Wonder Women in Humanitarian Crises

Born in war-torn South Sudan, she has fled with her children hoping to find sanctuary. But now she is confronted with the threat of disease. 

She has lost control over her own body. Living in Papua New Guinea (PNG) where family and sexual violence is prevalent, she is overshadowed by fear all her life. 

In some 70 countries, MSF’s field workers have witnessed how women are the first to assume the humanitarian mantle, shouldering heavy responsibilities for their family’s survival. They are also vulnerable, falling victim to violence and abuse because of tradition and culture, their social status and lack of protection. 

The women we have met may not be eloquent, or know how to fight for their rights. They are ordinary but resilient, braving disease and violence. They are true wonder women. 

Disease strikes when the conflict has not subsided

It is high noon and the hot South Sudanese sun is blasting down. But Nyapar only feels the heat of her son, Mut, as she carries him on her shoulder. He’s running a fever of 40 degrees Celsius and Nyapar is terrified that he may not survive as she reaches MSF’s makeshift clinic. An MSF nurse confirms the diagnosis of malaria with a rapid test. 

“All my children have had malaria recently,” says Nyapar. No wonder she is so anxious. She lost her husband in the war and three of her six children have died of disease.  As a widow, Nyapar has to raise the remaining children alone. 

A civil war erupted in South Sudan in December 2013 and violence swept across the country. Two years ago, Naypar left her village with her children, and arrived in the Protection of Civilian (PoC) camp in Unity State. 

Since last spring, fighting has escalated throughout the state. With the population of the PoC doubled, camp conditions have deteriorated as the makeshift shelters fill with mud and stagnant water. Following an unprecedented malaria outbreak, MSF has treated up to 4,000 malaria patients weekly, and has seen three to four people dying from malaria every day. Most of them are children.

Thankfully for Nyapar, Mut quickly shows signs of improvement. Nonetheless, she has to think of making money to support her kids. She makes long treks to gather firewood for sale, a dangerous job that takes her away from the relative security of the camp. 

Under the same sky, women in PNG have to face the violence perpetrated by family members or within their own community.

Family and sexual violence is widespread

A 6-year old girl was brought to the MSF’s Family Support Centre, suffering from vaginal and rectal injuries. ‘Mum was away. She left me with a couple from my village. One day, the man told me to come into the house and take off my pants. He touched me down there. I started to cry and he covered my mouth. I tried to shout……My tummy was very painful and it was difficult to walk. I bled and fell down on the road. In the end, an auntie brought me here.’

PNG has disturbing levels of family and sexual violence directed towards women and children. MSF provides confidential and integrated care to victims of violence. Out of 1,046 sexual violence survivors MSF treated in 2014 and 2015, nine out of ten were female, and more than half were children younger than 18 years. This is just the tip of the iceberg, as sexual violence and rape stay largely unreported due to stigma and shame. 

Even when girls grow up and get married, their nightmares continue. MSF’s clinics hear these stories all the time. “My husband held me down with his foot on my chest and I couldn’t move. I tried to hold onto the bush knife to stop him and the tip of the knife went into my eye…...I want the police to give me a family protection order. Then I can leave with my 5-year old daughter.”

Despite all odds, Aoife Ni Mhurchu, an MSF nurse highlights the resilient side of these traumatized women. “You can really see a sisterhood between the women in the ward, even if they don’t know each other, or they’re from different kin networks. They look after each other very well. They come in here having been beaten and raped. Still, you can see them grinning, chatting away after a while. They’re very resilient women.”

MSF’s medical and humanitarian action has focused on women and their children, helping them get the healthcare they need. Apart from assisting victims of family and sexual violence and treating sick women and children, MSF also provides maternal services in many places to help women deliver safely.

Syria: Medical facilities and civilians targeted in attacks

An MSF report shows that 94 attacks hit 63 MSF-supported facilities in Syria in 2015. 40 percent of the many thousands of casualties received in those facilities were women and children. MSF urges all warring parties, particularly the four permanent members of the United Nations Security Council, to ensure medical facilities and civilians are spared in attacks.

Greece: Looking after refugees in transit

Despite the arrival of winter, more than 94,000 people have risked their lives to reach Greek islands in unseaworthy boats since this year. MSF is working in several transit centres to provide emergency first aid, water, high-energy biscuits and blankets to those in need.

Sudan: Thousands fled fighting in North Darfur

Around 58,000 people have fled their homes because of new fighting in the area. They make a 50km trek to camps in the hot, dry semi-desert area and struggle to survive. MSF is providing water, food and medical care to the displaced, and planning to launch a vaccination campaign for measles and polio.

Democratic Republic of Congo: Treating malnutrition and malaria

As a measles epidemic gradually fades, malnutrition and malaria continue to rage across the country. MSF supports 27 health centres with medicines and diagnostic tests for malaria in the Manono region, and has opened ambulatory therapeutic feeding centres in more than fifteen other remote areas.

Renewed outbreaks of inter-communal violence since September 2015 are keeping the population in the Central African Republic (CAR) on edge, with many fearing a flare-up of full conflict. The worsening security situation has also crushed hopes for the 450,000 internally displaced people - and a similar number of refugees who have fled to neighbouring countries - of returning home in the near future.

In the capital Bangui, over 30,000 people have taken refuge in overcrowded, unsanitary makeshift camps across town, or in churches and schools. MSF is running mobile clinics, a hospital and a maternity clinic in camps in and around Bangui, The team also provides medical care once a week at the central mosque in a Muslim enclave.

Lucienne help her sick daughter make an appointment at the MSF hospital in the camp.  She fled her home two years ago when four of her neighbours were killed during an outbreak of violence. Since then, she has been seeking safety in a camp together with her family. “Life is too difficult in the camp. It’s unsafe, dirty and the flies are everywhere” she says.

Reims Pali, Assistant Field Coordinator for MSF, has witnessed the situation deteriorate in the last two years. “In comparison to the abuses, killings and robberies in their neighborhoods, they feel relatively safe here. But the living conditions in the sites are very difficult. Unless the security situation gets better, they will have to stay here in these camps.”

MSF now has over 300 international and more than 2,000 Central African staff deployed in the country. The organisation runs activities in 15 locations and provides assistance to Central African refugees in neighbouring countries.

One midnight in September, I was woken up by our guard after the arrival of a gun-shot patient. I went to the operating room immediately with our Indian surgeon Bhavna, and saw the young patient with his face covered in blood. His skull was fractured where a bullet had penetrated.　Though I had seen many patients here before, I was still shocked when Bhavna tried to locate the bullet with her hand. It was deep inside the brain and she couldn’t remove it because of the risk of more damage. After spending two or three hours repairing the wound, it was early morning when we finally went back to rest.

As the only healthcare provider here, we received patients with the whole range of critical, medical conditions. Not all those emergencies ended perfectly, but I was moved by the efforts everyone made to give our patients at least a chance to live.

Ray Wei is an MSF field worker from Guangzhou. He worked in MSF’s project in Papua New Guinea from May 2015 to January 2016.

This little boy in the picture comes from the Central African Republic. He’s a refugee from the fighting there and because he’s suffering from malnutrition, He is consuming Ready-to-Use Therapeutic Food (RUTF), a major tool used by MSF to treat malnourished children. 

Malnutrition weakens immune systems, opening the door for deadly illnesses like malaria, pneumonia and measles. Impaired growth and brain damage are possible. Most of the damage is done before a child reaches two years of age.

RUTF was invented by French medical researchers in 1997 and after several pilot tests, MSF started to use it as an essential tool to treat children during food crises. It can cure up to 90% of children with uncomplicated malnutrition.

What are the advantages of RUTF? International food aid used to rely on fortified blended foods to improve the quality of children's diets, mostly in the form of a corn-soy blend. But they rarely include all of the elements needed by a malnourished child, and the cereal and soy components make absorption of nutrients difficult for children. 

RUTF, which carries 500 kcal (equal to six bananas) per pack, provides the essential vitamins, minerals, fat and proteins children need to survive and grow properly. Formulated in a peanut-milk paste that children find tasty and easy to eat, RUTF helps mothers provide nourishment for their children. The packs are instantly consumable, easy to store and transport even in hot or humid climates, and don’t need to be cooked or prepared with warm water, thus eliminating the risk of contamination. 

In the past, mothers needed to bring their children to therapeutic feeding centres or even have them hospitalized to receive complete nutritional therapy. Now RUTF can be handed out for home use. "I prefer to come here once a week rather than staying in a treatment centre,” says one mother in Niger, who has a child needing RUTF. “I have to take care of the fields and my other children - I have three other children at home." 

RUTF is a low-cost and efficient kind of therapeutic food. For example, 13 children can be treated for a week at the cost of only HKD $516.

A donation platform based on the e-cart concept

Through our online “MSF Warehouse”, you can now deliver various relief items including RUTF to the front line and help save more lives: 

msf.hk/warehouse/rutf-en

“MSF Warehouse” is a donation platform based on the e-cart concept. The items you see on this site are the materials and supplies from actual MSF warehouse located around the world, with the largest in Bordeaux, France. MSF has a sophisticated logistics system that allows critical supplies stored at the warehouses to be sent to projects in Africa, Asia, Latin America and other parts of the world rapidly, as soon as they are needed.