Three months after the coup, Central African Republic still has no functioning healthcare
system.
Around 11,000 people living with HIV-AIDS have seen their treatment discontinued.
Bossangoa is located north of the capital city Bangui...
During the hostilities this woman was one of many to escape into the forest.
The rebels looted and then torched her home.
When she returned, she needed to resume her HIV treatment...
But the hospital had also been looted and there were no antiretroviral drugs left.
Woman (local dialect) Many people in the village are in the same
situation like me.
They are at home without treatment and some already died.
Bossangoa now finds itself without even the most basic healthcare, so MSF has opened a
project to provide medical consultations to its inhabitants.
The teams also regularly go into the bush where people are still hiding.
The doctors biggest concerns are malaria, diarrheal diseases, malnutrition and sexual
violence.
Observing the risks to the population caused by the lack of antiretroviral drugs, the teams
are also providing HIV treatments.
Medical staff (man, local dialect) When you are home, you have to take these
drugs.
This treatment is for two months.
When they are finished, you have to come back to the hospital.
These emergency measures will soon be insufficient.
The country has been living in persistent crisis for several decades and the instability
created by the March 2013 coup has made the situation even worse.
Syria With many of the country's public hospitals
damaged, the Syrian population is in urgent need of medical care.
MSF is running six health structures in the north of the country.
The conflict raging in Syria is escalating but the war-wounded are not the only ones
in need of medical assistance.
Despite extreme violence and security risks, MSF health structures set up inside the country
are trying to respond to people's medical needs.
Pierre Garrigou, projet coordinatorMSF (man in English)
Due to the latest clashes and the war here in this area, a lot of people,
the population around, are going up to north, trying to go to Turkey or at
least stay on the border, here on the Syrian side.
Some people are staying in their own towns and villages in the middle
of the fighting, villages which are bombed by planes or shelled by artillery...
This hospital, located in the north of the country, treats people suffering from chronic
illness and women needing obstetric care—the kind of medical assistance that's been sorely
neglected since the beginning of the war.
The MSF team also assists 7,500 people living in this transit camp near the Turkish border.
They distribute basic necessities and set up water and wastewater systems...
To prevent a measles epidemic, vaccination campaigns have been set up in the north of
the country.
More than 75,000 children have been vaccinated.
Yemen 0.2 % of the Yemeni population are living
with HIV/Aids.
But the sick suffer from a lack of access to treatment and are discriminated against
by their communities and doctors.
The clinic at Al-Gumhuri hospital is the only place in the Yemeni capital Sana'a, to provide
antiretroviral drugs.
The reticence of medical workers complicates access to treatment.
Prejudice, lack of knowledge of the disease...
At Al Guhmuri too, the medical personnel needed convincing.
Dr Addul Fattah, HIV treatment clinic, Al-Gumhuri Hospital, Sana'a (man in English)
At the beginning they refused to admit patients onto the wards, they
refused to see the patients if they needed any medical care or medical advice.
Now, we try and try.
We began with courses for doctors and nurses.
We feel it has improved a little bit but still there
is stigma and discrimination in the hospitals, community and family members of the patients.
At the beginning of 2013, MSF decided to work with the national programme and local associations,
and support them in their work.
The purpose is to raise awareness about the disease, combat stigma, and improve access
to treatment.
Women living with HIV-AIDS are particularly vulnerable.
Offering them improved screening and greater support are two of the priorities here.
Colombia A large city on the Pacific coast, Buenaventura
is one of Columbia's biggest ports.
Tuberculosis is more prevalent here than anywhere else in the country.
Martha's story is pretty much that of all the tuberculosis patients here.
Martha was diagnosed along with her husband in 2008 and they received their first treatment.
Martha Diaz Angulo (woman in Spanish) The insurance company didn't give us all the
drugs, some weren't available.
We were feeling well then.
But in 2010, the fever and shivering came back.
The lack of full treatment in meant that Martha and her husband didn't get better.
In fact, they got sicker, and this time with drug-resistant tuberculosis.
MSF has been working in two of the town's facilities for three years supporting the
healthcare system and ensuring continuity of care for drug-resistant tuberculosis patients.
The teams also supervise activities at 15 medical stations that treat uncomplicated
TB cases.
Over 300 patients with tuberculosis, both drug-resistant and drug-sensitive cases, were
admitted to the programme in 2012.
Alexander Prieto Villan , doctor, MSF (man in Spanish)
The Columbian healthcare system is relatively complex.
This means that many patients face barriers to healthcare and find it difficult to get
treatment because there's a lot of red tape.
And in the meantime, some patients get even sicker.
Treatment of drug-resistant tuberculosis is lengthy and difficult to take.
To ensure its success, the team implements 'directly observed treatment': Patients come
every day and take their drugs—sometimes over 20 tablets and an injection.
MSF also provides psychological support, food and transport for people like Martha who no
longer have the strength to work and often live with limited resources.
Democratic Republic of Congo In 2003, MSF and several partners established
DNDi to develop new treatments for neglected diseases.
Sleeping sickness is one of its target diseases.
A new drug, Fexinidazole, is currently under trial in DRC.
Treatment for a person with sleeping sickness could well fit into this little box...
If its efficacy is proved, two to three Fexinidazole tablets a day for ten days would be a huge
improvement on current treatment options.
The original treatment, an arsenic derivative, was dangerous, even deadly.
The current standard treatment, NECT, is clearly better, but it combines tablets and a drip,
making it difficult to supply and administer in remote areas of DRC where the majority
of people suffering from the disease live.
NECT calls for 10kg of treatment per patient, Fexinidazol just a few grammes.
Dr Bernard Pecoul, director of DNDi (in French) we wanted a simple treatment for the disease,
one to be taken orally, if possible for a short period of time and not requiring any
sophisticated additional examinations, so that it can be used in the villages once patients
have been diagnosed ...
Simplified diagnosis and treatment administration are essential to eradicating sleeping sickness...
They are the only way to provide treatment to all those with the disease and thus prevent
tsetse flies from spreading the parasite.
If the clinical trial proves conclusive, Fexinidazole—a real tool in the fight against the disease—should
be registered within the next two years and sleeping sickness could be eradicated around
2020.