SPRING 2024
THE ROHINGYA:
Urgent action needed for their survival
LIFELINE IN SUDAN:
Restoring a wardamaged hospital
02 Editorial:
Dignity: our commitment to our fellow humans
It is time for the world to put an end to the crisis long known as “forgotten”: the Rohingya require our urgent action for their survival.
There are an estimated 2.8 million Rohingya people in the world today, but only one per cent of this community lives in freedom, with access to legal identity documents, rights to work and education, and the ability to selfidentify as Rohingya. The remaining 99 per cent are contained in camps or detention centres, or marginalised through harmful policies after being stripped of their citizenship in Myanmar in 1982.
camps, Bangladesh, after her husband abandoned them.
© Sahat Zia Hero
MEDECINS SANS FRONTIERES
Médecins Sans Frontières is an international, independent, medical humanitarian organisation that was founded in France in 1971. The organisation delivers emergency medical aid to people affected by armed conflict, epidemics, exclusion from healthcare and natural disasters. Assistance is provided based on need and irrespective of race, religion, gender or political affiliation.
Today Médecins Sans Frontières is a worldwide movement of 24 associations, including one in Australia.
In 2023, 138 Australians and New Zealanders filled roles in our medical humanitarian projects.
Nāu te rourou, nāku te rourou, ka ora ai te iwi - With 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.
CONNECT WITH US
Call 0508 633 324
Email contact.us@nz.msf.org
msf.org.nz
facebook.com/MSFANZ
@msf_anz
@MSFAustralia
You might wonder why MSF would highlight freedom, as a medical humanitarian organisation. The reason is that freedom, and all of the material factors and conditions related to it, has profound links with health.
MSF has been working alongside Rohingya communities for the last three decades. Our teams work with Rohingya people in their homeland, Rakhine state, Myanmar, where brutal conflict between the Myanmar Armed Forces and the Arakan Army is squeezing Rohingya ever tighter; over the border in Bangladesh, where over a million Rohingya people are stuck in fenced camps; and across the Andaman Sea in Malaysia, where they are pushed to the margins of society and forced to live in constant fear.
Their containment and lack of freedom has immense ramifications for their physical and mental health. MSF is bearing witness to an increasingly fragile present for the Rohingya, and a desperate future—one in which their existence as a people is not guaranteed, unless we take drastic action now.
Over the course of my time as a doctor and humanitarian with MSF, I’ve had the privilege to meet with patients and communities across the world. Most recently, I was in eastern Chad to meet with people who had fled the brutal war between the Sudanese Armed Forces and Rapid Support Forces in Sudan. The statement from many people that stuck in my mind was that they needed food, water, and dignity.
“Our medical action is our basic act of solidarity.”
Of these three things, dignity is perhaps the least tangible, but it is an important piece. It is something that the warring parties have attempted to strip from people in Sudan, over 18 months of indiscriminate violence, killings, torture and sexual violence waged on civilians, and persistent attacks on health workers and hospitals. Indeed, for me, dignity means that people are treated as human beings. This is such a simple concept, but it is something missing from many situations that people find themselves in around the world right now.
For the Rohingya in Bangladesh, over the past two years, a huge number of the community have been suffering from scabies—a skin disease that is easily treated when you have access to a doctor or pharmacist and to enough water and soap to wash. My colleagues in the Cox’s Bazar camps spend their days treating tiny babies, brought to our clinics by their parents, with scabies so severe that it covers their entire bodies with sores and prevents them from sleeping. What could be more undignified than that?
MSF teams in the camps have also been sounding the alarm on hepatitis C, after our study in June 2023 found that a staggering one in five people tested for the virus there have an active infection. The need for care exceeds MSF’s capacity, and people are being left at risk of serious and fatal complications such as cirrhosis or liver cancer.
For Rohingya remaining in Rakhine state, Myanmar (only around 450,000), they are facing indignity in the most brutal sense, in the form of extreme violence—which many are saying is worse than the horrific atrocities of 2017.
In the past months, Rohingya have been subjected to violent attacks, the razing of their towns and villages, and forced conscriptions. Some have made it over the border into Bangladesh to seek care with MSF, but many remain trapped.
As humanitarians, our medical action is our basic act of solidarity that we can offer to people. We will keep doing this, but this is not enough. There must be an end to the painful denial of Rohingya people’s freedom.
Political actions and solutions must be taken urgently, and not only with the view to safe return to Myanmar, but in the countries where they are living now and via resettlement.
This is where governments have an important role to play, in ensuring an end to containment policies affecting Rohingya people and the beginning of opportunities for them to claim their right to live in dignity.
Having a position where one can bear witness to suffering brings responsibility. MSF is thankful for the determination of our supporters in calling for action to assist our Rohingya patients, colleagues and friends, and we ask governments to heed our call.
Add your voice to support the protection of Rohingya people.
Dr Christos Christou MSF International President
A Rohingya couple carry their sick child through the Cox’s Bazar camps to find a doctor. © Sahat Zia Hero
KENYA
A milestone in medically assisted therapy
MSF has handed over our medically assisted therapy treatment facilities in Kiambu county, Kenya, after five years providing care for people who use drugs.
Running across the Karuri Level 4 Hospital and two other clinics, the program provided services through a harm reduction approach, aimed at reducing negative health, social, legal and financial consequences of drug addiction (including to opioids such as heroin) and at improving the lives of people who use drugs. Prior to MSF opening the program, people had to travel to Nairobi and access care via multiple different facilities.
Working with both incarcerated and non-incarcerated patients from the community, the program provided methadone and buprenorphine as opioid-substitution therapy. The program also provided prevention of infections and transmission of HIV and viral hepatitis, prevention and treatment of tuberculosis, mental health support, and re-integration support with families and communities. Patient-centred initiatives included deliveries of treatment to homes, hospitals and prisons via peer educators, and establishment of satellite dispensing sites.
The program will be continued by the Department of Health and Kenya Prison Services, with healthcare workers who have been trained by MSF.
Boxing trainees at the ‘empowerment centre’ in Karuri clinic, where the medically assisted therapy program includes activities geared towards sharing life skills and enhancing patient wellbeing. © Eugene Osidiana/MSF
PALESTINE
‘We keep losing patients’
Relentless bombings and airstrikes by Israeli forces continue to kill hundreds of people across Gaza. In July alone, MSF responded to 10 mass casualty incidents at Nasser and Al-Aqsa hospitals in southern Gaza, following strikes and fighting which often took place in areas where displaced people were sheltering.
“Every day in July has been one shock after another,” said MSF medical team leader Dr Javid Abdelmoneim. “Our Palestinian medical staff are still here, trying to stop patients from bleeding, to fix their broken arms, provide surgical care, but we keep on losing patients.”
At the end of July, Nasser hospital—meant for a maximum of 366 beds—had around 550 patients, including people with severe burns and trauma injuries, newborns and pregnant women. As the last remaining hospital in southern Gaza, Nasser hospital provides lifesaving support, including oxygen production, to several other nearby health facilities.
Since October 2023, MSF has responded to the needs of more than 1,500 Palestinians in Hebron who were forcibly displaced, had their houses demolished or possessions destroyed.
1,619 people accessed medically assisted therapy treatment with MSF in Kiambu September 2019 - June 2024
AUSTRALIA
Rohingya Social: A long table
On 22 August, MSF Australia partnered with Plate It Forward, Rohingya Maìyafuìnor Collaborative Network and the Creative Advocacy Partnership along with 90 guests, for a celebration of Rohingya cuisine, culture and survival. We shared in a curated, three-course menu featuring authentic Rohingya dishes, shared by Noor Azizah and Noor Uddin with Plate It Forward chef Ahana Dutt.
The night was a unique opportunity for guests to connect with Sydney’s Rohingya community, and to commit to actions to support Rohingya people. “We Rohingya are your neighbours,” said Noor Azizah. “So we do rely on you and your generosity, and any platform you can utilise to amplify our voices.”
Occupied lives in Hebron
Medical care for Palestinians in Hebron, the West Bank, is rapidly deteriorating because of restrictions imposed by Israeli forces and violence perpetrated by Israeli soldiers and settlers. In a new report, Occupied lives: the risk of forcible transfer of Palestinians in Hebron, MSF details how Ministry of Health clinics have been forced to close, pharmacies have run short of medications, and ambulances transporting the sick and wounded have been obstructed and attacked.
The report also highlights that coercive and violent policies and practices are pushing more Palestinians to flee their homes, in what may amount to forcible transfer.
City2Surf for MSF
On 11 August, 150 runners and walkers joined the City2Surf event, taking to Sydney’s hilly streets from the CBD to Bondi to raise money for MSF. A huge thank you to each enthusiastic participant! Together, they raised more than $38,000 to help our teams deliver medical humanitarian care where it’s needed.
AUSTRALIA
A Palestinian teenager finds shelter from the sun after his home was suddenly demolished without warning in Masafer Yatta, West Bank. © MSF
Guests at the Rohingya Social event in Sydney. © Victor Caringal/MSF MSF Australia runner Casey Cunningham on the 14km route. © Sportograf
Searching for freedom
Rohingya community members and an MSF staff member share the latest updates of the situation for Rohingya people in the Asia Pacific region, where durable solutions are urgently needed for a community suspended in a protracted crisis.
In early August, MSF teams working in Bangladesh’s Cox’s Bazar camps received an influx of Rohingya patients with violencerelated injuries. They were suffering mortar shell injuries and gunshot wounds and told medical staff that they had crossed the border from Rakhine state, Myanmar, fleeing violent attacks.
Some patients reported seeing people bombed while trying to find boats to cross the Naf river into Bangladesh, while others described seeing hundreds of dead bodies on the riverbanks. Many patients said they had been separated from loved ones, who they were fearful were trapped in Myanmar and would not survive. The incident signaled a worsening situation for Rohingya in Rakhine state, where conflict has been escalating since November 2023.
Yet, it is only one piece of the situation in which Rohingya people find themselves today. Rohingya have been ripped from their homelands and scattered around the region, however they continue to survive and demand a better deal for their health, wellbeing and futures. Noor Azizah and Solim Ullah, and MSF humanitarian affairs manager Tae-Eun Kim share their insights from three countries where MSF works with the community: Bangladesh, Malaysia and Myanmar.
1 in 8 Rohingya people who attempted to cross the Bay of Bengal and Andaman Sea in 2023 died or went missing (UNHCR estimate)
Over 1.1 million (39% of all Rohingya) live behind wire-fenced camps in Bangladesh and Myanmar
MSF first worked with Rohingya communities in 1992, in Cox’s Bazar, Bangladesh
Malaysia: Noor Azizah, Rohingya advocate
“I’m a Rohingya refugee who was displaced in Malaysia for eightand-a-half years. I have resettled in Australia and I’m now working on Rohingya issues globally.
Accessing healthcare in Malaysia was incredibly challenging. In particular, there are exorbitant fees for Rohingya to access healthcare. The lack of access made me feel like I wasn’t even considered human. It was a constant state of fear and uncertainty, knowing that if something happened, I wouldn’t be able to get help. The only way we were able to access healthcare was with the help of kind Malaysians who saw our desperation and came to assist us.
I went back to Malaysia last year with the organisation I run, Rohingya Maìyafuìnor Collaborative Network: a Rohingya-led, refugee-led, womenled organisation. While I was there, a sister told me that a Rohingya woman was very close to giving birth, and she was asked for RM5,000 (A$1,700) as a deposit. Unfortunately, she did not have this fund on her and she and her baby passed away.
In Malaysia and in other countries, you can see the impacts of the hate speech, misinformation and disinformation that is spreading about Rohingya. It is manifesting in physical violence towards us.
There’s a misrepresentation of where we come from; we’re not coming to steal the land; we’re being killed and persecuted. We are Indigenous to the land in Arakan (Rakhine state), we’ve been there for a very long time, and that’s something the military regime has erased through a very successful violent campaign. This is something we’re still combating.
The world tells Rohingya refugees to be grateful to just be alive, because we’ve been targeted for the last 81 years. We are very grateful, but we also require healthcare to contribute to society. And we also want our children to live and to thrive.”
In 2023, more than 4,400 Rohingya people attempted to reach Malaysia via boat from Bangladesh or Myanmar. Those who survived the perilous journey had in many cases escaped camps, but on arrival in Malaysia were faced with discriminatory deterrence-based policies targeting refugees, such as immigration raids, arrests and indefinite detention. Rohingya in Malaysia—even those registered as refugees—have no right to employment or education.
A Rohingya woman and her eightmonth-old son pictured at home, in a remote area of Penang, Malaysia. The infant suffers from breathing difficulties and needs a non-invasive ventilator to support his breathing while sleeping (2022). © Kit Chan
“My name is Solim Ullah, 22 years old, stuck in this open prison of a camp in Balukhali.
Maungdaw (in Rakhine state) was my home, but here, fear is our constant companion. Our movements are controlled, dictating where we can go. Our area is limited and marked with barbed wire. Education? A distant dream. There are armed groups in the camp who constantly threaten us. Abduction, beatings—their way or no way. We just want to live in peace, but ‘peace’ seems like a foreign word here.
Challenges pile up: no proper education, no decent (formal) jobs, barely enough food to survive. Rations might have increased, but so have food prices. To pay 2,200 taka (A$29) for a bag of rice? How can we afford a balanced diet on that? Water’s okay, at least in our camp. But waste management? A disaster. Volunteers stretched thin, schedules ignored, trash overflowing and making us sick. We’re tired of this cramped existence. We just want to be free.
Myanmar. That’s home, 15 years of my life. I yearn to go back. Even with its limitations, at least there I could get an education. Here, grade 11 is the ceiling. The world is full of possibilities—doctors, engineers, businessmen—but a proper education system is the key we lack.
We fled in 2017, a desperate trek through the mountains to escape the Myanmar military. Four gruelling days to reach Bangladesh, a country that opened its arms to us. We’re grateful, but this camp isn’t a life. Here life is yearning for a future where education unlocks our potential, where freedom lets us dream again.”
In Bangladesh, MSF runs one of our most comprehensive programs, offering healthcare to Rohingya refugees and host communities in Cox’s Bazar. Our healthcare services include maternity care, paediatric and newborn care, mental health support, and treatment for chronic diseases such as hepatitis C.
MSF’S WORK IN BANGLADESH IN 2023:
628,300 outpatient consultations
40,800 individual mental health consultations
24,000 patients admitted to hospital 5,270 births assisted
“The situation in Myanmar is very, very difficult. Half the country is under conflict, as fighting escalates between the Myanmar military and other armed groups.
Since the conflict erupted in October 2023, it has spread across the country, leading to a rapid rise in the number of people requiring humanitarian assistance in many regions. Both national and international humanitarian organisations have been forced to reduce or suspend their operations due to a wide spectrum of challenges including the unstable situation, shortages of supplies and resources, and travel restrictions.
The turmoil in Myanmar did not begin recently. The country has been in a state of instability since the military takeover in February 2021. By late October 2023, after the escalation of intense battles involving various ethnic armed groups, the situation became a severe humanitarian crisis. In Rakhine state particularly, Rohingya people, who have faced targeted violence for decades, are now left without protection.
MSF is witnessing that the Rohingya are caught in a sandwich situation between armed actors and are not safe, regardless of who is controlling a certain area. Many are trapped in villages or camps, without any freedom of movement and essential medical/humanitarian access.
The 25 August marked seven years since more than 700,000 Rohingya people fled their homes in Rakhine state, escaping a devastating violent campaign by the Myanmar military for the camps in Bangladesh.
For the hundreds of thousands of Rohingya still living in Rakhine State, their options now for crossing borders or escaping are extremely limited, leaving them trapped amid rising civilian casualties and worsening violence.”
MSF was forced to suspend our activities in northern Rakhine state in June due to extreme escalation of conflict, extreme violence and severe restrictions on humanitarian access. We continue to work in central Rakhine and maintain a presence to resume activities in the north as soon as it is possible to do so.
“MSF is witnessing that the Rohingya are caught in a sandwich situation between armed actors and are not safe.”
An MSF mobile clinic at Kyein Ni Pyin camp, Pauktaw, Rakhine state. Patients, many of whom are Rohingya, wait to be triaged. © Zoe Bennell/MSF
Solim Ullah in Balukhali camp, Cox’s Bazar. © MSF
Bangladesh: Solim Ullah, Rohingya community member in Cox’s Bazar
Myanmar: Tae-Eun Kim, MSF humanitarian affairs manager
Survivors of war in Chad
Sudan is the largest and fastest growing internal displacement crisis in the world, with the war forcing more than 10 million people from their homes, including two million who have crossed borders (IOM). MSF is providing assistance to those who have fled Sudan in both South Sudan and Chad.
Through the lens of award-winning photographer, Corentin Fohlen, meet some of the survivors of the mass violence sweeping across West Darfur’s capital, El Geneina, who have made it to eastern Chad and now face different challenges to survive.
Kaltom Ali Mohamed (27), and her two children: Abdulshani (right) and Aisha (left), lived east of Ardamata until the war started. Kaltom’s husband was shot in the legs, and they fled to Chad. On arrival in Adré, the husband was treated by MSF and Abdulshani was admitted to the MSF-supported paediatric hospital.
In El Geneina Adam Mohamat Khamis (32) was shot in the arm and fled with his family. “I lost my arm because I couldn’t get medical attention in time. We had to hide, walking in very difficult conditions, to hope to reach the Chadian border. Today we depend on food distributions.” Adam’s daughter asks when they’ll go home. She misses school (even though Adam gives history and geography lessons in the camps). “There’s no way we can go back to Sudan this time,” he says.
Affa Abdu Rahim (24), with her daughter Faiha Mohamed Walda (seven months). Faiha has just received some Plumpy’Nut therapeutic food in MSF’s outpatient nutrition program. Affa first came to Chad on foot while she was pregnant but then went back to look for her husband. After giving birth to her daughter in Sudan, she had to leave when war resumed, again without her husband. “It’s very difficult to get food here. I have a food ration card, but during the last distribution I didn’t get anything.”
Chadian Umsamaha Yacoub (25) with her son, Adam Said (five), who was admitted to MSF’s intensive nutritional unit for a week. “We have hosted up to ten refugee families at home in recent months. We share our food with them until they can be relocated to the camps and have access to distributions,” Umsamaha says. The mass arrival of new Sudanese refugees in this fragile territory has exacerbated the pressure on local resources and livelihoods.
in
remains partly
camp,
and suffers from convulsions after being shot in the skull in El
Many people in the camp live with permanent disabilities due to injuries sustained during fighting in the
Djouwahir Abderamane (23)
Ambelia
near the city of Adré. Djouwahir
paralysed
Geneina.
Sudanese city.
Tailor and fashion designer Mohamed Ali Abakar (43) making clothes in Ambelia camp.
Restoring a war-damaged hospital
When the frontline of the war in Sudan arrived in the city of Nyala, South Darfur, the hospital was so badly damaged it was barely functional. But with medical needs rising and other healthcare facilities out of action, the hospital also represented a potential lifeline. Emergency doctor Jennifer Hulse shares five ways she and her MSF colleagues worked with what they had to restore the hospital’s capacity.
1. Acting fast
Before the war, patients from across the region had travelled to Nyala Teaching Hospital to receive specialist care. When I arrived, MSF had just began supporting there, with the logistics team working to bring back basic infrastructure like electricity generators, running water and sanitation.
It wasn’t just essential infrastructure that was missing. At the peak of the violence, anyone who could do so had left Nyala city, trying to get their families to safety.
Most of the team who remained were junior doctors and nursing staff, trying to keep some services going in the face of incredible challenges. It was my job to support them to provide the most effective care possible in this new context.
Every department in the hospital needed support, but with limited resources available we had to focus on where we had the most potential to save lives: paediatrics, maternity care, and emergency medicine.
2. Getting supplies across the desert
Many hospitals in Darfur have been looted, and with big gaps in the humanitarian response, it’s almost impossible for them to get new stocks of vital medical supplies. In Nyala, hospital staff were scouring local pharmacies across the city, searching for basic items like spinal needles to do emergency caesarean sections. The scarcity meant some items had increased in price by five times what they had cost before the conflict.
There is a long, difficult route through the desert in neighbouring Chad. It’s less a road than a sandy track, but our supply team were determined. Just before I finished my assignment, we got a big order through, and after months of careful rationing, trucks full of vital supplies arrived at last.
3. Keeping oxygen flowing
Medical oxygen is one of the most important tools we have for sick patients. On the day that the hospital’s oxygen factory broke down, lives were on the line. With the mobile phone network down because of the war, there was no way to call for a repair. We ran around the hospital, assessing how many patients were currently on oxygen, whether the flow could safely be reduced for any of them, and calculating how long we had before the supply ran out entirely.
Meanwhile, the logistics team sent people across the city to track down the one engineer who could fix the system. With time running out for our patients, they not only found him, but also sourced a replacement part, ensuring that no critical patient was left without oxygen.
4. Transforming blood transfusion
Nyala hospital’s blood bank is essential for many patients, from women experiencing post-partum haemorrhage, to people arriving at the emergency room with traumatic injuries.
But to store blood safely, it must be kept below a certain temperature. The electricity for the hospital in Nyala was provided by generators, but these had been damaged during the conflict: some sprayed with bullets, others missing parts that had been stolen. The team were able to repair one of the generators, but this wasn’t enough to provide 24-hour power for the whole hospital. This meant the blood fridge couldn’t be run continually, and dramatically reduced the shelf-life of the blood.
Sourcing the two powerful new generators we needed would take time. But we were in luck: one day, a truck pulled up to the hospital. It didn’t have a new generator, but it had a new fridge, with so much insulation that it was designed to stay cold for 12 hours without electricity, meaning the blood bank would be safe overnight while the generator was down.
“We needed many thousands of doses of vaccines, but keeping them at the right temperature once they arrived (after being trucked in the desert heat!) was going to be a challenge.”
5. Vaccinations
At this point, no vaccines had arrived in Darfur for over a year due to the war. We were starting to see cases of measles at the hospital, which is highly contagious and dangerous for young children. With so many people living in overcrowded camps, there was potential for a devastating outbreak.
When the vaccines were arriving, we only had a day’s warning. A fridge wouldn’t be big enough. Working fast, we found a cold room at a market which had previously been used for vegetables, and the logistics team sourced enough fuel to power the generator 24/7.
When the trucks arrived, we saw they were packed with insulated cool boxes. Each one had a temperature monitoring tag inside. Had they survived the journey? Yes. The vaccines had all been kept cool, and by partnering with the Ministry of Health, together we ensured that around a week later, every dose had been used to protect a vulnerable child.
A LASTING LEGACY
Professor Krishna Somers Home: Perth, WA/Noongar Land
Professor Krishna Somers was a gifted researcher, teacher, administrator, and medical ambassador. He was known as the “favourite house guest of half the world!”
Kris made an immense contribution to the medical profession during his lifetime. His special interest was endomyocardial fibrosis (a type of progressive heart disease common in rural populations in tropical and subtropical regions in low-income countries) on which he was an esteemed authority figure. He published about 130 papers on cardiovascular topics and acted as consultant to the World Health Organization on cardiomyopathies and medical training. He is renowned for his pioneering work on cardiac catheterisation and intra-cardiac biopsy.
Kris’ own experiences fleeing from oppressive political regimes, first from South Africa during the apartheid years, and then from Uganda under Idi Amin, shaped his concerns for migrants and refugees and led to his lifelong contributions to try to improve the circumstances for these groups of displaced peoples, including through supporting MSF’s work. In his own words, Kris explained, “I’ve always been interested in diasporas and social justice”.
The visionary legacy that Kris so kindly left behind will ensure that his desire to help others, so keenly demonstrated throughout his life, will continue well into the future. Kris’ gift has and will continue to make a significant impact to our projects around the world, as we provide medical assistance to people in crisis in over 70 countries. We are so proud to honour Krishna’s memory through our work.
To find out more about leaving a legacy via your Will, please go to: msf.org.nz/leave-a-legacy
Anaesthetist
Three
Sri Lanka; Ituri, Democratic Republic of Congo; and Aweil, South Sudan.
Dr Graham
attends to an emergency surgery patient late at night in Aweil Civil Hospital, Aweil, South Sudan. June 2024. © MSF
You’ve come back to MSF after 20 years. What experience has stayed with you most since then?
When I was working in Sri Lanka in 2002, in the MSF obstetrics project established during the war, we had a newborn baby that needed to be intubated and ventilated just after birth. The problem was that there was no continuing care available, so we had to transfer the patient 16 hours over a reasonably big distance of poor roads and across the areas controlled by the two warring parties. What I particularly remember is the coordinated efforts from both sides of the combat, and the MSF logistical team and hospital staff; everybody came together to do all they could to give this little baby its best chance of surviving.
What motivated you to return to MSF in 2024?
I feel an innate need to be part of a world greater than my myself. Being a doctor has put me in a privileged position where I can contribute in person, so it was always my intention to reengage with humanitarian work once my children were older and less dependent.
What were some of the features and challenges of your role in South Sudan?
The security situation in Aweil was reasonably stable while I was there and the MSF project for women and children is well-established and resourced. This meant that it was easy to slot in and work effectively right from the start. MSF runs two operating theatres at the same time thanks to having an experienced, locally hired anaesthetic nurse in the team. During the day we were generally in the operating room from 8am to 6 pm, mostly doing paediatric surgeries like burns dressings, bone fractures and whatever emergencies arose. Once that finished, I was on call for emergencies overnight. This meant anything from a quiet night in bed to being really busy with emergency patient after patient, primarily involving obstetric haemorrhages and caesarean sections.
The biggest challenge from my side was dealing with the 45°C heat: there are only so many cold showers you can have in a day (or night)! The only air conditioning was in the operating theatre room, so even if you were called out at 2am, you really appreciated the luxury of it.
“Everybody came together to do all they could to give this little baby its best chance of surviving.”
How has MSF changed over time, from your point of view?
MSF has become quite a large organisation with most people now having some awareness of its values and what we do. It has also become more diverse and there is an increased number of locally hired staff working with MSF. I think this is a really positive direction, because it’s the local staff who maintain the continuity and community within projects.
Is there anything different in the role of an anaesthetist in MSF now compared to 20 years ago?
The role of anaesthetics has always been an important part of peri-operative care, helping take care of patients throughout their surgical journey. What has changed is that developments and technology have made it easier for us to provide high quality and safer management despite being in a challenging environment like South Sudan.
What do you love most about humanitarian work?
For me the best part of humanitarian aid is the human part. Working with staff who are truly committed to patient care and with patients who smile so generously despite everything they are going through is truly humbling. Sharing our stories, laughing about our differences and rejoicing in the commonality of our human mission is what I most enjoy about working outside my usual environment.
MSF is a fantastic organisation to work with, whose values parallel my own. I look forward to continuing regular assignments in the future.
Our anaesthetists
Anaesthetists may need to work with limited medical equipment, supplies, and facilities to treat trauma patients of all ages, following guidelines set by MSF. Adaptability in high-stakes situations and strong judgement and technical skills are required. Anaesthetists also provide guidance and training to locally hired staff.
Need experience?
We often receive applications from people with the right attitude but who need to gain additional experience to be successful in the complex and varied contexts in which MSF works. This webinar covers what low-resource and remote experience MSF looks for, and tips on how to gain it.
Watch back, and see upcoming webinars here: msf.org.nz/join-our-team/workoverseas/recruitment-events
Interested? Please apply at msf.org.nz/join-our-team
Dr Graham Knottenbelt
Home: Auckland (Tāmaki Makaurau)
MSF experience:
assignments since 2002 in Puthukkudiyiruppu,
Knottenbelt
ON ASSIGNMENT
Women sit out the front of a building at El Geneina
Staff from Australia and New Zealand currently on assignment with MSF.
This list of project staff comprises only those recruited by MSF Australia. 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.
Afghanistan
Hospital Director
Surgeon
Bangladesh
Hospital Director
Infection Prevention and Control Manager
Ethiopia
Deputy Head of Mission
Midwife Activity Manager
Greece
Nursing Activity Manager
Haiti
Deputy Head of Mission
Humanitarian Affairs Manager
Project Coordinator
Iraq
Midwife Supervisor
msf.org.nz
facebook.com/MSFANZ
@msf_anz
@MSFAustralia
Kenya Doctor
Finance and HR Manager
Kiribati Head of Mission
Nursing Activity Manager
Project Coordinator
Kyrgyzstan Energy Manager
Lebanon Midwife Activity Manager
Liberia Logistics Manager
Libya Head of Mission
Project Coordinator
Malawi
Obstetrician Gynaecologist
Mozambique Medical Referent
Nigeria Nurse
Palestine ER Doctor
Finance and HR Coordinator
Logistics Team Leader
Medical Coordinator
Nursing Activity Manager
Nursing Activity Manager
Personnel Administration Manager
Project Finance and HR Manager
Psychologist
Papua New Guinea
Project Coordinator
Sierra Leone
Project Coordinator
South Sudan
Intersectional Legal Advisor
Nursing Activity Manager
Paediatrician
Project Finance and HR Manager
Sudan Epidemiology Activity Manager
Project Coordinator
Medical Referent
Syria Head of Mission
Yemen
Epidemiologist
Midwife Activity Manager
Various/Other
Deputy Medical Coordinator
Finance Coordinator
Project Coordinator
Regional Advocacy Representative
Hospital, West Darfur, Sudan. © MSF