Journal Article > CommentaryFull Text
Travel Med Infect Dis. 2 April 2025; Online ahead of print; 102849.; DOI:10.1016/j.tmaid.2025.102849
Abbara A, González-Sanz M, AlKharrat A, Khalife M, Elferruh Y, et al.
Travel Med Infect Dis. 2 April 2025; Online ahead of print; 102849.; DOI:10.1016/j.tmaid.2025.102849
Conference Material > Poster
Haar R, Rayes D, Burbach R, Hamze M, Weis R, et al.
MSF Scientific Day International 2024. 16 May 2024; DOI:10.57740/0w4cFNxFOg
Journal Article > EditorialFull Text
Int Orthop. 11 January 2024; Online ahead of print (Issue 2); 323-330.; DOI:10.1007/s00264-024-06089-5
Hernigou P, Homma Y, Herard P, Scarlat MM
Int Orthop. 11 January 2024; Online ahead of print (Issue 2); 323-330.; DOI:10.1007/s00264-024-06089-5
Journal Article > Case Report/SeriesFull Text
Confl Health. 7 February 2023; Volume 17 (Issue 1); 5.; DOI:10.1186/s13031-023-00503-2
MacVinish S, van Leeuwen C, Hoetjes M, Aoki Y, Foley D, et al.
Confl Health. 7 February 2023; Volume 17 (Issue 1); 5.; DOI:10.1186/s13031-023-00503-2
BACKGROUND
Thalassaemia affects many families in Northeast Syria, an area devastated by over a decade of conflict which has significantly impacted their health system. People with thalassaemia require holistic multidisciplinary care for the clinical complications of thalassaemia. The risks of thalassaemia treatment include blood-borne viral infections secondary to unsafe transfusion, increased vulnerability to serious bacterial infection following splenectomy, and complications of both iron overload and iron chelation therapy. Médecins Sans Frontières (MSF) provided outpatient thalassaemia care programmes in northeast Syria between April 2017 October 2019 in a complex conflict context challenged by population displacement, the destruction of medical facilities, and periods of insecurity.
METHODS
We performed a secondary descriptive analysis of the thalassaemia cohort data to describe basic clinical and demographic characteristics of the patient population. A desk review of internal and publicly available documents was supplemented by informal interviews with MSF staff to describe and analyse the programmatic approach.
CASE DESCRIPTION
MSF delivered programmes with thalassaemia investigations, provision of blood transfusion, iron chelation therapy, and psychosocial support. Thalassemia programmes were novel for the organisation and operational learning took place alongside service implementation. Lessons were identified on equipment procurement and the requirements for the implementation of vital investigations (including ferritin testing), to inform clinical decision making. Lessons included the importance of supply planning for sufficient blood products to meet diverse clinical needs in a conflict area, so those with thalassaemia have continued access to blood products among the competing priorities. Iron chelation therapy met a large need in this cohort. Adapted protocols were implemented to balance social factors, hygiene considerations, toxicity, tolerability, and adherence to therapy. Wider service needs included considerations for family planning advice and services, continuity of care and patient access through decentralised services or laboratory access, psychosocial support, and improved data collection including quality of life measurements to understand the full impact of such programmes.
CONCLUSIONS
Although this type of programming was not “routine” for the organisation, MSF demonstrated that life-sustaining thalassaemia care can be provided in complex conflict settings. International non-governmental organisations can consider this care possible in similar contexts.
Thalassaemia affects many families in Northeast Syria, an area devastated by over a decade of conflict which has significantly impacted their health system. People with thalassaemia require holistic multidisciplinary care for the clinical complications of thalassaemia. The risks of thalassaemia treatment include blood-borne viral infections secondary to unsafe transfusion, increased vulnerability to serious bacterial infection following splenectomy, and complications of both iron overload and iron chelation therapy. Médecins Sans Frontières (MSF) provided outpatient thalassaemia care programmes in northeast Syria between April 2017 October 2019 in a complex conflict context challenged by population displacement, the destruction of medical facilities, and periods of insecurity.
METHODS
We performed a secondary descriptive analysis of the thalassaemia cohort data to describe basic clinical and demographic characteristics of the patient population. A desk review of internal and publicly available documents was supplemented by informal interviews with MSF staff to describe and analyse the programmatic approach.
CASE DESCRIPTION
MSF delivered programmes with thalassaemia investigations, provision of blood transfusion, iron chelation therapy, and psychosocial support. Thalassemia programmes were novel for the organisation and operational learning took place alongside service implementation. Lessons were identified on equipment procurement and the requirements for the implementation of vital investigations (including ferritin testing), to inform clinical decision making. Lessons included the importance of supply planning for sufficient blood products to meet diverse clinical needs in a conflict area, so those with thalassaemia have continued access to blood products among the competing priorities. Iron chelation therapy met a large need in this cohort. Adapted protocols were implemented to balance social factors, hygiene considerations, toxicity, tolerability, and adherence to therapy. Wider service needs included considerations for family planning advice and services, continuity of care and patient access through decentralised services or laboratory access, psychosocial support, and improved data collection including quality of life measurements to understand the full impact of such programmes.
CONCLUSIONS
Although this type of programming was not “routine” for the organisation, MSF demonstrated that life-sustaining thalassaemia care can be provided in complex conflict settings. International non-governmental organisations can consider this care possible in similar contexts.
Conference Material > Video
Nasser H, Jha Y, Keane G, Carreño C, Mental Health Working Group
MSF Scientific Days International 2022. 10 June 2022; DOI:10.57740/z68q-6865
Conference Material > Video
Croft LA
MSF Scientific Days International 2022. 7 June 2022; DOI:10.57740/rfm5-5s75
Conference Material > Poster
Al Laham D, Ali E, Moussally K, Nahas N, Alameddine A, et al.
MSF Scientific Days International 2020. 13 May 2020; DOI:10.7490/f1000research.1117937.1
• Since 2011, the conflict in Syria has had a huge impact on its population, many of whom are now displaced
• The Syrian crisis has not only affected the physical health of refugees, but has also had a drastic effect on their mental health
• Wadi Khaled, a rural district in the north of Lebanon, hosts about 36,000 displaced Syrians, and is one of most under-served and marginalized areas of Lebanon
• Médecins Sans Frontières (MSF) has been providing mental health services to Syrian refugees and the Lebanese host population in Akkar, Wadi Khaled since 2016.
• The Syrian crisis has not only affected the physical health of refugees, but has also had a drastic effect on their mental health
• Wadi Khaled, a rural district in the north of Lebanon, hosts about 36,000 displaced Syrians, and is one of most under-served and marginalized areas of Lebanon
• Médecins Sans Frontières (MSF) has been providing mental health services to Syrian refugees and the Lebanese host population in Akkar, Wadi Khaled since 2016.
Conference Material > Abstract
Croft LA, Puig-García M, Silver C, Pearlman J, Stellmach DUS, et al.
MSF Scientific Days International 2022. 9 May 2022; DOI:10.57740/b641-d608
INTRODUCTION
Between 2020 and 2021, MSF’s social sciences team designed and supported implementation of qualitative assessments to better understand community-level outbreak responses and well-being in the context of Covid-19. Assessments were conducted in seven sites, specifically Nigeria, Sierra Leone, Chad, Iraq, Tajikistan, Syria, and Somaliland. Although a single protocol was designed and followed, each site was unique in terms of its setting (e.g. camp, conflict, urban, or rural), who implemented assessments (e.g. field epidemiologists, health promotion staff), timing of implementation (early phase of the pandemic versus late phase), and community involvement. Here we present a synthesis of the assessments to inform future public health responses.
METHODS
Synthesis involved secondary analysis of qualitative reports over five iterative phases. Phase 1 involved in-depth reading of each report, during which analytic annotation and note-taking took place. In Phase 2, each report was coded inductively. In Phase 3, codes were reviewed, defined, and clustered into initial categories and themes. Phase 4 involved reviewing and refining codes, categories, and themes, and establishing connections. In Phase 5, synthesis findings were organised and written up. The process was managed using the software ATLAS.ti.
ETHICS
This synthesis is an a posteriori analysis of secondary data. Ethics approval for primary data was granted by officials in Nigeria, Sierra Leone, Chad, Iraq, Tajikistan, Syria, and Somaliland and the MSF Ethics Review Board.
RESULTS
Overall 138, people participated in the assessments, of which 21 (15%) were women. Participants included health workers, community members, traditional healers, chiefs, young people, women’s leaders and local staff. Four themes were identified: 1) exacerbation of pre-existing vulnerabilities and inequalities; 2) disruption of coping mechanisms; 3) awareness of the risks of Covid-19; 4) community as a public health enabler. The pandemic was seen to magnify existing social inequalities and overall health burden. Public health measures to control the spread of Covid-19 often disrupted community coping mechanisms by causing fear of separation and practical challenges around compliance. Awareness of the risks of Covid-19 and understanding of prevention measures were high, with socio-economic costs of compliance relying on external funding and relief. A community led intervention for effective public health controls varied between sites, depending on previous outbreak experiences (e.g. Ebola and tuberculosis), and/or settings experiencing protracted conflict (e.g. Syria, and Iraq).
CONCLUSION
Our synthesis illustrates syndemic effects of the pandemic. From an operational perspective, there is a need to diversify humanitarian, social, and health interventions, and strengthen approaches to working with communities to identify how best to take forward public health measures in humanitarian settings.
CONFLICTS OF INTEREST
None declared.
Between 2020 and 2021, MSF’s social sciences team designed and supported implementation of qualitative assessments to better understand community-level outbreak responses and well-being in the context of Covid-19. Assessments were conducted in seven sites, specifically Nigeria, Sierra Leone, Chad, Iraq, Tajikistan, Syria, and Somaliland. Although a single protocol was designed and followed, each site was unique in terms of its setting (e.g. camp, conflict, urban, or rural), who implemented assessments (e.g. field epidemiologists, health promotion staff), timing of implementation (early phase of the pandemic versus late phase), and community involvement. Here we present a synthesis of the assessments to inform future public health responses.
METHODS
Synthesis involved secondary analysis of qualitative reports over five iterative phases. Phase 1 involved in-depth reading of each report, during which analytic annotation and note-taking took place. In Phase 2, each report was coded inductively. In Phase 3, codes were reviewed, defined, and clustered into initial categories and themes. Phase 4 involved reviewing and refining codes, categories, and themes, and establishing connections. In Phase 5, synthesis findings were organised and written up. The process was managed using the software ATLAS.ti.
ETHICS
This synthesis is an a posteriori analysis of secondary data. Ethics approval for primary data was granted by officials in Nigeria, Sierra Leone, Chad, Iraq, Tajikistan, Syria, and Somaliland and the MSF Ethics Review Board.
RESULTS
Overall 138, people participated in the assessments, of which 21 (15%) were women. Participants included health workers, community members, traditional healers, chiefs, young people, women’s leaders and local staff. Four themes were identified: 1) exacerbation of pre-existing vulnerabilities and inequalities; 2) disruption of coping mechanisms; 3) awareness of the risks of Covid-19; 4) community as a public health enabler. The pandemic was seen to magnify existing social inequalities and overall health burden. Public health measures to control the spread of Covid-19 often disrupted community coping mechanisms by causing fear of separation and practical challenges around compliance. Awareness of the risks of Covid-19 and understanding of prevention measures were high, with socio-economic costs of compliance relying on external funding and relief. A community led intervention for effective public health controls varied between sites, depending on previous outbreak experiences (e.g. Ebola and tuberculosis), and/or settings experiencing protracted conflict (e.g. Syria, and Iraq).
CONCLUSION
Our synthesis illustrates syndemic effects of the pandemic. From an operational perspective, there is a need to diversify humanitarian, social, and health interventions, and strengthen approaches to working with communities to identify how best to take forward public health measures in humanitarian settings.
CONFLICTS OF INTEREST
None declared.
Conference Material > Slide Presentation
Nasser H, Jha Y, Keane G, Carreño C, Mental Health Working Group
MSF Scientific Days International 2022. 10 May 2022; DOI:10.57740/74t1-zq11
Journal Article > Short ReportAbstract
J Am Coll Surg. 4 February 2015; Volume 220 (Issue 5); DOI:10.1016/j.jamcollsurg.2015.01.022
Kada F, Abyad M, Contini S, De Paoli L, Mancini L
J Am Coll Surg. 4 February 2015; Volume 220 (Issue 5); DOI:10.1016/j.jamcollsurg.2015.01.022