COVID-19: What is MSF doing? - full interview with medical director about MSF priorities, concerns & actions

Full interview with Clair Mills, MSF medical director about MSF priorities, concerns and actions regarding coronavirus.

As everyone knows the situation in Europe is very challenging at the moment and the health system is under a lot of stress, particularly in France, increasingly in other countries as well. This means that for MSF this is an extremely challenging time.

Many of our staff who would ordinarily be going to the fields are working in French hospitals for instance. It also means that supplies and other things that are really important to maintain our projects and be able to respond to the virus in our missions in Africa, in Asia and in other parts of the world are very challenging at the moment.

Our major concerns are firstly to protect our staff because we cannot respond if our staff is not safe. Secondly, we want to support authorities in all places where we work to carry out the important measures of social distancing that’s keeping people safely apart, so we can prevent the spread of this virus. Thirdly, it’s really important that we have the capacity to respond and to look after people and to be able to treat them. The last thing we realize is that there’s a lot of social and economic consequences of this crisis, which are unfolding, and that something that concerns us as well.

I think at this stage of the pandemic, all countries are at risk. I think we cannot ignore that fact that this is a global issue now. Of course, countries that have already managed many cases like China and South Korea have shown us what’s important to do, and that’s really important that we all understand this.
I think 6 weeks ago many of us in France would have thought completely insane that the government asks us to stay home. But this is incredibly important and I think for countries that have not yet taken these measures, there are likely to come. It’s important as MSF we support that and we support our staff doing that.

In MSF, we work in many places where the health system is very fragile where there are already not enough staff or resources, people often have problems of access particularly with conflicts and crises like Afghanistan, like Iran, much of the Middle East, like Burkina Faso. So these are places where we are trying very hard to maintain operations so that they can keep treating the diseases that are already killing people, but also that we can help the response in those countries. We will be a part of that bigger response to support the necessary measures both in terms of prevention, but also in terms of treatment of the virus.

There are a number of big challenges for us. Firstly, the travel restrictions means that the way we normally operate sending international staff all around the world is very difficult. And part of that because we are not very sure that we are going to be able to bring people back if they need to go back to their homes. We of course will do our best.
Second thing is that the supply chain is particularly problematic, particularly for things like masks, gowns and gloves and other important equipment such as oxygen concentrators. This means that we are asking people to be really sensitive about the use of protective gear. As for WHO and MSF recommendations, you don’t wear a mask if you’re fit and well. We really need to save those for health staff when they really need them. We are working on all the possible supply options with supply centres in Europe. We are also asking each mission to look at options for local or regional purchases, because we know this is going to be a big problem for the coming months.

When you think about the communities we work with anywhere in the world, there are people with particular vulnerabilities to this virus, and that is obviously people with medical conditions such as diabetes, high blood pressure or heart diseases, people who are already under treatment for that kind of conditions. But also just by the nature of the context we work, people are often vulnerable because they don’t have access to care, because they can be affected economically in severe ways by this crisis. So It’s difficult to say who’s the most vulnerable, sometimes most people are going to feel vulnerable at some point but we particularly need to focus on people in our contexts who really need us at this time.

One of the populations we need to think about in particular is people who live in close proximity with each other, and that include places like refugee camps. Obviously it also applies to many of the big urban areas we work. This means that we need to inform people in a very common sense way about the precautions they need to take. And of course it’s very simple things: hand washing, that becomes more and more difficult if you don’t have access to water of course, but these are the things that each of our projects, each of our missions has been asked to look at.

This is a new virus and there are many researchers working around the clock developing a new vaccine. There are already studies on the way, we are very hopeful that a vaccine will be found, but it will be at least a year - most people think - before there will be production in any volume that will be useful for us. We can’t depend on a vaccine right now, we really have to depend on the measures that are important to reduce the transmission of any virus, like a flu virus. That means keeping distance from people, making sure that the people around you who have medical conditions can keep away safely at home and be looked after, making sure that you wash your hands regularly. And of course this is really important at this time because many people have anxiety and stress, that we talk to each other, virtually of course now for many of us, but that we keep in contact with people, that we look out for our neighbours, that we look at for our colleagues. And I think we have to give an enormous thanks to the contributions of all our staff and the health services that we are running are making. Because these are the people that we really depend on.

MSF is already supporting hospitals in Italy and has some other projects in development. We are looking to develop a project in Iran where obviously there are a lot of cases now. We are also supporting the authorities in Afghanistan based around our project in Herat, which is very close to the Iranian border. In all our projects, we are preparing to manage this epidemic. At this point, in many places without local transmissions, we try to ensure that there’s good preparation, that we’re part of the overall approach to this epidemic in the country, that we support the social measures that need to take place and that we ensure the protection of our staff.

In Europe, in France, and in other countries that are already affected by the epidemic, there are still things that we can do, even if we are stuck inside. Firstly none of the work that MSF does can be done without the support of you, our donors and our friends. Secondly I think it’s important to keep a sense of perspective. We know that health systems in Europe are really under pressure, this is why we’ve all been asked to stay at home. But please remember that in many places in the world, health systems are more fragile and less able to cope. So I think that in a sense of global solidarity it’s really important to remember this.

Lastly, if you are a health worker or a logistician and have a previous MSF experience and want to support either missions in Europe or overseas, please contact our recruitment.

I think that in these really challenging times, when people are often stressed and anxious, people are worried about their incomes, about their families, about being far away from them and there’s a lot of unknown factors, it’s really important to look after each other. And the sense of solidarity, the sense that we are all in this together is really important to keep in mind.

MSF priority right now is to protect our staff, to maintain the operations with this not much transmissions yet but to be able to respond, make sure that we are able to support local authorities, to carry out social measures to prevent this epidemic spreading further and to be able to treat patients.