MSF 2018 ROUND-UP: A year in pictures

Doctors Without Borders (MSF) teams continued to provide life-saving and life-changing medical care in over 70 countries around the world in 2018.

Photojournalists and staff photographers were there beside them – bearing witness to and capturing the work of our dedicated teams, and the stories of the individuals and communities they assist.

Whether caught in or fleeing conflict and violence, affected by disease or epidemics, or hit by natural disasters, our patients each have their own unique story tell. Stories of suffering and vulnerability, bravery and resilience. These pictures of the year, were (taken between November 2017 and December 2018).

Health workers embrace whilst putting on their personal protective equipment(PPE) before heading into the red zone at a newly build MSF supported ebola treatment centre(ETC) on November 07, 2018 in Bunia. Three months into the 10th Ebola outbreak in DRC. The epicentre has moved from the small village of Mangina, where the first cases were reported, to the bigger town of Beni; more cases are also being reported in the even larger city of Butembo. With over 300 cases and almost 200 deaths, and numbers rising every week. MSF continues to participate to the response and is looking into ways to expand its support of the Ministry of Health to tackle the epidemics. Photographer: John Wessels
Haussian, a 13-year-old boy from Falluja, has lived with his family in a tent in Amriyat al-Falluja camp for the past three years. Asked what he wants to be when he grows up, he replies: “If I stay alive, I want to be a doctor.” He says he loves football and, above all, Argentinian superstar Leo Messi. And asked why he is playing with a broken bike, he says: “I am happy playing with this bike until God sends me a better one. God is generous.” Photographer: Mohammad Ghannam
Rasmiyya, 63, who raised seven sons and four daughters, now lives alone in a camp for displaced people. Her story reflects the multiple layers of violence and loss that many in Iraq have suffered over recent years. In 2004, following the US invasion, she lost four of her seven sons in the bombing of their home city Falluja. Their names were Haqqi, aged 27 at the time of his death, Omar, aged 25, Adnan, 16, and Ahmad, 21. “I was out of the house. My husband and I had gone to buy food for the children. When we came back we saw the house had been reduced to rubble. I wished at that moment that I could have stayed home and died with them. It took me a while to find some peace again. God gave them to me, and God took them away again. I am now waiting to see them in heaven,” she says. The US compensated Rasmiyya and her husband for the destruction of their home, which they were able to rebuild. Another of her sons, Sarhan, has been jailed since 2006, accused of collaborating with militants. “He is still in prison to date. Sometimes I hear news that he is still alive in there,” Rasmiyya says. Several years went by, the Islamic State took over Falluja, and once again life became unbearable for Rasmiyya and her family. “The bombing (by the US-led coalition against IS) was horrific and constant,” she says. “I fled Falluja with my son Mohammad, on January 8, 2014. We went to Baghdad. The journey there was really hard because the roads were blocked. But we eventually made it.” For a time, Rasmiyya’s husband Ismail refused to leave Falluja in spite of the bombing. But in 2015 she travelled back to her home city to convince him to flee. “I didn’t recognise him, he was so thin,” she said. “And after two months in Baghdad, he died. We had no money, and there were no adequate medical services for us.” In October 2016, Rasmiyya had little choice but to move to Amriyat al-Falluja camp for IDPs. “My other son Mohammad, who came with me to the camp, was lucky to find a job in a factory nearby. But three months ago, a group of armed men arrived in a car and took him away. I have had no news of him since.” Rasmiyya calls Mohammad’s phone at least five times a day since he was taken and it is still turned off. “I always think he will answer.” Rasmiyya has four daughters living in Baghdad, as well as a son named Khaled. “I wish I could fly there to see them. The checkpoints surrounding the camp prevent me from leaving,” she says. Photographer: Mohammad Ghannam
In the stabilization room, the team are administering an intravenous catheter. In Niger, in Zinder region, MSF has been working with the Ministry of Health since 2005 in order to improve paediatric care for children under five preventing, detecting and treating childhood diseases. In the city of Magaria, MSF runs the 435-bed paediatric unit of the district hospital, mainly treating malaria and malnutrition during the seasonal peak period. MSF also supports 11 health centres, 14 health posts and six stabilization rooms for under-fives in the Magaria and Dungass areas, and manages medical referrals to the Paediatric Unit. Photographer: Laurence Hoenig
Condemned to drown at sea or be locked up in Libya. A woman in detention centre. Her testimony: “We were abandoned at sea. People lost hope. Why did we let people die at sea? They have all the means to rescue us. We are all humans. If we try to go to Europe, it’s to have a better life. People will keep continuing taking journey by sea. There are people who are escaping war, others are escaping poverty; people should be rescued and later on each individual case is looked at. We are not in Libya to stay here, we want to go to Europe. We are not criminals”. Photographer: Sara CretaDiffa, Niger: Young managed touched by the conflict. MOHAMMED Family. Hindatou, Halisa and Mohammed Hindatou is 23-years-old and has two younger siblings, 14-year-old Mohammed and 13-year-old Halisa. They come from northern Nigeria. They were kidnapped by an armed group and spent several months in captivity before fleeing and reuniting with part of their family. Halisa is always restless and she has nightmares. Mohammed has similar problems; he witnessed several murders.Photographer: Juan Carlos Tomasi
New Balkan migration route through Bosnia. Local Red Cross volunteers are now providing some meals to people sheltering in and around the squat at Bihać, Bosnia, close to the border of Croatia. Photographer: Kamila StepienTrapped in Moria. Thousands of life jackets left behind by arriving migrants are gathered at a dump on Lesbos Island, Greece. Thousands of people seeking safety after fleeing countries such as Syria, Afghanistan, Iraq, Sudan, and Congo continue to risk their lives to reach Europe. Those who try to arrive via Turkey and the Aegean Sea have been trapped for an indefinite period of time on islands in Greece as part of the EU/Turkey deal and its deterrence and containment approach. In Moria refugee camp, on Lesbos island, there are currently more than 7,500 people in a camp made for a maximum of 2,500. With the camp so full, refugees are now staying in an informal extension of the camp known as Olive Grove. The awful conditions at Moria camp/Olive Grove and arbitrary administrative situations have had a dramatic impact on their health and in particular their mental health. Médecins Sans Frontières teams provide medical and mental health support outside Moria camp and run a clinic for severe mental health cases in Mytilene, the capital of the island. Photographer: Robin Hammond
Trapped in Moria. Thousands of people seeking safety after fleeing countries such as Syria, Afghanistan, Iraq, Sudan, and Congo continue to risk their lives to reach Europe. Those who try to arrive via Turkey and the Aegean Sea have been trapped for an indefinite period of time on islands in Greece as part of the EU/Turkey deal and its deterrence and containment approach. In Moria refugee camp, on Lesbos island, there are currently more than 7,500 people in a camp made for a maximum of 2,500. With the camp so full, refugees are now staying in an informal extension of the camp known as Olive Grove. The awful conditions at Moria camp/Olive Grove and arbitrary administrative situations have had a dramatic impact on their health and in particular their mental health. Médecins Sans Frontières teams provide medical and mental health support outside Moria camp and run a clinic for severe mental health cases in Mytilene, the capital of the island. Photographer: Robin HammondHalima and her mother wait in the rain for a distribution of food in Jatmoli refugee makeshift settlement. More than 693,000 Rohingya refugees have arrived in Cox's Bazar district in south-eastern Bangladesh since late August 2017 after fleeing violence in Rakhine State, Myanmar. The refugees - from a minority Muslim group denied citizenship and other rights in Myanmar - have settled in existing settlements in Bangladesh. Due to the influx of people, authorities have set up additional makeshift settlements and new camps in the region, in an effort to cope with this humanitarian crisis. Photographer: Pablo Tosco
Rozia and her two-month-old son Zubair in the MSF hospital in Goyalmara. Many of the children admitted to the hospital have contracted infections from unhygienic birthing practises, and the unsanitary living conditions in the camp during their first days of life. More than 693,000 Rohingya refugees have arrived in Cox's Bazar district in south-eastern Bangladesh since late August 2017 after fleeing violence in Rakhine State, Myanmar. The refugees - from a minority Muslim group denied citizenship and other rights in Myanmar - have settled in existing settlements in Bangladesh. Due to the influx of people, authorities have set up additional makeshift settlements and new camps in the region, in an effort to cope with this humanitarian crisis. Photographer: Pablo ToscoMosul’s old town experienced intense shelling, aerial bombing and attacks with improvised explosive devices (IED) during the conflict to retake the city from the Islamic State group in 2016/17. Much of the old city is still inaccessible due to the destruction and presence of IEDs, unexploded ordinance (UXO) and booby traps. Between 5,000 and 7,000 people have returned to their homes in Mosul’s old city, despite the danger of explosive remnants of war. They face extremely difficult conditions, often living without water and electricity and in partially damaged houses. Photographer: Sacha Myers
North Yemen: living under daily coalition airstrikes. Yemen, gouvernorat de Saada, Haydan, mars 2018. Les enfants de la famille Ghani posent devant l'entrée de leur maison, bombardée pendant la guerre de Saada, entre 2004 et 2010. Saada governorate in Yemen, Haydan, March 2018. Ghani family children posing in front of the entrance of their house, bombed during the war of Saada, between 2004 and 2010. Photographer: Agnes Varraine-LecaViolence in Ituri province forces tens of thousands from their homes. Sanitation workers spray the hands and feet of Congolese refugees upon their arrival to Sebagoro, Uganda, on the shores of Lake Albert. Cholera is endemic to this region of Uganda. Approximately 60,000 refugees arrived to Uganda on boats, fleeing the conflict in their home province of Ituri, Congo between December 2017 and March 2018. Sebagoro, Hoima province, Uganda. March 9, 2018. Copyright Diana Zeyneb Alhindawi. Photographer: Diana Zeyneb Alhindawi
Fighting in Ituri province. Bawma Yoame (56), recovers in a hospital room on 2 March 2018 in Bunia, after an attack on his village left him severely wounded with multiple lacerations to the head. Fighting in Ituri province has left thousands of Congolese displaced and some 100 have lost their lives. PHOTO/JOHN WESSELSMany of the migrants arrive with sores and wounds on their feet after days on the roadMexico is the desperate destination of thousands of Central Americans whose primary objective is not to reach the United States, but to flee from the violence in their countries. Violence follows them, though. During their trip and in Mexico they are very vulnerable to physical violence by criminal gangs, petty criminals and authorities. Sexual abuse and violations are, unfortunately, also rutinarily reported (both for male and female migrants and also gang rape is reported). MSF works in different shelters all along the Mexican routes to the north of the country. Photographer: Juan Carlos Tomasi
99 Survivors Rescued Sinking in Mediterranean Sea - Many Presumed Drowned. In a nightmarish day on the Mediterranean yesterday, 99 survivors from a sinking rubber boat were rescued by the Aquarius, a search and rescue vessel run by Médecins Sans Frontières (MSF) and SOS MEDITERRANEE, but an unknown number of men, women and children are missing, presumed drowned. Two women are confirmed dead. “The scene was devastating, with many urgent medical cases in quick succession. They just kept coming, one after another, unconscious and not breathing,” said MSF nurse Aoife Ni Mhurchu. Dozens of people were already in the sea when the Aquarius arrived at the scene around 9.30am, and the rubber boat was already deflating. All floating devices were deployed from Aquarius, rafts were launched and the rescue team started pulling people from the sea. The MSF medical team on board the Aquarius resuscitated six young children, and one woman. Despite their best efforts they were unable to resuscitate two other women who had drowned. “It is absolutely heartbreaking. These women were mothers. We’re now trying to care for their very young children who remain onboard Aquarius” said Ni Mhurchu. All medical emergencies together with their caretakers were evacuated from Aquarius by an Italian Navy Helicopter to Sfax, Tunisia – a total of sixteen people. This included all six resuscitated children and several women with water on their lungs. The MSF medical team also treated many severe fuel burns, as well as over a dozen mild to moderate hypothermia cases. Many survivors were disorientated and confused as a result of inhaling fuel which had leaked into the rubber boat. Photographer: Laurin Schmid/
Pediatric services in Zahle hospital, Bekaa Valley. Amara is the youngest in a family of 10 children. Since her birth, she has suffered from chest and breathing problems, so she was admitted to the paediatric ward that MSF runs in Elias Haraoui Governmental Hospital in Zahle, where she stayed for 10 days. Amara’s mother, Rakad, is very grateful for the free services that her daughter received from MSF in the hospital. Since she was born, Amara’s health situation was putting burdens on her parents who can’t afford the cost of her treatment. Rakad lives with her husband and 10 children in a refugee settlement. In addition to Amara’s health problems, two of Rakad’s children suffer from a physical disability and require treatment. All that Rakad wishes for is that her children get better, and the situation in Syria goes back to normal so the family can return. Photographer: Florian SERIEX
IDP's camp in Monguno, Maiduguri State, Nigeria. Photographer: Maro VerliViolence hit Paoua region. Leonard Gangbe, 33, farmer, is treated at the Paoua hospital in northwestern Central African Republic. He says he was shot in the head while armed men were trying to steal his oxen. The day before the attack he had fled Betoko with relatives after the town had been attacked by an armed group that was trying to dislodge another one that had been occupying Betoko for several months. Paoua, December 28, 2017. Photographer: Alexis Huguet
Young women gathered in a disused health facility in ruins, waiting to see the MSF medical officer, during a mobile clinic in the village of Kier. Mobile Clinics in Akobo and Kier : providing access to basic healthcare in remote areas. Photographer: Frederic NOY40-year-old Mahamadou Agaïri, a shopkeeper from Ansongo, wearing his 2-day-old baby in 'Kangourou' style, an unprecedented gesture in a place where men don't normally carry babies. His wife, who underwent an obstetric operation during the delivery, is still weak and recovering in bed in the hospital. Mahamadou's newborn was hospitalised in the neonatal unit in Ansongo. Since 2012 MSF has supported services in the referral hospital in Ansongo, including outpatients, emergency care and hospitalisation, maternal health, treatment of chronic illnesses, nutrition, and neonatal and paediatric services. As well as this, victims of violence, including victims of sexual violence, are treated and provided with psychological support. At the community health centre in the town, rehabilitated by MSF, the teams provide primary health care to pregnant women and children under 5. Photographer: Seydou Camara
MSF bio lab at MSF’s Aden hospital in Yemen. Aya Omar 10, lost her leg after an armed group threw a bomb on her family’s house. She was sleeping next to her four brothers and sisters when the incident happened, but she was the only injured. “I always feel enthusiastic when my mom tells me that we’re going to the physio session. I’m stronger than I was after the surgery. I go to the mini market by myself and I play in front of the house.”Aya says. Photographer: Ehab ZawatiIn many occupied buildings people organize social and cultural activities involving even the population living in the surrounding area: services providing social and legal aid, courses of computer, Italian and other foreign language, painting, tailoring etc. A group of women coming mostly from Italy and Nigeria are running a theatre laboratory in a primary school. The Nigerian women are among the residents of an occupied building not far from the school. Among them, Patience. She arrived in Italy in 2012 after a very difficult journey through the Mediterranean sea, when her life and her few-month child’s were almost lost. This dramatic experience is now the plot of a theatre piece, in which she is the main character. Photographer: Alessandro Penso

Angela Makamure

Press Officer, Doctors Without Borders (MSF) Southern Africa

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