and therapeutic feeding ward for children with severe malnutrition at Renk’s country hospital. In Upper Nile State, we operated a medical facility offering general checkups, vaccinations, social support and protection services. We also transferred patients needing hospital care to our facilities in Malakal.
In September, the health ministry declared a hepatitis E outbreak in Fangak county. In response, we launched a vaccination campaign—the first to ever be conducted in South Sudan during the initial stages of an active outbreak in such a remote location—targeting women and girls of childbearing age, the group most vulnerable to the disease.
PATIENT CARER:
“We need courage and help to survive”
Marta Kalibe shared her family’s story from Renk Civil Hospital, in South Sudan’s Upper Nile state, after they were forced to flee the fighting in Khartoum, Sudan.
“Our lives changed in April. We were a family of eight living in Khartoum: our home was full. Everything was okay until we heard the bombs and gunshots; neighbours and people we knew were dying. My husband stayed behind, and my children and I left for South Sudan, the country we had originally migrated from. The change in food, the long journey and the grief have been arduous for me and my family. I have lost three children [to illness], and two are fighting for their lives.
“I have been at the hospital for three weeks watching over my eightyear-old son and my five-year-old daughter, both suffering from malnutrition. They are receiving special food and medicines, and a doctor checks their vital signs many times a day. As soon as my children feel better, my husband will join us and we will continue our journey. We will need a lot of courage and help to survive during the coming difficult days.”
In 2023, MSF continued to support Afghanistan’s struggling health system by providing specialised healthcare across the country.
MSF ran nine projects in eight provinces, maintaining a focus on emergency care, surgery and mother and child health.
In Khost, we continued to run an 83-bed maternity hospital, providing comprehensive emergency obstetric and neonatal care and a safe space for mothers with high-risk pregnancies and obstetric complications to deliver. We also supported eight health facilities in the province with medicine donations and funding for additional midwives, so that women with no risk factors for obstetric complications could give birth closer to home.
In Bamyan, we ran a community healthcare program for people in remote and underserved districts with a focus on mother and child health.
In Herat, we launched an emergency response after earthquakes hit the province, killing more than 2,000 people and displacing over 250,000. We donated emergency kits and helped treat the wounded at Herat regional hospital, the main treatment facility for earthquake victims.
There was a gradual but stable increase in the number of patients coming to MSF facilities in 2023, largely due to an improved security situation that made it easier for people to travel. However, many people continued to face huge challenges to access care. Our facilities experienced very high occupancy rates in the year, reaching 130 to 200 per cent.
Kunduz
Herat Kabul
Mazar-i-Sharif
Lashkar Gah
Kandahar Bamyan
Khost
ANZ FUNDING:
$3,302,626
TOTAL FUNDING:
$48.6 MILLION
ANZ STAFF: 10
TOTAL STAFF: 2,015
In 2023, MSF ran multiple health facilities in Bangladesh, primarily serving Rohingya refugees and host communities in Cox’s Bazar and the capital, Dhaka.
August 2023 marked six years since more than 700,000 Rohingya people fled targeted violence by the military in Myanmar into Cox’s Bazar, yet the possibility of safe return remained remote. MSF witnessed severe consequences on the physical and mental health of refugees in the camps, amid dire and overcrowded living conditions, a lack of basic services and complete reliance on humanitarian aid.
MSF provided general and specialised health services in Cox’s Bazar, including emergency care, sexual and reproductive care and mental health support.
We also treated patients with non-communicable diseases, such as diabetes and hypertension, and survivors of sexual and gender-based violence. We treated refugees with injuries sustained from physical assaults and other forms of severe violence, and further indication of the dangerous living conditions in the camps.
In May, a World Health Organization survey revealed that nearly 40 per cent of people in the camps had scabies, reflecting what we had been seeing in our clinics between March 2022 and May 2023. MSF advocated for a mass drug administration in the camps which was implemented at the end of the year.
STAFF MEMBER:
Advocating for a human life
Muhammad Hubaib is a humanitarian affairs liaison volunteer in Cox’s Bazar. He shared reflections on his work in the lead up to August 2023.
“I work in a team with five other Rohingya colleagues, as paid volunteers. The core part of my role is to monitor the humanitarian situation of the camps and to identify the gaps. I work with community leaders, authorities and other organisations in the camps, and with external agencies and donors, to assist our delivery of services and to advocate for a change for the better for our people. My team is like a family for me.
“I pray that not even an animal would have the life of a refugee, in any condition. It is almost the sixth year since we took refuge in Bangladesh, and we are still seeing no light on the horizon to return home. We are struggling and surviving in a challenging situation, while the world is forgetting our wish for repatriation to Myanmar, for safety and for our rights. We need support; we need the attention of the international community to live, at least, a human life.”
Cox’s Bazar District
Dhaka
ANZ FUNDING:
$2,921,416
TOTAL FUNDING: $121.2 MILLION
ANZ STAFF: 2
TOTAL STAFF: 3,058
In Nigeria, MSF scaled up activities to address the neglected malnutrition crisis and assist people displaced by violence, and we ran programs to improve maternal and child health.
In recent years, conflict, extreme weather events and deteriorating economic conditions have deepened the humanitarian crisis in North West, North East and North Central Nigeria. The country also has one of the highest maternal death rates in the world. Underfunding, lack of access to health services, soaring inflation and cultural practices that hinder women from seeking care all contribute to these rates.
In 2023, we opened a women’s health clinic for mothers of malnourished children admitted to the inpatient therapeutic feeding centre we support in Katsina. We also ran obstetric and neonatal activities, including surgery for conditions such as obstetric fistula, at Jahun general hospital in Jigawa state.
In Kano state, our teams supported two general healthcare centres and a clinic for maternal and child health, while in Cross River, we provided emergency obstetric and neonatal care. We also supported four basic emergency obstetric and neonatal care centres in northeastern Nigeria.
In Benue, where we witnessed extremely high rates of sexual and gender-based violence (SGBV) in displacement sites, we offered sexual and reproductive healthcare and comprehensive care.
MSF has supported the Noma Children’s Hospital in Sokoto, northwest Nigeria, since 2014, with reconstructive surgery, nutrition, mental health support and community outreach activities to assist patients with noma: a disfiguring and potentially deadly infection. Noma was included in the World Health Organization’s Neglected Tropical Diseases list in December following longterm advocacy by our teams.
MSF Australia contributed $376,855 in 2023 to Climate Smart, an MSF project to scale climate solutions across the organisation. Climate Smart is aligned with MSF’s commitment to reduce carbon emissions by 50 per cent by 2030.
The project is driving a range of initiatives to address climate impacts on medical humanitarian operations, including energy transition, developing a global MSF carbon baseline, and establishing a sustainable supply chain.
In November 2023, Climate Smart launched the Energy Assessment pilot, with the purpose to identify opportunities for reducing emissions across vehicles, energy and buildings in three projects across Bangladesh, Central African Republic and Iraq.
There is also an ongoing initiative to mitigate the environmental footprint of single use medical items, by orienting procurement towards more sustainable alternatives and rationalising consumption. The first step is identifying the most commonly used single-use medical items and assessing each item’s entire lifecycle, from production to disposal, to understand its environmental footprint.
SUPPORTER:
Beyond our own borders
Jane Clifford and her husband Andrew have been valued supporters of MSF since 2013. When it comes to philanthropy, Jane values trust and supporting people globally.
“One of the things we really love about MSF is they assist people at their most vulnerable. You have doctors and nurses who are giving up their time and using their expertise to help people. Being a doctor or nurse isn’t my skillset but I know I can contribute to help provide that care.
“When we decided to start supporting MSF, we had a young family, and we knew we wanted to give to a global organisation. Australia is a bountiful country; many of us live a safe and stable life. It’s not always easy for everyone here but we usually have places to go if we can’t feed our child or need medical care. In many other places that is not the reality. Anyone who has a family or loved ones can put themselves in that position. I think we can all relate to the story of the minority who is marginalised or treated poorly. It’s the idea of helping someone in need beyond your own borders.
“Trust is important. I prefer to give without too many strings attached; I know with MSF, we can trust they’re putting our donation where it will have the best impact. “
“The first patient I was called in to see was a woman who had been shot in the stomach and chest while she was six months pregnant. We were very afraid for her because a piece of bullet was lodged in her uterus. Unfortunately, the baby died, but she was able to survive.”
Clémence Chbat Midwife and women’s health advisor, in Adré, June 2023
Every woman in the different phases of her life has important, specific health needs. Yet in too many places, women and girls face a lack of care, delays in accessing care, or poor quality care, causing preventable suffering, illness and often premature death.
To address this, MSF focuses on providing respectful and tailored healthcare that upholds women’s autonomy and increases their timely access to care in whatever context we work in.
In 2023, women’s health needs during crises were highlighted by the conflict in Sudan and Democratic Republic of Congo. Hundreds of thousands of people were trapped or displaced internally, or across borders. People struggled to obtain adequate food, safe drinking water, maintain basic sanitation, or find healthcare. For women and girls, this compromised their access to services such as contraception, maternity care and protection from sexually transmitted infections, and increasingly exposed them to sexual and intimate partner violence.
In Sudan, many maternity services stopped functioning regularly, leaving pregnant women who might require a blood transfusion, a caesarean section or other emergency services to deliver their babies in unsafe conditions. MSF supported maternity teams to provide continued access to emergency obstetric, sexual violence care and safe abortion care in the capital, and opened a maternity service in North Darfur.
In neighbouring Chad, as the influx of people fleeing Sudan grew in June, so too did the number of pregnant and injured women and girls. In Adré town, MSF established a comprehensive emergency obstetric and newborn care centre, and trained midwives to help expand care in the existing health centres as well as at a community level. This allowed us to provide our full suite of safe sexual and reproductive health services.
In DRC, MSF continued to be alarmed by unprecedented numbers of survivors of sexual violence, almost all women, seeking care, in displaced persons’ camps in Goma. Many described being attacked while searching for food or firewood to survive. MSF opened dedicated clinics to provide medical care and psychosocial support to survivors. Training and working with health promoters and community health volunteers was pivotal in linking survivors to care.
Left: Between 15-18 June, MSF provided care to 62 pregnant women for gunshot wounds and other physical injuries in Adré, Chad, after they managed to cross with others from Darfur, Sudan, having been trapped due to the conflict for two months.
When an emergency occurs, it’s vital MSF moves fast. Our priority is getting aid to those who need it, not wrangling red tape. We need quick access to resources so we can deploy our medical humanitarian teams and supplies as soon as possible.
$10.8 million
AUSTRALIAN AND NEW ZEALAND FUNDING TO MSF EMERGENCY FUND
THIS INCLUDED $1 MILLION TO THE GLOBAL EMERGENCY FUND.
The MSF emergency fund ensures we have adequate financial resources ready so that our teams don’t lose precious time when an earthquake hits, or when a war breaks out. We don’t usually know the scale or scope of our response until after an initial assessment at the site of the crisis, and it’s only at this point we can estimate how much money we will need to assist the people affected.
Often, crises with the most media coverage receive the most donations. Not every emergency captures the world’s attention, and due to the 24/7 news cycle, attention often moves on quickly before the emergency is over. Our core values of independence, impartiality and neutrality guide us to provide aid where it is needed.
In 2023, our Australian and New Zealand donors contributed $10.8 million (AUD) to MSF’s emergency fund. This generosity supported MSF’s response to emergencies in Afghanistan, Libya, Palestine, Sudan, Syria, Ukraine and other countries, including wars, disease outbreaks, disasters such as earthquakes and floods, and emergency preparation activities.
Emergency response in Ukraine
In 2023, MSF supported the health authorities in Ukraine by filling critical gaps in care, particularly in areas close to the frontlines. We used specially designed medical trains to evacuate thousands of patients from frontline areas to safer places where they could receive specialised care.
At the end of the year, we wound down this service and scaled up to focus on emergency care. Of the many thousands of patients we referred during the year, almost 60 per cent were treated for violent trauma.
The re-escalation of war in Gaza
MSF teams were already treating patients in Gaza prior to October 2023, including a cohort of patients injured in previous escalations. When the current war began in October, our teams adapted to provide emergency care for people under intense bombing and violence, including attacks on health facilities and humanitarian staff.
Throughout the remainder of 2023, emergency fund donations went towards supporting activities such as surgical and inpatient care, burns care, mass casualty responses, and donations of medicines and medical supplies.
Evacuation by medical train
“On 18 April 2023, I lost my leg. The market where I worked as a salesperson in the city of Ukrainsk, in Donetsk region, was hit by missiles, and I was severely injured.”
Tetiana was evacuated from the market to a hospital and transported by an MSF medical train to the Lviv region, where doctors and physiotherapists fitted her with a prosthesis.
“When MSF doctors took me to the hospital in the west of the country, I felt lost. I didn’t know how I would cope with an amputation. Now, with a prosthetic limb, I live in Kyiv with my son, and at 72 years old, I am happy to have survived.”
MSF has been treating acute malnutrition since our founders first responded in Biafra, a territory now part of southern Nigeria, in 1971. In the five decades since, we’ve taken advantage of new therapeutic foods and adapted protocols to help prevent and cure acute malnutrition in crisis contexts where people are deprived of life-sustaining nutrition and healthcare.
Severe acute malnutrition is linked to a high risk of death in children, who face a vicious cycle: a child who is malnourished is more susceptible to disease, and a sick child more prone to malnutrition. Communities, families and caregivers can struggle to meet their children’s very important nutritional needs due to a range of factors. In 2023, the situation was catastrophic for people in multiple countries, including Nigeria, Niger, Democratic Republic and Chad. On the one hand we saw key drivers of food insecurity— conflict, economic and financial crisis, and climate disruption—exacerbated and, on the other, a crisis in the resources needed to deal with them.
In northern Nigeria, the numbers of acutely malnourished children escalated early. By the time the annual ‘lean season’ started in May – the period between harvests when stocks of food run low –several of our inpatient therapeutic feeding centres were already full. We urgently added beds and staff, and opened additional outpatient centres to treat children without severe complications and enable them to recover at home.
We also publicly called on aid organisations, the government and local health authorities, to immediately scale up care, but also provide food support for affected communities.
In eastern Chad, malnutrition was also on the rise, the Sudan war driving people across the border into conditions where they could barely subsist. On a single day in Adré health centre in November we assessed 567 children, referring the most severe to hospital, while those who could be treated at home received therapeutic food and treatment to take until their next follow-up medical consultation.
In the face of a limited humanitarian response, we were very pleased to be able to partner with the World Food Programme, receiving enriched flourbased supplies to care for malnourished pregnant and breastfeeding women and girls and to support the most vulnerable families with protective rations.
Thank you for standing in solidarity with patients around the world. We are so grateful for your support, which makes it possible for MSF to deliver immediate and longer-term medical humanitarian care to people in crisis.
MSF strives to maintain a high level of private income, which is essential for us to operate independently and to respond effectively to the most urgent needs.
Whether you’ve supported for 12 months or over the last 30 years, we can’t thank you enough for being a valued part of our global movement.
